|
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 |
$119.79
|
| 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 |
$114.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.91
|
| Rate for Payer: Meridian Medicaid |
$119.79
|
| 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 |
$114.08
|
| 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 |
$114.08
|
| 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
|
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 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 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 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 |
$201.63
|
| 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 |
$192.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.12
|
| Rate for Payer: Meridian Medicaid |
$201.63
|
| 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 |
$192.01
|
| 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 |
$192.01
|
| Rate for Payer: VA VA |
$102.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.05
|
|
|
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 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 |
$119.79
|
| 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 |
$114.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.15
|
| Rate for Payer: Meridian Medicaid |
$119.79
|
| 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 |
$114.08
|
| 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 |
$114.08
|
| Rate for Payer: VA VA |
$52.52
|
| 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 |
$119.79
|
| Rate for Payer: BCBS MAPPO |
$59.53
|
| Rate for Payer: BCBS Trust/PPO |
$195.77
|
| Rate for Payer: BCN Commercial |
$185.15
|
| Rate for Payer: BCN Medicare Advantage |
$59.53
|
| 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 |
$59.53
|
| Rate for Payer: Healthscope Commercial |
$214.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.60
|
| Rate for Payer: Mclaren Medicaid |
$114.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.51
|
| Rate for Payer: Meridian Medicaid |
$119.79
|
| 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 |
$59.53
|
| Rate for Payer: PHP Commercial |
$202.42
|
| Rate for Payer: PHP Medicare Advantage |
$59.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.08
|
| 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 |
$59.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.56
|
| Rate for Payer: UHC Core |
$198.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.53
|
| Rate for Payer: UHC Exchange |
$59.53
|
| Rate for Payer: UHC Medicare Advantage |
$59.53
|
| Rate for Payer: UHCCP Medicaid |
$114.08
|
| Rate for Payer: VA VA |
$59.53
|
| 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 |
$192.01 |
| 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 |
$201.63
|
| 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 |
$192.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$254.51
|
| Rate for Payer: Meridian Medicaid |
$201.63
|
| 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 |
$192.01
|
| 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 |
$192.01
|
| 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
|
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 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 |
$201.63
|
| 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 |
$192.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.69
|
| Rate for Payer: Meridian Medicaid |
$201.63
|
| 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 |
$192.01
|
| 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 |
$192.01
|
| Rate for Payer: VA VA |
$85.42
|
| 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 |
$201.63
|
| 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 |
$192.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.07
|
| Rate for Payer: Meridian Medicaid |
$201.63
|
| 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 |
$192.01
|
| 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 |
$192.01
|
| Rate for Payer: VA VA |
$102.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$308.76
|
|
|
HC CAST PANTALOON
|
Facility
|
OP
|
$918.57
|
|
|
Service Code
|
CPT 29305
|
| Hospital Charge Code |
70000003
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$192.01 |
| Max. Negotiated Rate |
$826.71 |
| Rate for Payer: Aetna Commercial |
$780.78
|
| Rate for Payer: Aetna Medicare |
$238.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$287.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$287.05
|
| Rate for Payer: BCBS Complete |
$201.63
|
| Rate for Payer: BCBS MAPPO |
$229.64
|
| Rate for Payer: BCBS Trust/PPO |
$755.16
|
| Rate for Payer: BCN Commercial |
$714.19
|
| Rate for Payer: BCN Medicare Advantage |
$229.64
|
| Rate for Payer: Cash Price |
$734.86
|
| Rate for Payer: Cash Price |
$734.86
|
| Rate for Payer: Cofinity Commercial |
$789.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.64
|
| Rate for Payer: Healthscope Commercial |
$826.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$688.93
|
| Rate for Payer: Mclaren Medicaid |
$192.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$241.12
|
| Rate for Payer: Meridian Medicaid |
$201.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$264.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$780.78
|
| Rate for Payer: Nomi Health Commercial |
$753.23
|
| Rate for Payer: PACE Senior Care Partners |
$218.16
|
| Rate for Payer: PACE SWMI |
$229.64
|
| Rate for Payer: PHP Commercial |
$780.78
|
| Rate for Payer: PHP Medicare Advantage |
$229.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.07
|
| Rate for Payer: Priority Health HMO/PPO |
$799.16
|
| Rate for Payer: Priority Health Medicare |
$231.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$615.44
|
| Rate for Payer: Railroad Medicare Medicare |
$229.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$808.34
|
| Rate for Payer: UHC Core |
$767.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$229.64
|
| Rate for Payer: UHC Exchange |
$229.64
|
| Rate for Payer: UHC Medicare Advantage |
$229.64
|
| Rate for Payer: UHCCP Medicaid |
$192.01
|
| Rate for Payer: VA VA |
$229.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$688.93
|
|
|
HC CAST PANTALOON
|
Facility
|
IP
|
$918.57
|
|
|
Service Code
|
CPT 29305
|
| Hospital Charge Code |
70000003
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$597.07 |
| Max. Negotiated Rate |
$826.71 |
| Rate for Payer: Aetna Commercial |
$780.78
|
| Rate for Payer: BCBS Trust/PPO |
$749.83
|
| Rate for Payer: BCN Commercial |
$709.87
|
| Rate for Payer: Cash Price |
$734.86
|
| Rate for Payer: Cofinity Commercial |
$789.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.86
|
| Rate for Payer: Healthscope Commercial |
$826.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$688.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$780.78
|
| Rate for Payer: Nomi Health Commercial |
$753.23
|
| Rate for Payer: PHP Commercial |
$780.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.07
|
| Rate for Payer: Priority Health HMO/PPO |
$799.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$615.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$808.34
|
| Rate for Payer: UHC Core |
$767.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$688.93
|
|
|
HC CAST PTB WALKING
|
Facility
|
IP
|
$411.68
|
|
|
Service Code
|
CPT 29435
|
| Hospital Charge Code |
70000009
|
|
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 PTB WALKING
|
Facility
|
OP
|
$411.68
|
|
|
Service Code
|
CPT 29435
|
| Hospital Charge Code |
70000009
|
|
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 |
$201.63
|
| 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 |
$192.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.07
|
| Rate for Payer: Meridian Medicaid |
$201.63
|
| 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 |
$192.01
|
| 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 |
$192.01
|
| Rate for Payer: VA VA |
$102.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$308.76
|
|
|
HC CAST REPAIR
|
Facility
|
IP
|
$178.81
|
|
| Hospital Charge Code |
27000041
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$116.23 |
| Max. Negotiated Rate |
$160.93 |
| Rate for Payer: Aetna Commercial |
$151.99
|
| Rate for Payer: BCBS Trust/PPO |
$145.96
|
| Rate for Payer: BCN Commercial |
$138.18
|
| Rate for Payer: Cash Price |
$143.05
|
| Rate for Payer: Cofinity Commercial |
$153.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.05
|
| Rate for Payer: Healthscope Commercial |
$160.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$134.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.99
|
| Rate for Payer: Nomi Health Commercial |
$146.62
|
| Rate for Payer: PHP Commercial |
$151.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.23
|
| Rate for Payer: Priority Health HMO/PPO |
$155.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$119.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.35
|
| Rate for Payer: UHC Core |
$149.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$134.11
|
|
|
HC CAST REPAIR
|
Facility
|
OP
|
$178.81
|
|
| Hospital Charge Code |
27000041
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$42.47 |
| Max. Negotiated Rate |
$160.93 |
| Rate for Payer: Aetna Commercial |
$151.99
|
| Rate for Payer: Aetna Medicare |
$46.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.88
|
| Rate for Payer: BCBS Complete |
$71.52
|
| Rate for Payer: BCBS MAPPO |
$44.70
|
| Rate for Payer: BCBS Trust/PPO |
$147.00
|
| Rate for Payer: BCN Commercial |
$139.02
|
| Rate for Payer: BCN Medicare Advantage |
$44.70
|
| Rate for Payer: Cash Price |
$143.05
|
| Rate for Payer: Cofinity Commercial |
$153.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.70
|
| Rate for Payer: Healthscope Commercial |
$160.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$134.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.99
|
| Rate for Payer: Nomi Health Commercial |
$146.62
|
| Rate for Payer: PACE Senior Care Partners |
$42.47
|
| Rate for Payer: PACE SWMI |
$44.70
|
| Rate for Payer: PHP Commercial |
$151.99
|
| Rate for Payer: PHP Medicare Advantage |
$44.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.23
|
| Rate for Payer: Priority Health HMO/PPO |
$155.56
|
| Rate for Payer: Priority Health Medicare |
$45.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$119.80
|
| Rate for Payer: Railroad Medicare Medicare |
$44.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.35
|
| Rate for Payer: UHC Core |
$149.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.70
|
| Rate for Payer: UHC Exchange |
$44.70
|
| Rate for Payer: UHC Medicare Advantage |
$44.70
|
| Rate for Payer: VA VA |
$44.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$134.11
|
|
|
HC CAST RISSER BODY ONLY
|
Facility
|
OP
|
$309.38
|
|
|
Service Code
|
CPT 29010
|
| Hospital Charge Code |
70000001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$73.48 |
| Max. Negotiated Rate |
$278.44 |
| Rate for Payer: Aetna Commercial |
$262.97
|
| Rate for Payer: Aetna Medicare |
$80.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$96.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$96.68
|
| Rate for Payer: BCBS Complete |
$201.63
|
| Rate for Payer: BCBS MAPPO |
$77.34
|
| Rate for Payer: BCBS Trust/PPO |
$254.34
|
| Rate for Payer: BCN Commercial |
$240.54
|
| Rate for Payer: BCN Medicare Advantage |
$77.34
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Cofinity Commercial |
$266.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.34
|
| Rate for Payer: Healthscope Commercial |
$278.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.03
|
| Rate for Payer: Mclaren Medicaid |
$192.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.21
|
| Rate for Payer: Meridian Medicaid |
$201.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$88.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.97
|
| Rate for Payer: Nomi Health Commercial |
$253.69
|
| Rate for Payer: PACE Senior Care Partners |
$73.48
|
| Rate for Payer: PACE SWMI |
$77.34
|
| Rate for Payer: PHP Commercial |
$262.97
|
| Rate for Payer: PHP Medicare Advantage |
$77.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.10
|
| Rate for Payer: Priority Health HMO/PPO |
$269.16
|
| Rate for Payer: Priority Health Medicare |
$78.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.28
|
| Rate for Payer: Railroad Medicare Medicare |
$77.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.25
|
| Rate for Payer: UHC Core |
$258.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$77.34
|
| Rate for Payer: UHC Exchange |
$77.34
|
| Rate for Payer: UHC Medicare Advantage |
$77.34
|
| Rate for Payer: UHCCP Medicaid |
$192.01
|
| Rate for Payer: VA VA |
$77.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.03
|
|
|
HC CAST RISSER BODY ONLY
|
Facility
|
IP
|
$309.38
|
|
|
Service Code
|
CPT 29010
|
| Hospital Charge Code |
70000001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$201.10 |
| Max. Negotiated Rate |
$278.44 |
| Rate for Payer: Aetna Commercial |
$262.97
|
| Rate for Payer: BCBS Trust/PPO |
$252.55
|
| Rate for Payer: BCN Commercial |
$239.09
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Cofinity Commercial |
$266.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.50
|
| Rate for Payer: Healthscope Commercial |
$278.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.97
|
| Rate for Payer: Nomi Health Commercial |
$253.69
|
| Rate for Payer: PHP Commercial |
$262.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.10
|
| Rate for Payer: Priority Health HMO/PPO |
$269.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.25
|
| Rate for Payer: UHC Core |
$258.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.03
|
|
|
HC CAST SHORT ARM
|
Facility
|
OP
|
$300.18
|
|
|
Service Code
|
CPT 29075
|
| Hospital Charge Code |
43000001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$71.29 |
| Max. Negotiated Rate |
$270.16 |
| Rate for Payer: Aetna Commercial |
$255.15
|
| Rate for Payer: Aetna Medicare |
$78.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.81
|
| Rate for Payer: BCBS Complete |
$201.63
|
| Rate for Payer: BCBS MAPPO |
$75.05
|
| Rate for Payer: BCBS Trust/PPO |
$246.78
|
| Rate for Payer: BCN Commercial |
$233.39
|
| Rate for Payer: BCN Medicare Advantage |
$75.05
|
| Rate for Payer: Cash Price |
$240.14
|
| Rate for Payer: Cash Price |
$240.14
|
| Rate for Payer: Cofinity Commercial |
$258.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.05
|
| Rate for Payer: Healthscope Commercial |
$270.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.13
|
| Rate for Payer: Mclaren Medicaid |
$192.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.80
|
| Rate for Payer: Meridian Medicaid |
$201.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.15
|
| Rate for Payer: Nomi Health Commercial |
$246.15
|
| Rate for Payer: PACE Senior Care Partners |
$71.29
|
| Rate for Payer: PACE SWMI |
$75.05
|
| Rate for Payer: PHP Commercial |
$255.15
|
| Rate for Payer: PHP Medicare Advantage |
$75.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.12
|
| Rate for Payer: Priority Health HMO/PPO |
$261.16
|
| Rate for Payer: Priority Health Medicare |
$75.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.12
|
| Rate for Payer: Railroad Medicare Medicare |
$75.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.16
|
| Rate for Payer: UHC Core |
$250.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.05
|
| Rate for Payer: UHC Exchange |
$75.05
|
| Rate for Payer: UHC Medicare Advantage |
$75.05
|
| Rate for Payer: UHCCP Medicaid |
$192.01
|
| Rate for Payer: VA VA |
$75.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.13
|
|
