|
HC CASSETTES QUEST
|
Facility
|
IP
|
$78.03
|
|
| Hospital Charge Code |
27000458
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$54.31 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: BCBS Trust/PPO |
$64.44
|
| Rate for Payer: BCN Commercial |
$64.44
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC CASSETTES QUEST
|
Facility
|
OP
|
$78.03
|
|
| Hospital Charge Code |
27000458
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.76 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$20.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.38
|
| Rate for Payer: BCBS Complete |
$14.44
|
| Rate for Payer: BCBS MAPPO |
$19.51
|
| Rate for Payer: BCBS Trust/PPO |
$64.15
|
| Rate for Payer: BCN Commercial |
$64.15
|
| Rate for Payer: BCN Medicare Advantage |
$19.51
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.51
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$13.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.48
|
| Rate for Payer: Meridian Medicaid |
$14.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PACE Senior Care Partners |
$18.53
|
| Rate for Payer: PACE SWMI |
$19.51
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$19.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Medicare |
$19.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.31
|
| Rate for Payer: Railroad Medicare Medicare |
$19.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: UHC Exchange |
$19.51
|
| Rate for Payer: UHC Medicaid |
$13.76
|
| Rate for Payer: UHC Medicare Advantage |
$19.51
|
| Rate for Payer: UHCCP Medicaid |
$13.76
|
| Rate for Payer: VA VA |
$19.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC CAST CLUB FOOT
|
Facility
|
IP
|
$430.97
|
|
|
Service Code
|
CPT 29450
|
| Hospital Charge Code |
70000011
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$299.96 |
| Max. Negotiated Rate |
$387.87 |
| Rate for Payer: Aetna Commercial |
$366.32
|
| Rate for Payer: BCBS Trust/PPO |
$355.94
|
| Rate for Payer: BCN Commercial |
$355.94
|
| Rate for Payer: Cash Price |
$344.78
|
| Rate for Payer: Cofinity Commercial |
$370.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.78
|
| Rate for Payer: Healthscope Commercial |
$387.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$323.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$366.32
|
| Rate for Payer: Nomi Health Commercial |
$353.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$323.23
|
| Rate for Payer: PHP Commercial |
$366.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$374.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$299.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$379.25
|
| Rate for Payer: UHC Core |
$359.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$323.23
|
|
|
HC CAST CLUB FOOT
|
Facility
|
OP
|
$430.97
|
|
|
Service Code
|
CPT 29450
|
| Hospital Charge Code |
70000011
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$75.98 |
| Max. Negotiated Rate |
$387.87 |
| Rate for Payer: Aetna Commercial |
$366.32
|
| Rate for Payer: Aetna Medicare |
$112.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$134.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$134.68
|
| Rate for Payer: BCBS Complete |
$79.77
|
| Rate for Payer: BCBS MAPPO |
$107.74
|
| Rate for Payer: BCBS Trust/PPO |
$354.30
|
| Rate for Payer: BCN Commercial |
$354.30
|
| Rate for Payer: BCN Medicare Advantage |
$107.74
|
| Rate for Payer: Cash Price |
$344.78
|
| Rate for Payer: Cofinity Commercial |
$370.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.74
|
| Rate for Payer: Healthscope Commercial |
$387.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$323.23
|
| Rate for Payer: Mclaren Medicaid |
$75.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.13
|
| Rate for Payer: Meridian Medicaid |
$79.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$118.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$366.32
|
| Rate for Payer: Nomi Health Commercial |
$353.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$323.23
|
| Rate for Payer: PACE Senior Care Partners |
$102.36
|
| Rate for Payer: PACE SWMI |
$107.74
|
| Rate for Payer: PHP Commercial |
$366.32
|
| Rate for Payer: PHP Medicare Advantage |
$107.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$374.94
|
| Rate for Payer: Priority Health Medicare |
$108.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$299.96
|
| Rate for Payer: Railroad Medicare Medicare |
$107.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$379.25
|
| Rate for Payer: UHC Core |
$359.86
|
| Rate for Payer: UHC Exchange |
$107.74
|
| Rate for Payer: UHC Medicaid |
$75.98
|
| Rate for Payer: UHC Medicare Advantage |
$107.74
|
| Rate for Payer: UHCCP Medicaid |
$75.98
|
| Rate for Payer: VA VA |
$107.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$323.23
|
|
|
HC CAST COLOR ROLL
|
Facility
|
IP
|
$62.78
|
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$43.69 |
| Max. Negotiated Rate |
$56.50 |
| Rate for Payer: Aetna Commercial |
$53.36
|
| Rate for Payer: BCBS Trust/PPO |
$51.85
|
| Rate for Payer: BCN Commercial |
$51.85
|
| Rate for Payer: Cash Price |
$50.22
|
| Rate for Payer: Cofinity Commercial |
$53.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.22
|
| Rate for Payer: Healthscope Commercial |
$56.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.36
|
| Rate for Payer: Nomi Health Commercial |
$51.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.09
|
| Rate for Payer: PHP Commercial |
$53.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.25
|
| Rate for Payer: UHC Core |
$52.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.09
|
|
|
HC CAST COLOR ROLL
|
Facility
|
OP
|
$62.78
|
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$56.50 |
| Rate for Payer: Aetna Commercial |
$53.36
|
| Rate for Payer: Aetna Medicare |
$16.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.62
|
| Rate for Payer: BCBS Complete |
$11.62
|
| Rate for Payer: BCBS MAPPO |
$15.70
|
| Rate for Payer: BCBS Trust/PPO |
$51.61
|
| Rate for Payer: BCN Commercial |
$51.61
|
| Rate for Payer: BCN Medicare Advantage |
$15.70
|
| Rate for Payer: Cash Price |
$50.22
|
| Rate for Payer: Cofinity Commercial |
$53.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.70
|
| Rate for Payer: Healthscope Commercial |
$56.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.09
|
| Rate for Payer: Mclaren Medicaid |
$11.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.48
|
| Rate for Payer: Meridian Medicaid |
$11.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.36
|
| Rate for Payer: Nomi Health Commercial |
$51.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.09
|
| Rate for Payer: PACE Senior Care Partners |
$14.91
|
| Rate for Payer: PACE SWMI |
$15.70
|
| Rate for Payer: PHP Commercial |
$53.36
|
| Rate for Payer: PHP Medicare Advantage |
$15.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.62
|
| Rate for Payer: Priority Health Medicare |
$15.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.69
|
| Rate for Payer: Railroad Medicare Medicare |
$15.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.25
|
| Rate for Payer: UHC Core |
$52.42
|
| Rate for Payer: UHC Exchange |
$15.70
|
| Rate for Payer: UHC Medicaid |
$11.07
|
| Rate for Payer: UHC Medicare Advantage |
$15.70
|
| Rate for Payer: UHCCP Medicaid |
$11.07
|
| Rate for Payer: VA VA |
$15.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.09
|
|
|
HC CAST CYLINDER
|
Facility
|
IP
|
$416.23
|
|
|
Service Code
|
CPT 29365
|
| Hospital Charge Code |
70000006
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$289.70 |
| Max. Negotiated Rate |
$374.61 |
| Rate for Payer: Aetna Commercial |
$353.80
|
| Rate for Payer: BCBS Trust/PPO |
$343.76
|
| Rate for Payer: BCN Commercial |
$343.76
|
| Rate for Payer: Cash Price |
$332.98
|
| Rate for Payer: Cofinity Commercial |
$357.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.98
|
| Rate for Payer: Healthscope Commercial |
$374.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.80
|
| Rate for Payer: Nomi Health Commercial |
$341.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.17
|
| Rate for Payer: PHP Commercial |
$353.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.28
|
| Rate for Payer: UHC Core |
$347.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.17
|
|
|
HC CAST CYLINDER
|
Facility
|
OP
|
$416.23
|
|
|
Service Code
|
CPT 29365
|
| Hospital Charge Code |
70000006
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$73.38 |
| Max. Negotiated Rate |
$374.61 |
| Rate for Payer: Aetna Commercial |
$353.80
|
| Rate for Payer: Aetna Medicare |
$108.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.07
|
| Rate for Payer: BCBS Complete |
$77.04
|
| Rate for Payer: BCBS MAPPO |
$104.06
|
| Rate for Payer: BCBS Trust/PPO |
$342.18
|
| Rate for Payer: BCN Commercial |
$342.18
|
| Rate for Payer: BCN Medicare Advantage |
$104.06
|
| Rate for Payer: Cash Price |
$332.98
|
| Rate for Payer: Cofinity Commercial |
$357.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.06
|
| Rate for Payer: Healthscope Commercial |
$374.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.17
|
| Rate for Payer: Mclaren Medicaid |
$73.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.26
|
| Rate for Payer: Meridian Medicaid |
$77.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.80
|
| Rate for Payer: Nomi Health Commercial |
$341.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.17
|
| Rate for Payer: PACE Senior Care Partners |
$98.85
|
| Rate for Payer: PACE SWMI |
$104.06
|
| Rate for Payer: PHP Commercial |
$353.80
|
| Rate for Payer: PHP Medicare Advantage |
$104.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.12
|
| Rate for Payer: Priority Health Medicare |
$105.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.70
|
| Rate for Payer: Railroad Medicare Medicare |
$104.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.28
|
| Rate for Payer: UHC Core |
$347.55
|
| Rate for Payer: UHC Exchange |
$104.06
|
| Rate for Payer: UHC Medicaid |
$73.38
|
| Rate for Payer: UHC Medicare Advantage |
$104.06
|
| Rate for Payer: UHCCP Medicaid |
$73.38
|
| Rate for Payer: VA VA |
$104.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.17
|
|
|
HC CAST FINGER (CONTRACTURE)
|
Facility
|
IP
|
$214.29
|
|
|
Service Code
|
CPT 29086
|
| Hospital Charge Code |
43000021
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$149.15 |
| Max. Negotiated Rate |
$192.86 |
| Rate for Payer: Aetna Commercial |
$182.15
|
| Rate for Payer: BCBS Trust/PPO |
$176.98
|
| Rate for Payer: BCN Commercial |
$176.98
|
| Rate for Payer: Cash Price |
$171.43
|
| Rate for Payer: Cofinity Commercial |
$184.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.43
|
| Rate for Payer: Healthscope Commercial |
$192.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.15
|
| Rate for Payer: Nomi Health Commercial |
$175.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.72
|
| Rate for Payer: PHP Commercial |
$182.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$186.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.58
|
| Rate for Payer: UHC Core |
$178.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.72
|
|
|
HC CAST FINGER (CONTRACTURE)
|
Facility
|
OP
|
$214.29
|
|
|
Service Code
|
CPT 29086
|
| Hospital Charge Code |
43000021
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$37.78 |
| Max. Negotiated Rate |
$192.86 |
| Rate for Payer: Aetna Commercial |
$182.15
|
| Rate for Payer: Aetna Medicare |
$55.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.97
|
| Rate for Payer: BCBS Complete |
$39.67
|
| Rate for Payer: BCBS MAPPO |
$53.57
|
| Rate for Payer: BCBS Trust/PPO |
$176.17
|
| Rate for Payer: BCN Commercial |
$176.17
|
| Rate for Payer: BCN Medicare Advantage |
$53.57
|
| Rate for Payer: Cash Price |
$171.43
|
| Rate for Payer: Cofinity Commercial |
$184.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.57
|
| Rate for Payer: Healthscope Commercial |
$192.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.72
|
| Rate for Payer: Mclaren Medicaid |
$37.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.25
|
| Rate for Payer: Meridian Medicaid |
$39.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$58.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.15
|
| Rate for Payer: Nomi Health Commercial |
$175.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.72
|
| Rate for Payer: PACE Senior Care Partners |
$50.89
|
| Rate for Payer: PACE SWMI |
$53.57
|
| Rate for Payer: PHP Commercial |
$182.15
|
| Rate for Payer: PHP Medicare Advantage |
$53.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$186.43
|
| Rate for Payer: Priority Health Medicare |
$54.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.15
|
| Rate for Payer: Railroad Medicare Medicare |
$53.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.58
|
| Rate for Payer: UHC Core |
$178.93
|
| Rate for Payer: UHC Exchange |
$53.57
|
| Rate for Payer: UHC Medicaid |
$37.78
|
| Rate for Payer: UHC Medicare Advantage |
$53.57
|
| Rate for Payer: UHCCP Medicaid |
$37.78
|
| Rate for Payer: VA VA |
$53.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.72
|
|
|
HC CAST GAUNTLET
|
Facility
|
OP
|
$242.90
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
42100002
|
|
Hospital Revenue Code
|
421
|
| Min. Negotiated Rate |
$42.82 |
| Max. Negotiated Rate |
$218.61 |
| Rate for Payer: Aetna Commercial |
$206.47
|
| Rate for Payer: Aetna Medicare |
$63.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$75.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$75.91
|
| Rate for Payer: BCBS Complete |
$44.96
|
| Rate for Payer: BCBS MAPPO |
$60.73
|
| Rate for Payer: BCBS Trust/PPO |
$199.69
|
| Rate for Payer: BCN Commercial |
$199.69
|
| Rate for Payer: BCN Medicare Advantage |
$60.73
|
| Rate for Payer: Cash Price |
$194.32
|
| Rate for Payer: Cofinity Commercial |
$208.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.73
|
| Rate for Payer: Healthscope Commercial |
$218.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.18
|
| Rate for Payer: Mclaren Medicaid |
$42.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.76
|
| Rate for Payer: Meridian Medicaid |
$44.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$66.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.47
|
| Rate for Payer: Nomi Health Commercial |
$199.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.18
|
| Rate for Payer: PACE Senior Care Partners |
$57.69
|
| Rate for Payer: PACE SWMI |
$60.73
|
| Rate for Payer: PHP Commercial |
$206.47
|
| Rate for Payer: PHP Medicare Advantage |
$60.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$211.32
|
| Rate for Payer: Priority Health Medicare |
$61.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.06
|
| Rate for Payer: Railroad Medicare Medicare |
$60.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.75
|
| Rate for Payer: UHC Core |
$202.82
|
| Rate for Payer: UHC Exchange |
$60.73
|
| Rate for Payer: UHC Medicaid |
$42.82
|
| Rate for Payer: UHC Medicare Advantage |
$60.73
|
| Rate for Payer: UHCCP Medicaid |
$42.82
|
| Rate for Payer: VA VA |
$60.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.18
|
|
|
HC CAST GAUNTLET
|
Facility
|
IP
|
$242.90
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
42100002
|
|
Hospital Revenue Code
|
421
|
| Min. Negotiated Rate |
$169.06 |
| Max. Negotiated Rate |
$218.61 |
| Rate for Payer: Aetna Commercial |
$206.47
|
| Rate for Payer: BCBS Trust/PPO |
$200.61
|
| Rate for Payer: BCN Commercial |
$200.61
|
| Rate for Payer: Cash Price |
$194.32
|
| Rate for Payer: Cofinity Commercial |
$208.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.32
|
| Rate for Payer: Healthscope Commercial |
$218.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.47
|
| Rate for Payer: Nomi Health Commercial |
$199.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.18
|
| Rate for Payer: PHP Commercial |
$206.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$211.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.75
|
| Rate for Payer: UHC Core |
$202.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.18
|
|
|
HC CAST HIP SPICA 1 AND 1 HALF OR BOTH
|
Facility
|
IP
|
$988.94
|
|
|
Service Code
|
CPT 29325
|
| Hospital Charge Code |
70000004
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$688.30 |
| Max. Negotiated Rate |
$890.05 |
| Rate for Payer: Aetna Commercial |
$840.60
|
| Rate for Payer: BCBS Trust/PPO |
$816.77
|
| Rate for Payer: BCN Commercial |
$816.77
|
| Rate for Payer: Cash Price |
$791.15
|
| Rate for Payer: Cofinity Commercial |
$850.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$791.15
|
| Rate for Payer: Healthscope Commercial |
$890.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$741.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$840.60
|
| Rate for Payer: Nomi Health Commercial |
$810.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$741.71
|
| Rate for Payer: PHP Commercial |
$840.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$860.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$688.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$870.27
|
| Rate for Payer: UHC Core |
$825.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$741.71
|
|
|
HC CAST HIP SPICA 1 AND 1 HALF OR BOTH
|
Facility
|
OP
|
$988.94
|
|
|
Service Code
|
CPT 29325
|
| Hospital Charge Code |
70000004
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$174.35 |
| Max. Negotiated Rate |
$890.05 |
| Rate for Payer: Aetna Commercial |
$840.60
|
| Rate for Payer: Aetna Medicare |
$257.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$309.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$309.04
|
| Rate for Payer: BCBS Complete |
$183.05
|
| Rate for Payer: BCBS MAPPO |
$247.24
|
| Rate for Payer: BCBS Trust/PPO |
$813.01
|
| Rate for Payer: BCN Commercial |
$813.01
|
| Rate for Payer: BCN Medicare Advantage |
$247.24
|
| Rate for Payer: Cash Price |
$791.15
|
| Rate for Payer: Cofinity Commercial |
$850.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$791.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.24
|
| Rate for Payer: Healthscope Commercial |
$890.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$741.71
|
| Rate for Payer: Mclaren Medicaid |
$174.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$259.60
|
| Rate for Payer: Meridian Medicaid |
$183.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$284.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$271.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$840.60
|
| Rate for Payer: Nomi Health Commercial |
$810.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$741.71
|
| Rate for Payer: PACE Senior Care Partners |
$234.87
|
| Rate for Payer: PACE SWMI |
$247.24
|
| Rate for Payer: PHP Commercial |
$840.60
|
| Rate for Payer: PHP Medicare Advantage |
$247.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$860.38
|
| Rate for Payer: Priority Health Medicare |
$249.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$688.30
|
| Rate for Payer: Railroad Medicare Medicare |
$247.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$870.27
|
| Rate for Payer: UHC Core |
$825.76
|
| Rate for Payer: UHC Exchange |
$247.24
|
| Rate for Payer: UHC Medicaid |
$174.35
|
| Rate for Payer: UHC Medicare Advantage |
$247.24
|
| Rate for Payer: UHCCP Medicaid |
$174.35
|
| Rate for Payer: VA VA |
$247.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$741.71
|
|
|
HC CAST LONG ARM
|
Facility
|
OP
|
$348.51
|
|
|
Service Code
|
CPT 29065
|
| Hospital Charge Code |
42100001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$61.44 |
| Max. Negotiated Rate |
$313.66 |
| Rate for Payer: Aetna Commercial |
$296.23
|
| Rate for Payer: Aetna Medicare |
$90.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.91
|
| Rate for Payer: BCBS Complete |
$64.51
|
| Rate for Payer: BCBS MAPPO |
$87.13
|
| Rate for Payer: BCBS Trust/PPO |
$286.51
|
| Rate for Payer: BCN Commercial |
$286.51
|
| Rate for Payer: BCN Medicare Advantage |
$87.13
|
| Rate for Payer: Cash Price |
$278.81
|
| Rate for Payer: Cofinity Commercial |
$299.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$278.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.13
|
| Rate for Payer: Healthscope Commercial |
$313.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$261.38
|
| Rate for Payer: Mclaren Medicaid |
$61.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.48
|
| Rate for Payer: Meridian Medicaid |
$64.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$296.23
|
| Rate for Payer: Nomi Health Commercial |
$285.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$261.38
|
| Rate for Payer: PACE Senior Care Partners |
$82.77
|
| Rate for Payer: PACE SWMI |
$87.13
|
| Rate for Payer: PHP Commercial |
$296.23
|
| Rate for Payer: PHP Medicare Advantage |
$87.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$303.20
|
| Rate for Payer: Priority Health Medicare |
$88.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$242.56
|
| Rate for Payer: Railroad Medicare Medicare |
$87.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.69
|
| Rate for Payer: UHC Core |
$291.01
|
| Rate for Payer: UHC Exchange |
$87.13
|
| Rate for Payer: UHC Medicaid |
$61.44
|
| Rate for Payer: UHC Medicare Advantage |
$87.13
|
| Rate for Payer: UHCCP Medicaid |
$61.44
|
| Rate for Payer: VA VA |
$87.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$261.38
|
|
|
HC CAST LONG ARM
|
Facility
|
IP
|
$348.51
|
|
|
Service Code
|
CPT 29065
|
| Hospital Charge Code |
42100001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$242.56 |
| Max. Negotiated Rate |
$313.66 |
| Rate for Payer: Aetna Commercial |
$296.23
|
| Rate for Payer: BCBS Trust/PPO |
$287.83
|
| Rate for Payer: BCN Commercial |
$287.83
|
| Rate for Payer: Cash Price |
$278.81
|
| Rate for Payer: Cofinity Commercial |
$299.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$278.81
|
| Rate for Payer: Healthscope Commercial |
$313.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$261.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$296.23
|
| Rate for Payer: Nomi Health Commercial |
$285.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$261.38
|
| Rate for Payer: PHP Commercial |
$296.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$303.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$242.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.69
|
| Rate for Payer: UHC Core |
$291.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$261.38
|
|
|
HC CAST LONG LEG
|
Facility
|
OP
|
$419.91
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
70000005
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$74.03 |
| Max. Negotiated Rate |
$377.92 |
| Rate for Payer: Aetna Commercial |
$356.92
|
| Rate for Payer: Aetna Medicare |
$109.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$131.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$131.22
|
| Rate for Payer: BCBS Complete |
$77.73
|
| Rate for Payer: BCBS MAPPO |
$104.98
|
| Rate for Payer: BCBS Trust/PPO |
$345.21
|
| Rate for Payer: BCN Commercial |
$345.21
|
| Rate for Payer: BCN Medicare Advantage |
$104.98
|
| Rate for Payer: Cash Price |
$335.93
|
| Rate for Payer: Cofinity Commercial |
$361.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.98
|
| Rate for Payer: Healthscope Commercial |
$377.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$314.93
|
| Rate for Payer: Mclaren Medicaid |
$74.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.23
|
| Rate for Payer: Meridian Medicaid |
$77.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$120.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$115.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$356.92
|
| Rate for Payer: Nomi Health Commercial |
$344.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$314.93
|
| Rate for Payer: PACE Senior Care Partners |
$99.73
|
| Rate for Payer: PACE SWMI |
$104.98
|
| Rate for Payer: PHP Commercial |
$356.92
|
| Rate for Payer: PHP Medicare Advantage |
$104.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$365.32
|
| Rate for Payer: Priority Health Medicare |
$106.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$292.26
|
| Rate for Payer: Railroad Medicare Medicare |
$104.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$369.52
|
| Rate for Payer: UHC Core |
$350.62
|
| Rate for Payer: UHC Exchange |
$104.98
|
| Rate for Payer: UHC Medicaid |
$74.03
|
| Rate for Payer: UHC Medicare Advantage |
$104.98
|
| Rate for Payer: UHCCP Medicaid |
$74.03
|
| Rate for Payer: VA VA |
$104.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$314.93
|
|
|
HC CAST LONG LEG
|
Facility
|
IP
|
$419.91
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
70000005
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$292.26 |
| Max. Negotiated Rate |
$377.92 |
| Rate for Payer: Aetna Commercial |
$356.92
|
| Rate for Payer: BCBS Trust/PPO |
$346.80
|
| Rate for Payer: BCN Commercial |
$346.80
|
| Rate for Payer: Cash Price |
$335.93
|
| Rate for Payer: Cofinity Commercial |
$361.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.93
|
| Rate for Payer: Healthscope Commercial |
$377.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$314.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$356.92
|
| Rate for Payer: Nomi Health Commercial |
$344.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$314.93
|
| Rate for Payer: PHP Commercial |
$356.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$365.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$292.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$369.52
|
| Rate for Payer: UHC Core |
$350.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$314.93
|
|
|
HC CAST PANTALOON
|
Facility
|
IP
|
$936.94
|
|
|
Service Code
|
CPT 29305
|
| Hospital Charge Code |
70000003
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$652.11 |
| Max. Negotiated Rate |
$843.25 |
| Rate for Payer: Aetna Commercial |
$796.40
|
| Rate for Payer: BCBS Trust/PPO |
$773.82
|
| Rate for Payer: BCN Commercial |
$773.82
|
| Rate for Payer: Cash Price |
$749.55
|
| Rate for Payer: Cofinity Commercial |
$805.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$749.55
|
| Rate for Payer: Healthscope Commercial |
$843.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$702.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$796.40
|
| Rate for Payer: Nomi Health Commercial |
$768.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$702.71
|
| Rate for Payer: PHP Commercial |
$796.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$815.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$652.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$824.51
|
| Rate for Payer: UHC Core |
$782.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$702.71
|
|
|
HC CAST PANTALOON
|
Facility
|
OP
|
$936.94
|
|
|
Service Code
|
CPT 29305
|
| Hospital Charge Code |
70000003
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$165.18 |
| Max. Negotiated Rate |
$843.25 |
| Rate for Payer: Aetna Commercial |
$796.40
|
| Rate for Payer: Aetna Medicare |
$243.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.79
|
| Rate for Payer: BCBS Complete |
$173.43
|
| Rate for Payer: BCBS MAPPO |
$234.24
|
| Rate for Payer: BCBS Trust/PPO |
$770.26
|
| Rate for Payer: BCN Commercial |
$770.26
|
| Rate for Payer: BCN Medicare Advantage |
$234.24
|
| Rate for Payer: Cash Price |
$749.55
|
| Rate for Payer: Cofinity Commercial |
$805.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$749.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$234.24
|
| Rate for Payer: Healthscope Commercial |
$843.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$702.71
|
| Rate for Payer: Mclaren Medicaid |
$165.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.95
|
| Rate for Payer: Meridian Medicaid |
$173.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$269.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$257.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$796.40
|
| Rate for Payer: Nomi Health Commercial |
$768.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$702.71
|
| Rate for Payer: PACE Senior Care Partners |
$222.52
|
| Rate for Payer: PACE SWMI |
$234.24
|
| Rate for Payer: PHP Commercial |
$796.40
|
| Rate for Payer: PHP Medicare Advantage |
$234.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$815.14
|
| Rate for Payer: Priority Health Medicare |
$236.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$652.11
|
| Rate for Payer: Railroad Medicare Medicare |
$234.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$824.51
|
| Rate for Payer: UHC Core |
$782.34
|
| Rate for Payer: UHC Exchange |
$234.24
|
| Rate for Payer: UHC Medicaid |
$165.18
|
| Rate for Payer: UHC Medicare Advantage |
$234.24
|
| Rate for Payer: UHCCP Medicaid |
$165.18
|
| Rate for Payer: VA VA |
$234.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$702.71
|
|
|
HC CAST PTB WALKING
|
Facility
|
IP
|
$419.91
|
|
|
Service Code
|
CPT 29435
|
| Hospital Charge Code |
70000009
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$292.26 |
| Max. Negotiated Rate |
$377.92 |
| Rate for Payer: Aetna Commercial |
$356.92
|
| Rate for Payer: BCBS Trust/PPO |
$346.80
|
| Rate for Payer: BCN Commercial |
$346.80
|
| Rate for Payer: Cash Price |
$335.93
|
| Rate for Payer: Cofinity Commercial |
$361.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.93
|
| Rate for Payer: Healthscope Commercial |
$377.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$314.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$356.92
|
| Rate for Payer: Nomi Health Commercial |
$344.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$314.93
|
| Rate for Payer: PHP Commercial |
$356.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$365.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$292.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$369.52
|
| Rate for Payer: UHC Core |
$350.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$314.93
|
|
|
HC CAST PTB WALKING
|
Facility
|
OP
|
$419.91
|
|
|
Service Code
|
CPT 29435
|
| Hospital Charge Code |
70000009
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$74.03 |
| Max. Negotiated Rate |
$377.92 |
| Rate for Payer: Aetna Commercial |
$356.92
|
| Rate for Payer: Aetna Medicare |
$109.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$131.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$131.22
|
| Rate for Payer: BCBS Complete |
$77.73
|
| Rate for Payer: BCBS MAPPO |
$104.98
|
| Rate for Payer: BCBS Trust/PPO |
$345.21
|
| Rate for Payer: BCN Commercial |
$345.21
|
| Rate for Payer: BCN Medicare Advantage |
$104.98
|
| Rate for Payer: Cash Price |
$335.93
|
| Rate for Payer: Cofinity Commercial |
$361.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.98
|
| Rate for Payer: Healthscope Commercial |
$377.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$314.93
|
| Rate for Payer: Mclaren Medicaid |
$74.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.23
|
| Rate for Payer: Meridian Medicaid |
$77.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$120.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$115.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$356.92
|
| Rate for Payer: Nomi Health Commercial |
$344.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$314.93
|
| Rate for Payer: PACE Senior Care Partners |
$99.73
|
| Rate for Payer: PACE SWMI |
$104.98
|
| Rate for Payer: PHP Commercial |
$356.92
|
| Rate for Payer: PHP Medicare Advantage |
$104.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$365.32
|
| Rate for Payer: Priority Health Medicare |
$106.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$292.26
|
| Rate for Payer: Railroad Medicare Medicare |
$104.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$369.52
|
| Rate for Payer: UHC Core |
$350.62
|
| Rate for Payer: UHC Exchange |
$104.98
|
| Rate for Payer: UHC Medicaid |
$74.03
|
| Rate for Payer: UHC Medicare Advantage |
$104.98
|
| Rate for Payer: UHCCP Medicaid |
$74.03
|
| Rate for Payer: VA VA |
$104.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$314.93
|
|
|
HC CAST REPAIR
|
Facility
|
IP
|
$182.39
|
|
| Hospital Charge Code |
27000041
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$164.15 |
| Rate for Payer: Aetna Commercial |
$155.03
|
| Rate for Payer: BCBS Trust/PPO |
$150.64
|
| Rate for Payer: BCN Commercial |
$150.64
|
| Rate for Payer: Cash Price |
$145.91
|
| Rate for Payer: Cofinity Commercial |
$156.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.91
|
| Rate for Payer: Healthscope Commercial |
$164.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$155.03
|
| Rate for Payer: Nomi Health Commercial |
$149.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.79
|
| Rate for Payer: PHP Commercial |
$155.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$158.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.50
|
| Rate for Payer: UHC Core |
$152.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.79
|
|
|
HC CAST REPAIR
|
Facility
|
OP
|
$182.39
|
|
| Hospital Charge Code |
27000041
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$32.16 |
| Max. Negotiated Rate |
$164.15 |
| Rate for Payer: Aetna Commercial |
$155.03
|
| Rate for Payer: Aetna Medicare |
$47.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$57.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$57.00
|
| Rate for Payer: BCBS Complete |
$33.76
|
| Rate for Payer: BCBS MAPPO |
$45.60
|
| Rate for Payer: BCBS Trust/PPO |
$149.94
|
| Rate for Payer: BCN Commercial |
$149.94
|
| Rate for Payer: BCN Medicare Advantage |
$45.60
|
| Rate for Payer: Cash Price |
$145.91
|
| Rate for Payer: Cofinity Commercial |
$156.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.60
|
| Rate for Payer: Healthscope Commercial |
$164.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.79
|
| Rate for Payer: Mclaren Medicaid |
$32.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.88
|
| Rate for Payer: Meridian Medicaid |
$33.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$50.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$155.03
|
| Rate for Payer: Nomi Health Commercial |
$149.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.79
|
| Rate for Payer: PACE Senior Care Partners |
$43.32
|
| Rate for Payer: PACE SWMI |
$45.60
|
| Rate for Payer: PHP Commercial |
$155.03
|
| Rate for Payer: PHP Medicare Advantage |
$45.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$158.68
|
| Rate for Payer: Priority Health Medicare |
$46.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.94
|
| Rate for Payer: Railroad Medicare Medicare |
$45.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.50
|
| Rate for Payer: UHC Core |
$152.30
|
| Rate for Payer: UHC Exchange |
$45.60
|
| Rate for Payer: UHC Medicaid |
$32.16
|
| Rate for Payer: UHC Medicare Advantage |
$45.60
|
| Rate for Payer: UHCCP Medicaid |
$32.16
|
| Rate for Payer: VA VA |
$45.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.79
|
|
|
HC CAST RISSER BODY ONLY
|
Facility
|
OP
|
$315.57
|
|
|
Service Code
|
CPT 29010
|
| Hospital Charge Code |
70000001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$55.63 |
| Max. Negotiated Rate |
$284.01 |
| Rate for Payer: Aetna Commercial |
$268.23
|
| Rate for Payer: Aetna Medicare |
$82.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.62
|
| Rate for Payer: BCBS Complete |
$58.41
|
| Rate for Payer: BCBS MAPPO |
$78.89
|
| Rate for Payer: BCBS Trust/PPO |
$259.43
|
| Rate for Payer: BCN Commercial |
$259.43
|
| Rate for Payer: BCN Medicare Advantage |
$78.89
|
| Rate for Payer: Cash Price |
$252.46
|
| Rate for Payer: Cofinity Commercial |
$271.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.89
|
| Rate for Payer: Healthscope Commercial |
$284.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.68
|
| Rate for Payer: Mclaren Medicaid |
$55.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.84
|
| Rate for Payer: Meridian Medicaid |
$58.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$86.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.23
|
| Rate for Payer: Nomi Health Commercial |
$258.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.68
|
| Rate for Payer: PACE Senior Care Partners |
$74.95
|
| Rate for Payer: PACE SWMI |
$78.89
|
| Rate for Payer: PHP Commercial |
$268.23
|
| Rate for Payer: PHP Medicare Advantage |
$78.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$274.55
|
| Rate for Payer: Priority Health Medicare |
$79.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.64
|
| Rate for Payer: Railroad Medicare Medicare |
$78.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$277.70
|
| Rate for Payer: UHC Core |
$263.50
|
| Rate for Payer: UHC Exchange |
$78.89
|
| Rate for Payer: UHC Medicaid |
$55.63
|
| Rate for Payer: UHC Medicare Advantage |
$78.89
|
| Rate for Payer: UHCCP Medicaid |
$55.63
|
| Rate for Payer: VA VA |
$78.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.68
|
|
