|
HC CLOSED RX METACARPAL FX, MANIP
|
Facility
|
IP
|
$421.54
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
76100167
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$274.00 |
| Max. Negotiated Rate |
$379.39 |
| Rate for Payer: Aetna Commercial |
$358.31
|
| Rate for Payer: BCBS Trust/PPO |
$344.10
|
| Rate for Payer: BCN Commercial |
$325.77
|
| Rate for Payer: Cash Price |
$337.23
|
| Rate for Payer: Cofinity Commercial |
$362.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.23
|
| Rate for Payer: Healthscope Commercial |
$379.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$316.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$358.31
|
| Rate for Payer: Nomi Health Commercial |
$345.66
|
| Rate for Payer: PHP Commercial |
$358.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.00
|
| Rate for Payer: Priority Health HMO/PPO |
$366.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$282.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$370.96
|
| Rate for Payer: UHC Core |
$351.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$316.16
|
|
|
HC CLOSED RX METACARPAL FX, MANIP
|
Facility
|
OP
|
$421.54
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
76100167
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$100.12 |
| Max. Negotiated Rate |
$379.39 |
| Rate for Payer: Aetna Commercial |
$358.31
|
| Rate for Payer: Aetna Medicare |
$109.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$131.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$131.73
|
| Rate for Payer: BCBS Complete |
$178.43
|
| Rate for Payer: BCBS MAPPO |
$105.38
|
| Rate for Payer: BCBS Trust/PPO |
$346.55
|
| Rate for Payer: BCN Commercial |
$327.75
|
| Rate for Payer: BCN Medicare Advantage |
$105.38
|
| Rate for Payer: Cash Price |
$337.23
|
| Rate for Payer: Cash Price |
$337.23
|
| Rate for Payer: Cofinity Commercial |
$362.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.38
|
| Rate for Payer: Healthscope Commercial |
$379.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$316.16
|
| Rate for Payer: Mclaren Medicaid |
$169.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.65
|
| Rate for Payer: Meridian Medicaid |
$178.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$121.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$358.31
|
| Rate for Payer: Nomi Health Commercial |
$345.66
|
| Rate for Payer: PACE Senior Care Partners |
$100.12
|
| Rate for Payer: PACE SWMI |
$105.38
|
| Rate for Payer: PHP Commercial |
$358.31
|
| Rate for Payer: PHP Medicare Advantage |
$105.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.00
|
| Rate for Payer: Priority Health HMO/PPO |
$366.74
|
| Rate for Payer: Priority Health Medicare |
$106.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$282.43
|
| Rate for Payer: Railroad Medicare Medicare |
$105.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$370.96
|
| Rate for Payer: UHC Core |
$351.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$105.38
|
| Rate for Payer: UHC Exchange |
$105.38
|
| Rate for Payer: UHC Medicare Advantage |
$105.38
|
| Rate for Payer: UHCCP Medicaid |
$169.93
|
| Rate for Payer: VA VA |
$105.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$316.16
|
|
|
HC CLOSED RX METATARSAL FX
|
Facility
|
IP
|
$351.28
|
|
|
Service Code
|
CPT 28470
|
| Hospital Charge Code |
76100175
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$228.33 |
| Max. Negotiated Rate |
$316.15 |
| Rate for Payer: Aetna Commercial |
$298.59
|
| Rate for Payer: BCBS Trust/PPO |
$286.75
|
| Rate for Payer: BCN Commercial |
$271.47
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cofinity Commercial |
$302.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.02
|
| Rate for Payer: Healthscope Commercial |
$316.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.59
|
| Rate for Payer: Nomi Health Commercial |
$288.05
|
| Rate for Payer: PHP Commercial |
$298.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.33
|
| Rate for Payer: Priority Health HMO/PPO |
$305.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.13
|
| Rate for Payer: UHC Core |
$293.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.46
|
|
|
HC CLOSED RX METATARSAL FX
|
Facility
|
OP
|
$351.28
|
|
|
Service Code
|
CPT 28470
|
| Hospital Charge Code |
76100175
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$83.43 |
| Max. Negotiated Rate |
$316.15 |
| Rate for Payer: Aetna Commercial |
$298.59
|
| Rate for Payer: Aetna Medicare |
$91.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.78
|
| Rate for Payer: BCBS Complete |
$178.43
|
| Rate for Payer: BCBS MAPPO |
$87.82
|
| Rate for Payer: BCBS Trust/PPO |
$288.79
|
| Rate for Payer: BCN Commercial |
$273.12
|
| Rate for Payer: BCN Medicare Advantage |
$87.82
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cofinity Commercial |
$302.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.82
|
| Rate for Payer: Healthscope Commercial |
$316.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.46
|
| Rate for Payer: Mclaren Medicaid |
$169.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.21
|
| Rate for Payer: Meridian Medicaid |
$178.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.59
|
| Rate for Payer: Nomi Health Commercial |
$288.05
|
| Rate for Payer: PACE Senior Care Partners |
$83.43
|
| Rate for Payer: PACE SWMI |
$87.82
|
| Rate for Payer: PHP Commercial |
$298.59
|
| Rate for Payer: PHP Medicare Advantage |
$87.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.33
|
| Rate for Payer: Priority Health HMO/PPO |
$305.61
|
| Rate for Payer: Priority Health Medicare |
$88.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.36
|
| Rate for Payer: Railroad Medicare Medicare |
$87.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.13
|
| Rate for Payer: UHC Core |
$293.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.82
|
| Rate for Payer: UHC Exchange |
$87.82
|
| Rate for Payer: UHC Medicare Advantage |
$87.82
|
| Rate for Payer: UHCCP Medicaid |
$169.93
|
| Rate for Payer: VA VA |
$87.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.46
|
|
|
HC CLOSED RX NAVICULAR FX
|
Facility
|
OP
|
$351.28
|
|
|
Service Code
|
CPT 25622
|
| Hospital Charge Code |
76100164
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$83.43 |
| Max. Negotiated Rate |
$316.15 |
| Rate for Payer: Aetna Commercial |
$298.59
|
| Rate for Payer: Aetna Medicare |
$91.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.78
|
| Rate for Payer: BCBS Complete |
$178.43
|
| Rate for Payer: BCBS MAPPO |
$87.82
|
| Rate for Payer: BCBS Trust/PPO |
$288.79
|
| Rate for Payer: BCN Commercial |
$273.12
|
| Rate for Payer: BCN Medicare Advantage |
$87.82
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cofinity Commercial |
$302.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.82
|
| Rate for Payer: Healthscope Commercial |
$316.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.46
|
| Rate for Payer: Mclaren Medicaid |
$169.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.21
|
| Rate for Payer: Meridian Medicaid |
$178.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.59
|
| Rate for Payer: Nomi Health Commercial |
$288.05
|
| Rate for Payer: PACE Senior Care Partners |
$83.43
|
| Rate for Payer: PACE SWMI |
$87.82
|
| Rate for Payer: PHP Commercial |
$298.59
|
| Rate for Payer: PHP Medicare Advantage |
$87.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.33
|
| Rate for Payer: Priority Health HMO/PPO |
$305.61
|
| Rate for Payer: Priority Health Medicare |
$88.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.36
|
| Rate for Payer: Railroad Medicare Medicare |
$87.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.13
|
| Rate for Payer: UHC Core |
$293.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.82
|
| Rate for Payer: UHC Exchange |
$87.82
|
| Rate for Payer: UHC Medicare Advantage |
$87.82
|
| Rate for Payer: UHCCP Medicaid |
$169.93
|
| Rate for Payer: VA VA |
$87.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.46
|
|
|
HC CLOSED RX NAVICULAR FX
|
Facility
|
IP
|
$351.28
|
|
|
Service Code
|
CPT 25622
|
| Hospital Charge Code |
76100164
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$228.33 |
| Max. Negotiated Rate |
$316.15 |
| Rate for Payer: Aetna Commercial |
$298.59
|
| Rate for Payer: BCBS Trust/PPO |
$286.75
|
| Rate for Payer: BCN Commercial |
$271.47
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cofinity Commercial |
$302.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.02
|
| Rate for Payer: Healthscope Commercial |
$316.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.59
|
| Rate for Payer: Nomi Health Commercial |
$288.05
|
| Rate for Payer: PHP Commercial |
$298.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.33
|
| Rate for Payer: Priority Health HMO/PPO |
$305.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.13
|
| Rate for Payer: UHC Core |
$293.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.46
|
|
|
HC CLOSED RX PATELLA FX
|
Facility
|
IP
|
$351.28
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
76100171
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$228.33 |
| Max. Negotiated Rate |
$316.15 |
| Rate for Payer: Aetna Commercial |
$298.59
|
| Rate for Payer: BCBS Trust/PPO |
$286.75
|
| Rate for Payer: BCN Commercial |
$271.47
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cofinity Commercial |
$302.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.02
|
| Rate for Payer: Healthscope Commercial |
$316.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.59
|
| Rate for Payer: Nomi Health Commercial |
$288.05
|
| Rate for Payer: PHP Commercial |
$298.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.33
|
| Rate for Payer: Priority Health HMO/PPO |
$305.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.13
|
| Rate for Payer: UHC Core |
$293.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.46
|
|
|
HC CLOSED RX PATELLA FX
|
Facility
|
OP
|
$351.28
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
76100171
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$83.43 |
| Max. Negotiated Rate |
$316.15 |
| Rate for Payer: Aetna Commercial |
$298.59
|
| Rate for Payer: Aetna Medicare |
$91.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.78
|
| Rate for Payer: BCBS Complete |
$178.43
|
| Rate for Payer: BCBS MAPPO |
$87.82
|
| Rate for Payer: BCBS Trust/PPO |
$288.79
|
| Rate for Payer: BCN Commercial |
$273.12
|
| Rate for Payer: BCN Medicare Advantage |
$87.82
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cofinity Commercial |
$302.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.82
|
| Rate for Payer: Healthscope Commercial |
$316.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.46
|
| Rate for Payer: Mclaren Medicaid |
$169.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.21
|
| Rate for Payer: Meridian Medicaid |
$178.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.59
|
| Rate for Payer: Nomi Health Commercial |
$288.05
|
| Rate for Payer: PACE Senior Care Partners |
$83.43
|
| Rate for Payer: PACE SWMI |
$87.82
|
| Rate for Payer: PHP Commercial |
$298.59
|
| Rate for Payer: PHP Medicare Advantage |
$87.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.33
|
| Rate for Payer: Priority Health HMO/PPO |
$305.61
|
| Rate for Payer: Priority Health Medicare |
$88.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.36
|
| Rate for Payer: Railroad Medicare Medicare |
$87.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.13
|
| Rate for Payer: UHC Core |
$293.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.82
|
| Rate for Payer: UHC Exchange |
$87.82
|
| Rate for Payer: UHC Medicare Advantage |
$87.82
|
| Rate for Payer: UHCCP Medicaid |
$169.93
|
| Rate for Payer: VA VA |
$87.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.46
|
|
|
HC CLOSED RX POST HIP ARTHRPLAS DISLOC
|
Facility
|
IP
|
$635.11
|
|
|
Service Code
|
CPT 27265
|
| Hospital Charge Code |
76100363
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$412.82 |
| Max. Negotiated Rate |
$571.60 |
| Rate for Payer: Aetna Commercial |
$539.84
|
| Rate for Payer: BCBS Trust/PPO |
$518.44
|
| Rate for Payer: BCN Commercial |
$490.81
|
| Rate for Payer: Cash Price |
$508.09
|
| Rate for Payer: Cofinity Commercial |
$546.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$508.09
|
| Rate for Payer: Healthscope Commercial |
$571.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$476.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.84
|
| Rate for Payer: Nomi Health Commercial |
$520.79
|
| Rate for Payer: PHP Commercial |
$539.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.82
|
| Rate for Payer: Priority Health HMO/PPO |
$552.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$425.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$558.90
|
| Rate for Payer: UHC Core |
$530.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$476.33
|
|
|
HC CLOSED RX POST HIP ARTHRPLAS DISLOC
|
Facility
|
OP
|
$635.11
|
|
|
Service Code
|
CPT 27265
|
| Hospital Charge Code |
76100363
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$150.84 |
| Max. Negotiated Rate |
$571.60 |
| Rate for Payer: Aetna Commercial |
$539.84
|
| Rate for Payer: Aetna Medicare |
$165.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$198.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$198.47
|
| Rate for Payer: BCBS Complete |
$178.43
|
| Rate for Payer: BCBS MAPPO |
$158.78
|
| Rate for Payer: BCBS Trust/PPO |
$522.12
|
| Rate for Payer: BCN Commercial |
$493.80
|
| Rate for Payer: BCN Medicare Advantage |
$158.78
|
| Rate for Payer: Cash Price |
$508.09
|
| Rate for Payer: Cash Price |
$508.09
|
| Rate for Payer: Cofinity Commercial |
$546.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$508.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.78
|
| Rate for Payer: Healthscope Commercial |
$571.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$476.33
|
| Rate for Payer: Mclaren Medicaid |
$169.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$166.72
|
| Rate for Payer: Meridian Medicaid |
$178.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$182.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.84
|
| Rate for Payer: Nomi Health Commercial |
$520.79
|
| Rate for Payer: PACE Senior Care Partners |
$150.84
|
| Rate for Payer: PACE SWMI |
$158.78
|
| Rate for Payer: PHP Commercial |
$539.84
|
| Rate for Payer: PHP Medicare Advantage |
$158.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.82
|
| Rate for Payer: Priority Health HMO/PPO |
$552.55
|
| Rate for Payer: Priority Health Medicare |
$160.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$425.52
|
| Rate for Payer: Railroad Medicare Medicare |
$158.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$558.90
|
| Rate for Payer: UHC Core |
$530.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$158.78
|
| Rate for Payer: UHC Exchange |
$158.78
|
| Rate for Payer: UHC Medicare Advantage |
$158.78
|
| Rate for Payer: UHCCP Medicaid |
$169.93
|
| Rate for Payer: VA VA |
$158.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$476.33
|
|
|
HC CLOSED RX PROX HUMERUS FRACTURE
|
Facility
|
IP
|
$351.28
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
76100160
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$228.33 |
| Max. Negotiated Rate |
$316.15 |
| Rate for Payer: Aetna Commercial |
$298.59
|
| Rate for Payer: BCBS Trust/PPO |
$286.75
|
| Rate for Payer: BCN Commercial |
$271.47
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cofinity Commercial |
$302.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.02
|
| Rate for Payer: Healthscope Commercial |
$316.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.59
|
| Rate for Payer: Nomi Health Commercial |
$288.05
|
| Rate for Payer: PHP Commercial |
$298.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.33
|
| Rate for Payer: Priority Health HMO/PPO |
$305.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.13
|
| Rate for Payer: UHC Core |
$293.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.46
|
|
|
HC CLOSED RX PROX HUMERUS FRACTURE
|
Facility
|
OP
|
$351.28
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
76100160
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$83.43 |
| Max. Negotiated Rate |
$316.15 |
| Rate for Payer: Aetna Commercial |
$298.59
|
| Rate for Payer: Aetna Medicare |
$91.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.78
|
| Rate for Payer: BCBS Complete |
$178.43
|
| Rate for Payer: BCBS MAPPO |
$87.82
|
| Rate for Payer: BCBS Trust/PPO |
$288.79
|
| Rate for Payer: BCN Commercial |
$273.12
|
| Rate for Payer: BCN Medicare Advantage |
$87.82
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cofinity Commercial |
$302.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.82
|
| Rate for Payer: Healthscope Commercial |
$316.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.46
|
| Rate for Payer: Mclaren Medicaid |
$169.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.21
|
| Rate for Payer: Meridian Medicaid |
$178.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.59
|
| Rate for Payer: Nomi Health Commercial |
$288.05
|
| Rate for Payer: PACE Senior Care Partners |
$83.43
|
| Rate for Payer: PACE SWMI |
$87.82
|
| Rate for Payer: PHP Commercial |
$298.59
|
| Rate for Payer: PHP Medicare Advantage |
$87.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.33
|
| Rate for Payer: Priority Health HMO/PPO |
$305.61
|
| Rate for Payer: Priority Health Medicare |
$88.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.36
|
| Rate for Payer: Railroad Medicare Medicare |
$87.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.13
|
| Rate for Payer: UHC Core |
$293.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.82
|
| Rate for Payer: UHC Exchange |
$87.82
|
| Rate for Payer: UHC Medicare Advantage |
$87.82
|
| Rate for Payer: UHCCP Medicaid |
$169.93
|
| Rate for Payer: VA VA |
$87.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.46
|
|
|
HC CLOSED RX PROX THIGH FX
|
Facility
|
IP
|
$622.16
|
|
|
Service Code
|
CPT 27230
|
| Hospital Charge Code |
76100317
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$404.40 |
| Max. Negotiated Rate |
$559.94 |
| Rate for Payer: Aetna Commercial |
$528.84
|
| Rate for Payer: BCBS Trust/PPO |
$507.87
|
| Rate for Payer: BCN Commercial |
$480.81
|
| Rate for Payer: Cash Price |
$497.73
|
| Rate for Payer: Cofinity Commercial |
$535.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$497.73
|
| Rate for Payer: Healthscope Commercial |
$559.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$466.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$528.84
|
| Rate for Payer: Nomi Health Commercial |
$510.17
|
| Rate for Payer: PHP Commercial |
$528.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$404.40
|
| Rate for Payer: Priority Health HMO/PPO |
$541.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$416.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$547.50
|
| Rate for Payer: UHC Core |
$519.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$466.62
|
|
|
HC CLOSED RX PROX THIGH FX
|
Facility
|
OP
|
$622.16
|
|
|
Service Code
|
CPT 27230
|
| Hospital Charge Code |
76100317
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$147.76 |
| Max. Negotiated Rate |
$559.94 |
| Rate for Payer: Aetna Commercial |
$528.84
|
| Rate for Payer: Aetna Medicare |
$161.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$194.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$194.42
|
| Rate for Payer: BCBS Complete |
$178.43
|
| Rate for Payer: BCBS MAPPO |
$155.54
|
| Rate for Payer: BCBS Trust/PPO |
$511.48
|
| Rate for Payer: BCN Commercial |
$483.73
|
| Rate for Payer: BCN Medicare Advantage |
$155.54
|
| Rate for Payer: Cash Price |
$497.73
|
| Rate for Payer: Cash Price |
$497.73
|
| Rate for Payer: Cofinity Commercial |
$535.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$497.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.54
|
| Rate for Payer: Healthscope Commercial |
$559.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$466.62
|
| Rate for Payer: Mclaren Medicaid |
$169.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.32
|
| Rate for Payer: Meridian Medicaid |
$178.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$178.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$528.84
|
| Rate for Payer: Nomi Health Commercial |
$510.17
|
| Rate for Payer: PACE Senior Care Partners |
$147.76
|
| Rate for Payer: PACE SWMI |
$155.54
|
| Rate for Payer: PHP Commercial |
$528.84
|
| Rate for Payer: PHP Medicare Advantage |
$155.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$404.40
|
| Rate for Payer: Priority Health HMO/PPO |
$541.28
|
| Rate for Payer: Priority Health Medicare |
$157.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$416.85
|
| Rate for Payer: Railroad Medicare Medicare |
$155.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$547.50
|
| Rate for Payer: UHC Core |
$519.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$155.54
|
| Rate for Payer: UHC Exchange |
$155.54
|
| Rate for Payer: UHC Medicare Advantage |
$155.54
|
| Rate for Payer: UHCCP Medicaid |
$169.93
|
| Rate for Payer: VA VA |
$155.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$466.62
|
|
|
HC CLOSED RX RADIAL HEAD/NECK FX
|
Facility
|
OP
|
$351.28
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
76100161
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$83.43 |
| Max. Negotiated Rate |
$316.15 |
| Rate for Payer: Aetna Commercial |
$298.59
|
| Rate for Payer: Aetna Medicare |
$91.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.78
|
| Rate for Payer: BCBS Complete |
$178.43
|
| Rate for Payer: BCBS MAPPO |
$87.82
|
| Rate for Payer: BCBS Trust/PPO |
$288.79
|
| Rate for Payer: BCN Commercial |
$273.12
|
| Rate for Payer: BCN Medicare Advantage |
$87.82
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cofinity Commercial |
$302.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.82
|
| Rate for Payer: Healthscope Commercial |
$316.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.46
|
| Rate for Payer: Mclaren Medicaid |
$169.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.21
|
| Rate for Payer: Meridian Medicaid |
$178.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.59
|
| Rate for Payer: Nomi Health Commercial |
$288.05
|
| Rate for Payer: PACE Senior Care Partners |
$83.43
|
| Rate for Payer: PACE SWMI |
$87.82
|
| Rate for Payer: PHP Commercial |
$298.59
|
| Rate for Payer: PHP Medicare Advantage |
$87.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.33
|
| Rate for Payer: Priority Health HMO/PPO |
$305.61
|
| Rate for Payer: Priority Health Medicare |
$88.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.36
|
| Rate for Payer: Railroad Medicare Medicare |
$87.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.13
|
| Rate for Payer: UHC Core |
$293.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.82
|
| Rate for Payer: UHC Exchange |
$87.82
|
| Rate for Payer: UHC Medicare Advantage |
$87.82
|
| Rate for Payer: UHCCP Medicaid |
$169.93
|
| Rate for Payer: VA VA |
$87.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.46
|
|
|
HC CLOSED RX RADIAL HEAD/NECK FX
|
Facility
|
IP
|
$351.28
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
76100161
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$228.33 |
| Max. Negotiated Rate |
$316.15 |
| Rate for Payer: Aetna Commercial |
$298.59
|
| Rate for Payer: BCBS Trust/PPO |
$286.75
|
| Rate for Payer: BCN Commercial |
$271.47
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cofinity Commercial |
$302.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.02
|
| Rate for Payer: Healthscope Commercial |
$316.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.59
|
| Rate for Payer: Nomi Health Commercial |
$288.05
|
| Rate for Payer: PHP Commercial |
$298.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.33
|
| Rate for Payer: Priority Health HMO/PPO |
$305.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.13
|
| Rate for Payer: UHC Core |
$293.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.46
|
|
|
HC CLOSED RX RAD/ULNA SHAFT FX
|
Facility
|
OP
|
$351.28
|
|
|
Service Code
|
CPT 25560
|
| Hospital Charge Code |
76100162
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$83.43 |
| Max. Negotiated Rate |
$316.15 |
| Rate for Payer: Aetna Commercial |
$298.59
|
| Rate for Payer: Aetna Medicare |
$91.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.78
|
| Rate for Payer: BCBS Complete |
$178.43
|
| Rate for Payer: BCBS MAPPO |
$87.82
|
| Rate for Payer: BCBS Trust/PPO |
$288.79
|
| Rate for Payer: BCN Commercial |
$273.12
|
| Rate for Payer: BCN Medicare Advantage |
$87.82
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cofinity Commercial |
$302.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.82
|
| Rate for Payer: Healthscope Commercial |
$316.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.46
|
| Rate for Payer: Mclaren Medicaid |
$169.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.21
|
| Rate for Payer: Meridian Medicaid |
$178.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.59
|
| Rate for Payer: Nomi Health Commercial |
$288.05
|
| Rate for Payer: PACE Senior Care Partners |
$83.43
|
| Rate for Payer: PACE SWMI |
$87.82
|
| Rate for Payer: PHP Commercial |
$298.59
|
| Rate for Payer: PHP Medicare Advantage |
$87.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.33
|
| Rate for Payer: Priority Health HMO/PPO |
$305.61
|
| Rate for Payer: Priority Health Medicare |
$88.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.36
|
| Rate for Payer: Railroad Medicare Medicare |
$87.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.13
|
| Rate for Payer: UHC Core |
$293.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.82
|
| Rate for Payer: UHC Exchange |
$87.82
|
| Rate for Payer: UHC Medicare Advantage |
$87.82
|
| Rate for Payer: UHCCP Medicaid |
$169.93
|
| Rate for Payer: VA VA |
$87.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.46
|
|
|
HC CLOSED RX RAD/ULNA SHAFT FX
|
Facility
|
IP
|
$351.28
|
|
|
Service Code
|
CPT 25560
|
| Hospital Charge Code |
76100162
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$228.33 |
| Max. Negotiated Rate |
$316.15 |
| Rate for Payer: Aetna Commercial |
$298.59
|
| Rate for Payer: BCBS Trust/PPO |
$286.75
|
| Rate for Payer: BCN Commercial |
$271.47
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cofinity Commercial |
$302.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.02
|
| Rate for Payer: Healthscope Commercial |
$316.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.59
|
| Rate for Payer: Nomi Health Commercial |
$288.05
|
| Rate for Payer: PHP Commercial |
$298.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.33
|
| Rate for Payer: Priority Health HMO/PPO |
$305.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.13
|
| Rate for Payer: UHC Core |
$293.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.46
|
|
|
HC CLOSED RX TIBIAL PLATEAU FX
|
Facility
|
IP
|
$351.28
|
|
|
Service Code
|
CPT 27530
|
| Hospital Charge Code |
76100172
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$228.33 |
| Max. Negotiated Rate |
$316.15 |
| Rate for Payer: Aetna Commercial |
$298.59
|
| Rate for Payer: BCBS Trust/PPO |
$286.75
|
| Rate for Payer: BCN Commercial |
$271.47
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cofinity Commercial |
$302.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.02
|
| Rate for Payer: Healthscope Commercial |
$316.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.59
|
| Rate for Payer: Nomi Health Commercial |
$288.05
|
| Rate for Payer: PHP Commercial |
$298.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.33
|
| Rate for Payer: Priority Health HMO/PPO |
$305.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.13
|
| Rate for Payer: UHC Core |
$293.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.46
|
|
|
HC CLOSED RX TIBIAL PLATEAU FX
|
Facility
|
OP
|
$351.28
|
|
|
Service Code
|
CPT 27530
|
| Hospital Charge Code |
76100172
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$83.43 |
| Max. Negotiated Rate |
$316.15 |
| Rate for Payer: Aetna Commercial |
$298.59
|
| Rate for Payer: Aetna Medicare |
$91.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.78
|
| Rate for Payer: BCBS Complete |
$178.43
|
| Rate for Payer: BCBS MAPPO |
$87.82
|
| Rate for Payer: BCBS Trust/PPO |
$288.79
|
| Rate for Payer: BCN Commercial |
$273.12
|
| Rate for Payer: BCN Medicare Advantage |
$87.82
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cofinity Commercial |
$302.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.82
|
| Rate for Payer: Healthscope Commercial |
$316.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.46
|
| Rate for Payer: Mclaren Medicaid |
$169.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.21
|
| Rate for Payer: Meridian Medicaid |
$178.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.59
|
| Rate for Payer: Nomi Health Commercial |
$288.05
|
| Rate for Payer: PACE Senior Care Partners |
$83.43
|
| Rate for Payer: PACE SWMI |
$87.82
|
| Rate for Payer: PHP Commercial |
$298.59
|
| Rate for Payer: PHP Medicare Advantage |
$87.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.33
|
| Rate for Payer: Priority Health HMO/PPO |
$305.61
|
| Rate for Payer: Priority Health Medicare |
$88.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.36
|
| Rate for Payer: Railroad Medicare Medicare |
$87.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.13
|
| Rate for Payer: UHC Core |
$293.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.82
|
| Rate for Payer: UHC Exchange |
$87.82
|
| Rate for Payer: UHC Medicare Advantage |
$87.82
|
| Rate for Payer: UHCCP Medicaid |
$169.93
|
| Rate for Payer: VA VA |
$87.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.46
|
|
|
HC CLOSED RX TIBIA SHAFT FX
|
Facility
|
OP
|
$386.41
|
|
|
Service Code
|
CPT 27750
|
| Hospital Charge Code |
76100173
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$91.77 |
| Max. Negotiated Rate |
$347.77 |
| Rate for Payer: Aetna Commercial |
$328.45
|
| Rate for Payer: Aetna Medicare |
$100.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$120.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$120.75
|
| Rate for Payer: BCBS Complete |
$178.43
|
| Rate for Payer: BCBS MAPPO |
$96.60
|
| Rate for Payer: BCBS Trust/PPO |
$317.67
|
| Rate for Payer: BCN Commercial |
$300.43
|
| Rate for Payer: BCN Medicare Advantage |
$96.60
|
| Rate for Payer: Cash Price |
$309.13
|
| Rate for Payer: Cash Price |
$309.13
|
| Rate for Payer: Cofinity Commercial |
$332.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$309.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.60
|
| Rate for Payer: Healthscope Commercial |
$347.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.81
|
| Rate for Payer: Mclaren Medicaid |
$169.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.43
|
| Rate for Payer: Meridian Medicaid |
$178.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.45
|
| Rate for Payer: Nomi Health Commercial |
$316.86
|
| Rate for Payer: PACE Senior Care Partners |
$91.77
|
| Rate for Payer: PACE SWMI |
$96.60
|
| Rate for Payer: PHP Commercial |
$328.45
|
| Rate for Payer: PHP Medicare Advantage |
$96.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.17
|
| Rate for Payer: Priority Health HMO/PPO |
$336.18
|
| Rate for Payer: Priority Health Medicare |
$97.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$258.89
|
| Rate for Payer: Railroad Medicare Medicare |
$96.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$340.04
|
| Rate for Payer: UHC Core |
$322.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.60
|
| Rate for Payer: UHC Exchange |
$96.60
|
| Rate for Payer: UHC Medicare Advantage |
$96.60
|
| Rate for Payer: UHCCP Medicaid |
$169.93
|
| Rate for Payer: VA VA |
$96.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.81
|
|
|
HC CLOSED RX TIBIA SHAFT FX
|
Facility
|
IP
|
$386.41
|
|
|
Service Code
|
CPT 27750
|
| Hospital Charge Code |
76100173
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$251.17 |
| Max. Negotiated Rate |
$347.77 |
| Rate for Payer: Aetna Commercial |
$328.45
|
| Rate for Payer: BCBS Trust/PPO |
$315.43
|
| Rate for Payer: BCN Commercial |
$298.62
|
| Rate for Payer: Cash Price |
$309.13
|
| Rate for Payer: Cofinity Commercial |
$332.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$309.13
|
| Rate for Payer: Healthscope Commercial |
$347.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.45
|
| Rate for Payer: Nomi Health Commercial |
$316.86
|
| Rate for Payer: PHP Commercial |
$328.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.17
|
| Rate for Payer: Priority Health HMO/PPO |
$336.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$258.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$340.04
|
| Rate for Payer: UHC Core |
$322.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.81
|
|
|
HC CLOSED TREATMENT DISLOCATED SHOULDER W MANIP
|
Facility
|
IP
|
$634.64
|
|
|
Service Code
|
CPT 23650
|
| Hospital Charge Code |
76100436
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$412.52 |
| Max. Negotiated Rate |
$571.18 |
| Rate for Payer: Aetna Commercial |
$539.44
|
| Rate for Payer: BCBS Trust/PPO |
$518.06
|
| Rate for Payer: BCN Commercial |
$490.45
|
| Rate for Payer: Cash Price |
$507.71
|
| Rate for Payer: Cofinity Commercial |
$545.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$507.71
|
| Rate for Payer: Healthscope Commercial |
$571.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$475.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.44
|
| Rate for Payer: Nomi Health Commercial |
$520.40
|
| Rate for Payer: PHP Commercial |
$539.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.52
|
| Rate for Payer: Priority Health HMO/PPO |
$552.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$425.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$558.48
|
| Rate for Payer: UHC Core |
$529.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$475.98
|
|
|
HC CLOSED TREATMENT DISLOCATED SHOULDER W MANIP
|
Facility
|
OP
|
$634.64
|
|
|
Service Code
|
CPT 23650
|
| Hospital Charge Code |
76100436
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$150.73 |
| Max. Negotiated Rate |
$571.18 |
| Rate for Payer: Aetna Commercial |
$539.44
|
| Rate for Payer: Aetna Medicare |
$165.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$198.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$198.32
|
| Rate for Payer: BCBS Complete |
$178.43
|
| Rate for Payer: BCBS MAPPO |
$158.66
|
| Rate for Payer: BCBS Trust/PPO |
$521.74
|
| Rate for Payer: BCN Commercial |
$493.43
|
| Rate for Payer: BCN Medicare Advantage |
$158.66
|
| Rate for Payer: Cash Price |
$507.71
|
| Rate for Payer: Cash Price |
$507.71
|
| Rate for Payer: Cofinity Commercial |
$545.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$507.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.66
|
| Rate for Payer: Healthscope Commercial |
$571.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$475.98
|
| Rate for Payer: Mclaren Medicaid |
$169.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$166.59
|
| Rate for Payer: Meridian Medicaid |
$178.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$182.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.44
|
| Rate for Payer: Nomi Health Commercial |
$520.40
|
| Rate for Payer: PACE Senior Care Partners |
$150.73
|
| Rate for Payer: PACE SWMI |
$158.66
|
| Rate for Payer: PHP Commercial |
$539.44
|
| Rate for Payer: PHP Medicare Advantage |
$158.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.52
|
| Rate for Payer: Priority Health HMO/PPO |
$552.14
|
| Rate for Payer: Priority Health Medicare |
$160.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$425.21
|
| Rate for Payer: Railroad Medicare Medicare |
$158.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$558.48
|
| Rate for Payer: UHC Core |
$529.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$158.66
|
| Rate for Payer: UHC Exchange |
$158.66
|
| Rate for Payer: UHC Medicare Advantage |
$158.66
|
| Rate for Payer: UHCCP Medicaid |
$169.93
|
| Rate for Payer: VA VA |
$158.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$475.98
|
|
|
HC CLOSED TX ACETAB FX; W/O MANIP
|
Facility
|
IP
|
$381.83
|
|
|
Service Code
|
CPT 27220
|
| Hospital Charge Code |
76100286
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$248.19 |
| Max. Negotiated Rate |
$343.65 |
| Rate for Payer: Aetna Commercial |
$324.56
|
| Rate for Payer: BCBS Trust/PPO |
$311.69
|
| Rate for Payer: BCN Commercial |
$295.08
|
| Rate for Payer: Cash Price |
$305.46
|
| Rate for Payer: Cofinity Commercial |
$328.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$305.46
|
| Rate for Payer: Healthscope Commercial |
$343.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$286.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$324.56
|
| Rate for Payer: Nomi Health Commercial |
$313.10
|
| Rate for Payer: PHP Commercial |
$324.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.19
|
| Rate for Payer: Priority Health HMO/PPO |
$332.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$255.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.01
|
| Rate for Payer: UHC Core |
$318.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$286.37
|
|
