|
HC CK-MB FRACTION
|
Facility
|
OP
|
$101.96
|
|
|
Service Code
|
CPT 82553
|
| Hospital Charge Code |
30100179
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.35 |
| Max. Negotiated Rate |
$91.76 |
| Rate for Payer: Aetna Commercial |
$86.67
|
| Rate for Payer: Aetna Medicare |
$26.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.86
|
| Rate for Payer: BCBS Complete |
$8.77
|
| Rate for Payer: BCBS MAPPO |
$25.49
|
| Rate for Payer: BCBS Trust/PPO |
$83.82
|
| Rate for Payer: BCN Commercial |
$79.27
|
| Rate for Payer: BCN Medicare Advantage |
$25.49
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cofinity Commercial |
$87.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.49
|
| Rate for Payer: Healthscope Commercial |
$91.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.47
|
| Rate for Payer: Mclaren Medicaid |
$8.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.76
|
| Rate for Payer: Meridian Medicaid |
$8.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.67
|
| Rate for Payer: Nomi Health Commercial |
$83.61
|
| Rate for Payer: PACE Senior Care Partners |
$24.22
|
| Rate for Payer: PACE SWMI |
$25.49
|
| Rate for Payer: PHP Commercial |
$86.67
|
| Rate for Payer: PHP Medicare Advantage |
$25.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.27
|
| Rate for Payer: Priority Health HMO/PPO |
$88.71
|
| Rate for Payer: Priority Health Medicare |
$25.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.31
|
| Rate for Payer: Railroad Medicare Medicare |
$25.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.72
|
| Rate for Payer: UHC Core |
$85.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.49
|
| Rate for Payer: UHC Exchange |
$25.49
|
| Rate for Payer: UHC Medicare Advantage |
$25.49
|
| Rate for Payer: UHCCP Medicaid |
$8.35
|
| Rate for Payer: VA VA |
$25.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.47
|
|
|
HC CK-MB FRACTION
|
Facility
|
IP
|
$101.96
|
|
|
Service Code
|
CPT 82553
|
| Hospital Charge Code |
30100179
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$66.27 |
| Max. Negotiated Rate |
$91.76 |
| Rate for Payer: Aetna Commercial |
$86.67
|
| Rate for Payer: BCBS Trust/PPO |
$83.23
|
| Rate for Payer: BCN Commercial |
$78.79
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cofinity Commercial |
$87.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.57
|
| Rate for Payer: Healthscope Commercial |
$91.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.67
|
| Rate for Payer: Nomi Health Commercial |
$83.61
|
| Rate for Payer: PHP Commercial |
$86.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.27
|
| Rate for Payer: Priority Health HMO/PPO |
$88.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.72
|
| Rate for Payer: UHC Core |
$85.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.47
|
|
|
HC CLADOSPORIUM IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200032
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC CLADOSPORIUM IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200032
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC CLAM IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200033
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC CLAM IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200033
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC CLIP FIX DEVICE ROTATABLE
|
Facility
|
IP
|
$791.29
|
|
| Hospital Charge Code |
27200290
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$514.34 |
| Max. Negotiated Rate |
$712.16 |
| Rate for Payer: Aetna Commercial |
$672.60
|
| Rate for Payer: BCBS Trust/PPO |
$645.93
|
| Rate for Payer: BCN Commercial |
$611.51
|
| Rate for Payer: Cash Price |
$633.03
|
| Rate for Payer: Cofinity Commercial |
$680.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$633.03
|
| Rate for Payer: Healthscope Commercial |
$712.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$593.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$672.60
|
| Rate for Payer: Nomi Health Commercial |
$648.86
|
| Rate for Payer: PHP Commercial |
$672.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$514.34
|
| Rate for Payer: Priority Health HMO/PPO |
$688.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$530.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$696.34
|
| Rate for Payer: UHC Core |
$660.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$593.47
|
|
|
HC CLIP FIX DEVICE ROTATABLE
|
Facility
|
OP
|
$791.29
|
|
| Hospital Charge Code |
27200290
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$187.93 |
| Max. Negotiated Rate |
$712.16 |
| Rate for Payer: Aetna Commercial |
$672.60
|
| Rate for Payer: Aetna Medicare |
$205.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$247.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$247.28
|
| Rate for Payer: BCBS Complete |
$316.52
|
| Rate for Payer: BCBS MAPPO |
$197.82
|
| Rate for Payer: BCBS Trust/PPO |
$650.52
|
| Rate for Payer: BCN Commercial |
$615.23
|
| Rate for Payer: BCN Medicare Advantage |
$197.82
|
| Rate for Payer: Cash Price |
$633.03
|
| Rate for Payer: Cofinity Commercial |
$680.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$633.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.82
|
| Rate for Payer: Healthscope Commercial |
$712.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$593.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$207.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$227.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$672.60
|
| Rate for Payer: Nomi Health Commercial |
$648.86
|
| Rate for Payer: PACE Senior Care Partners |
$187.93
|
| Rate for Payer: PACE SWMI |
$197.82
|
| Rate for Payer: PHP Commercial |
$672.60
|
| Rate for Payer: PHP Medicare Advantage |
$197.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$514.34
|
| Rate for Payer: Priority Health HMO/PPO |
$688.42
|
| Rate for Payer: Priority Health Medicare |
$199.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$530.16
|
| Rate for Payer: Railroad Medicare Medicare |
$197.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$696.34
|
| Rate for Payer: UHC Core |
$660.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.82
|
| Rate for Payer: UHC Exchange |
$197.82
|
| Rate for Payer: UHC Medicare Advantage |
$197.82
|
| Rate for Payer: VA VA |
$197.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$593.47
|
|
|
HC CLOSED RX CARPAL FX
|
Facility
|
IP
|
$351.28
|
|
|
Service Code
|
CPT 25630
|
| Hospital Charge Code |
76100165
|
|
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 CARPAL FX
|
Facility
|
OP
|
$351.28
|
|
|
Service Code
|
CPT 25630
|
| Hospital Charge Code |
76100165
|
|
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 |
$182.12
|
| 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 |
$173.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.21
|
| Rate for Payer: Meridian Medicaid |
$182.12
|
| 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 |
$173.43
|
| 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 |
$173.43
|
| Rate for Payer: VA VA |
$87.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.46
|
|
|
HC CLOSED RX DIST FIBULA FX
|
Facility
|
IP
|
$351.28
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
76100174
|
|
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 DIST FIBULA FX
|
Facility
|
OP
|
$351.28
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
76100174
|
|
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 |
$182.12
|
| 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 |
$173.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.21
|
| Rate for Payer: Meridian Medicaid |
$182.12
|
| 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 |
$173.43
|
| 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 |
$173.43
|
| Rate for Payer: VA VA |
$87.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.46
|
|
|
HC CLOSED RX DIST RAD/ULNA FX
|
Facility
|
OP
|
$360.81
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
76100163
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$85.69 |
| Max. Negotiated Rate |
$324.73 |
| Rate for Payer: Aetna Commercial |
$306.69
|
| Rate for Payer: Aetna Medicare |
$93.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$112.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$112.75
|
| Rate for Payer: BCBS Complete |
$182.12
|
| Rate for Payer: BCBS MAPPO |
$90.20
|
| Rate for Payer: BCBS Trust/PPO |
$296.62
|
| Rate for Payer: BCN Commercial |
$280.53
|
| Rate for Payer: BCN Medicare Advantage |
$90.20
|
| Rate for Payer: Cash Price |
$288.65
|
| Rate for Payer: Cash Price |
$288.65
|
| Rate for Payer: Cofinity Commercial |
$310.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.20
|
| Rate for Payer: Healthscope Commercial |
$324.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$270.61
|
| Rate for Payer: Mclaren Medicaid |
$173.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.71
|
| Rate for Payer: Meridian Medicaid |
$182.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306.69
|
| Rate for Payer: Nomi Health Commercial |
$295.86
|
| Rate for Payer: PACE Senior Care Partners |
$85.69
|
| Rate for Payer: PACE SWMI |
$90.20
|
| Rate for Payer: PHP Commercial |
$306.69
|
| Rate for Payer: PHP Medicare Advantage |
$90.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.53
|
| Rate for Payer: Priority Health HMO/PPO |
$313.90
|
| Rate for Payer: Priority Health Medicare |
$91.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.74
|
| Rate for Payer: Railroad Medicare Medicare |
$90.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$317.51
|
| Rate for Payer: UHC Core |
$301.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.20
|
| Rate for Payer: UHC Exchange |
$90.20
|
| Rate for Payer: UHC Medicare Advantage |
$90.20
|
| Rate for Payer: UHCCP Medicaid |
$173.43
|
| Rate for Payer: VA VA |
$90.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$270.61
|
|
|
HC CLOSED RX DIST RAD/ULNA FX
|
Facility
|
IP
|
$360.81
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
76100163
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$234.53 |
| Max. Negotiated Rate |
$324.73 |
| Rate for Payer: Aetna Commercial |
$306.69
|
| Rate for Payer: BCBS Trust/PPO |
$294.53
|
| Rate for Payer: BCN Commercial |
$278.83
|
| Rate for Payer: Cash Price |
$288.65
|
| Rate for Payer: Cofinity Commercial |
$310.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.65
|
| Rate for Payer: Healthscope Commercial |
$324.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$270.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306.69
|
| Rate for Payer: Nomi Health Commercial |
$295.86
|
| Rate for Payer: PHP Commercial |
$306.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.53
|
| Rate for Payer: Priority Health HMO/PPO |
$313.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$317.51
|
| Rate for Payer: UHC Core |
$301.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$270.61
|
|
|
HC CLOSED RX METACARPAL FX
|
Facility
|
IP
|
$351.28
|
|
|
Service Code
|
CPT 26600
|
| Hospital Charge Code |
76100166
|
|
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 METACARPAL FX
|
Facility
|
OP
|
$351.28
|
|
|
Service Code
|
CPT 26600
|
| Hospital Charge Code |
76100166
|
|
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 |
$182.12
|
| 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 |
$173.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.21
|
| Rate for Payer: Meridian Medicaid |
$182.12
|
| 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 |
$173.43
|
| 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 |
$173.43
|
| Rate for Payer: VA VA |
$87.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.46
|
|
|
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 |
$182.12
|
| Rate for Payer: BCBS MAPPO |
$105.39
|
| Rate for Payer: BCBS Trust/PPO |
$346.55
|
| Rate for Payer: BCN Commercial |
$327.75
|
| Rate for Payer: BCN Medicare Advantage |
$105.39
|
| 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 |
$105.39
|
| Rate for Payer: Healthscope Commercial |
$379.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$316.15
|
| Rate for Payer: Mclaren Medicaid |
$173.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.65
|
| Rate for Payer: Meridian Medicaid |
$182.12
|
| 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 |
$105.39
|
| Rate for Payer: PHP Commercial |
$358.31
|
| Rate for Payer: PHP Medicare Advantage |
$105.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.43
|
| 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 |
$105.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$370.96
|
| Rate for Payer: UHC Core |
$351.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$105.39
|
| Rate for Payer: UHC Exchange |
$105.39
|
| Rate for Payer: UHC Medicare Advantage |
$105.39
|
| Rate for Payer: UHCCP Medicaid |
$173.43
|
| Rate for Payer: VA VA |
$105.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$316.15
|
|
|
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 |
$316.15
|
| 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 |
$316.15
|
|
|
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 |
$182.12
|
| 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 |
$173.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.21
|
| Rate for Payer: Meridian Medicaid |
$182.12
|
| 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 |
$173.43
|
| 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 |
$173.43
|
| Rate for Payer: VA VA |
$87.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.46
|
|
|
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 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 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 |
$182.12
|
| 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 |
$173.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.21
|
| Rate for Payer: Meridian Medicaid |
$182.12
|
| 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 |
$173.43
|
| 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 |
$173.43
|
| Rate for Payer: VA VA |
$87.82
|
| 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 |
$182.12
|
| 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 |
$173.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.21
|
| Rate for Payer: Meridian Medicaid |
$182.12
|
| 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 |
$173.43
|
| 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 |
$173.43
|
| 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
|
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 |
$182.12
|
| 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 |
$173.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$166.72
|
| Rate for Payer: Meridian Medicaid |
$182.12
|
| 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 |
$173.43
|
| 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 |
$173.43
|
| Rate for Payer: VA VA |
$158.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$476.33
|
|
