|
HC BRACE HEEL RELIEF SHOE
|
Facility
|
OP
|
$187.27
|
|
|
Service Code
|
HCPCS L3260
|
| Hospital Charge Code |
27000467
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$33.02 |
| Max. Negotiated Rate |
$168.54 |
| Rate for Payer: Aetna Commercial |
$159.18
|
| Rate for Payer: Aetna Medicare |
$48.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.52
|
| Rate for Payer: BCBS Complete |
$34.66
|
| Rate for Payer: BCBS MAPPO |
$46.82
|
| Rate for Payer: BCBS Trust/PPO |
$153.95
|
| Rate for Payer: BCN Commercial |
$153.95
|
| Rate for Payer: BCN Medicare Advantage |
$46.82
|
| Rate for Payer: Cash Price |
$149.82
|
| Rate for Payer: Cofinity Commercial |
$161.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.82
|
| Rate for Payer: Healthscope Commercial |
$168.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.45
|
| Rate for Payer: Mclaren Medicaid |
$33.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.16
|
| Rate for Payer: Meridian Medicaid |
$34.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$51.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.18
|
| Rate for Payer: Nomi Health Commercial |
$153.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.45
|
| Rate for Payer: PACE Senior Care Partners |
$44.48
|
| Rate for Payer: PACE SWMI |
$46.82
|
| Rate for Payer: PHP Commercial |
$159.18
|
| Rate for Payer: PHP Medicare Advantage |
$46.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$162.92
|
| Rate for Payer: Priority Health Medicare |
$47.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$130.34
|
| Rate for Payer: Railroad Medicare Medicare |
$46.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.80
|
| Rate for Payer: UHC Core |
$156.37
|
| Rate for Payer: UHC Exchange |
$46.82
|
| Rate for Payer: UHC Medicaid |
$33.02
|
| Rate for Payer: UHC Medicare Advantage |
$46.82
|
| Rate for Payer: UHCCP Medicaid |
$33.02
|
| Rate for Payer: VA VA |
$46.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.45
|
|
|
HC BRACE HFO NONTORSION JNTS PRE CST
|
Facility
|
OP
|
$130.05
|
|
|
Service Code
|
HCPCS L3929
|
| Hospital Charge Code |
27400051
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$22.93 |
| Max. Negotiated Rate |
$117.05 |
| Rate for Payer: Aetna Commercial |
$110.54
|
| Rate for Payer: Aetna Medicare |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.64
|
| Rate for Payer: BCBS Complete |
$24.07
|
| Rate for Payer: BCBS MAPPO |
$32.51
|
| Rate for Payer: BCBS Trust/PPO |
$106.91
|
| Rate for Payer: BCN Commercial |
$106.91
|
| Rate for Payer: BCN Medicare Advantage |
$32.51
|
| Rate for Payer: Cash Price |
$104.04
|
| Rate for Payer: Cofinity Commercial |
$111.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.51
|
| Rate for Payer: Healthscope Commercial |
$117.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.54
|
| Rate for Payer: Mclaren Medicaid |
$22.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.14
|
| Rate for Payer: Meridian Medicaid |
$24.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.54
|
| Rate for Payer: Nomi Health Commercial |
$106.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.54
|
| Rate for Payer: PACE Senior Care Partners |
$30.89
|
| Rate for Payer: PACE SWMI |
$32.51
|
| Rate for Payer: PHP Commercial |
$110.54
|
| Rate for Payer: PHP Medicare Advantage |
$32.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$113.14
|
| Rate for Payer: Priority Health Medicare |
$32.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.51
|
| Rate for Payer: Railroad Medicare Medicare |
$32.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.44
|
| Rate for Payer: UHC Core |
$108.59
|
| Rate for Payer: UHC Exchange |
$32.51
|
| Rate for Payer: UHC Medicaid |
$22.93
|
| Rate for Payer: UHC Medicare Advantage |
$32.51
|
| Rate for Payer: UHCCP Medicaid |
$22.93
|
| Rate for Payer: VA VA |
$32.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.54
|
|
|
HC BRACE HFO NONTORSION JNTS PRE CST
|
Facility
|
IP
|
$130.05
|
|
|
Service Code
|
HCPCS L3929
|
| Hospital Charge Code |
27400051
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$90.51 |
| Max. Negotiated Rate |
$117.05 |
| Rate for Payer: Aetna Commercial |
$110.54
|
| Rate for Payer: BCBS Trust/PPO |
$107.41
|
| Rate for Payer: BCN Commercial |
$107.41
|
| Rate for Payer: Cash Price |
$104.04
|
| Rate for Payer: Cofinity Commercial |
$111.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.04
|
| Rate for Payer: Healthscope Commercial |
$117.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.54
|
| Rate for Payer: Nomi Health Commercial |
$106.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.54
|
| Rate for Payer: PHP Commercial |
$110.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$113.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.44
|
| Rate for Payer: UHC Core |
$108.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.54
|
|
|
HC BRACE HFO W/O JOINTS CF
|
Facility
|
OP
|
$263.18
|
|
|
Service Code
|
HCPCS L3913
|
| Hospital Charge Code |
27400042
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$46.40 |
| Max. Negotiated Rate |
$236.86 |
| Rate for Payer: Aetna Commercial |
$223.70
|
| Rate for Payer: Aetna Medicare |
$68.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.24
|
| Rate for Payer: BCBS Complete |
$48.71
|
| Rate for Payer: BCBS MAPPO |
$65.80
|
| Rate for Payer: BCBS Trust/PPO |
$216.36
|
| Rate for Payer: BCN Commercial |
$216.36
|
| Rate for Payer: BCN Medicare Advantage |
$65.80
|
| Rate for Payer: Cash Price |
$210.54
|
| Rate for Payer: Cofinity Commercial |
$226.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.80
|
| Rate for Payer: Healthscope Commercial |
$236.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.38
|
| Rate for Payer: Mclaren Medicaid |
$46.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.08
|
| Rate for Payer: Meridian Medicaid |
$48.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.70
|
| Rate for Payer: Nomi Health Commercial |
$215.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.38
|
| Rate for Payer: PACE Senior Care Partners |
$62.51
|
| Rate for Payer: PACE SWMI |
$65.80
|
| Rate for Payer: PHP Commercial |
$223.70
|
| Rate for Payer: PHP Medicare Advantage |
$65.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$228.97
|
| Rate for Payer: Priority Health Medicare |
$66.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$183.17
|
| Rate for Payer: Railroad Medicare Medicare |
$65.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.60
|
| Rate for Payer: UHC Core |
$219.76
|
| Rate for Payer: UHC Exchange |
$65.80
|
| Rate for Payer: UHC Medicaid |
$46.40
|
| Rate for Payer: UHC Medicare Advantage |
$65.80
|
| Rate for Payer: UHCCP Medicaid |
$46.40
|
| Rate for Payer: VA VA |
$65.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.38
|
|
|
HC BRACE HFO W/O JOINTS CF
|
Facility
|
IP
|
$263.18
|
|
|
Service Code
|
HCPCS L3913
|
| Hospital Charge Code |
27400042
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$183.17 |
| Max. Negotiated Rate |
$236.86 |
| Rate for Payer: Aetna Commercial |
$223.70
|
| Rate for Payer: BCBS Trust/PPO |
$217.36
|
| Rate for Payer: BCN Commercial |
$217.36
|
| Rate for Payer: Cash Price |
$210.54
|
| Rate for Payer: Cofinity Commercial |
$226.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.54
|
| Rate for Payer: Healthscope Commercial |
$236.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.70
|
| Rate for Payer: Nomi Health Commercial |
$215.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.38
|
| Rate for Payer: PHP Commercial |
$223.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$228.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$183.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.60
|
| Rate for Payer: UHC Core |
$219.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.38
|
|
|
HC BRACE HIP ABDUCTION
|
Facility
|
OP
|
$1,884.62
|
|
|
Service Code
|
HCPCS L1686
|
| Hospital Charge Code |
27000007
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$332.26 |
| Max. Negotiated Rate |
$1,696.16 |
| Rate for Payer: Aetna Commercial |
$1,601.93
|
| Rate for Payer: Aetna Medicare |
$490.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$588.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$588.94
|
| Rate for Payer: BCBS Complete |
$348.84
|
| Rate for Payer: BCBS MAPPO |
$471.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,549.35
|
| Rate for Payer: BCN Commercial |
$1,549.35
|
| Rate for Payer: BCN Medicare Advantage |
$471.15
|
| Rate for Payer: Cash Price |
$1,507.70
|
| Rate for Payer: Cofinity Commercial |
$1,620.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,507.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$471.15
|
| Rate for Payer: Healthscope Commercial |
$1,696.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,413.46
|
| Rate for Payer: Mclaren Medicaid |
$332.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$494.71
|
| Rate for Payer: Meridian Medicaid |
$348.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$541.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$518.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,601.93
|
| Rate for Payer: Nomi Health Commercial |
$1,545.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,413.46
|
| Rate for Payer: PACE Senior Care Partners |
$447.60
|
| Rate for Payer: PACE SWMI |
$471.15
|
| Rate for Payer: PHP Commercial |
$1,601.93
|
| Rate for Payer: PHP Medicare Advantage |
$471.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,639.62
|
| Rate for Payer: Priority Health Medicare |
$475.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,311.70
|
| Rate for Payer: Railroad Medicare Medicare |
$471.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,658.47
|
| Rate for Payer: UHC Core |
$1,573.66
|
| Rate for Payer: UHC Exchange |
$471.15
|
| Rate for Payer: UHC Medicaid |
$332.26
|
| Rate for Payer: UHC Medicare Advantage |
$471.15
|
| Rate for Payer: UHCCP Medicaid |
$332.26
|
| Rate for Payer: VA VA |
$471.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,413.46
|
|
|
HC BRACE HIP ABDUCTION
|
Facility
|
IP
|
$1,884.62
|
|
|
Service Code
|
HCPCS L1686
|
| Hospital Charge Code |
27000007
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,311.70 |
| Max. Negotiated Rate |
$1,696.16 |
| Rate for Payer: Aetna Commercial |
$1,601.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,556.51
|
| Rate for Payer: BCN Commercial |
$1,556.51
|
| Rate for Payer: Cash Price |
$1,507.70
|
| Rate for Payer: Cofinity Commercial |
$1,620.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,507.70
|
| Rate for Payer: Healthscope Commercial |
$1,696.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,413.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,601.93
|
| Rate for Payer: Nomi Health Commercial |
$1,545.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,413.46
|
| Rate for Payer: PHP Commercial |
$1,601.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,639.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,311.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,658.47
|
| Rate for Payer: UHC Core |
$1,573.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,413.46
|
|
|
HC BRACE HUMERAL SLEEVE
|
Facility
|
IP
|
$849.73
|
|
|
Service Code
|
HCPCS L3980
|
| Hospital Charge Code |
27000008
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$591.41 |
| Max. Negotiated Rate |
$764.76 |
| Rate for Payer: Aetna Commercial |
$722.27
|
| Rate for Payer: BCBS Trust/PPO |
$701.79
|
| Rate for Payer: BCN Commercial |
$701.79
|
| Rate for Payer: Cash Price |
$679.78
|
| Rate for Payer: Cofinity Commercial |
$730.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$679.78
|
| Rate for Payer: Healthscope Commercial |
$764.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$637.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$722.27
|
| Rate for Payer: Nomi Health Commercial |
$696.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$637.30
|
| Rate for Payer: PHP Commercial |
$722.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$739.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$591.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$747.76
|
| Rate for Payer: UHC Core |
$709.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$637.30
|
|
|
HC BRACE HUMERAL SLEEVE
|
Facility
|
OP
|
$849.73
|
|
|
Service Code
|
HCPCS L3980
|
| Hospital Charge Code |
27000008
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$149.81 |
| Max. Negotiated Rate |
$764.76 |
| Rate for Payer: Aetna Commercial |
$722.27
|
| Rate for Payer: Aetna Medicare |
$220.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$265.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$265.54
|
| Rate for Payer: BCBS Complete |
$157.29
|
| Rate for Payer: BCBS MAPPO |
$212.43
|
| Rate for Payer: BCBS Trust/PPO |
$698.56
|
| Rate for Payer: BCN Commercial |
$698.56
|
| Rate for Payer: BCN Medicare Advantage |
$212.43
|
| Rate for Payer: Cash Price |
$679.78
|
| Rate for Payer: Cofinity Commercial |
$730.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$679.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$212.43
|
| Rate for Payer: Healthscope Commercial |
$764.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$637.30
|
| Rate for Payer: Mclaren Medicaid |
$149.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$223.05
|
| Rate for Payer: Meridian Medicaid |
$157.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$244.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$233.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$722.27
|
| Rate for Payer: Nomi Health Commercial |
$696.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$637.30
|
| Rate for Payer: PACE Senior Care Partners |
$201.81
|
| Rate for Payer: PACE SWMI |
$212.43
|
| Rate for Payer: PHP Commercial |
$722.27
|
| Rate for Payer: PHP Medicare Advantage |
$212.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$149.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$739.27
|
| Rate for Payer: Priority Health Medicare |
$214.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$591.41
|
| Rate for Payer: Railroad Medicare Medicare |
$212.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$747.76
|
| Rate for Payer: UHC Core |
$709.52
|
| Rate for Payer: UHC Exchange |
$212.43
|
| Rate for Payer: UHC Medicaid |
$149.81
|
| Rate for Payer: UHC Medicare Advantage |
$212.43
|
| Rate for Payer: UHCCP Medicaid |
$149.81
|
| Rate for Payer: VA VA |
$212.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$637.30
|
|
|
HC BRACE JEWETT/CASH
|
Facility
|
IP
|
$977.12
|
|
|
Service Code
|
HCPCS L0472
|
| Hospital Charge Code |
27400003
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$680.08 |
| Max. Negotiated Rate |
$879.41 |
| Rate for Payer: Aetna Commercial |
$830.55
|
| Rate for Payer: BCBS Trust/PPO |
$807.00
|
| Rate for Payer: BCN Commercial |
$807.00
|
| Rate for Payer: Cash Price |
$781.70
|
| Rate for Payer: Cofinity Commercial |
$840.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$781.70
|
| Rate for Payer: Healthscope Commercial |
$879.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$732.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$830.55
|
| Rate for Payer: Nomi Health Commercial |
$801.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$732.84
|
| Rate for Payer: PHP Commercial |
$830.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$850.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$680.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$859.87
|
| Rate for Payer: UHC Core |
$815.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$732.84
|
|
|
HC BRACE JEWETT/CASH
|
Facility
|
OP
|
$977.12
|
|
|
Service Code
|
HCPCS L0472
|
| Hospital Charge Code |
27400003
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$172.27 |
| Max. Negotiated Rate |
$879.41 |
| Rate for Payer: Aetna Commercial |
$830.55
|
| Rate for Payer: Aetna Medicare |
$254.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$305.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$305.35
|
| Rate for Payer: BCBS Complete |
$180.86
|
| Rate for Payer: BCBS MAPPO |
$244.28
|
| Rate for Payer: BCBS Trust/PPO |
$803.29
|
| Rate for Payer: BCN Commercial |
$803.29
|
| Rate for Payer: BCN Medicare Advantage |
$244.28
|
| Rate for Payer: Cash Price |
$781.70
|
| Rate for Payer: Cofinity Commercial |
$840.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$781.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$244.28
|
| Rate for Payer: Healthscope Commercial |
$879.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$732.84
|
| Rate for Payer: Mclaren Medicaid |
$172.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$256.49
|
| Rate for Payer: Meridian Medicaid |
$180.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$280.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$268.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$830.55
|
| Rate for Payer: Nomi Health Commercial |
$801.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$732.84
|
| Rate for Payer: PACE Senior Care Partners |
$232.07
|
| Rate for Payer: PACE SWMI |
$244.28
|
| Rate for Payer: PHP Commercial |
$830.55
|
| Rate for Payer: PHP Medicare Advantage |
$244.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$172.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$850.09
|
| Rate for Payer: Priority Health Medicare |
$246.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$680.08
|
| Rate for Payer: Railroad Medicare Medicare |
$244.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$859.87
|
| Rate for Payer: UHC Core |
$815.90
|
| Rate for Payer: UHC Exchange |
$244.28
|
| Rate for Payer: UHC Medicaid |
$172.27
|
| Rate for Payer: UHC Medicare Advantage |
$244.28
|
| Rate for Payer: UHCCP Medicaid |
$172.27
|
| Rate for Payer: VA VA |
$244.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$732.84
|
|
|
HC BRACE KAFO CUSTOM
|
Facility
|
IP
|
$5,070.44
|
|
| Hospital Charge Code |
27000033
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$3,529.03 |
| Max. Negotiated Rate |
$4,563.40 |
| Rate for Payer: Aetna Commercial |
$4,309.87
|
| Rate for Payer: BCBS Trust/PPO |
$4,187.68
|
| Rate for Payer: BCN Commercial |
$4,187.68
|
| Rate for Payer: Cash Price |
$4,056.35
|
| Rate for Payer: Cofinity Commercial |
$4,360.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,056.35
|
| Rate for Payer: Healthscope Commercial |
$4,563.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,802.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,309.87
|
| Rate for Payer: Nomi Health Commercial |
$4,157.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,802.83
|
| Rate for Payer: PHP Commercial |
$4,309.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,411.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,529.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,461.99
|
| Rate for Payer: UHC Core |
$4,233.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,802.83
|
|
|
HC BRACE KAFO CUSTOM
|
Facility
|
OP
|
$5,070.44
|
|
| Hospital Charge Code |
27000033
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$893.92 |
| Max. Negotiated Rate |
$4,563.40 |
| Rate for Payer: Aetna Commercial |
$4,309.87
|
| Rate for Payer: Aetna Medicare |
$1,318.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,584.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,584.51
|
| Rate for Payer: BCBS Complete |
$938.54
|
| Rate for Payer: BCBS MAPPO |
$1,267.61
|
| Rate for Payer: BCBS Trust/PPO |
$4,168.41
|
| Rate for Payer: BCN Commercial |
$4,168.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,267.61
|
| Rate for Payer: Cash Price |
$4,056.35
|
| Rate for Payer: Cofinity Commercial |
$4,360.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,056.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,267.61
|
| Rate for Payer: Healthscope Commercial |
$4,563.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,802.83
|
| Rate for Payer: Mclaren Medicaid |
$893.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,330.99
|
| Rate for Payer: Meridian Medicaid |
$938.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,457.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,394.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,309.87
|
| Rate for Payer: Nomi Health Commercial |
$4,157.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,802.83
|
| Rate for Payer: PACE Senior Care Partners |
$1,204.23
|
| Rate for Payer: PACE SWMI |
$1,267.61
|
| Rate for Payer: PHP Commercial |
$4,309.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,267.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$893.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,411.28
|
| Rate for Payer: Priority Health Medicare |
$1,280.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,529.03
|
| Rate for Payer: Railroad Medicare Medicare |
$1,267.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,461.99
|
| Rate for Payer: UHC Core |
$4,233.82
|
| Rate for Payer: UHC Exchange |
$1,267.61
|
| Rate for Payer: UHC Medicaid |
$893.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,267.61
|
| Rate for Payer: UHCCP Medicaid |
$893.92
|
| Rate for Payer: VA VA |
$1,267.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,802.83
|
|
|
HC BRACE KNEE HINGED CUSTOM
|
Facility
|
IP
|
$1,413.08
|
|
|
Service Code
|
HCPCS L1832
|
| Hospital Charge Code |
27400004
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$983.50 |
| Max. Negotiated Rate |
$1,271.77 |
| Rate for Payer: Aetna Commercial |
$1,201.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,167.06
|
| Rate for Payer: BCN Commercial |
$1,167.06
|
| Rate for Payer: Cash Price |
$1,130.46
|
| Rate for Payer: Cofinity Commercial |
$1,215.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.46
|
| Rate for Payer: Healthscope Commercial |
$1,271.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,059.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,201.12
|
| Rate for Payer: Nomi Health Commercial |
$1,158.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,059.81
|
| Rate for Payer: PHP Commercial |
$1,201.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,229.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$983.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,243.51
|
| Rate for Payer: UHC Core |
$1,179.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,059.81
|
|
|
HC BRACE KNEE HINGED CUSTOM
|
Facility
|
OP
|
$1,413.08
|
|
|
Service Code
|
HCPCS L1832
|
| Hospital Charge Code |
27400004
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$249.13 |
| Max. Negotiated Rate |
$1,271.77 |
| Rate for Payer: Aetna Commercial |
$1,201.12
|
| Rate for Payer: Aetna Medicare |
$367.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$441.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$441.59
|
| Rate for Payer: BCBS Complete |
$261.56
|
| Rate for Payer: BCBS MAPPO |
$353.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,161.69
|
| Rate for Payer: BCN Commercial |
$1,161.69
|
| Rate for Payer: BCN Medicare Advantage |
$353.27
|
| Rate for Payer: Cash Price |
$1,130.46
|
| Rate for Payer: Cofinity Commercial |
$1,215.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$353.27
|
| Rate for Payer: Healthscope Commercial |
$1,271.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,059.81
|
| Rate for Payer: Mclaren Medicaid |
$249.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.93
|
| Rate for Payer: Meridian Medicaid |
$261.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$406.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$388.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,201.12
|
| Rate for Payer: Nomi Health Commercial |
$1,158.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,059.81
|
| Rate for Payer: PACE Senior Care Partners |
$335.61
|
| Rate for Payer: PACE SWMI |
$353.27
|
| Rate for Payer: PHP Commercial |
$1,201.12
|
| Rate for Payer: PHP Medicare Advantage |
$353.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,229.38
|
| Rate for Payer: Priority Health Medicare |
$356.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$983.50
|
| Rate for Payer: Railroad Medicare Medicare |
$353.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,243.51
|
| Rate for Payer: UHC Core |
$1,179.92
|
| Rate for Payer: UHC Exchange |
$353.27
|
| Rate for Payer: UHC Medicaid |
$249.13
|
| Rate for Payer: UHC Medicare Advantage |
$353.27
|
| Rate for Payer: UHCCP Medicaid |
$249.13
|
| Rate for Payer: VA VA |
$353.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,059.81
|
|
|
HC BRACE KNEE HINGED OTS
|
Facility
|
IP
|
$1,662.46
|
|
|
Service Code
|
HCPCS L1833
|
| Hospital Charge Code |
27400021
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,157.07 |
| Max. Negotiated Rate |
$1,496.21 |
| Rate for Payer: Aetna Commercial |
$1,413.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,373.03
|
| Rate for Payer: BCN Commercial |
$1,373.03
|
| Rate for Payer: Cash Price |
$1,329.97
|
| Rate for Payer: Cofinity Commercial |
$1,429.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,329.97
|
| Rate for Payer: Healthscope Commercial |
$1,496.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,246.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,413.09
|
| Rate for Payer: Nomi Health Commercial |
$1,363.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,246.85
|
| Rate for Payer: PHP Commercial |
$1,413.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,446.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,157.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,462.96
|
| Rate for Payer: UHC Core |
$1,388.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,246.85
|
|
|
HC BRACE KNEE HINGED OTS
|
Facility
|
OP
|
$1,662.46
|
|
|
Service Code
|
HCPCS L1833
|
| Hospital Charge Code |
27400021
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$293.09 |
| Max. Negotiated Rate |
$1,496.21 |
| Rate for Payer: Aetna Commercial |
$1,413.09
|
| Rate for Payer: Aetna Medicare |
$432.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$519.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$519.52
|
| Rate for Payer: BCBS Complete |
$307.72
|
| Rate for Payer: BCBS MAPPO |
$415.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,366.71
|
| Rate for Payer: BCN Commercial |
$1,366.71
|
| Rate for Payer: BCN Medicare Advantage |
$415.62
|
| Rate for Payer: Cash Price |
$1,329.97
|
| Rate for Payer: Cofinity Commercial |
$1,429.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,329.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$415.62
|
| Rate for Payer: Healthscope Commercial |
$1,496.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,246.85
|
| Rate for Payer: Mclaren Medicaid |
$293.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$436.40
|
| Rate for Payer: Meridian Medicaid |
$307.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$477.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$457.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,413.09
|
| Rate for Payer: Nomi Health Commercial |
$1,363.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,246.85
|
| Rate for Payer: PACE Senior Care Partners |
$394.83
|
| Rate for Payer: PACE SWMI |
$415.62
|
| Rate for Payer: PHP Commercial |
$1,413.09
|
| Rate for Payer: PHP Medicare Advantage |
$415.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$293.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,446.34
|
| Rate for Payer: Priority Health Medicare |
$419.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,157.07
|
| Rate for Payer: Railroad Medicare Medicare |
$415.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,462.96
|
| Rate for Payer: UHC Core |
$1,388.15
|
| Rate for Payer: UHC Exchange |
$415.62
|
| Rate for Payer: UHC Medicaid |
$293.09
|
| Rate for Payer: UHC Medicare Advantage |
$415.62
|
| Rate for Payer: UHCCP Medicaid |
$293.09
|
| Rate for Payer: VA VA |
$415.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,246.85
|
|
|
HC BRACE KNEE IMMOBILIZER
|
Facility
|
OP
|
$206.89
|
|
|
Service Code
|
HCPCS L1830
|
| Hospital Charge Code |
27400008
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$36.47 |
| Max. Negotiated Rate |
$186.20 |
| Rate for Payer: Aetna Commercial |
$175.86
|
| Rate for Payer: Aetna Medicare |
$53.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.65
|
| Rate for Payer: BCBS Complete |
$38.30
|
| Rate for Payer: BCBS MAPPO |
$51.72
|
| Rate for Payer: BCBS Trust/PPO |
$170.08
|
| Rate for Payer: BCN Commercial |
$170.08
|
| Rate for Payer: BCN Medicare Advantage |
$51.72
|
| Rate for Payer: Cash Price |
$165.51
|
| Rate for Payer: Cofinity Commercial |
$177.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.72
|
| Rate for Payer: Healthscope Commercial |
$186.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.17
|
| Rate for Payer: Mclaren Medicaid |
$36.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.31
|
| Rate for Payer: Meridian Medicaid |
$38.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.86
|
| Rate for Payer: Nomi Health Commercial |
$169.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$155.17
|
| Rate for Payer: PACE Senior Care Partners |
$49.14
|
| Rate for Payer: PACE SWMI |
$51.72
|
| Rate for Payer: PHP Commercial |
$175.86
|
| Rate for Payer: PHP Medicare Advantage |
$51.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$179.99
|
| Rate for Payer: Priority Health Medicare |
$52.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.00
|
| Rate for Payer: Railroad Medicare Medicare |
$51.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.06
|
| Rate for Payer: UHC Core |
$172.75
|
| Rate for Payer: UHC Exchange |
$51.72
|
| Rate for Payer: UHC Medicaid |
$36.47
|
| Rate for Payer: UHC Medicare Advantage |
$51.72
|
| Rate for Payer: UHCCP Medicaid |
$36.47
|
| Rate for Payer: VA VA |
$51.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.17
|
|
|
HC BRACE KNEE IMMOBILIZER
|
Facility
|
IP
|
$206.89
|
|
|
Service Code
|
HCPCS L1830
|
| Hospital Charge Code |
27400008
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$144.00 |
| Max. Negotiated Rate |
$186.20 |
| Rate for Payer: Aetna Commercial |
$175.86
|
| Rate for Payer: BCBS Trust/PPO |
$170.87
|
| Rate for Payer: BCN Commercial |
$170.87
|
| Rate for Payer: Cash Price |
$165.51
|
| Rate for Payer: Cofinity Commercial |
$177.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.51
|
| Rate for Payer: Healthscope Commercial |
$186.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.86
|
| Rate for Payer: Nomi Health Commercial |
$169.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$155.17
|
| Rate for Payer: PHP Commercial |
$175.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$179.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.06
|
| Rate for Payer: UHC Core |
$172.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.17
|
|
|
HC BRACE LO SAG RGD A&P L1-L5 PREFAB
|
Facility
|
IP
|
$664.82
|
|
|
Service Code
|
HCPCS L0627
|
| Hospital Charge Code |
27400025
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$462.71 |
| Max. Negotiated Rate |
$598.34 |
| Rate for Payer: Aetna Commercial |
$565.10
|
| Rate for Payer: BCBS Trust/PPO |
$549.07
|
| Rate for Payer: BCN Commercial |
$549.07
|
| Rate for Payer: Cash Price |
$531.86
|
| Rate for Payer: Cofinity Commercial |
$571.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$531.86
|
| Rate for Payer: Healthscope Commercial |
$598.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$498.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$565.10
|
| Rate for Payer: Nomi Health Commercial |
$545.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$498.62
|
| Rate for Payer: PHP Commercial |
$565.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$578.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$462.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$585.04
|
| Rate for Payer: UHC Core |
$555.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$498.62
|
|
|
HC BRACE LO SAG RGD A&P L1-L5 PREFAB
|
Facility
|
OP
|
$664.82
|
|
|
Service Code
|
HCPCS L0627
|
| Hospital Charge Code |
27400025
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$117.21 |
| Max. Negotiated Rate |
$598.34 |
| Rate for Payer: Aetna Commercial |
$565.10
|
| Rate for Payer: Aetna Medicare |
$172.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$207.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$207.76
|
| Rate for Payer: BCBS Complete |
$123.06
|
| Rate for Payer: BCBS MAPPO |
$166.21
|
| Rate for Payer: BCBS Trust/PPO |
$546.55
|
| Rate for Payer: BCN Commercial |
$546.55
|
| Rate for Payer: BCN Medicare Advantage |
$166.21
|
| Rate for Payer: Cash Price |
$531.86
|
| Rate for Payer: Cofinity Commercial |
$571.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$531.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.21
|
| Rate for Payer: Healthscope Commercial |
$598.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$498.62
|
| Rate for Payer: Mclaren Medicaid |
$117.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$174.52
|
| Rate for Payer: Meridian Medicaid |
$123.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$191.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$182.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$565.10
|
| Rate for Payer: Nomi Health Commercial |
$545.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$498.62
|
| Rate for Payer: PACE Senior Care Partners |
$157.89
|
| Rate for Payer: PACE SWMI |
$166.21
|
| Rate for Payer: PHP Commercial |
$565.10
|
| Rate for Payer: PHP Medicare Advantage |
$166.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$578.39
|
| Rate for Payer: Priority Health Medicare |
$167.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$462.71
|
| Rate for Payer: Railroad Medicare Medicare |
$166.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$585.04
|
| Rate for Payer: UHC Core |
$555.12
|
| Rate for Payer: UHC Exchange |
$166.21
|
| Rate for Payer: UHC Medicaid |
$117.21
|
| Rate for Payer: UHC Medicare Advantage |
$166.21
|
| Rate for Payer: UHCCP Medicaid |
$117.21
|
| Rate for Payer: VA VA |
$166.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$498.62
|
|
|
HC BRACE LS CORSET CUSTOM
|
Facility
|
IP
|
$189.35
|
|
|
Service Code
|
HCPCS L0626
|
| Hospital Charge Code |
27400005
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$131.79 |
| Max. Negotiated Rate |
$170.41 |
| Rate for Payer: Aetna Commercial |
$160.95
|
| Rate for Payer: BCBS Trust/PPO |
$156.38
|
| Rate for Payer: BCN Commercial |
$156.38
|
| Rate for Payer: Cash Price |
$151.48
|
| Rate for Payer: Cofinity Commercial |
$162.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.48
|
| Rate for Payer: Healthscope Commercial |
$170.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.95
|
| Rate for Payer: Nomi Health Commercial |
$155.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.01
|
| Rate for Payer: PHP Commercial |
$160.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$164.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$166.63
|
| Rate for Payer: UHC Core |
$158.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.01
|
|
|
HC BRACE LS CORSET CUSTOM
|
Facility
|
OP
|
$189.35
|
|
|
Service Code
|
HCPCS L0626
|
| Hospital Charge Code |
27400005
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$33.38 |
| Max. Negotiated Rate |
$170.41 |
| Rate for Payer: Aetna Commercial |
$160.95
|
| Rate for Payer: Aetna Medicare |
$49.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.17
|
| Rate for Payer: BCBS Complete |
$35.05
|
| Rate for Payer: BCBS MAPPO |
$47.34
|
| Rate for Payer: BCBS Trust/PPO |
$155.66
|
| Rate for Payer: BCN Commercial |
$155.66
|
| Rate for Payer: BCN Medicare Advantage |
$47.34
|
| Rate for Payer: Cash Price |
$151.48
|
| Rate for Payer: Cofinity Commercial |
$162.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.34
|
| Rate for Payer: Healthscope Commercial |
$170.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.01
|
| Rate for Payer: Mclaren Medicaid |
$33.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.70
|
| Rate for Payer: Meridian Medicaid |
$35.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$52.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.95
|
| Rate for Payer: Nomi Health Commercial |
$155.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.01
|
| Rate for Payer: PACE Senior Care Partners |
$44.97
|
| Rate for Payer: PACE SWMI |
$47.34
|
| Rate for Payer: PHP Commercial |
$160.95
|
| Rate for Payer: PHP Medicare Advantage |
$47.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$164.73
|
| Rate for Payer: Priority Health Medicare |
$47.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.79
|
| Rate for Payer: Railroad Medicare Medicare |
$47.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$166.63
|
| Rate for Payer: UHC Core |
$158.11
|
| Rate for Payer: UHC Exchange |
$47.34
|
| Rate for Payer: UHC Medicaid |
$33.38
|
| Rate for Payer: UHC Medicare Advantage |
$47.34
|
| Rate for Payer: UHCCP Medicaid |
$33.38
|
| Rate for Payer: VA VA |
$47.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.01
|
|
|
HC BRACE LS CORSET OTS
|
Facility
|
OP
|
$198.82
|
|
|
Service Code
|
HCPCS L0641
|
| Hospital Charge Code |
27400019
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$35.05 |
| Max. Negotiated Rate |
$178.94 |
| Rate for Payer: Aetna Commercial |
$169.00
|
| Rate for Payer: Aetna Medicare |
$51.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.13
|
| Rate for Payer: BCBS Complete |
$36.80
|
| Rate for Payer: BCBS MAPPO |
$49.70
|
| Rate for Payer: BCBS Trust/PPO |
$163.45
|
| Rate for Payer: BCN Commercial |
$163.45
|
| Rate for Payer: BCN Medicare Advantage |
$49.70
|
| Rate for Payer: Cash Price |
$159.06
|
| Rate for Payer: Cofinity Commercial |
$170.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.70
|
| Rate for Payer: Healthscope Commercial |
$178.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.12
|
| Rate for Payer: Mclaren Medicaid |
$35.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.19
|
| Rate for Payer: Meridian Medicaid |
$36.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.00
|
| Rate for Payer: Nomi Health Commercial |
$163.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.12
|
| Rate for Payer: PACE Senior Care Partners |
$47.22
|
| Rate for Payer: PACE SWMI |
$49.70
|
| Rate for Payer: PHP Commercial |
$169.00
|
| Rate for Payer: PHP Medicare Advantage |
$49.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$172.97
|
| Rate for Payer: Priority Health Medicare |
$50.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.38
|
| Rate for Payer: Railroad Medicare Medicare |
$49.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.96
|
| Rate for Payer: UHC Core |
$166.01
|
| Rate for Payer: UHC Exchange |
$49.70
|
| Rate for Payer: UHC Medicaid |
$35.05
|
| Rate for Payer: UHC Medicare Advantage |
$49.70
|
| Rate for Payer: UHCCP Medicaid |
$35.05
|
| Rate for Payer: VA VA |
$49.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.12
|
|
|
HC BRACE LS CORSET OTS
|
Facility
|
IP
|
$198.82
|
|
|
Service Code
|
HCPCS L0641
|
| Hospital Charge Code |
27400019
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$138.38 |
| Max. Negotiated Rate |
$178.94 |
| Rate for Payer: Aetna Commercial |
$169.00
|
| Rate for Payer: BCBS Trust/PPO |
$164.21
|
| Rate for Payer: BCN Commercial |
$164.21
|
| Rate for Payer: Cash Price |
$159.06
|
| Rate for Payer: Cofinity Commercial |
$170.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.06
|
| Rate for Payer: Healthscope Commercial |
$178.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.00
|
| Rate for Payer: Nomi Health Commercial |
$163.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.12
|
| Rate for Payer: PHP Commercial |
$169.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$172.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.96
|
| Rate for Payer: UHC Core |
$166.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.12
|
|
