|
HC CLOSED RX TIBIAL PLATEAU FX
|
Facility
|
OP
|
$358.31
|
|
|
Service Code
|
CPT 27530
|
| Hospital Charge Code |
76100172
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$63.17 |
| Max. Negotiated Rate |
$322.48 |
| Rate for Payer: Aetna Commercial |
$304.56
|
| Rate for Payer: Aetna Medicare |
$93.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.97
|
| Rate for Payer: BCBS Complete |
$66.32
|
| Rate for Payer: BCBS MAPPO |
$89.58
|
| Rate for Payer: BCBS Trust/PPO |
$294.57
|
| Rate for Payer: BCN Commercial |
$294.57
|
| Rate for Payer: BCN Medicare Advantage |
$89.58
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Cofinity Commercial |
$308.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.58
|
| Rate for Payer: Healthscope Commercial |
$322.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.73
|
| Rate for Payer: Mclaren Medicaid |
$63.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.06
|
| Rate for Payer: Meridian Medicaid |
$66.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.56
|
| Rate for Payer: Nomi Health Commercial |
$293.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.73
|
| Rate for Payer: PACE Senior Care Partners |
$85.10
|
| Rate for Payer: PACE SWMI |
$89.58
|
| Rate for Payer: PHP Commercial |
$304.56
|
| Rate for Payer: PHP Medicare Advantage |
$89.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$311.73
|
| Rate for Payer: Priority Health Medicare |
$90.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.38
|
| Rate for Payer: Railroad Medicare Medicare |
$89.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.31
|
| Rate for Payer: UHC Core |
$299.19
|
| Rate for Payer: UHC Exchange |
$89.58
|
| Rate for Payer: UHC Medicaid |
$63.17
|
| Rate for Payer: UHC Medicare Advantage |
$89.58
|
| Rate for Payer: UHCCP Medicaid |
$63.17
|
| Rate for Payer: VA VA |
$89.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.73
|
|
|
HC CLOSED RX TIBIAL PLATEAU FX
|
Facility
|
IP
|
$358.31
|
|
|
Service Code
|
CPT 27530
|
| Hospital Charge Code |
76100172
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$249.38 |
| Max. Negotiated Rate |
$322.48 |
| Rate for Payer: Aetna Commercial |
$304.56
|
| Rate for Payer: BCBS Trust/PPO |
$295.93
|
| Rate for Payer: BCN Commercial |
$295.93
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Cofinity Commercial |
$308.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.65
|
| Rate for Payer: Healthscope Commercial |
$322.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.56
|
| Rate for Payer: Nomi Health Commercial |
$293.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.73
|
| Rate for Payer: PHP Commercial |
$304.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$311.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.31
|
| Rate for Payer: UHC Core |
$299.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.73
|
|
|
HC CLOSED RX TIBIA SHAFT FX
|
Facility
|
IP
|
$394.14
|
|
|
Service Code
|
CPT 27750
|
| Hospital Charge Code |
76100173
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$274.32 |
| Max. Negotiated Rate |
$354.73 |
| Rate for Payer: Aetna Commercial |
$335.02
|
| Rate for Payer: BCBS Trust/PPO |
$325.52
|
| Rate for Payer: BCN Commercial |
$325.52
|
| Rate for Payer: Cash Price |
$315.31
|
| Rate for Payer: Cofinity Commercial |
$338.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.31
|
| Rate for Payer: Healthscope Commercial |
$354.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$335.02
|
| Rate for Payer: Nomi Health Commercial |
$323.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$295.61
|
| Rate for Payer: PHP Commercial |
$335.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$342.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$274.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$346.84
|
| Rate for Payer: UHC Core |
$329.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.61
|
|
|
HC CLOSED RX TIBIA SHAFT FX
|
Facility
|
OP
|
$394.14
|
|
|
Service Code
|
CPT 27750
|
| Hospital Charge Code |
76100173
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$69.49 |
| Max. Negotiated Rate |
$354.73 |
| Rate for Payer: Aetna Commercial |
$335.02
|
| Rate for Payer: Aetna Medicare |
$102.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$123.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$123.17
|
| Rate for Payer: BCBS Complete |
$72.96
|
| Rate for Payer: BCBS MAPPO |
$98.53
|
| Rate for Payer: BCBS Trust/PPO |
$324.02
|
| Rate for Payer: BCN Commercial |
$324.02
|
| Rate for Payer: BCN Medicare Advantage |
$98.53
|
| Rate for Payer: Cash Price |
$315.31
|
| Rate for Payer: Cofinity Commercial |
$338.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.53
|
| Rate for Payer: Healthscope Commercial |
$354.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.61
|
| Rate for Payer: Mclaren Medicaid |
$69.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.46
|
| Rate for Payer: Meridian Medicaid |
$72.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$113.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$335.02
|
| Rate for Payer: Nomi Health Commercial |
$323.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$295.61
|
| Rate for Payer: PACE Senior Care Partners |
$93.61
|
| Rate for Payer: PACE SWMI |
$98.53
|
| Rate for Payer: PHP Commercial |
$335.02
|
| Rate for Payer: PHP Medicare Advantage |
$98.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$342.90
|
| Rate for Payer: Priority Health Medicare |
$99.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$274.32
|
| Rate for Payer: Railroad Medicare Medicare |
$98.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$346.84
|
| Rate for Payer: UHC Core |
$329.11
|
| Rate for Payer: UHC Exchange |
$98.53
|
| Rate for Payer: UHC Medicaid |
$69.49
|
| Rate for Payer: UHC Medicare Advantage |
$98.53
|
| Rate for Payer: UHCCP Medicaid |
$69.49
|
| Rate for Payer: VA VA |
$98.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.61
|
|
|
HC CLOSED TREATMENT DISLOCATED SHOULDER W MANIP
|
Facility
|
OP
|
$647.33
|
|
|
Service Code
|
CPT 23650
|
| Hospital Charge Code |
76100436
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.12 |
| Max. Negotiated Rate |
$582.60 |
| Rate for Payer: Aetna Commercial |
$550.23
|
| Rate for Payer: Aetna Medicare |
$168.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$202.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$202.29
|
| Rate for Payer: BCBS Complete |
$119.82
|
| Rate for Payer: BCBS MAPPO |
$161.83
|
| Rate for Payer: BCBS Trust/PPO |
$532.17
|
| Rate for Payer: BCN Commercial |
$532.17
|
| Rate for Payer: BCN Medicare Advantage |
$161.83
|
| Rate for Payer: Cash Price |
$517.86
|
| Rate for Payer: Cofinity Commercial |
$556.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$517.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.83
|
| Rate for Payer: Healthscope Commercial |
$582.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$485.50
|
| Rate for Payer: Mclaren Medicaid |
$114.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.92
|
| Rate for Payer: Meridian Medicaid |
$119.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$178.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$550.23
|
| Rate for Payer: Nomi Health Commercial |
$530.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$485.50
|
| Rate for Payer: PACE Senior Care Partners |
$153.74
|
| Rate for Payer: PACE SWMI |
$161.83
|
| Rate for Payer: PHP Commercial |
$550.23
|
| Rate for Payer: PHP Medicare Advantage |
$161.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$563.18
|
| Rate for Payer: Priority Health Medicare |
$163.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$450.54
|
| Rate for Payer: Railroad Medicare Medicare |
$161.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$569.65
|
| Rate for Payer: UHC Core |
$540.52
|
| Rate for Payer: UHC Exchange |
$161.83
|
| Rate for Payer: UHC Medicaid |
$114.12
|
| Rate for Payer: UHC Medicare Advantage |
$161.83
|
| Rate for Payer: UHCCP Medicaid |
$114.12
|
| Rate for Payer: VA VA |
$161.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$485.50
|
|
|
HC CLOSED TREATMENT DISLOCATED SHOULDER W MANIP
|
Facility
|
IP
|
$647.33
|
|
|
Service Code
|
CPT 23650
|
| Hospital Charge Code |
76100436
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$450.54 |
| Max. Negotiated Rate |
$582.60 |
| Rate for Payer: Aetna Commercial |
$550.23
|
| Rate for Payer: BCBS Trust/PPO |
$534.63
|
| Rate for Payer: BCN Commercial |
$534.63
|
| Rate for Payer: Cash Price |
$517.86
|
| Rate for Payer: Cofinity Commercial |
$556.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$517.86
|
| Rate for Payer: Healthscope Commercial |
$582.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$485.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$550.23
|
| Rate for Payer: Nomi Health Commercial |
$530.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$485.50
|
| Rate for Payer: PHP Commercial |
$550.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$563.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$450.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$569.65
|
| Rate for Payer: UHC Core |
$540.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$485.50
|
|
|
HC CLOSED TX ACETAB FX; W/O MANIP
|
Facility
|
OP
|
$389.47
|
|
|
Service Code
|
CPT 27220
|
| Hospital Charge Code |
76100286
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$68.66 |
| Max. Negotiated Rate |
$350.52 |
| Rate for Payer: Aetna Commercial |
$331.05
|
| Rate for Payer: Aetna Medicare |
$101.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$121.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$121.71
|
| Rate for Payer: BCBS Complete |
$72.09
|
| Rate for Payer: BCBS MAPPO |
$97.37
|
| Rate for Payer: BCBS Trust/PPO |
$320.18
|
| Rate for Payer: BCN Commercial |
$320.18
|
| Rate for Payer: BCN Medicare Advantage |
$97.37
|
| Rate for Payer: Cash Price |
$311.58
|
| Rate for Payer: Cofinity Commercial |
$334.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$311.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.37
|
| Rate for Payer: Healthscope Commercial |
$350.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.10
|
| Rate for Payer: Mclaren Medicaid |
$68.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.24
|
| Rate for Payer: Meridian Medicaid |
$72.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.05
|
| Rate for Payer: Nomi Health Commercial |
$319.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$292.10
|
| Rate for Payer: PACE Senior Care Partners |
$92.50
|
| Rate for Payer: PACE SWMI |
$97.37
|
| Rate for Payer: PHP Commercial |
$331.05
|
| Rate for Payer: PHP Medicare Advantage |
$97.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$338.84
|
| Rate for Payer: Priority Health Medicare |
$98.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$271.07
|
| Rate for Payer: Railroad Medicare Medicare |
$97.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.73
|
| Rate for Payer: UHC Core |
$325.21
|
| Rate for Payer: UHC Exchange |
$97.37
|
| Rate for Payer: UHC Medicaid |
$68.66
|
| Rate for Payer: UHC Medicare Advantage |
$97.37
|
| Rate for Payer: UHCCP Medicaid |
$68.66
|
| Rate for Payer: VA VA |
$97.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.10
|
|
|
HC CLOSED TX ACETAB FX; W/O MANIP
|
Facility
|
IP
|
$389.47
|
|
|
Service Code
|
CPT 27220
|
| Hospital Charge Code |
76100286
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$271.07 |
| Max. Negotiated Rate |
$350.52 |
| Rate for Payer: Aetna Commercial |
$331.05
|
| Rate for Payer: BCBS Trust/PPO |
$321.66
|
| Rate for Payer: BCN Commercial |
$321.66
|
| Rate for Payer: Cash Price |
$311.58
|
| Rate for Payer: Cofinity Commercial |
$334.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$311.58
|
| Rate for Payer: Healthscope Commercial |
$350.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.05
|
| Rate for Payer: Nomi Health Commercial |
$319.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$292.10
|
| Rate for Payer: PHP Commercial |
$331.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$338.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$271.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.73
|
| Rate for Payer: UHC Core |
$325.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.10
|
|
|
HC CLOSED TX BIMALLEOLAR ANKLE FX W/O MANIP
|
Facility
|
IP
|
$638.72
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
76100492
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$444.55 |
| Max. Negotiated Rate |
$574.85 |
| Rate for Payer: Aetna Commercial |
$542.91
|
| Rate for Payer: BCBS Trust/PPO |
$527.52
|
| Rate for Payer: BCN Commercial |
$527.52
|
| Rate for Payer: Cash Price |
$510.98
|
| Rate for Payer: Cofinity Commercial |
$549.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$510.98
|
| Rate for Payer: Healthscope Commercial |
$574.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$479.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$542.91
|
| Rate for Payer: Nomi Health Commercial |
$523.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$479.04
|
| Rate for Payer: PHP Commercial |
$542.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$555.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$444.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$562.07
|
| Rate for Payer: UHC Core |
$533.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$479.04
|
|
|
HC CLOSED TX BIMALLEOLAR ANKLE FX W/O MANIP
|
Facility
|
OP
|
$638.72
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
76100492
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$112.61 |
| Max. Negotiated Rate |
$574.85 |
| Rate for Payer: Aetna Commercial |
$542.91
|
| Rate for Payer: Aetna Medicare |
$166.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$199.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$199.60
|
| Rate for Payer: BCBS Complete |
$118.23
|
| Rate for Payer: BCBS MAPPO |
$159.68
|
| Rate for Payer: BCBS Trust/PPO |
$525.09
|
| Rate for Payer: BCN Commercial |
$525.09
|
| Rate for Payer: BCN Medicare Advantage |
$159.68
|
| Rate for Payer: Cash Price |
$510.98
|
| Rate for Payer: Cofinity Commercial |
$549.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$510.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.68
|
| Rate for Payer: Healthscope Commercial |
$574.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$479.04
|
| Rate for Payer: Mclaren Medicaid |
$112.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.66
|
| Rate for Payer: Meridian Medicaid |
$118.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$183.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$175.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$542.91
|
| Rate for Payer: Nomi Health Commercial |
$523.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$479.04
|
| Rate for Payer: PACE Senior Care Partners |
$151.70
|
| Rate for Payer: PACE SWMI |
$159.68
|
| Rate for Payer: PHP Commercial |
$542.91
|
| Rate for Payer: PHP Medicare Advantage |
$159.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$555.69
|
| Rate for Payer: Priority Health Medicare |
$161.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$444.55
|
| Rate for Payer: Railroad Medicare Medicare |
$159.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$562.07
|
| Rate for Payer: UHC Core |
$533.33
|
| Rate for Payer: UHC Exchange |
$159.68
|
| Rate for Payer: UHC Medicaid |
$112.61
|
| Rate for Payer: UHC Medicare Advantage |
$159.68
|
| Rate for Payer: UHCCP Medicaid |
$112.61
|
| Rate for Payer: VA VA |
$159.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$479.04
|
|
|
HC CLOSED TX BIMALLEOLAR FX W/MANIP
|
Facility
|
OP
|
$1,846.51
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
76100295
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$325.54 |
| Max. Negotiated Rate |
$1,661.86 |
| Rate for Payer: Aetna Commercial |
$1,569.53
|
| Rate for Payer: Aetna Medicare |
$480.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$577.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$577.03
|
| Rate for Payer: BCBS Complete |
$341.79
|
| Rate for Payer: BCBS MAPPO |
$461.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,518.02
|
| Rate for Payer: BCN Commercial |
$1,518.02
|
| Rate for Payer: BCN Medicare Advantage |
$461.63
|
| Rate for Payer: Cash Price |
$1,477.21
|
| Rate for Payer: Cofinity Commercial |
$1,588.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,477.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$461.63
|
| Rate for Payer: Healthscope Commercial |
$1,661.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,384.88
|
| Rate for Payer: Mclaren Medicaid |
$325.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$484.71
|
| Rate for Payer: Meridian Medicaid |
$341.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$530.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$507.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,569.53
|
| Rate for Payer: Nomi Health Commercial |
$1,514.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,384.88
|
| Rate for Payer: PACE Senior Care Partners |
$438.55
|
| Rate for Payer: PACE SWMI |
$461.63
|
| Rate for Payer: PHP Commercial |
$1,569.53
|
| Rate for Payer: PHP Medicare Advantage |
$461.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$325.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,606.46
|
| Rate for Payer: Priority Health Medicare |
$466.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,285.17
|
| Rate for Payer: Railroad Medicare Medicare |
$461.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,624.93
|
| Rate for Payer: UHC Core |
$1,541.84
|
| Rate for Payer: UHC Exchange |
$461.63
|
| Rate for Payer: UHC Medicaid |
$325.54
|
| Rate for Payer: UHC Medicare Advantage |
$461.63
|
| Rate for Payer: UHCCP Medicaid |
$325.54
|
| Rate for Payer: VA VA |
$461.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,384.88
|
|
|
HC CLOSED TX BIMALLEOLAR FX W/MANIP
|
Facility
|
IP
|
$1,846.51
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
76100295
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,285.17 |
| Max. Negotiated Rate |
$1,661.86 |
| Rate for Payer: Aetna Commercial |
$1,569.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,525.03
|
| Rate for Payer: BCN Commercial |
$1,525.03
|
| Rate for Payer: Cash Price |
$1,477.21
|
| Rate for Payer: Cofinity Commercial |
$1,588.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,477.21
|
| Rate for Payer: Healthscope Commercial |
$1,661.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,384.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,569.53
|
| Rate for Payer: Nomi Health Commercial |
$1,514.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,384.88
|
| Rate for Payer: PHP Commercial |
$1,569.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,606.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,285.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,624.93
|
| Rate for Payer: UHC Core |
$1,541.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,384.88
|
|
|
HC CLOSED TX CALCANEAL FX, W/O MANIP
|
Facility
|
IP
|
$343.26
|
|
|
Service Code
|
CPT 28400
|
| Hospital Charge Code |
76100267
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$238.91 |
| Max. Negotiated Rate |
$308.93 |
| Rate for Payer: Aetna Commercial |
$291.77
|
| Rate for Payer: BCBS Trust/PPO |
$283.50
|
| Rate for Payer: BCN Commercial |
$283.50
|
| Rate for Payer: Cash Price |
$274.61
|
| Rate for Payer: Cofinity Commercial |
$295.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.61
|
| Rate for Payer: Healthscope Commercial |
$308.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.77
|
| Rate for Payer: Nomi Health Commercial |
$281.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.44
|
| Rate for Payer: PHP Commercial |
$291.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$298.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.07
|
| Rate for Payer: UHC Core |
$286.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.44
|
|
|
HC CLOSED TX CALCANEAL FX, W/O MANIP
|
Facility
|
OP
|
$343.26
|
|
|
Service Code
|
CPT 28400
|
| Hospital Charge Code |
76100267
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$60.52 |
| Max. Negotiated Rate |
$308.93 |
| Rate for Payer: Aetna Commercial |
$291.77
|
| Rate for Payer: Aetna Medicare |
$89.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.27
|
| Rate for Payer: BCBS Complete |
$63.54
|
| Rate for Payer: BCBS MAPPO |
$85.81
|
| Rate for Payer: BCBS Trust/PPO |
$282.19
|
| Rate for Payer: BCN Commercial |
$282.19
|
| Rate for Payer: BCN Medicare Advantage |
$85.81
|
| Rate for Payer: Cash Price |
$274.61
|
| Rate for Payer: Cofinity Commercial |
$295.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.81
|
| Rate for Payer: Healthscope Commercial |
$308.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.44
|
| Rate for Payer: Mclaren Medicaid |
$60.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.11
|
| Rate for Payer: Meridian Medicaid |
$63.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$94.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.77
|
| Rate for Payer: Nomi Health Commercial |
$281.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.44
|
| Rate for Payer: PACE Senior Care Partners |
$81.52
|
| Rate for Payer: PACE SWMI |
$85.81
|
| Rate for Payer: PHP Commercial |
$291.77
|
| Rate for Payer: PHP Medicare Advantage |
$85.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$298.64
|
| Rate for Payer: Priority Health Medicare |
$86.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.91
|
| Rate for Payer: Railroad Medicare Medicare |
$85.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.07
|
| Rate for Payer: UHC Core |
$286.62
|
| Rate for Payer: UHC Exchange |
$85.81
|
| Rate for Payer: UHC Medicaid |
$60.52
|
| Rate for Payer: UHC Medicare Advantage |
$85.81
|
| Rate for Payer: UHCCP Medicaid |
$60.52
|
| Rate for Payer: VA VA |
$85.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.44
|
|
|
HC CLOSED TX CLAVICLE FX W/O MANIP
|
Facility
|
OP
|
$343.23
|
|
|
Service Code
|
CPT 23500
|
| Hospital Charge Code |
76100229
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$60.51 |
| Max. Negotiated Rate |
$308.91 |
| Rate for Payer: Aetna Commercial |
$291.75
|
| Rate for Payer: Aetna Medicare |
$89.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.26
|
| Rate for Payer: BCBS Complete |
$63.53
|
| Rate for Payer: BCBS MAPPO |
$85.81
|
| Rate for Payer: BCBS Trust/PPO |
$282.17
|
| Rate for Payer: BCN Commercial |
$282.17
|
| Rate for Payer: BCN Medicare Advantage |
$85.81
|
| Rate for Payer: Cash Price |
$274.58
|
| Rate for Payer: Cofinity Commercial |
$295.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.81
|
| Rate for Payer: Healthscope Commercial |
$308.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.42
|
| Rate for Payer: Mclaren Medicaid |
$60.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.10
|
| Rate for Payer: Meridian Medicaid |
$63.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$94.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.75
|
| Rate for Payer: Nomi Health Commercial |
$281.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.42
|
| Rate for Payer: PACE Senior Care Partners |
$81.52
|
| Rate for Payer: PACE SWMI |
$85.81
|
| Rate for Payer: PHP Commercial |
$291.75
|
| Rate for Payer: PHP Medicare Advantage |
$85.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$298.61
|
| Rate for Payer: Priority Health Medicare |
$86.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.89
|
| Rate for Payer: Railroad Medicare Medicare |
$85.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.04
|
| Rate for Payer: UHC Core |
$286.60
|
| Rate for Payer: UHC Exchange |
$85.81
|
| Rate for Payer: UHC Medicaid |
$60.51
|
| Rate for Payer: UHC Medicare Advantage |
$85.81
|
| Rate for Payer: UHCCP Medicaid |
$60.51
|
| Rate for Payer: VA VA |
$85.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.42
|
|
|
HC CLOSED TX CLAVICLE FX W/O MANIP
|
Facility
|
IP
|
$343.23
|
|
|
Service Code
|
CPT 23500
|
| Hospital Charge Code |
76100229
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$238.89 |
| Max. Negotiated Rate |
$308.91 |
| Rate for Payer: Aetna Commercial |
$291.75
|
| Rate for Payer: BCBS Trust/PPO |
$283.47
|
| Rate for Payer: BCN Commercial |
$283.47
|
| Rate for Payer: Cash Price |
$274.58
|
| Rate for Payer: Cofinity Commercial |
$295.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.58
|
| Rate for Payer: Healthscope Commercial |
$308.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.75
|
| Rate for Payer: Nomi Health Commercial |
$281.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.42
|
| Rate for Payer: PHP Commercial |
$291.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$298.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.04
|
| Rate for Payer: UHC Core |
$286.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.42
|
|
|
HC CLOSED TX DISTAL RADIAL FX/EPIPHYSEAL SEPARATION W/MANIP
|
Facility
|
OP
|
$2,157.53
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
76100240
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$380.37 |
| Max. Negotiated Rate |
$1,941.78 |
| Rate for Payer: Aetna Commercial |
$1,833.90
|
| Rate for Payer: Aetna Medicare |
$560.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$674.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$674.23
|
| Rate for Payer: BCBS Complete |
$399.36
|
| Rate for Payer: BCBS MAPPO |
$539.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,773.71
|
| Rate for Payer: BCN Commercial |
$1,773.71
|
| Rate for Payer: BCN Medicare Advantage |
$539.38
|
| Rate for Payer: Cash Price |
$1,726.02
|
| Rate for Payer: Cofinity Commercial |
$1,855.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,726.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$539.38
|
| Rate for Payer: Healthscope Commercial |
$1,941.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,618.15
|
| Rate for Payer: Mclaren Medicaid |
$380.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$566.35
|
| Rate for Payer: Meridian Medicaid |
$399.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$620.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$593.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,833.90
|
| Rate for Payer: Nomi Health Commercial |
$1,769.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,618.15
|
| Rate for Payer: PACE Senior Care Partners |
$512.41
|
| Rate for Payer: PACE SWMI |
$539.38
|
| Rate for Payer: PHP Commercial |
$1,833.90
|
| Rate for Payer: PHP Medicare Advantage |
$539.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$380.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,877.05
|
| Rate for Payer: Priority Health Medicare |
$544.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,501.64
|
| Rate for Payer: Railroad Medicare Medicare |
$539.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,898.63
|
| Rate for Payer: UHC Core |
$1,801.54
|
| Rate for Payer: UHC Exchange |
$539.38
|
| Rate for Payer: UHC Medicaid |
$380.37
|
| Rate for Payer: UHC Medicare Advantage |
$539.38
|
| Rate for Payer: UHCCP Medicaid |
$380.37
|
| Rate for Payer: VA VA |
$539.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,618.15
|
|
|
HC CLOSED TX DISTAL RADIAL FX/EPIPHYSEAL SEPARATION W/MANIP
|
Facility
|
IP
|
$2,157.53
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
76100240
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,501.64 |
| Max. Negotiated Rate |
$1,941.78 |
| Rate for Payer: Aetna Commercial |
$1,833.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,781.90
|
| Rate for Payer: BCN Commercial |
$1,781.90
|
| Rate for Payer: Cash Price |
$1,726.02
|
| Rate for Payer: Cofinity Commercial |
$1,855.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,726.02
|
| Rate for Payer: Healthscope Commercial |
$1,941.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,618.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,833.90
|
| Rate for Payer: Nomi Health Commercial |
$1,769.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,618.15
|
| Rate for Payer: PHP Commercial |
$1,833.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,877.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,501.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,898.63
|
| Rate for Payer: UHC Core |
$1,801.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,618.15
|
|
|
HC CLOSED TX FEMORAL FX, DISTAL END, MEDIAL/LAT CONDYLE W/O MANIP
|
Facility
|
OP
|
$372.48
|
|
|
Service Code
|
CPT 27508
|
| Hospital Charge Code |
76100299
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$65.67 |
| Max. Negotiated Rate |
$335.23 |
| Rate for Payer: Aetna Commercial |
$316.61
|
| Rate for Payer: Aetna Medicare |
$96.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$116.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$116.40
|
| Rate for Payer: BCBS Complete |
$68.95
|
| Rate for Payer: BCBS MAPPO |
$93.12
|
| Rate for Payer: BCBS Trust/PPO |
$306.22
|
| Rate for Payer: BCN Commercial |
$306.22
|
| Rate for Payer: BCN Medicare Advantage |
$93.12
|
| Rate for Payer: Cash Price |
$297.98
|
| Rate for Payer: Cofinity Commercial |
$320.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.12
|
| Rate for Payer: Healthscope Commercial |
$335.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.36
|
| Rate for Payer: Mclaren Medicaid |
$65.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.78
|
| Rate for Payer: Meridian Medicaid |
$68.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$102.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.61
|
| Rate for Payer: Nomi Health Commercial |
$305.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$279.36
|
| Rate for Payer: PACE Senior Care Partners |
$88.46
|
| Rate for Payer: PACE SWMI |
$93.12
|
| Rate for Payer: PHP Commercial |
$316.61
|
| Rate for Payer: PHP Medicare Advantage |
$93.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$324.06
|
| Rate for Payer: Priority Health Medicare |
$94.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$259.25
|
| Rate for Payer: Railroad Medicare Medicare |
$93.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$327.78
|
| Rate for Payer: UHC Core |
$311.02
|
| Rate for Payer: UHC Exchange |
$93.12
|
| Rate for Payer: UHC Medicaid |
$65.67
|
| Rate for Payer: UHC Medicare Advantage |
$93.12
|
| Rate for Payer: UHCCP Medicaid |
$65.67
|
| Rate for Payer: VA VA |
$93.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.36
|
|
|
HC CLOSED TX FEMORAL FX, DISTAL END, MEDIAL/LAT CONDYLE W/O MANIP
|
Facility
|
IP
|
$372.48
|
|
|
Service Code
|
CPT 27508
|
| Hospital Charge Code |
76100299
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$259.25 |
| Max. Negotiated Rate |
$335.23 |
| Rate for Payer: Aetna Commercial |
$316.61
|
| Rate for Payer: BCBS Trust/PPO |
$307.63
|
| Rate for Payer: BCN Commercial |
$307.63
|
| Rate for Payer: Cash Price |
$297.98
|
| Rate for Payer: Cofinity Commercial |
$320.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.98
|
| Rate for Payer: Healthscope Commercial |
$335.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.61
|
| Rate for Payer: Nomi Health Commercial |
$305.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$279.36
|
| Rate for Payer: PHP Commercial |
$316.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$324.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$259.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$327.78
|
| Rate for Payer: UHC Core |
$311.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.36
|
|
|
HC CLOSED TX FRACTURE WB ARTICLR PRTN DSTL TIBIA WO MANIP
|
Facility
|
OP
|
$678.30
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
76100525
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$119.58 |
| Max. Negotiated Rate |
$610.47 |
| Rate for Payer: Aetna Commercial |
$576.55
|
| Rate for Payer: Aetna Medicare |
$176.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$211.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$211.97
|
| Rate for Payer: BCBS Complete |
$125.55
|
| Rate for Payer: BCBS MAPPO |
$169.57
|
| Rate for Payer: BCBS Trust/PPO |
$557.63
|
| Rate for Payer: BCN Commercial |
$557.63
|
| Rate for Payer: BCN Medicare Advantage |
$169.57
|
| Rate for Payer: Cash Price |
$542.64
|
| Rate for Payer: Cofinity Commercial |
$583.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$542.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.57
|
| Rate for Payer: Healthscope Commercial |
$610.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$508.73
|
| Rate for Payer: Mclaren Medicaid |
$119.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.05
|
| Rate for Payer: Meridian Medicaid |
$125.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$186.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$576.55
|
| Rate for Payer: Nomi Health Commercial |
$556.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$508.73
|
| Rate for Payer: PACE Senior Care Partners |
$161.10
|
| Rate for Payer: PACE SWMI |
$169.57
|
| Rate for Payer: PHP Commercial |
$576.55
|
| Rate for Payer: PHP Medicare Advantage |
$169.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$590.12
|
| Rate for Payer: Priority Health Medicare |
$171.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$472.10
|
| Rate for Payer: Railroad Medicare Medicare |
$169.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$596.90
|
| Rate for Payer: UHC Core |
$566.38
|
| Rate for Payer: UHC Exchange |
$169.57
|
| Rate for Payer: UHC Medicaid |
$119.58
|
| Rate for Payer: UHC Medicare Advantage |
$169.57
|
| Rate for Payer: UHCCP Medicaid |
$119.58
|
| Rate for Payer: VA VA |
$169.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$508.73
|
|
|
HC CLOSED TX FRACTURE WB ARTICLR PRTN DSTL TIBIA WO MANIP
|
Facility
|
IP
|
$678.30
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
76100525
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$472.10 |
| Max. Negotiated Rate |
$610.47 |
| Rate for Payer: Aetna Commercial |
$576.55
|
| Rate for Payer: BCBS Trust/PPO |
$560.21
|
| Rate for Payer: BCN Commercial |
$560.21
|
| Rate for Payer: Cash Price |
$542.64
|
| Rate for Payer: Cofinity Commercial |
$583.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$542.64
|
| Rate for Payer: Healthscope Commercial |
$610.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$508.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$576.55
|
| Rate for Payer: Nomi Health Commercial |
$556.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$508.73
|
| Rate for Payer: PHP Commercial |
$576.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$590.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$472.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$596.90
|
| Rate for Payer: UHC Core |
$566.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$508.73
|
|
|
HC CLOSED TX GREAT TOE FX W/O MANIPULATION
|
Facility
|
OP
|
$343.26
|
|
|
Service Code
|
CPT 28490
|
| Hospital Charge Code |
76100237
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$60.52 |
| Max. Negotiated Rate |
$308.93 |
| Rate for Payer: Aetna Commercial |
$291.77
|
| Rate for Payer: Aetna Medicare |
$89.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.27
|
| Rate for Payer: BCBS Complete |
$63.54
|
| Rate for Payer: BCBS MAPPO |
$85.81
|
| Rate for Payer: BCBS Trust/PPO |
$282.19
|
| Rate for Payer: BCN Commercial |
$282.19
|
| Rate for Payer: BCN Medicare Advantage |
$85.81
|
| Rate for Payer: Cash Price |
$274.61
|
| Rate for Payer: Cofinity Commercial |
$295.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.81
|
| Rate for Payer: Healthscope Commercial |
$308.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.44
|
| Rate for Payer: Mclaren Medicaid |
$60.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.11
|
| Rate for Payer: Meridian Medicaid |
$63.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$94.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.77
|
| Rate for Payer: Nomi Health Commercial |
$281.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.44
|
| Rate for Payer: PACE Senior Care Partners |
$81.52
|
| Rate for Payer: PACE SWMI |
$85.81
|
| Rate for Payer: PHP Commercial |
$291.77
|
| Rate for Payer: PHP Medicare Advantage |
$85.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$298.64
|
| Rate for Payer: Priority Health Medicare |
$86.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.91
|
| Rate for Payer: Railroad Medicare Medicare |
$85.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.07
|
| Rate for Payer: UHC Core |
$286.62
|
| Rate for Payer: UHC Exchange |
$85.81
|
| Rate for Payer: UHC Medicaid |
$60.52
|
| Rate for Payer: UHC Medicare Advantage |
$85.81
|
| Rate for Payer: UHCCP Medicaid |
$60.52
|
| Rate for Payer: VA VA |
$85.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.44
|
|
|
HC CLOSED TX GREAT TOE FX W/O MANIPULATION
|
Facility
|
IP
|
$343.26
|
|
|
Service Code
|
CPT 28490
|
| Hospital Charge Code |
76100237
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$238.91 |
| Max. Negotiated Rate |
$308.93 |
| Rate for Payer: Aetna Commercial |
$291.77
|
| Rate for Payer: BCBS Trust/PPO |
$283.50
|
| Rate for Payer: BCN Commercial |
$283.50
|
| Rate for Payer: Cash Price |
$274.61
|
| Rate for Payer: Cofinity Commercial |
$295.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.61
|
| Rate for Payer: Healthscope Commercial |
$308.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.77
|
| Rate for Payer: Nomi Health Commercial |
$281.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.44
|
| Rate for Payer: PHP Commercial |
$291.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$298.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.07
|
| Rate for Payer: UHC Core |
$286.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.44
|
|
|
HC CLOSED TX GR TROCHANTERIC FX W/O MANIP
|
Facility
|
IP
|
$343.26
|
|
|
Service Code
|
CPT 27246
|
| Hospital Charge Code |
76100262
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$238.91 |
| Max. Negotiated Rate |
$308.93 |
| Rate for Payer: Aetna Commercial |
$291.77
|
| Rate for Payer: BCBS Trust/PPO |
$283.50
|
| Rate for Payer: BCN Commercial |
$283.50
|
| Rate for Payer: Cash Price |
$274.61
|
| Rate for Payer: Cofinity Commercial |
$295.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.61
|
| Rate for Payer: Healthscope Commercial |
$308.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.77
|
| Rate for Payer: Nomi Health Commercial |
$281.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.44
|
| Rate for Payer: PHP Commercial |
$291.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$298.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.07
|
| Rate for Payer: UHC Core |
$286.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.44
|
|
