|
HC CAROTENE
|
Facility
|
OP
|
$150.96
|
|
|
Service Code
|
CPT 82380
|
| Hospital Charge Code |
30100137
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.67 |
| Max. Negotiated Rate |
$135.86 |
| Rate for Payer: Aetna Commercial |
$128.32
|
| Rate for Payer: Aetna Medicare |
$39.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.18
|
| Rate for Payer: BCBS Complete |
$7.00
|
| Rate for Payer: BCBS MAPPO |
$37.74
|
| Rate for Payer: BCBS Trust/PPO |
$124.10
|
| Rate for Payer: BCN Commercial |
$117.37
|
| Rate for Payer: BCN Medicare Advantage |
$37.74
|
| Rate for Payer: Cash Price |
$120.77
|
| Rate for Payer: Cash Price |
$120.77
|
| Rate for Payer: Cofinity Commercial |
$129.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.74
|
| Rate for Payer: Healthscope Commercial |
$135.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.22
|
| Rate for Payer: Mclaren Medicaid |
$6.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.63
|
| Rate for Payer: Meridian Medicaid |
$7.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.32
|
| Rate for Payer: Nomi Health Commercial |
$123.79
|
| Rate for Payer: PACE Senior Care Partners |
$35.85
|
| Rate for Payer: PACE SWMI |
$37.74
|
| Rate for Payer: PHP Commercial |
$128.32
|
| Rate for Payer: PHP Medicare Advantage |
$37.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.12
|
| Rate for Payer: Priority Health HMO/PPO |
$131.34
|
| Rate for Payer: Priority Health Medicare |
$38.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.14
|
| Rate for Payer: Railroad Medicare Medicare |
$37.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.84
|
| Rate for Payer: UHC Core |
$126.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.74
|
| Rate for Payer: UHC Exchange |
$37.74
|
| Rate for Payer: UHC Medicare Advantage |
$37.74
|
| Rate for Payer: UHCCP Medicaid |
$6.67
|
| Rate for Payer: VA VA |
$37.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.22
|
|
|
HC CAROTID/VERTEBRAL LIMITED
|
Facility
|
OP
|
$726.53
|
|
|
Service Code
|
CPT 93882
|
| Hospital Charge Code |
40200054
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$653.88 |
| Rate for Payer: Aetna Commercial |
$617.55
|
| Rate for Payer: Aetna Medicare |
$188.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$227.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$227.04
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$181.63
|
| Rate for Payer: BCBS Trust/PPO |
$597.28
|
| Rate for Payer: BCN Commercial |
$564.88
|
| Rate for Payer: BCN Medicare Advantage |
$181.63
|
| Rate for Payer: Cash Price |
$581.22
|
| Rate for Payer: Cash Price |
$581.22
|
| Rate for Payer: Cofinity Commercial |
$624.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$581.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.63
|
| Rate for Payer: Healthscope Commercial |
$653.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$544.90
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$190.71
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$208.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$617.55
|
| Rate for Payer: Nomi Health Commercial |
$595.75
|
| Rate for Payer: PACE Senior Care Partners |
$172.55
|
| Rate for Payer: PACE SWMI |
$181.63
|
| Rate for Payer: PHP Commercial |
$617.55
|
| Rate for Payer: PHP Medicare Advantage |
$181.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$472.24
|
| Rate for Payer: Priority Health HMO/PPO |
$632.08
|
| Rate for Payer: Priority Health Medicare |
$183.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$486.78
|
| Rate for Payer: Railroad Medicare Medicare |
$181.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$639.35
|
| Rate for Payer: UHC Core |
$606.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$181.63
|
| Rate for Payer: UHC Exchange |
$181.63
|
| Rate for Payer: UHC Medicare Advantage |
$181.63
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$181.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$544.90
|
|
|
HC CAROTID/VERTEBRAL LIMITED
|
Facility
|
IP
|
$726.53
|
|
|
Service Code
|
CPT 93882
|
| Hospital Charge Code |
40200054
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$472.24 |
| Max. Negotiated Rate |
$653.88 |
| Rate for Payer: Aetna Commercial |
$617.55
|
| Rate for Payer: BCBS Trust/PPO |
$593.07
|
| Rate for Payer: BCN Commercial |
$561.46
|
| Rate for Payer: Cash Price |
$581.22
|
| Rate for Payer: Cofinity Commercial |
$624.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$581.22
|
| Rate for Payer: Healthscope Commercial |
$653.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$544.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$617.55
|
| Rate for Payer: Nomi Health Commercial |
$595.75
|
| Rate for Payer: PHP Commercial |
$617.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$472.24
|
| Rate for Payer: Priority Health HMO/PPO |
$632.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$486.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$639.35
|
| Rate for Payer: UHC Core |
$606.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$544.90
|
|
|
HC CAROTID/VERTEBRAL ULTRASOUND
|
Facility
|
OP
|
$1,382.09
|
|
|
Service Code
|
CPT 93880
|
| Hospital Charge Code |
92100001
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,243.88 |
| Rate for Payer: Aetna Commercial |
$1,174.78
|
| Rate for Payer: Aetna Medicare |
$359.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$431.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$431.90
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$345.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,136.22
|
| Rate for Payer: BCN Commercial |
$1,074.57
|
| Rate for Payer: BCN Medicare Advantage |
$345.52
|
| Rate for Payer: Cash Price |
$1,105.67
|
| Rate for Payer: Cash Price |
$1,105.67
|
| Rate for Payer: Cofinity Commercial |
$1,188.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,105.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$345.52
|
| Rate for Payer: Healthscope Commercial |
$1,243.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,036.57
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$362.80
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$397.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,174.78
|
| Rate for Payer: Nomi Health Commercial |
$1,133.31
|
| Rate for Payer: PACE Senior Care Partners |
$328.25
|
| Rate for Payer: PACE SWMI |
$345.52
|
| Rate for Payer: PHP Commercial |
$1,174.78
|
| Rate for Payer: PHP Medicare Advantage |
$345.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$898.36
|
| Rate for Payer: Priority Health HMO/PPO |
$1,202.42
|
| Rate for Payer: Priority Health Medicare |
$348.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$926.00
|
| Rate for Payer: Railroad Medicare Medicare |
$345.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,216.24
|
| Rate for Payer: UHC Core |
$1,154.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$345.52
|
| Rate for Payer: UHC Exchange |
$345.52
|
| Rate for Payer: UHC Medicare Advantage |
$345.52
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$345.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,036.57
|
|
|
HC CAROTID/VERTEBRAL ULTRASOUND
|
Facility
|
IP
|
$1,382.09
|
|
|
Service Code
|
CPT 93880
|
| Hospital Charge Code |
92100001
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$898.36 |
| Max. Negotiated Rate |
$1,243.88 |
| Rate for Payer: Aetna Commercial |
$1,174.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,128.20
|
| Rate for Payer: BCN Commercial |
$1,068.08
|
| Rate for Payer: Cash Price |
$1,105.67
|
| Rate for Payer: Cofinity Commercial |
$1,188.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,105.67
|
| Rate for Payer: Healthscope Commercial |
$1,243.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,036.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,174.78
|
| Rate for Payer: Nomi Health Commercial |
$1,133.31
|
| Rate for Payer: PHP Commercial |
$1,174.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$898.36
|
| Rate for Payer: Priority Health HMO/PPO |
$1,202.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$926.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,216.24
|
| Rate for Payer: UHC Core |
$1,154.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,036.57
|
|
|
HC CASHEW IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200030
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC CASHEW IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200030
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC CASSETTES QUEST
|
Facility
|
OP
|
$76.50
|
|
| Hospital Charge Code |
27000458
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.17 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: Aetna Medicare |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.91
|
| Rate for Payer: BCBS Complete |
$30.60
|
| Rate for Payer: BCBS MAPPO |
$19.12
|
| Rate for Payer: BCBS Trust/PPO |
$62.89
|
| Rate for Payer: BCN Commercial |
$59.48
|
| Rate for Payer: BCN Medicare Advantage |
$19.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.12
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PACE Senior Care Partners |
$18.17
|
| Rate for Payer: PACE SWMI |
$19.12
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: PHP Medicare Advantage |
$19.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: Priority Health HMO/PPO |
$66.56
|
| Rate for Payer: Priority Health Medicare |
$19.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.26
|
| Rate for Payer: Railroad Medicare Medicare |
$19.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.12
|
| Rate for Payer: UHC Exchange |
$19.12
|
| Rate for Payer: UHC Medicare Advantage |
$19.12
|
| Rate for Payer: VA VA |
$19.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC CASSETTES QUEST
|
Facility
|
IP
|
$76.50
|
|
| Hospital Charge Code |
27000458
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$49.72 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: BCBS Trust/PPO |
$62.45
|
| Rate for Payer: BCN Commercial |
$59.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: Priority Health HMO/PPO |
$66.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC CAST CLUB FOOT
|
Facility
|
OP
|
$422.52
|
|
|
Service Code
|
CPT 29450
|
| Hospital Charge Code |
70000011
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$100.35 |
| Max. Negotiated Rate |
$380.27 |
| Rate for Payer: Aetna Commercial |
$359.14
|
| Rate for Payer: Aetna Medicare |
$109.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$132.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$132.04
|
| Rate for Payer: BCBS Complete |
$117.37
|
| Rate for Payer: BCBS MAPPO |
$105.63
|
| Rate for Payer: BCBS Trust/PPO |
$347.35
|
| Rate for Payer: BCN Commercial |
$328.51
|
| Rate for Payer: BCN Medicare Advantage |
$105.63
|
| Rate for Payer: Cash Price |
$338.02
|
| Rate for Payer: Cash Price |
$338.02
|
| Rate for Payer: Cofinity Commercial |
$363.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.63
|
| Rate for Payer: Healthscope Commercial |
$380.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$316.89
|
| Rate for Payer: Mclaren Medicaid |
$111.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.91
|
| Rate for Payer: Meridian Medicaid |
$117.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$121.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.14
|
| Rate for Payer: Nomi Health Commercial |
$346.47
|
| Rate for Payer: PACE Senior Care Partners |
$100.35
|
| Rate for Payer: PACE SWMI |
$105.63
|
| Rate for Payer: PHP Commercial |
$359.14
|
| Rate for Payer: PHP Medicare Advantage |
$105.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$111.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.64
|
| Rate for Payer: Priority Health HMO/PPO |
$367.59
|
| Rate for Payer: Priority Health Medicare |
$106.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$283.09
|
| Rate for Payer: Railroad Medicare Medicare |
$105.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$371.82
|
| Rate for Payer: UHC Core |
$352.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$105.63
|
| Rate for Payer: UHC Exchange |
$105.63
|
| Rate for Payer: UHC Medicare Advantage |
$105.63
|
| Rate for Payer: UHCCP Medicaid |
$111.78
|
| Rate for Payer: VA VA |
$105.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$316.89
|
|
|
HC CAST CLUB FOOT
|
Facility
|
IP
|
$422.52
|
|
|
Service Code
|
CPT 29450
|
| Hospital Charge Code |
70000011
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$274.64 |
| Max. Negotiated Rate |
$380.27 |
| Rate for Payer: Aetna Commercial |
$359.14
|
| Rate for Payer: BCBS Trust/PPO |
$344.90
|
| Rate for Payer: BCN Commercial |
$326.52
|
| Rate for Payer: Cash Price |
$338.02
|
| Rate for Payer: Cofinity Commercial |
$363.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.02
|
| Rate for Payer: Healthscope Commercial |
$380.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$316.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.14
|
| Rate for Payer: Nomi Health Commercial |
$346.47
|
| Rate for Payer: PHP Commercial |
$359.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.64
|
| Rate for Payer: Priority Health HMO/PPO |
$367.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$283.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$371.82
|
| Rate for Payer: UHC Core |
$352.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$316.89
|
|
|
HC CAST COLOR ROLL
|
Facility
|
IP
|
$61.55
|
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$40.01 |
| Max. Negotiated Rate |
$55.40 |
| Rate for Payer: Aetna Commercial |
$52.32
|
| Rate for Payer: BCBS Trust/PPO |
$50.24
|
| Rate for Payer: BCN Commercial |
$47.57
|
| Rate for Payer: Cash Price |
$49.24
|
| Rate for Payer: Cofinity Commercial |
$52.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.24
|
| Rate for Payer: Healthscope Commercial |
$55.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.32
|
| Rate for Payer: Nomi Health Commercial |
$50.47
|
| Rate for Payer: PHP Commercial |
$52.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.01
|
| Rate for Payer: Priority Health HMO/PPO |
$53.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.16
|
| Rate for Payer: UHC Core |
$51.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.16
|
|
|
HC CAST COLOR ROLL
|
Facility
|
OP
|
$61.55
|
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.62 |
| Max. Negotiated Rate |
$55.40 |
| Rate for Payer: Aetna Commercial |
$52.32
|
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.23
|
| Rate for Payer: BCBS Complete |
$24.62
|
| Rate for Payer: BCBS MAPPO |
$15.39
|
| Rate for Payer: BCBS Trust/PPO |
$50.60
|
| Rate for Payer: BCN Commercial |
$47.86
|
| Rate for Payer: BCN Medicare Advantage |
$15.39
|
| Rate for Payer: Cash Price |
$49.24
|
| Rate for Payer: Cofinity Commercial |
$52.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.39
|
| Rate for Payer: Healthscope Commercial |
$55.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.32
|
| Rate for Payer: Nomi Health Commercial |
$50.47
|
| Rate for Payer: PACE Senior Care Partners |
$14.62
|
| Rate for Payer: PACE SWMI |
$15.39
|
| Rate for Payer: PHP Commercial |
$52.32
|
| Rate for Payer: PHP Medicare Advantage |
$15.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.01
|
| Rate for Payer: Priority Health HMO/PPO |
$53.55
|
| Rate for Payer: Priority Health Medicare |
$15.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.24
|
| Rate for Payer: Railroad Medicare Medicare |
$15.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.16
|
| Rate for Payer: UHC Core |
$51.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.39
|
| Rate for Payer: UHC Exchange |
$15.39
|
| Rate for Payer: UHC Medicare Advantage |
$15.39
|
| Rate for Payer: VA VA |
$15.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.16
|
|
|
HC CAST CYLINDER
|
Facility
|
OP
|
$408.07
|
|
|
Service Code
|
CPT 29365
|
| Hospital Charge Code |
70000006
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$96.92 |
| Max. Negotiated Rate |
$367.26 |
| Rate for Payer: Aetna Commercial |
$346.86
|
| Rate for Payer: Aetna Medicare |
$106.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$127.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$127.52
|
| Rate for Payer: BCBS Complete |
$197.55
|
| Rate for Payer: BCBS MAPPO |
$102.02
|
| Rate for Payer: BCBS Trust/PPO |
$335.47
|
| Rate for Payer: BCN Commercial |
$317.27
|
| Rate for Payer: BCN Medicare Advantage |
$102.02
|
| Rate for Payer: Cash Price |
$326.46
|
| Rate for Payer: Cash Price |
$326.46
|
| Rate for Payer: Cofinity Commercial |
$350.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.02
|
| Rate for Payer: Healthscope Commercial |
$367.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.05
|
| Rate for Payer: Mclaren Medicaid |
$188.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.12
|
| Rate for Payer: Meridian Medicaid |
$197.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$117.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.86
|
| Rate for Payer: Nomi Health Commercial |
$334.62
|
| Rate for Payer: PACE Senior Care Partners |
$96.92
|
| Rate for Payer: PACE SWMI |
$102.02
|
| Rate for Payer: PHP Commercial |
$346.86
|
| Rate for Payer: PHP Medicare Advantage |
$102.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.25
|
| Rate for Payer: Priority Health HMO/PPO |
$355.02
|
| Rate for Payer: Priority Health Medicare |
$103.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.41
|
| Rate for Payer: Railroad Medicare Medicare |
$102.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.10
|
| Rate for Payer: UHC Core |
$340.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.02
|
| Rate for Payer: UHC Exchange |
$102.02
|
| Rate for Payer: UHC Medicare Advantage |
$102.02
|
| Rate for Payer: UHCCP Medicaid |
$188.13
|
| Rate for Payer: VA VA |
$102.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.05
|
|
|
HC CAST CYLINDER
|
Facility
|
IP
|
$408.07
|
|
|
Service Code
|
CPT 29365
|
| Hospital Charge Code |
70000006
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$265.25 |
| Max. Negotiated Rate |
$367.26 |
| Rate for Payer: Aetna Commercial |
$346.86
|
| Rate for Payer: BCBS Trust/PPO |
$333.11
|
| Rate for Payer: BCN Commercial |
$315.36
|
| Rate for Payer: Cash Price |
$326.46
|
| Rate for Payer: Cofinity Commercial |
$350.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.46
|
| Rate for Payer: Healthscope Commercial |
$367.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.86
|
| Rate for Payer: Nomi Health Commercial |
$334.62
|
| Rate for Payer: PHP Commercial |
$346.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.25
|
| Rate for Payer: Priority Health HMO/PPO |
$355.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.10
|
| Rate for Payer: UHC Core |
$340.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.05
|
|
|
HC CAST FINGER (CONTRACTURE)
|
Facility
|
OP
|
$210.09
|
|
|
Service Code
|
CPT 29086
|
| Hospital Charge Code |
43000021
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$49.90 |
| Max. Negotiated Rate |
$189.08 |
| Rate for Payer: Aetna Commercial |
$178.58
|
| Rate for Payer: Aetna Medicare |
$54.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.65
|
| Rate for Payer: BCBS Complete |
$117.37
|
| Rate for Payer: BCBS MAPPO |
$52.52
|
| Rate for Payer: BCBS Trust/PPO |
$172.71
|
| Rate for Payer: BCN Commercial |
$163.34
|
| Rate for Payer: BCN Medicare Advantage |
$52.52
|
| Rate for Payer: Cash Price |
$168.07
|
| Rate for Payer: Cash Price |
$168.07
|
| Rate for Payer: Cofinity Commercial |
$180.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.52
|
| Rate for Payer: Healthscope Commercial |
$189.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.57
|
| Rate for Payer: Mclaren Medicaid |
$111.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.15
|
| Rate for Payer: Meridian Medicaid |
$117.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.58
|
| Rate for Payer: Nomi Health Commercial |
$172.27
|
| Rate for Payer: PACE Senior Care Partners |
$49.90
|
| Rate for Payer: PACE SWMI |
$52.52
|
| Rate for Payer: PHP Commercial |
$178.58
|
| Rate for Payer: PHP Medicare Advantage |
$52.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$111.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.56
|
| Rate for Payer: Priority Health HMO/PPO |
$182.78
|
| Rate for Payer: Priority Health Medicare |
$53.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.76
|
| Rate for Payer: Railroad Medicare Medicare |
$52.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.88
|
| Rate for Payer: UHC Core |
$175.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.52
|
| Rate for Payer: UHC Exchange |
$52.52
|
| Rate for Payer: UHC Medicare Advantage |
$52.52
|
| Rate for Payer: UHCCP Medicaid |
$111.78
|
| Rate for Payer: VA VA |
$52.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.57
|
|
|
HC CAST FINGER (CONTRACTURE)
|
Facility
|
IP
|
$210.09
|
|
|
Service Code
|
CPT 29086
|
| Hospital Charge Code |
43000021
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$136.56 |
| Max. Negotiated Rate |
$189.08 |
| Rate for Payer: Aetna Commercial |
$178.58
|
| Rate for Payer: BCBS Trust/PPO |
$171.50
|
| Rate for Payer: BCN Commercial |
$162.36
|
| Rate for Payer: Cash Price |
$168.07
|
| Rate for Payer: Cofinity Commercial |
$180.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.07
|
| Rate for Payer: Healthscope Commercial |
$189.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.58
|
| Rate for Payer: Nomi Health Commercial |
$172.27
|
| Rate for Payer: PHP Commercial |
$178.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.56
|
| Rate for Payer: Priority Health HMO/PPO |
$182.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.88
|
| Rate for Payer: UHC Core |
$175.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.57
|
|
|
HC CAST GAUNTLET
|
Facility
|
OP
|
$238.14
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
42100002
|
|
Hospital Revenue Code
|
421
|
| Min. Negotiated Rate |
$56.56 |
| Max. Negotiated Rate |
$214.33 |
| Rate for Payer: Aetna Commercial |
$202.42
|
| Rate for Payer: Aetna Medicare |
$61.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$74.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$74.42
|
| Rate for Payer: BCBS Complete |
$117.37
|
| Rate for Payer: BCBS MAPPO |
$59.54
|
| Rate for Payer: BCBS Trust/PPO |
$195.77
|
| Rate for Payer: BCN Commercial |
$185.15
|
| Rate for Payer: BCN Medicare Advantage |
$59.54
|
| Rate for Payer: Cash Price |
$190.51
|
| Rate for Payer: Cash Price |
$190.51
|
| Rate for Payer: Cofinity Commercial |
$204.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.54
|
| Rate for Payer: Healthscope Commercial |
$214.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.60
|
| Rate for Payer: Mclaren Medicaid |
$111.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.51
|
| Rate for Payer: Meridian Medicaid |
$117.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.42
|
| Rate for Payer: Nomi Health Commercial |
$195.27
|
| Rate for Payer: PACE Senior Care Partners |
$56.56
|
| Rate for Payer: PACE SWMI |
$59.54
|
| Rate for Payer: PHP Commercial |
$202.42
|
| Rate for Payer: PHP Medicare Advantage |
$59.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$111.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.79
|
| Rate for Payer: Priority Health HMO/PPO |
$207.18
|
| Rate for Payer: Priority Health Medicare |
$60.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$159.55
|
| Rate for Payer: Railroad Medicare Medicare |
$59.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.56
|
| Rate for Payer: UHC Core |
$198.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.54
|
| Rate for Payer: UHC Exchange |
$59.54
|
| Rate for Payer: UHC Medicare Advantage |
$59.54
|
| Rate for Payer: UHCCP Medicaid |
$111.78
|
| Rate for Payer: VA VA |
$59.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.60
|
|
|
HC CAST GAUNTLET
|
Facility
|
IP
|
$238.14
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
42100002
|
|
Hospital Revenue Code
|
421
|
| Min. Negotiated Rate |
$154.79 |
| Max. Negotiated Rate |
$214.33 |
| Rate for Payer: Aetna Commercial |
$202.42
|
| Rate for Payer: BCBS Trust/PPO |
$194.39
|
| Rate for Payer: BCN Commercial |
$184.03
|
| Rate for Payer: Cash Price |
$190.51
|
| Rate for Payer: Cofinity Commercial |
$204.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.51
|
| Rate for Payer: Healthscope Commercial |
$214.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.42
|
| Rate for Payer: Nomi Health Commercial |
$195.27
|
| Rate for Payer: PHP Commercial |
$202.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.79
|
| Rate for Payer: Priority Health HMO/PPO |
$207.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$159.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.56
|
| Rate for Payer: UHC Core |
$198.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.60
|
|
|
HC CAST HIP SPICA 1 AND 1 HALF OR BOTH
|
Facility
|
OP
|
$969.55
|
|
|
Service Code
|
CPT 29325
|
| Hospital Charge Code |
70000004
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$188.13 |
| Max. Negotiated Rate |
$872.60 |
| Rate for Payer: Aetna Commercial |
$824.12
|
| Rate for Payer: Aetna Medicare |
$252.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$302.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$302.98
|
| Rate for Payer: BCBS Complete |
$197.55
|
| Rate for Payer: BCBS MAPPO |
$242.39
|
| Rate for Payer: BCBS Trust/PPO |
$797.07
|
| Rate for Payer: BCN Commercial |
$753.83
|
| Rate for Payer: BCN Medicare Advantage |
$242.39
|
| Rate for Payer: Cash Price |
$775.64
|
| Rate for Payer: Cash Price |
$775.64
|
| Rate for Payer: Cofinity Commercial |
$833.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.39
|
| Rate for Payer: Healthscope Commercial |
$872.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$727.16
|
| Rate for Payer: Mclaren Medicaid |
$188.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$254.51
|
| Rate for Payer: Meridian Medicaid |
$197.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$278.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$824.12
|
| Rate for Payer: Nomi Health Commercial |
$795.03
|
| Rate for Payer: PACE Senior Care Partners |
$230.27
|
| Rate for Payer: PACE SWMI |
$242.39
|
| Rate for Payer: PHP Commercial |
$824.12
|
| Rate for Payer: PHP Medicare Advantage |
$242.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.21
|
| Rate for Payer: Priority Health HMO/PPO |
$843.51
|
| Rate for Payer: Priority Health Medicare |
$244.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$649.60
|
| Rate for Payer: Railroad Medicare Medicare |
$242.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$853.20
|
| Rate for Payer: UHC Core |
$809.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$242.39
|
| Rate for Payer: UHC Exchange |
$242.39
|
| Rate for Payer: UHC Medicare Advantage |
$242.39
|
| Rate for Payer: UHCCP Medicaid |
$188.13
|
| Rate for Payer: VA VA |
$242.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$727.16
|
|
|
HC CAST HIP SPICA 1 AND 1 HALF OR BOTH
|
Facility
|
IP
|
$969.55
|
|
|
Service Code
|
CPT 29325
|
| Hospital Charge Code |
70000004
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$630.21 |
| Max. Negotiated Rate |
$872.60 |
| Rate for Payer: Aetna Commercial |
$824.12
|
| Rate for Payer: BCBS Trust/PPO |
$791.44
|
| Rate for Payer: BCN Commercial |
$749.27
|
| Rate for Payer: Cash Price |
$775.64
|
| Rate for Payer: Cofinity Commercial |
$833.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.64
|
| Rate for Payer: Healthscope Commercial |
$872.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$727.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$824.12
|
| Rate for Payer: Nomi Health Commercial |
$795.03
|
| Rate for Payer: PHP Commercial |
$824.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.21
|
| Rate for Payer: Priority Health HMO/PPO |
$843.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$649.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$853.20
|
| Rate for Payer: UHC Core |
$809.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$727.16
|
|
|
HC CAST LONG ARM
|
Facility
|
OP
|
$341.68
|
|
|
Service Code
|
CPT 29065
|
| Hospital Charge Code |
42100001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$81.15 |
| Max. Negotiated Rate |
$307.51 |
| Rate for Payer: Aetna Commercial |
$290.43
|
| Rate for Payer: Aetna Medicare |
$88.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.78
|
| Rate for Payer: BCBS Complete |
$197.55
|
| Rate for Payer: BCBS MAPPO |
$85.42
|
| Rate for Payer: BCBS Trust/PPO |
$280.90
|
| Rate for Payer: BCN Commercial |
$265.66
|
| Rate for Payer: BCN Medicare Advantage |
$85.42
|
| Rate for Payer: Cash Price |
$273.34
|
| Rate for Payer: Cash Price |
$273.34
|
| Rate for Payer: Cofinity Commercial |
$293.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$273.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.42
|
| Rate for Payer: Healthscope Commercial |
$307.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$256.26
|
| Rate for Payer: Mclaren Medicaid |
$188.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.69
|
| Rate for Payer: Meridian Medicaid |
$197.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$290.43
|
| Rate for Payer: Nomi Health Commercial |
$280.18
|
| Rate for Payer: PACE Senior Care Partners |
$81.15
|
| Rate for Payer: PACE SWMI |
$85.42
|
| Rate for Payer: PHP Commercial |
$290.43
|
| Rate for Payer: PHP Medicare Advantage |
$85.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.09
|
| Rate for Payer: Priority Health HMO/PPO |
$297.26
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.93
|
| Rate for Payer: Railroad Medicare Medicare |
$85.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$300.68
|
| Rate for Payer: UHC Core |
$285.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.42
|
| Rate for Payer: UHC Exchange |
$85.42
|
| Rate for Payer: UHC Medicare Advantage |
$85.42
|
| Rate for Payer: UHCCP Medicaid |
$188.13
|
| Rate for Payer: VA VA |
$85.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$256.26
|
|
|
HC CAST LONG ARM
|
Facility
|
IP
|
$341.68
|
|
|
Service Code
|
CPT 29065
|
| Hospital Charge Code |
42100001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$222.09 |
| Max. Negotiated Rate |
$307.51 |
| Rate for Payer: Aetna Commercial |
$290.43
|
| Rate for Payer: BCBS Trust/PPO |
$278.91
|
| Rate for Payer: BCN Commercial |
$264.05
|
| Rate for Payer: Cash Price |
$273.34
|
| Rate for Payer: Cofinity Commercial |
$293.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$273.34
|
| Rate for Payer: Healthscope Commercial |
$307.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$256.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$290.43
|
| Rate for Payer: Nomi Health Commercial |
$280.18
|
| Rate for Payer: PHP Commercial |
$290.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.09
|
| Rate for Payer: Priority Health HMO/PPO |
$297.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$300.68
|
| Rate for Payer: UHC Core |
$285.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$256.26
|
|
|
HC CAST LONG LEG
|
Facility
|
IP
|
$411.68
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
70000005
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$267.59 |
| Max. Negotiated Rate |
$370.51 |
| Rate for Payer: Aetna Commercial |
$349.93
|
| Rate for Payer: BCBS Trust/PPO |
$336.05
|
| Rate for Payer: BCN Commercial |
$318.15
|
| Rate for Payer: Cash Price |
$329.34
|
| Rate for Payer: Cofinity Commercial |
$354.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.34
|
| Rate for Payer: Healthscope Commercial |
$370.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$308.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$349.93
|
| Rate for Payer: Nomi Health Commercial |
$337.58
|
| Rate for Payer: PHP Commercial |
$349.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.59
|
| Rate for Payer: Priority Health HMO/PPO |
$358.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$362.28
|
| Rate for Payer: UHC Core |
$343.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$308.76
|
|
|
HC CAST LONG LEG
|
Facility
|
OP
|
$411.68
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
70000005
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$97.77 |
| Max. Negotiated Rate |
$370.51 |
| Rate for Payer: Aetna Commercial |
$349.93
|
| Rate for Payer: Aetna Medicare |
$107.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$128.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$128.65
|
| Rate for Payer: BCBS Complete |
$197.55
|
| Rate for Payer: BCBS MAPPO |
$102.92
|
| Rate for Payer: BCBS Trust/PPO |
$338.44
|
| Rate for Payer: BCN Commercial |
$320.08
|
| Rate for Payer: BCN Medicare Advantage |
$102.92
|
| Rate for Payer: Cash Price |
$329.34
|
| Rate for Payer: Cash Price |
$329.34
|
| Rate for Payer: Cofinity Commercial |
$354.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.92
|
| Rate for Payer: Healthscope Commercial |
$370.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$308.76
|
| Rate for Payer: Mclaren Medicaid |
$188.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.07
|
| Rate for Payer: Meridian Medicaid |
$197.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$118.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$349.93
|
| Rate for Payer: Nomi Health Commercial |
$337.58
|
| Rate for Payer: PACE Senior Care Partners |
$97.77
|
| Rate for Payer: PACE SWMI |
$102.92
|
| Rate for Payer: PHP Commercial |
$349.93
|
| Rate for Payer: PHP Medicare Advantage |
$102.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.59
|
| Rate for Payer: Priority Health HMO/PPO |
$358.16
|
| Rate for Payer: Priority Health Medicare |
$103.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.83
|
| Rate for Payer: Railroad Medicare Medicare |
$102.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$362.28
|
| Rate for Payer: UHC Core |
$343.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.92
|
| Rate for Payer: UHC Exchange |
$102.92
|
| Rate for Payer: UHC Medicare Advantage |
$102.92
|
| Rate for Payer: UHCCP Medicaid |
$188.13
|
| Rate for Payer: VA VA |
$102.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$308.76
|
|
