|
HC CLOSE RX PROX/MID FING SHFT FX
|
Facility
|
IP
|
$358.31
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
76100168
|
|
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 CLOSURE DEVICE
|
Facility
|
IP
|
$1,161.23
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27200012
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$808.22 |
| Max. Negotiated Rate |
$1,045.11 |
| Rate for Payer: Aetna Commercial |
$987.05
|
| Rate for Payer: BCBS Trust/PPO |
$959.06
|
| Rate for Payer: BCN Commercial |
$959.06
|
| Rate for Payer: Cash Price |
$928.98
|
| Rate for Payer: Cofinity Commercial |
$998.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.98
|
| Rate for Payer: Healthscope Commercial |
$1,045.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$870.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$987.05
|
| Rate for Payer: Nomi Health Commercial |
$952.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$870.92
|
| Rate for Payer: PHP Commercial |
$987.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,010.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$808.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,021.88
|
| Rate for Payer: UHC Core |
$969.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$870.92
|
|
|
HC CLOSURE DEVICE
|
Facility
|
OP
|
$1,161.23
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27200012
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$204.72 |
| Max. Negotiated Rate |
$1,045.11 |
| Rate for Payer: Aetna Commercial |
$987.05
|
| Rate for Payer: Aetna Medicare |
$301.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$362.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$362.88
|
| Rate for Payer: BCBS Complete |
$214.94
|
| Rate for Payer: BCBS MAPPO |
$290.31
|
| Rate for Payer: BCBS Trust/PPO |
$954.65
|
| Rate for Payer: BCN Commercial |
$954.65
|
| Rate for Payer: BCN Medicare Advantage |
$290.31
|
| Rate for Payer: Cash Price |
$928.98
|
| Rate for Payer: Cofinity Commercial |
$998.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$290.31
|
| Rate for Payer: Healthscope Commercial |
$1,045.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$870.92
|
| Rate for Payer: Mclaren Medicaid |
$204.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$304.82
|
| Rate for Payer: Meridian Medicaid |
$214.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$333.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$319.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$987.05
|
| Rate for Payer: Nomi Health Commercial |
$952.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$870.92
|
| Rate for Payer: PACE Senior Care Partners |
$275.79
|
| Rate for Payer: PACE SWMI |
$290.31
|
| Rate for Payer: PHP Commercial |
$987.05
|
| Rate for Payer: PHP Medicare Advantage |
$290.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,010.27
|
| Rate for Payer: Priority Health Medicare |
$293.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$808.22
|
| Rate for Payer: Railroad Medicare Medicare |
$290.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,021.88
|
| Rate for Payer: UHC Core |
$969.63
|
| Rate for Payer: UHC Exchange |
$290.31
|
| Rate for Payer: UHC Medicaid |
$204.72
|
| Rate for Payer: UHC Medicare Advantage |
$290.31
|
| Rate for Payer: UHCCP Medicaid |
$204.72
|
| Rate for Payer: VA VA |
$290.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$870.92
|
|
|
HC CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<
|
Facility
|
IP
|
$719.00
|
|
|
Service Code
|
CPT 40830
|
| Hospital Charge Code |
76100545
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$500.42 |
| Max. Negotiated Rate |
$647.10 |
| Rate for Payer: Aetna Commercial |
$611.15
|
| Rate for Payer: BCBS Trust/PPO |
$593.82
|
| Rate for Payer: BCN Commercial |
$593.82
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cofinity Commercial |
$618.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.20
|
| Rate for Payer: Healthscope Commercial |
$647.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$539.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.15
|
| Rate for Payer: Nomi Health Commercial |
$589.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.25
|
| Rate for Payer: PHP Commercial |
$611.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$625.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$500.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$632.72
|
| Rate for Payer: UHC Core |
$600.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$539.25
|
|
|
HC CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<
|
Facility
|
OP
|
$719.00
|
|
|
Service Code
|
CPT 40830
|
| Hospital Charge Code |
76100545
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$126.76 |
| Max. Negotiated Rate |
$647.10 |
| Rate for Payer: Aetna Commercial |
$611.15
|
| Rate for Payer: Aetna Medicare |
$186.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$224.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$224.69
|
| Rate for Payer: BCBS Complete |
$133.09
|
| Rate for Payer: BCBS MAPPO |
$179.75
|
| Rate for Payer: BCBS Trust/PPO |
$591.09
|
| Rate for Payer: BCN Commercial |
$591.09
|
| Rate for Payer: BCN Medicare Advantage |
$179.75
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cofinity Commercial |
$618.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.75
|
| Rate for Payer: Healthscope Commercial |
$647.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$539.25
|
| Rate for Payer: Mclaren Medicaid |
$126.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.74
|
| Rate for Payer: Meridian Medicaid |
$133.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$206.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$197.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.15
|
| Rate for Payer: Nomi Health Commercial |
$589.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.25
|
| Rate for Payer: PACE Senior Care Partners |
$170.76
|
| Rate for Payer: PACE SWMI |
$179.75
|
| Rate for Payer: PHP Commercial |
$611.15
|
| Rate for Payer: PHP Medicare Advantage |
$179.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$625.53
|
| Rate for Payer: Priority Health Medicare |
$181.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$500.42
|
| Rate for Payer: Railroad Medicare Medicare |
$179.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$632.72
|
| Rate for Payer: UHC Core |
$600.37
|
| Rate for Payer: UHC Exchange |
$179.75
|
| Rate for Payer: UHC Medicaid |
$126.76
|
| Rate for Payer: UHC Medicare Advantage |
$179.75
|
| Rate for Payer: UHCCP Medicaid |
$126.76
|
| Rate for Payer: VA VA |
$179.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$539.25
|
|
|
HC CLOZAPINE LEVEL
|
Facility
|
OP
|
$47.76
|
|
|
Service Code
|
CPT 80159
|
| Hospital Charge Code |
30100159
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.42 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: Aetna Medicare |
$12.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.93
|
| Rate for Payer: BCBS Complete |
$8.84
|
| Rate for Payer: BCBS MAPPO |
$11.94
|
| Rate for Payer: BCBS Trust/PPO |
$39.26
|
| Rate for Payer: BCN Commercial |
$39.26
|
| Rate for Payer: BCN Medicare Advantage |
$11.94
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.94
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Mclaren Medicaid |
$8.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.54
|
| Rate for Payer: Meridian Medicaid |
$8.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PACE Senior Care Partners |
$11.34
|
| Rate for Payer: PACE SWMI |
$11.94
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: PHP Medicare Advantage |
$11.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.55
|
| Rate for Payer: Priority Health Medicare |
$12.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.24
|
| Rate for Payer: Railroad Medicare Medicare |
$11.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.03
|
| Rate for Payer: UHC Core |
$39.88
|
| Rate for Payer: UHC Exchange |
$11.94
|
| Rate for Payer: UHC Medicaid |
$8.42
|
| Rate for Payer: UHC Medicare Advantage |
$11.94
|
| Rate for Payer: UHCCP Medicaid |
$8.42
|
| Rate for Payer: VA VA |
$11.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC CLOZAPINE LEVEL
|
Facility
|
IP
|
$47.76
|
|
|
Service Code
|
CPT 80159
|
| Hospital Charge Code |
30100159
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.24 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: BCBS Trust/PPO |
$39.44
|
| Rate for Payer: BCN Commercial |
$39.44
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.03
|
| Rate for Payer: UHC Core |
$39.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION
|
Facility
|
IP
|
$624.24
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
76100375
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$434.47 |
| Max. Negotiated Rate |
$561.82 |
| Rate for Payer: Aetna Commercial |
$530.60
|
| Rate for Payer: BCBS Trust/PPO |
$515.56
|
| Rate for Payer: BCN Commercial |
$515.56
|
| Rate for Payer: Cash Price |
$499.39
|
| Rate for Payer: Cofinity Commercial |
$536.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.39
|
| Rate for Payer: Healthscope Commercial |
$561.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.60
|
| Rate for Payer: Nomi Health Commercial |
$511.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.18
|
| Rate for Payer: PHP Commercial |
$530.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$543.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.33
|
| Rate for Payer: UHC Core |
$521.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.18
|
|
|
HC CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION
|
Facility
|
OP
|
$624.24
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
76100375
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$110.05 |
| Max. Negotiated Rate |
$561.82 |
| Rate for Payer: Aetna Commercial |
$530.60
|
| Rate for Payer: Aetna Medicare |
$162.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$195.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$195.07
|
| Rate for Payer: BCBS Complete |
$115.55
|
| Rate for Payer: BCBS MAPPO |
$156.06
|
| Rate for Payer: BCBS Trust/PPO |
$513.19
|
| Rate for Payer: BCN Commercial |
$513.19
|
| Rate for Payer: BCN Medicare Advantage |
$156.06
|
| Rate for Payer: Cash Price |
$499.39
|
| Rate for Payer: Cofinity Commercial |
$536.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.06
|
| Rate for Payer: Healthscope Commercial |
$561.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.18
|
| Rate for Payer: Mclaren Medicaid |
$110.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.86
|
| Rate for Payer: Meridian Medicaid |
$115.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$179.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$171.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.60
|
| Rate for Payer: Nomi Health Commercial |
$511.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.18
|
| Rate for Payer: PACE Senior Care Partners |
$148.26
|
| Rate for Payer: PACE SWMI |
$156.06
|
| Rate for Payer: PHP Commercial |
$530.60
|
| Rate for Payer: PHP Medicare Advantage |
$156.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$543.09
|
| Rate for Payer: Priority Health Medicare |
$157.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.47
|
| Rate for Payer: Railroad Medicare Medicare |
$156.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.33
|
| Rate for Payer: UHC Core |
$521.24
|
| Rate for Payer: UHC Exchange |
$156.06
|
| Rate for Payer: UHC Medicaid |
$110.05
|
| Rate for Payer: UHC Medicare Advantage |
$156.06
|
| Rate for Payer: UHCCP Medicaid |
$110.05
|
| Rate for Payer: VA VA |
$156.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.18
|
|
|
HC CLSD TX IP JT DISLOCATION W/MANIP W/O ANES
|
Facility
|
OP
|
$647.81
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
76100360
|
|
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 CLSD TX IP JT DISLOCATION W/MANIP W/O ANES
|
Facility
|
IP
|
$647.81
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
76100360
|
|
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 CLSD TX PELVIC RING FX W/O MANIPULATION
|
Facility
|
OP
|
$647.81
|
|
|
Service Code
|
CPT 27197
|
| Hospital Charge Code |
76100361
|
|
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 CLSD TX PELVIC RING FX W/O MANIPULATION
|
Facility
|
IP
|
$647.81
|
|
|
Service Code
|
CPT 27197
|
| Hospital Charge Code |
76100361
|
|
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 CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA
|
Facility
|
OP
|
$630.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
76100566
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$111.07 |
| Max. Negotiated Rate |
$567.00 |
| Rate for Payer: Aetna Commercial |
$535.50
|
| Rate for Payer: Aetna Medicare |
$163.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$196.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$196.88
|
| Rate for Payer: BCBS Complete |
$116.61
|
| Rate for Payer: BCBS MAPPO |
$157.50
|
| Rate for Payer: BCBS Trust/PPO |
$517.92
|
| Rate for Payer: BCN Commercial |
$517.92
|
| Rate for Payer: BCN Medicare Advantage |
$157.50
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Cofinity Commercial |
$541.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$504.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.50
|
| Rate for Payer: Healthscope Commercial |
$567.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$472.50
|
| Rate for Payer: Mclaren Medicaid |
$111.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.38
|
| Rate for Payer: Meridian Medicaid |
$116.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$181.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$173.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$535.50
|
| Rate for Payer: Nomi Health Commercial |
$516.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$472.50
|
| Rate for Payer: PACE Senior Care Partners |
$149.62
|
| Rate for Payer: PACE SWMI |
$157.50
|
| Rate for Payer: PHP Commercial |
$535.50
|
| Rate for Payer: PHP Medicare Advantage |
$157.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$111.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$548.10
|
| Rate for Payer: Priority Health Medicare |
$159.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$438.48
|
| Rate for Payer: Railroad Medicare Medicare |
$157.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$554.40
|
| Rate for Payer: UHC Core |
$526.05
|
| Rate for Payer: UHC Exchange |
$157.50
|
| Rate for Payer: UHC Medicaid |
$111.07
|
| Rate for Payer: UHC Medicare Advantage |
$157.50
|
| Rate for Payer: UHCCP Medicaid |
$111.07
|
| Rate for Payer: VA VA |
$157.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$472.50
|
|
|
HC CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA
|
Facility
|
IP
|
$630.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
76100566
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$438.48 |
| Max. Negotiated Rate |
$567.00 |
| Rate for Payer: Aetna Commercial |
$535.50
|
| Rate for Payer: BCBS Trust/PPO |
$520.32
|
| Rate for Payer: BCN Commercial |
$520.32
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Cofinity Commercial |
$541.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$504.00
|
| Rate for Payer: Healthscope Commercial |
$567.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$472.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$535.50
|
| Rate for Payer: Nomi Health Commercial |
$516.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$472.50
|
| Rate for Payer: PHP Commercial |
$535.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$548.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$438.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$554.40
|
| Rate for Payer: UHC Core |
$526.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$472.50
|
|
|
HC CL TX GREATER HUMERAL TUBEROSITY FX W/O MAN
|
Facility
|
OP
|
$335.08
|
|
|
Service Code
|
CPT 23620
|
| Hospital Charge Code |
76100325
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$59.07 |
| Max. Negotiated Rate |
$301.57 |
| Rate for Payer: Aetna Commercial |
$284.82
|
| Rate for Payer: Aetna Medicare |
$87.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$104.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$104.71
|
| Rate for Payer: BCBS Complete |
$62.02
|
| Rate for Payer: BCBS MAPPO |
$83.77
|
| Rate for Payer: BCBS Trust/PPO |
$275.47
|
| Rate for Payer: BCN Commercial |
$275.47
|
| Rate for Payer: BCN Medicare Advantage |
$83.77
|
| Rate for Payer: Cash Price |
$268.06
|
| Rate for Payer: Cofinity Commercial |
$288.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.77
|
| Rate for Payer: Healthscope Commercial |
$301.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$251.31
|
| Rate for Payer: Mclaren Medicaid |
$59.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.96
|
| Rate for Payer: Meridian Medicaid |
$62.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$96.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$92.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$284.82
|
| Rate for Payer: Nomi Health Commercial |
$274.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.31
|
| Rate for Payer: PACE Senior Care Partners |
$79.58
|
| Rate for Payer: PACE SWMI |
$83.77
|
| Rate for Payer: PHP Commercial |
$284.82
|
| Rate for Payer: PHP Medicare Advantage |
$83.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$291.52
|
| Rate for Payer: Priority Health Medicare |
$84.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$233.22
|
| Rate for Payer: Railroad Medicare Medicare |
$83.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$294.87
|
| Rate for Payer: UHC Core |
$279.79
|
| Rate for Payer: UHC Exchange |
$83.77
|
| Rate for Payer: UHC Medicaid |
$59.07
|
| Rate for Payer: UHC Medicare Advantage |
$83.77
|
| Rate for Payer: UHCCP Medicaid |
$59.07
|
| Rate for Payer: VA VA |
$83.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$251.31
|
|
|
HC CL TX GREATER HUMERAL TUBEROSITY FX W/O MAN
|
Facility
|
IP
|
$335.08
|
|
|
Service Code
|
CPT 23620
|
| Hospital Charge Code |
76100325
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$233.22 |
| Max. Negotiated Rate |
$301.57 |
| Rate for Payer: Aetna Commercial |
$284.82
|
| Rate for Payer: BCBS Trust/PPO |
$276.74
|
| Rate for Payer: BCN Commercial |
$276.74
|
| Rate for Payer: Cash Price |
$268.06
|
| Rate for Payer: Cofinity Commercial |
$288.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.06
|
| Rate for Payer: Healthscope Commercial |
$301.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$251.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$284.82
|
| Rate for Payer: Nomi Health Commercial |
$274.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.31
|
| Rate for Payer: PHP Commercial |
$284.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$291.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$233.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$294.87
|
| Rate for Payer: UHC Core |
$279.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$251.31
|
|
|
HC CL TX INTERCONDYL SPI&/TUBRST FX KNE W/WO MAN
|
Facility
|
IP
|
$624.24
|
|
|
Service Code
|
CPT 27538
|
| Hospital Charge Code |
76100374
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$434.47 |
| Max. Negotiated Rate |
$561.82 |
| Rate for Payer: Aetna Commercial |
$530.60
|
| Rate for Payer: BCBS Trust/PPO |
$515.56
|
| Rate for Payer: BCN Commercial |
$515.56
|
| Rate for Payer: Cash Price |
$499.39
|
| Rate for Payer: Cofinity Commercial |
$536.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.39
|
| Rate for Payer: Healthscope Commercial |
$561.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.60
|
| Rate for Payer: Nomi Health Commercial |
$511.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.18
|
| Rate for Payer: PHP Commercial |
$530.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$543.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.33
|
| Rate for Payer: UHC Core |
$521.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.18
|
|
|
HC CL TX INTERCONDYL SPI&/TUBRST FX KNE W/WO MAN
|
Facility
|
OP
|
$624.24
|
|
|
Service Code
|
CPT 27538
|
| Hospital Charge Code |
76100374
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$110.05 |
| Max. Negotiated Rate |
$561.82 |
| Rate for Payer: Aetna Commercial |
$530.60
|
| Rate for Payer: Aetna Medicare |
$162.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$195.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$195.07
|
| Rate for Payer: BCBS Complete |
$115.55
|
| Rate for Payer: BCBS MAPPO |
$156.06
|
| Rate for Payer: BCBS Trust/PPO |
$513.19
|
| Rate for Payer: BCN Commercial |
$513.19
|
| Rate for Payer: BCN Medicare Advantage |
$156.06
|
| Rate for Payer: Cash Price |
$499.39
|
| Rate for Payer: Cofinity Commercial |
$536.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.06
|
| Rate for Payer: Healthscope Commercial |
$561.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.18
|
| Rate for Payer: Mclaren Medicaid |
$110.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.86
|
| Rate for Payer: Meridian Medicaid |
$115.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$179.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$171.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.60
|
| Rate for Payer: Nomi Health Commercial |
$511.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.18
|
| Rate for Payer: PACE Senior Care Partners |
$148.26
|
| Rate for Payer: PACE SWMI |
$156.06
|
| Rate for Payer: PHP Commercial |
$530.60
|
| Rate for Payer: PHP Medicare Advantage |
$156.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$543.09
|
| Rate for Payer: Priority Health Medicare |
$157.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.47
|
| Rate for Payer: Railroad Medicare Medicare |
$156.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.33
|
| Rate for Payer: UHC Core |
$521.24
|
| Rate for Payer: UHC Exchange |
$156.06
|
| Rate for Payer: UHC Medicaid |
$110.05
|
| Rate for Payer: UHC Medicare Advantage |
$156.06
|
| Rate for Payer: UHCCP Medicaid |
$110.05
|
| Rate for Payer: VA VA |
$156.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.18
|
|
|
HC CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES
|
Facility
|
IP
|
$715.00
|
|
|
Service Code
|
CPT 28660
|
| Hospital Charge Code |
76100551
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$497.64 |
| Max. Negotiated Rate |
$643.50 |
| Rate for Payer: Aetna Commercial |
$607.75
|
| Rate for Payer: BCBS Trust/PPO |
$590.52
|
| Rate for Payer: BCN Commercial |
$590.52
|
| Rate for Payer: Cash Price |
$572.00
|
| Rate for Payer: Cofinity Commercial |
$614.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$572.00
|
| Rate for Payer: Healthscope Commercial |
$643.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$536.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$607.75
|
| Rate for Payer: Nomi Health Commercial |
$586.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$536.25
|
| Rate for Payer: PHP Commercial |
$607.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$622.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$497.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$629.20
|
| Rate for Payer: UHC Core |
$597.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$536.25
|
|
|
HC CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES
|
Facility
|
OP
|
$715.00
|
|
|
Service Code
|
CPT 28660
|
| Hospital Charge Code |
76100551
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$126.05 |
| Max. Negotiated Rate |
$643.50 |
| Rate for Payer: Aetna Commercial |
$607.75
|
| Rate for Payer: Aetna Medicare |
$185.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$223.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$223.44
|
| Rate for Payer: BCBS Complete |
$132.35
|
| Rate for Payer: BCBS MAPPO |
$178.75
|
| Rate for Payer: BCBS Trust/PPO |
$587.80
|
| Rate for Payer: BCN Commercial |
$587.80
|
| Rate for Payer: BCN Medicare Advantage |
$178.75
|
| Rate for Payer: Cash Price |
$572.00
|
| Rate for Payer: Cofinity Commercial |
$614.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$572.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.75
|
| Rate for Payer: Healthscope Commercial |
$643.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$536.25
|
| Rate for Payer: Mclaren Medicaid |
$126.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$187.69
|
| Rate for Payer: Meridian Medicaid |
$132.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$205.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$196.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$607.75
|
| Rate for Payer: Nomi Health Commercial |
$586.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$536.25
|
| Rate for Payer: PACE Senior Care Partners |
$169.81
|
| Rate for Payer: PACE SWMI |
$178.75
|
| Rate for Payer: PHP Commercial |
$607.75
|
| Rate for Payer: PHP Medicare Advantage |
$178.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$622.05
|
| Rate for Payer: Priority Health Medicare |
$180.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$497.64
|
| Rate for Payer: Railroad Medicare Medicare |
$178.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$629.20
|
| Rate for Payer: UHC Core |
$597.02
|
| Rate for Payer: UHC Exchange |
$178.75
|
| Rate for Payer: UHC Medicaid |
$126.05
|
| Rate for Payer: UHC Medicare Advantage |
$178.75
|
| Rate for Payer: UHCCP Medicaid |
$126.05
|
| Rate for Payer: VA VA |
$178.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$536.25
|
|
|
HC CL TX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES
|
Facility
|
OP
|
$678.30
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
76100520
|
|
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 CL TX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES
|
Facility
|
IP
|
$678.30
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
76100520
|
|
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 CMS CLINIC SUPPORT
|
Facility
|
IP
|
$141.03
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51000056
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$98.16 |
| Max. Negotiated Rate |
$126.93 |
| Rate for Payer: Aetna Commercial |
$119.88
|
| Rate for Payer: BCBS Trust/PPO |
$116.48
|
| Rate for Payer: BCN Commercial |
$116.48
|
| Rate for Payer: Cash Price |
$112.82
|
| Rate for Payer: Cofinity Commercial |
$121.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.82
|
| Rate for Payer: Healthscope Commercial |
$126.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.88
|
| Rate for Payer: Nomi Health Commercial |
$115.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.77
|
| Rate for Payer: PHP Commercial |
$119.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$122.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$98.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.11
|
| Rate for Payer: UHC Core |
$117.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.77
|
|
|
HC CMS CLINIC SUPPORT
|
Facility
|
OP
|
$141.03
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51000056
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$24.86 |
| Max. Negotiated Rate |
$126.93 |
| Rate for Payer: Aetna Commercial |
$119.88
|
| Rate for Payer: Aetna Medicare |
$36.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.07
|
| Rate for Payer: BCBS Complete |
$26.10
|
| Rate for Payer: BCBS MAPPO |
$35.26
|
| Rate for Payer: BCBS Trust/PPO |
$115.94
|
| Rate for Payer: BCCCP Commercial |
$87.68
|
| Rate for Payer: BCN Commercial |
$115.94
|
| Rate for Payer: BCN Medicare Advantage |
$35.26
|
| Rate for Payer: Cash Price |
$112.82
|
| Rate for Payer: Cash Price |
$112.82
|
| Rate for Payer: Cofinity Commercial |
$121.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.26
|
| Rate for Payer: Healthscope Commercial |
$126.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.77
|
| Rate for Payer: Mclaren Medicaid |
$24.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.02
|
| Rate for Payer: Meridian Medicaid |
$26.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.88
|
| Rate for Payer: Nomi Health Commercial |
$115.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.77
|
| Rate for Payer: PACE Senior Care Partners |
$33.49
|
| Rate for Payer: PACE SWMI |
$35.26
|
| Rate for Payer: PHP Commercial |
$119.88
|
| Rate for Payer: PHP Medicare Advantage |
$35.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$122.70
|
| Rate for Payer: Priority Health Medicare |
$35.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$98.16
|
| Rate for Payer: Railroad Medicare Medicare |
$35.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.11
|
| Rate for Payer: UHC Core |
$117.76
|
| Rate for Payer: UHC Exchange |
$35.26
|
| Rate for Payer: UHC Medicaid |
$24.86
|
| Rate for Payer: UHC Medicare Advantage |
$35.26
|
| Rate for Payer: UHCCP Medicaid |
$24.86
|
| Rate for Payer: VA VA |
$35.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.77
|
|
