|
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
|
|
|
HC CLOSED TX HUMERAL CONDYLAR FX, MED/LAT, W/O MANIP
|
Facility
|
IP
|
$343.26
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
76100260
|
|
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 HUMERAL CONDYLAR FX, MED/LAT, W/O MANIP
|
Facility
|
OP
|
$343.26
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
76100260
|
|
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 HUMERAL EPICONDYLAR FX MEDIAL/LATERAL W/O MANIP
|
Facility
|
OP
|
$343.26
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
76100241
|
|
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 HUMERAL EPICONDYLAR FX MEDIAL/LATERAL W/O MANIP
|
Facility
|
IP
|
$343.26
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
76100241
|
|
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 INTERPHALANGEAL JT DISLOC W MANIP REQUIRE ANESTH
|
Facility
|
IP
|
$775.20
|
|
|
Service Code
|
CPT 26775
|
| Hospital Charge Code |
76100524
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$539.54 |
| Max. Negotiated Rate |
$697.68 |
| Rate for Payer: Aetna Commercial |
$658.92
|
| Rate for Payer: BCBS Trust/PPO |
$640.24
|
| Rate for Payer: BCN Commercial |
$640.24
|
| Rate for Payer: Cash Price |
$620.16
|
| Rate for Payer: Cofinity Commercial |
$666.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$620.16
|
| Rate for Payer: Healthscope Commercial |
$697.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$581.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$658.92
|
| Rate for Payer: Nomi Health Commercial |
$635.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$581.40
|
| Rate for Payer: PHP Commercial |
$658.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$674.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$539.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$682.18
|
| Rate for Payer: UHC Core |
$647.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$581.40
|
|
|
HC CLOSED TX INTERPHALANGEAL JT DISLOC W MANIP REQUIRE ANESTH
|
Facility
|
OP
|
$775.20
|
|
|
Service Code
|
CPT 26775
|
| Hospital Charge Code |
76100524
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$136.67 |
| Max. Negotiated Rate |
$697.68 |
| Rate for Payer: Aetna Commercial |
$658.92
|
| Rate for Payer: Aetna Medicare |
$201.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.25
|
| Rate for Payer: BCBS Complete |
$143.49
|
| Rate for Payer: BCBS MAPPO |
$193.80
|
| Rate for Payer: BCBS Trust/PPO |
$637.29
|
| Rate for Payer: BCN Commercial |
$637.29
|
| Rate for Payer: BCN Medicare Advantage |
$193.80
|
| Rate for Payer: Cash Price |
$620.16
|
| Rate for Payer: Cofinity Commercial |
$666.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$620.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.80
|
| Rate for Payer: Healthscope Commercial |
$697.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$581.40
|
| Rate for Payer: Mclaren Medicaid |
$136.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.49
|
| Rate for Payer: Meridian Medicaid |
$143.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$213.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$658.92
|
| Rate for Payer: Nomi Health Commercial |
$635.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$581.40
|
| Rate for Payer: PACE Senior Care Partners |
$184.11
|
| Rate for Payer: PACE SWMI |
$193.80
|
| Rate for Payer: PHP Commercial |
$658.92
|
| Rate for Payer: PHP Medicare Advantage |
$193.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$674.42
|
| Rate for Payer: Priority Health Medicare |
$195.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$539.54
|
| Rate for Payer: Railroad Medicare Medicare |
$193.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$682.18
|
| Rate for Payer: UHC Core |
$647.29
|
| Rate for Payer: UHC Exchange |
$193.80
|
| Rate for Payer: UHC Medicaid |
$136.67
|
| Rate for Payer: UHC Medicare Advantage |
$193.80
|
| Rate for Payer: UHCCP Medicaid |
$136.67
|
| Rate for Payer: VA VA |
$193.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$581.40
|
|
|
HC CLOSED TX MED MALLEOLUS FX W/O MANIP
|
Facility
|
IP
|
$343.26
|
|
|
Service Code
|
CPT 27760
|
| Hospital Charge Code |
76100234
|
|
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 MED MALLEOLUS FX W/O MANIP
|
Facility
|
OP
|
$343.26
|
|
|
Service Code
|
CPT 27760
|
| Hospital Charge Code |
76100234
|
|
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 NASAL BONE FX W/MNPJ W/O STABILIZ
|
Facility
|
IP
|
$3,069.18
|
|
|
Service Code
|
CPT 21315
|
| Hospital Charge Code |
76100447
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,136.15 |
| Max. Negotiated Rate |
$2,762.26 |
| Rate for Payer: Aetna Commercial |
$2,608.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,534.84
|
| Rate for Payer: BCN Commercial |
$2,534.84
|
| Rate for Payer: Cash Price |
$2,455.34
|
| Rate for Payer: Cofinity Commercial |
$2,639.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,455.34
|
| Rate for Payer: Healthscope Commercial |
$2,762.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,301.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,608.80
|
| Rate for Payer: Nomi Health Commercial |
$2,516.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,301.89
|
| Rate for Payer: PHP Commercial |
$2,608.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,670.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,136.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,700.88
|
| Rate for Payer: UHC Core |
$2,562.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,301.89
|
|
|
HC CLOSED TX NASAL BONE FX W/MNPJ W/O STABILIZ
|
Facility
|
OP
|
$3,069.18
|
|
|
Service Code
|
CPT 21315
|
| Hospital Charge Code |
76100447
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$541.10 |
| Max. Negotiated Rate |
$2,762.26 |
| Rate for Payer: Aetna Commercial |
$2,608.80
|
| Rate for Payer: Aetna Medicare |
$797.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$959.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$959.12
|
| Rate for Payer: BCBS Complete |
$568.11
|
| Rate for Payer: BCBS MAPPO |
$767.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,523.17
|
| Rate for Payer: BCN Commercial |
$2,523.17
|
| Rate for Payer: BCN Medicare Advantage |
$767.29
|
| Rate for Payer: Cash Price |
$2,455.34
|
| Rate for Payer: Cofinity Commercial |
$2,639.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,455.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$767.29
|
| Rate for Payer: Healthscope Commercial |
$2,762.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,301.89
|
| Rate for Payer: Mclaren Medicaid |
$541.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$805.66
|
| Rate for Payer: Meridian Medicaid |
$568.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$882.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$844.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,608.80
|
| Rate for Payer: Nomi Health Commercial |
$2,516.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,301.89
|
| Rate for Payer: PACE Senior Care Partners |
$728.93
|
| Rate for Payer: PACE SWMI |
$767.29
|
| Rate for Payer: PHP Commercial |
$2,608.80
|
| Rate for Payer: PHP Medicare Advantage |
$767.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$541.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,670.19
|
| Rate for Payer: Priority Health Medicare |
$774.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,136.15
|
| Rate for Payer: Railroad Medicare Medicare |
$767.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,700.88
|
| Rate for Payer: UHC Core |
$2,562.77
|
| Rate for Payer: UHC Exchange |
$767.29
|
| Rate for Payer: UHC Medicaid |
$541.10
|
| Rate for Payer: UHC Medicare Advantage |
$767.29
|
| Rate for Payer: UHCCP Medicaid |
$541.10
|
| Rate for Payer: VA VA |
$767.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,301.89
|
|
|
HC CLOSED TX POST MALLEOLUS FX W/O MANIP
|
Facility
|
IP
|
$328.23
|
|
|
Service Code
|
CPT 27767
|
| Hospital Charge Code |
76100302
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$228.45 |
| Max. Negotiated Rate |
$295.41 |
| Rate for Payer: Aetna Commercial |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$271.09
|
| Rate for Payer: BCN Commercial |
$271.09
|
| Rate for Payer: Cash Price |
$262.58
|
| Rate for Payer: Cofinity Commercial |
$282.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.58
|
| Rate for Payer: Healthscope Commercial |
$295.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.00
|
| Rate for Payer: Nomi Health Commercial |
$269.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$246.17
|
| Rate for Payer: PHP Commercial |
$279.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$285.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.84
|
| Rate for Payer: UHC Core |
$274.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.17
|
|
|
HC CLOSED TX POST MALLEOLUS FX W/O MANIP
|
Facility
|
OP
|
$328.23
|
|
|
Service Code
|
CPT 27767
|
| Hospital Charge Code |
76100302
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$57.87 |
| Max. Negotiated Rate |
$295.41 |
| Rate for Payer: Aetna Commercial |
$279.00
|
| Rate for Payer: Aetna Medicare |
$85.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$102.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$102.57
|
| Rate for Payer: BCBS Complete |
$60.76
|
| Rate for Payer: BCBS MAPPO |
$82.06
|
| Rate for Payer: BCBS Trust/PPO |
$269.84
|
| Rate for Payer: BCN Commercial |
$269.84
|
| Rate for Payer: BCN Medicare Advantage |
$82.06
|
| Rate for Payer: Cash Price |
$262.58
|
| Rate for Payer: Cofinity Commercial |
$282.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.06
|
| Rate for Payer: Healthscope Commercial |
$295.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.17
|
| Rate for Payer: Mclaren Medicaid |
$57.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.16
|
| Rate for Payer: Meridian Medicaid |
$60.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$90.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.00
|
| Rate for Payer: Nomi Health Commercial |
$269.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$246.17
|
| Rate for Payer: PACE Senior Care Partners |
$77.95
|
| Rate for Payer: PACE SWMI |
$82.06
|
| Rate for Payer: PHP Commercial |
$279.00
|
| Rate for Payer: PHP Medicare Advantage |
$82.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$285.56
|
| Rate for Payer: Priority Health Medicare |
$82.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.45
|
| Rate for Payer: Railroad Medicare Medicare |
$82.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.84
|
| Rate for Payer: UHC Core |
$274.07
|
| Rate for Payer: UHC Exchange |
$82.06
|
| Rate for Payer: UHC Medicaid |
$57.87
|
| Rate for Payer: UHC Medicare Advantage |
$82.06
|
| Rate for Payer: UHCCP Medicaid |
$57.87
|
| Rate for Payer: VA VA |
$82.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.17
|
|
|
HC CLOSED TX PROX FIBULA/SHFT FX W/O MANJ
|
Facility
|
OP
|
$647.81
|
|
|
Service Code
|
CPT 27780
|
| Hospital Charge Code |
76100351
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.21 |
| Max. Negotiated Rate |
$583.03 |
| Rate for Payer: Aetna Commercial |
$550.64
|
| Rate for Payer: Aetna Medicare |
$168.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$202.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$202.44
|
| Rate for Payer: BCBS Complete |
$119.91
|
| Rate for Payer: BCBS MAPPO |
$161.95
|
| Rate for Payer: BCBS Trust/PPO |
$532.56
|
| Rate for Payer: BCN Commercial |
$532.56
|
| Rate for Payer: BCN Medicare Advantage |
$161.95
|
| Rate for Payer: Cash Price |
$518.25
|
| Rate for Payer: Cofinity Commercial |
$557.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$518.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.95
|
| Rate for Payer: Healthscope Commercial |
$583.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$485.86
|
| Rate for Payer: Mclaren Medicaid |
$114.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.05
|
| Rate for Payer: Meridian Medicaid |
$119.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$178.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$550.64
|
| Rate for Payer: Nomi Health Commercial |
$531.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$485.86
|
| Rate for Payer: PACE Senior Care Partners |
$153.85
|
| Rate for Payer: PACE SWMI |
$161.95
|
| Rate for Payer: PHP Commercial |
$550.64
|
| Rate for Payer: PHP Medicare Advantage |
$161.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$563.59
|
| Rate for Payer: Priority Health Medicare |
$163.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$450.88
|
| Rate for Payer: Railroad Medicare Medicare |
$161.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$570.07
|
| Rate for Payer: UHC Core |
$540.92
|
| Rate for Payer: UHC Exchange |
$161.95
|
| Rate for Payer: UHC Medicaid |
$114.21
|
| Rate for Payer: UHC Medicare Advantage |
$161.95
|
| Rate for Payer: UHCCP Medicaid |
$114.21
|
| Rate for Payer: VA VA |
$161.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$485.86
|
|
|
HC CLOSED TX PROX FIBULA/SHFT FX W/O MANJ
|
Facility
|
IP
|
$647.81
|
|
|
Service Code
|
CPT 27780
|
| Hospital Charge Code |
76100351
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$450.88 |
| Max. Negotiated Rate |
$583.03 |
| Rate for Payer: Aetna Commercial |
$550.64
|
| Rate for Payer: BCBS Trust/PPO |
$535.03
|
| Rate for Payer: BCN Commercial |
$535.03
|
| Rate for Payer: Cash Price |
$518.25
|
| Rate for Payer: Cofinity Commercial |
$557.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$518.25
|
| Rate for Payer: Healthscope Commercial |
$583.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$485.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$550.64
|
| Rate for Payer: Nomi Health Commercial |
$531.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$485.86
|
| Rate for Payer: PHP Commercial |
$550.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$563.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$450.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$570.07
|
| Rate for Payer: UHC Core |
$540.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$485.86
|
|
|
HC CLOSED TX PROX/MID PHALANX FX W/MANIP
|
Facility
|
IP
|
$343.26
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
76100232
|
|
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 PROX/MID PHALANX FX W/MANIP
|
Facility
|
OP
|
$343.26
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
76100232
|
|
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 RADIAL SHAFT FRACTURE W/O MANIP
|
Facility
|
IP
|
$647.81
|
|
|
Service Code
|
CPT 25500
|
| Hospital Charge Code |
76100352
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$450.88 |
| Max. Negotiated Rate |
$583.03 |
| Rate for Payer: Aetna Commercial |
$550.64
|
| Rate for Payer: BCBS Trust/PPO |
$535.03
|
| Rate for Payer: BCN Commercial |
$535.03
|
| Rate for Payer: Cash Price |
$518.25
|
| Rate for Payer: Cofinity Commercial |
$557.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$518.25
|
| Rate for Payer: Healthscope Commercial |
$583.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$485.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$550.64
|
| Rate for Payer: Nomi Health Commercial |
$531.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$485.86
|
| Rate for Payer: PHP Commercial |
$550.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$563.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$450.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$570.07
|
| Rate for Payer: UHC Core |
$540.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$485.86
|
|
|
HC CLOSED TX RADIAL SHAFT FRACTURE W/O MANIP
|
Facility
|
OP
|
$647.81
|
|
|
Service Code
|
CPT 25500
|
| Hospital Charge Code |
76100352
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.21 |
| Max. Negotiated Rate |
$583.03 |
| Rate for Payer: Aetna Commercial |
$550.64
|
| Rate for Payer: Aetna Medicare |
$168.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$202.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$202.44
|
| Rate for Payer: BCBS Complete |
$119.91
|
| Rate for Payer: BCBS MAPPO |
$161.95
|
| Rate for Payer: BCBS Trust/PPO |
$532.56
|
| Rate for Payer: BCN Commercial |
$532.56
|
| Rate for Payer: BCN Medicare Advantage |
$161.95
|
| Rate for Payer: Cash Price |
$518.25
|
| Rate for Payer: Cofinity Commercial |
$557.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$518.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.95
|
| Rate for Payer: Healthscope Commercial |
$583.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$485.86
|
| Rate for Payer: Mclaren Medicaid |
$114.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.05
|
| Rate for Payer: Meridian Medicaid |
$119.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$178.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$550.64
|
| Rate for Payer: Nomi Health Commercial |
$531.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$485.86
|
| Rate for Payer: PACE Senior Care Partners |
$153.85
|
| Rate for Payer: PACE SWMI |
$161.95
|
| Rate for Payer: PHP Commercial |
$550.64
|
| Rate for Payer: PHP Medicare Advantage |
$161.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$563.59
|
| Rate for Payer: Priority Health Medicare |
$163.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$450.88
|
| Rate for Payer: Railroad Medicare Medicare |
$161.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$570.07
|
| Rate for Payer: UHC Core |
$540.92
|
| Rate for Payer: UHC Exchange |
$161.95
|
| Rate for Payer: UHC Medicaid |
$114.21
|
| Rate for Payer: UHC Medicare Advantage |
$161.95
|
| Rate for Payer: UHCCP Medicaid |
$114.21
|
| Rate for Payer: VA VA |
$161.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$485.86
|
|
|
HC CLOSED TX SCAPULAR FX, W/O MANIP
|
Facility
|
OP
|
$343.26
|
|
|
Service Code
|
CPT 23570
|
| Hospital Charge Code |
76100273
|
|
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 SCAPULAR FX, W/O MANIP
|
Facility
|
IP
|
$343.26
|
|
|
Service Code
|
CPT 23570
|
| Hospital Charge Code |
76100273
|
|
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 SESAMOID FX
|
Facility
|
IP
|
$328.23
|
|
|
Service Code
|
CPT 28530
|
| Hospital Charge Code |
76100322
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$228.45 |
| Max. Negotiated Rate |
$295.41 |
| Rate for Payer: Aetna Commercial |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$271.09
|
| Rate for Payer: BCN Commercial |
$271.09
|
| Rate for Payer: Cash Price |
$262.58
|
| Rate for Payer: Cofinity Commercial |
$282.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.58
|
| Rate for Payer: Healthscope Commercial |
$295.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.00
|
| Rate for Payer: Nomi Health Commercial |
$269.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$246.17
|
| Rate for Payer: PHP Commercial |
$279.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$285.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.84
|
| Rate for Payer: UHC Core |
$274.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.17
|
|
|
HC CLOSED TX SESAMOID FX
|
Facility
|
OP
|
$328.23
|
|
|
Service Code
|
CPT 28530
|
| Hospital Charge Code |
76100322
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$57.87 |
| Max. Negotiated Rate |
$295.41 |
| Rate for Payer: Aetna Commercial |
$279.00
|
| Rate for Payer: Aetna Medicare |
$85.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$102.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$102.57
|
| Rate for Payer: BCBS Complete |
$60.76
|
| Rate for Payer: BCBS MAPPO |
$82.06
|
| Rate for Payer: BCBS Trust/PPO |
$269.84
|
| Rate for Payer: BCN Commercial |
$269.84
|
| Rate for Payer: BCN Medicare Advantage |
$82.06
|
| Rate for Payer: Cash Price |
$262.58
|
| Rate for Payer: Cofinity Commercial |
$282.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.06
|
| Rate for Payer: Healthscope Commercial |
$295.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.17
|
| Rate for Payer: Mclaren Medicaid |
$57.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.16
|
| Rate for Payer: Meridian Medicaid |
$60.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$90.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.00
|
| Rate for Payer: Nomi Health Commercial |
$269.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$246.17
|
| Rate for Payer: PACE Senior Care Partners |
$77.95
|
| Rate for Payer: PACE SWMI |
$82.06
|
| Rate for Payer: PHP Commercial |
$279.00
|
| Rate for Payer: PHP Medicare Advantage |
$82.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$285.56
|
| Rate for Payer: Priority Health Medicare |
$82.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.45
|
| Rate for Payer: Railroad Medicare Medicare |
$82.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.84
|
| Rate for Payer: UHC Core |
$274.07
|
| Rate for Payer: UHC Exchange |
$82.06
|
| Rate for Payer: UHC Medicaid |
$57.87
|
| Rate for Payer: UHC Medicare Advantage |
$82.06
|
| Rate for Payer: UHCCP Medicaid |
$57.87
|
| Rate for Payer: VA VA |
$82.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.17
|
|
|
HC CLOSED TX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/O MANIP
|
Facility
|
IP
|
$372.48
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
76100301
|
|
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 SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/O MANIP
|
Facility
|
OP
|
$372.48
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
76100301
|
|
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
|
|
