|
HC CAST SUPPLIES UNLISTED
|
Facility
|
IP
|
$104.04
|
|
| Hospital Charge Code |
27200343
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$67.63 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: BCBS Trust/PPO |
$84.93
|
| Rate for Payer: BCN Commercial |
$80.40
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health HMO/PPO |
$90.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.56
|
| Rate for Payer: UHC Core |
$86.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC CAST SUPPLIES UNLISTED
|
Facility
|
OP
|
$104.04
|
|
| Hospital Charge Code |
27200343
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.71 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: Aetna Medicare |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.51
|
| Rate for Payer: BCBS Complete |
$41.62
|
| Rate for Payer: BCBS MAPPO |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$85.53
|
| Rate for Payer: BCN Commercial |
$80.89
|
| Rate for Payer: BCN Medicare Advantage |
$26.01
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.01
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: PACE Senior Care Partners |
$24.71
|
| Rate for Payer: PACE SWMI |
$26.01
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: PHP Medicare Advantage |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health HMO/PPO |
$90.51
|
| Rate for Payer: Priority Health Medicare |
$26.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.71
|
| Rate for Payer: Railroad Medicare Medicare |
$26.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.56
|
| Rate for Payer: UHC Core |
$86.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.01
|
| Rate for Payer: UHC Exchange |
$26.01
|
| Rate for Payer: UHC Medicare Advantage |
$26.01
|
| Rate for Payer: VA VA |
$26.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC CAST SUP SHRT LEG ADULT FBRGLS
|
Facility
|
IP
|
$62.42
|
|
| Hospital Charge Code |
27200339
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$40.57 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: BCBS Trust/PPO |
$50.95
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC CAST SUP SHRT LEG ADULT FBRGLS
|
Facility
|
OP
|
$62.42
|
|
| Hospital Charge Code |
27200339
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.82 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$16.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.51
|
| Rate for Payer: BCBS Complete |
$24.97
|
| Rate for Payer: BCBS MAPPO |
$15.61
|
| Rate for Payer: BCBS Trust/PPO |
$51.32
|
| Rate for Payer: BCN Commercial |
$48.53
|
| Rate for Payer: BCN Medicare Advantage |
$15.61
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.61
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PACE Senior Care Partners |
$14.82
|
| Rate for Payer: PACE SWMI |
$15.61
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$15.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Medicare |
$15.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.82
|
| Rate for Payer: Railroad Medicare Medicare |
$15.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.61
|
| Rate for Payer: UHC Exchange |
$15.61
|
| Rate for Payer: UHC Medicare Advantage |
$15.61
|
| Rate for Payer: VA VA |
$15.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC CAST SUP SHRT LEG PED FBRGLS
|
Facility
|
IP
|
$21.85
|
|
| Hospital Charge Code |
27200340
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.20 |
| Max. Negotiated Rate |
$19.66 |
| Rate for Payer: Aetna Commercial |
$18.57
|
| Rate for Payer: BCBS Trust/PPO |
$17.84
|
| Rate for Payer: BCN Commercial |
$16.89
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$18.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$17.92
|
| Rate for Payer: PHP Commercial |
$18.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.20
|
| Rate for Payer: Priority Health HMO/PPO |
$19.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.23
|
| Rate for Payer: UHC Core |
$18.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.39
|
|
|
HC CAST SUP SHRT LEG PED FBRGLS
|
Facility
|
OP
|
$21.85
|
|
| Hospital Charge Code |
27200340
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.19 |
| Max. Negotiated Rate |
$19.66 |
| Rate for Payer: Aetna Commercial |
$18.57
|
| Rate for Payer: Aetna Medicare |
$5.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.83
|
| Rate for Payer: BCBS Complete |
$8.74
|
| Rate for Payer: BCBS MAPPO |
$5.46
|
| Rate for Payer: BCBS Trust/PPO |
$17.96
|
| Rate for Payer: BCN Commercial |
$16.99
|
| Rate for Payer: BCN Medicare Advantage |
$5.46
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$18.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.46
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$17.92
|
| Rate for Payer: PACE Senior Care Partners |
$5.19
|
| Rate for Payer: PACE SWMI |
$5.46
|
| Rate for Payer: PHP Commercial |
$18.57
|
| Rate for Payer: PHP Medicare Advantage |
$5.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.20
|
| Rate for Payer: Priority Health HMO/PPO |
$19.01
|
| Rate for Payer: Priority Health Medicare |
$5.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.64
|
| Rate for Payer: Railroad Medicare Medicare |
$5.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.23
|
| Rate for Payer: UHC Core |
$18.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.46
|
| Rate for Payer: UHC Exchange |
$5.46
|
| Rate for Payer: UHC Medicare Advantage |
$5.46
|
| Rate for Payer: VA VA |
$5.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.39
|
|
|
HC CAST SUP SHT ARM ADULT FBRGLS
|
Facility
|
IP
|
$43.70
|
|
| Hospital Charge Code |
27200329
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.41 |
| Max. Negotiated Rate |
$39.33 |
| Rate for Payer: Aetna Commercial |
$37.15
|
| Rate for Payer: BCBS Trust/PPO |
$35.67
|
| Rate for Payer: BCN Commercial |
$33.77
|
| Rate for Payer: Cash Price |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$37.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.96
|
| Rate for Payer: Healthscope Commercial |
$39.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.15
|
| Rate for Payer: Nomi Health Commercial |
$35.83
|
| Rate for Payer: PHP Commercial |
$37.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.41
|
| Rate for Payer: Priority Health HMO/PPO |
$38.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.46
|
| Rate for Payer: UHC Core |
$36.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.77
|
|
|
HC CAST SUP SHT ARM ADULT FBRGLS
|
Facility
|
OP
|
$43.70
|
|
| Hospital Charge Code |
27200329
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.38 |
| Max. Negotiated Rate |
$39.33 |
| Rate for Payer: Aetna Commercial |
$37.15
|
| Rate for Payer: Aetna Medicare |
$11.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.66
|
| Rate for Payer: BCBS Complete |
$17.48
|
| Rate for Payer: BCBS MAPPO |
$10.93
|
| Rate for Payer: BCBS Trust/PPO |
$35.93
|
| Rate for Payer: BCN Commercial |
$33.98
|
| Rate for Payer: BCN Medicare Advantage |
$10.93
|
| Rate for Payer: Cash Price |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$37.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.93
|
| Rate for Payer: Healthscope Commercial |
$39.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.15
|
| Rate for Payer: Nomi Health Commercial |
$35.83
|
| Rate for Payer: PACE Senior Care Partners |
$10.38
|
| Rate for Payer: PACE SWMI |
$10.93
|
| Rate for Payer: PHP Commercial |
$37.15
|
| Rate for Payer: PHP Medicare Advantage |
$10.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.41
|
| Rate for Payer: Priority Health HMO/PPO |
$38.02
|
| Rate for Payer: Priority Health Medicare |
$11.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.28
|
| Rate for Payer: Railroad Medicare Medicare |
$10.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.46
|
| Rate for Payer: UHC Core |
$36.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.93
|
| Rate for Payer: UHC Exchange |
$10.93
|
| Rate for Payer: UHC Medicare Advantage |
$10.93
|
| Rate for Payer: VA VA |
$10.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.77
|
|
|
HC CAST SUP SHT ARM PED FBRGLS
|
Facility
|
OP
|
$20.81
|
|
| Hospital Charge Code |
27200330
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$5.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.50
|
| Rate for Payer: BCBS Complete |
$8.32
|
| Rate for Payer: BCBS MAPPO |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$17.11
|
| Rate for Payer: BCN Commercial |
$16.18
|
| Rate for Payer: BCN Medicare Advantage |
$5.20
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.20
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Senior Care Partners |
$4.94
|
| Rate for Payer: PACE SWMI |
$5.20
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$5.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Medicare |
$5.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: Railroad Medicare Medicare |
$5.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.20
|
| Rate for Payer: UHC Exchange |
$5.20
|
| Rate for Payer: UHC Medicare Advantage |
$5.20
|
| Rate for Payer: VA VA |
$5.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC CAST SUP SHT ARM PED FBRGLS
|
Facility
|
IP
|
$20.81
|
|
| Hospital Charge Code |
27200330
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: BCBS Trust/PPO |
$16.99
|
| Rate for Payer: BCN Commercial |
$16.08
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC CAST SUP SHT ARM SPLINT ADULT FBRGLS
|
Facility
|
OP
|
$26.01
|
|
| Hospital Charge Code |
27200334
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$6.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.13
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCBS MAPPO |
$6.50
|
| Rate for Payer: BCBS Trust/PPO |
$21.38
|
| Rate for Payer: BCN Commercial |
$20.22
|
| Rate for Payer: BCN Medicare Advantage |
$6.50
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.50
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PACE Senior Care Partners |
$6.18
|
| Rate for Payer: PACE SWMI |
$6.50
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$6.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Medicare |
$6.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: Railroad Medicare Medicare |
$6.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.50
|
| Rate for Payer: UHC Exchange |
$6.50
|
| Rate for Payer: UHC Medicare Advantage |
$6.50
|
| Rate for Payer: VA VA |
$6.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC CAST SUP SHT ARM SPLINT ADULT FBRGLS
|
Facility
|
IP
|
$26.01
|
|
| Hospital Charge Code |
27200334
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: BCBS Trust/PPO |
$21.23
|
| Rate for Payer: BCN Commercial |
$20.10
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC CAST SUP SHT ARM SPLINT ADULT PLST
|
Facility
|
OP
|
$10.00
|
|
| Hospital Charge Code |
27200359
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.38 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: Aetna Commercial |
$8.50
|
| Rate for Payer: Aetna Medicare |
$2.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.12
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$2.50
|
| Rate for Payer: BCBS Trust/PPO |
$8.22
|
| Rate for Payer: BCN Commercial |
$7.78
|
| Rate for Payer: BCN Medicare Advantage |
$2.50
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$8.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.50
|
| Rate for Payer: Healthscope Commercial |
$9.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.50
|
| Rate for Payer: Nomi Health Commercial |
$8.20
|
| Rate for Payer: PACE Senior Care Partners |
$2.38
|
| Rate for Payer: PACE SWMI |
$2.50
|
| Rate for Payer: PHP Commercial |
$8.50
|
| Rate for Payer: PHP Medicare Advantage |
$2.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: Priority Health HMO/PPO |
$8.70
|
| Rate for Payer: Priority Health Medicare |
$2.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.70
|
| Rate for Payer: Railroad Medicare Medicare |
$2.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.80
|
| Rate for Payer: UHC Core |
$8.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.50
|
| Rate for Payer: UHC Exchange |
$2.50
|
| Rate for Payer: UHC Medicare Advantage |
$2.50
|
| Rate for Payer: VA VA |
$2.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.50
|
|
|
HC CAST SUP SHT ARM SPLINT ADULT PLST
|
Facility
|
IP
|
$10.00
|
|
| Hospital Charge Code |
27200359
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: Aetna Commercial |
$8.50
|
| Rate for Payer: BCBS Trust/PPO |
$8.16
|
| Rate for Payer: BCN Commercial |
$7.73
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$8.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.00
|
| Rate for Payer: Healthscope Commercial |
$9.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.50
|
| Rate for Payer: Nomi Health Commercial |
$8.20
|
| Rate for Payer: PHP Commercial |
$8.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: Priority Health HMO/PPO |
$8.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.80
|
| Rate for Payer: UHC Core |
$8.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.50
|
|
|
HC CAST SUP SHT ARM SPLINT PED FBRGLS
|
Facility
|
OP
|
$28.09
|
|
| Hospital Charge Code |
27200335
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.67 |
| Max. Negotiated Rate |
$25.28 |
| Rate for Payer: Aetna Commercial |
$23.88
|
| Rate for Payer: Aetna Medicare |
$7.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.78
|
| Rate for Payer: BCBS Complete |
$11.24
|
| Rate for Payer: BCBS MAPPO |
$7.02
|
| Rate for Payer: BCBS Trust/PPO |
$23.09
|
| Rate for Payer: BCN Commercial |
$21.84
|
| Rate for Payer: BCN Medicare Advantage |
$7.02
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cofinity Commercial |
$24.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.02
|
| Rate for Payer: Healthscope Commercial |
$25.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.88
|
| Rate for Payer: Nomi Health Commercial |
$23.03
|
| Rate for Payer: PACE Senior Care Partners |
$6.67
|
| Rate for Payer: PACE SWMI |
$7.02
|
| Rate for Payer: PHP Commercial |
$23.88
|
| Rate for Payer: PHP Medicare Advantage |
$7.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.26
|
| Rate for Payer: Priority Health HMO/PPO |
$24.44
|
| Rate for Payer: Priority Health Medicare |
$7.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.82
|
| Rate for Payer: Railroad Medicare Medicare |
$7.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.72
|
| Rate for Payer: UHC Core |
$23.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.02
|
| Rate for Payer: UHC Exchange |
$7.02
|
| Rate for Payer: UHC Medicare Advantage |
$7.02
|
| Rate for Payer: VA VA |
$7.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.07
|
|
|
HC CAST SUP SHT ARM SPLINT PED FBRGLS
|
Facility
|
IP
|
$28.09
|
|
| Hospital Charge Code |
27200335
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.26 |
| Max. Negotiated Rate |
$25.28 |
| Rate for Payer: Aetna Commercial |
$23.88
|
| Rate for Payer: BCBS Trust/PPO |
$22.93
|
| Rate for Payer: BCN Commercial |
$21.71
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cofinity Commercial |
$24.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.47
|
| Rate for Payer: Healthscope Commercial |
$25.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.88
|
| Rate for Payer: Nomi Health Commercial |
$23.03
|
| Rate for Payer: PHP Commercial |
$23.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.26
|
| Rate for Payer: Priority Health HMO/PPO |
$24.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.72
|
| Rate for Payer: UHC Core |
$23.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.07
|
|
|
HC CAST SUP SHT GAUNTLET FBRGLS
|
Facility
|
OP
|
$57.22
|
|
| Hospital Charge Code |
27200331
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.59 |
| Max. Negotiated Rate |
$51.50 |
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: Aetna Medicare |
$14.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.88
|
| Rate for Payer: BCBS Complete |
$22.89
|
| Rate for Payer: BCBS MAPPO |
$14.30
|
| Rate for Payer: BCBS Trust/PPO |
$47.04
|
| Rate for Payer: BCN Commercial |
$44.49
|
| Rate for Payer: BCN Medicare Advantage |
$14.30
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$49.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.30
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$46.92
|
| Rate for Payer: PACE Senior Care Partners |
$13.59
|
| Rate for Payer: PACE SWMI |
$14.30
|
| Rate for Payer: PHP Commercial |
$48.64
|
| Rate for Payer: PHP Medicare Advantage |
$14.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.19
|
| Rate for Payer: Priority Health HMO/PPO |
$49.78
|
| Rate for Payer: Priority Health Medicare |
$14.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.34
|
| Rate for Payer: Railroad Medicare Medicare |
$14.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.35
|
| Rate for Payer: UHC Core |
$47.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.30
|
| Rate for Payer: UHC Exchange |
$14.30
|
| Rate for Payer: UHC Medicare Advantage |
$14.30
|
| Rate for Payer: VA VA |
$14.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.91
|
|
|
HC CAST SUP SHT GAUNTLET FBRGLS
|
Facility
|
IP
|
$57.22
|
|
| Hospital Charge Code |
27200331
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.19 |
| Max. Negotiated Rate |
$51.50 |
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: BCBS Trust/PPO |
$46.71
|
| Rate for Payer: BCN Commercial |
$44.22
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$49.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$46.92
|
| Rate for Payer: PHP Commercial |
$48.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.19
|
| Rate for Payer: Priority Health HMO/PPO |
$49.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.35
|
| Rate for Payer: UHC Core |
$47.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.91
|
|
|
HC CAST SUP SHT LEG SPLINT ADULT FBRGLS
|
Facility
|
IP
|
$31.21
|
|
| Hospital Charge Code |
27200341
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.29 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: BCBS Trust/PPO |
$25.48
|
| Rate for Payer: BCN Commercial |
$24.12
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.29
|
| Rate for Payer: Priority Health HMO/PPO |
$27.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.46
|
| Rate for Payer: UHC Core |
$26.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC CAST SUP SHT LEG SPLINT ADULT FBRGLS
|
Facility
|
OP
|
$31.21
|
|
| Hospital Charge Code |
27200341
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.41 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna Medicare |
$8.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.75
|
| Rate for Payer: BCBS Complete |
$12.48
|
| Rate for Payer: BCBS MAPPO |
$7.80
|
| Rate for Payer: BCBS Trust/PPO |
$25.66
|
| Rate for Payer: BCN Commercial |
$24.27
|
| Rate for Payer: BCN Medicare Advantage |
$7.80
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.80
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: PACE Senior Care Partners |
$7.41
|
| Rate for Payer: PACE SWMI |
$7.80
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: PHP Medicare Advantage |
$7.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.29
|
| Rate for Payer: Priority Health HMO/PPO |
$27.15
|
| Rate for Payer: Priority Health Medicare |
$7.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.91
|
| Rate for Payer: Railroad Medicare Medicare |
$7.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.46
|
| Rate for Payer: UHC Core |
$26.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.80
|
| Rate for Payer: UHC Exchange |
$7.80
|
| Rate for Payer: UHC Medicare Advantage |
$7.80
|
| Rate for Payer: VA VA |
$7.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC CAST SUP SHT LEG SPLINT PED FBRGLS
|
Facility
|
IP
|
$26.01
|
|
| Hospital Charge Code |
27200342
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: BCBS Trust/PPO |
$21.23
|
| Rate for Payer: BCN Commercial |
$20.10
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC CAST SUP SHT LEG SPLINT PED FBRGLS
|
Facility
|
OP
|
$26.01
|
|
| Hospital Charge Code |
27200342
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$6.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.13
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCBS MAPPO |
$6.50
|
| Rate for Payer: BCBS Trust/PPO |
$21.38
|
| Rate for Payer: BCN Commercial |
$20.22
|
| Rate for Payer: BCN Medicare Advantage |
$6.50
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.50
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PACE Senior Care Partners |
$6.18
|
| Rate for Payer: PACE SWMI |
$6.50
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$6.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Medicare |
$6.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: Railroad Medicare Medicare |
$6.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.50
|
| Rate for Payer: UHC Exchange |
$6.50
|
| Rate for Payer: UHC Medicare Advantage |
$6.50
|
| Rate for Payer: VA VA |
$6.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC CAST TOTAL CONTACT
|
Facility
|
OP
|
$497.87
|
|
|
Service Code
|
CPT 29445
|
| Hospital Charge Code |
70000021
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$118.24 |
| Max. Negotiated Rate |
$448.08 |
| Rate for Payer: Aetna Commercial |
$423.19
|
| Rate for Payer: Aetna Medicare |
$129.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$155.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$155.58
|
| Rate for Payer: BCBS Complete |
$201.63
|
| Rate for Payer: BCBS MAPPO |
$124.47
|
| Rate for Payer: BCBS Trust/PPO |
$409.30
|
| Rate for Payer: BCN Commercial |
$387.09
|
| Rate for Payer: BCN Medicare Advantage |
$124.47
|
| Rate for Payer: Cash Price |
$398.30
|
| Rate for Payer: Cash Price |
$398.30
|
| Rate for Payer: Cofinity Commercial |
$428.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$398.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.47
|
| Rate for Payer: Healthscope Commercial |
$448.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$373.40
|
| Rate for Payer: Mclaren Medicaid |
$192.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.69
|
| Rate for Payer: Meridian Medicaid |
$201.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$143.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$423.19
|
| Rate for Payer: Nomi Health Commercial |
$408.25
|
| Rate for Payer: PACE Senior Care Partners |
$118.24
|
| Rate for Payer: PACE SWMI |
$124.47
|
| Rate for Payer: PHP Commercial |
$423.19
|
| Rate for Payer: PHP Medicare Advantage |
$124.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$323.62
|
| Rate for Payer: Priority Health HMO/PPO |
$433.15
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$333.57
|
| Rate for Payer: Railroad Medicare Medicare |
$124.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$438.13
|
| Rate for Payer: UHC Core |
$415.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.47
|
| Rate for Payer: UHC Exchange |
$124.47
|
| Rate for Payer: UHC Medicare Advantage |
$124.47
|
| Rate for Payer: UHCCP Medicaid |
$192.01
|
| Rate for Payer: VA VA |
$124.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$373.40
|
|
|
HC CAST TOTAL CONTACT
|
Facility
|
IP
|
$497.87
|
|
|
Service Code
|
CPT 29445
|
| Hospital Charge Code |
70000021
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$323.62 |
| Max. Negotiated Rate |
$448.08 |
| Rate for Payer: Aetna Commercial |
$423.19
|
| Rate for Payer: BCBS Trust/PPO |
$406.41
|
| Rate for Payer: BCN Commercial |
$384.75
|
| Rate for Payer: Cash Price |
$398.30
|
| Rate for Payer: Cofinity Commercial |
$428.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$398.30
|
| Rate for Payer: Healthscope Commercial |
$448.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$373.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$423.19
|
| Rate for Payer: Nomi Health Commercial |
$408.25
|
| Rate for Payer: PHP Commercial |
$423.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$323.62
|
| Rate for Payer: Priority Health HMO/PPO |
$433.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$333.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$438.13
|
| Rate for Payer: UHC Core |
$415.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$373.40
|
|
|
HC CAST WEDGE
|
Facility
|
IP
|
$358.65
|
|
|
Service Code
|
CPT 29740
|
| Hospital Charge Code |
70000019
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$233.12 |
| Max. Negotiated Rate |
$322.79 |
| Rate for Payer: Aetna Commercial |
$304.85
|
| Rate for Payer: BCBS Trust/PPO |
$292.77
|
| Rate for Payer: BCN Commercial |
$277.16
|
| Rate for Payer: Cash Price |
$286.92
|
| Rate for Payer: Cofinity Commercial |
$308.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.92
|
| Rate for Payer: Healthscope Commercial |
$322.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.85
|
| Rate for Payer: Nomi Health Commercial |
$294.09
|
| Rate for Payer: PHP Commercial |
$304.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.12
|
| Rate for Payer: Priority Health HMO/PPO |
$312.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$240.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.61
|
| Rate for Payer: UHC Core |
$299.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.99
|
|
