|
HC CAST SHORT ARM
|
Facility
|
OP
|
$293.81
|
|
|
Service Code
|
CPT 29075
|
| Hospital Charge Code |
43000001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$61.89 |
| Max. Negotiated Rate |
$751.49 |
| Rate for Payer: Aetna American Axle |
$190.98
|
| Rate for Payer: Aetna Commercial |
$249.74
|
| Rate for Payer: Aetna Medicare |
$248.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$298.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$298.40
|
| Rate for Payer: BCBS Complete |
$137.12
|
| Rate for Payer: BCBS MAPPO |
$238.72
|
| Rate for Payer: BCBS Trust/PPO |
$155.34
|
| Rate for Payer: BCN Medicare Advantage |
$238.72
|
| Rate for Payer: Cash Price |
$235.05
|
| Rate for Payer: Cash Price |
$235.05
|
| Rate for Payer: Cofinity Commercial |
$252.68
|
| Rate for Payer: Cofinity Commercial |
$205.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$235.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.72
|
| Rate for Payer: Healthscope Commercial |
$264.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$205.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.36
|
| Rate for Payer: Mclaren Medicaid |
$130.58
|
| Rate for Payer: Mclaren Medicare |
$238.72
|
| Rate for Payer: Meridian Medicaid |
$137.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$250.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$249.74
|
| Rate for Payer: PACE Medicare |
$226.78
|
| Rate for Payer: PACE SWMI |
$238.72
|
| Rate for Payer: PHP Commercial |
$249.74
|
| Rate for Payer: PHP Medicare Advantage |
$238.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$751.49
|
| Rate for Payer: Priority Health Medicare |
$238.72
|
| Rate for Payer: Priority Health Narrow Network |
$601.19
|
| Rate for Payer: Priority Health SBD |
$185.10
|
| Rate for Payer: Railroad Medicare Medicare |
$238.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.72
|
| Rate for Payer: UHC Exchange |
$61.89
|
| Rate for Payer: UHC Medicare Advantage |
$245.88
|
| Rate for Payer: UMR Bronson Commercial |
$108.71
|
| Rate for Payer: VA VA |
$238.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.36
|
|
|
HC CAST SHORT LEG
|
Facility
|
IP
|
$361.62
|
|
|
Service Code
|
CPT 29405
|
| Hospital Charge Code |
70000007
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$159.11 |
| Max. Negotiated Rate |
$325.46 |
| Rate for Payer: Aetna American Axle |
$235.05
|
| Rate for Payer: Aetna Commercial |
$307.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.05
|
| Rate for Payer: Cash Price |
$289.30
|
| Rate for Payer: Cofinity Commercial |
$253.13
|
| Rate for Payer: Cofinity Commercial |
$310.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.30
|
| Rate for Payer: Healthscope Commercial |
$325.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$253.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$271.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$307.38
|
| Rate for Payer: PHP Commercial |
$307.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.13
|
| Rate for Payer: Priority Health SBD |
$227.82
|
| Rate for Payer: UMR Bronson Commercial |
$159.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$271.22
|
|
|
HC CAST SHORT LEG
|
Facility
|
OP
|
$361.62
|
|
|
Service Code
|
CPT 29405
|
| Hospital Charge Code |
70000007
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$57.96 |
| Max. Negotiated Rate |
$751.49 |
| Rate for Payer: Aetna American Axle |
$235.05
|
| Rate for Payer: Aetna Commercial |
$307.38
|
| Rate for Payer: Aetna Medicare |
$248.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$298.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$298.40
|
| Rate for Payer: BCBS Complete |
$137.12
|
| Rate for Payer: BCBS MAPPO |
$238.72
|
| Rate for Payer: BCBS Trust/PPO |
$256.56
|
| Rate for Payer: BCN Medicare Advantage |
$238.72
|
| Rate for Payer: Cash Price |
$289.30
|
| Rate for Payer: Cash Price |
$289.30
|
| Rate for Payer: Cofinity Commercial |
$310.99
|
| Rate for Payer: Cofinity Commercial |
$253.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.72
|
| Rate for Payer: Healthscope Commercial |
$325.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$253.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$271.22
|
| Rate for Payer: Mclaren Medicaid |
$130.58
|
| Rate for Payer: Mclaren Medicare |
$238.72
|
| Rate for Payer: Meridian Medicaid |
$137.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$250.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$307.38
|
| Rate for Payer: PACE Medicare |
$226.78
|
| Rate for Payer: PACE SWMI |
$238.72
|
| Rate for Payer: PHP Commercial |
$307.38
|
| Rate for Payer: PHP Medicare Advantage |
$238.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$751.49
|
| Rate for Payer: Priority Health Medicare |
$238.72
|
| Rate for Payer: Priority Health Narrow Network |
$601.19
|
| Rate for Payer: Priority Health SBD |
$227.82
|
| Rate for Payer: Railroad Medicare Medicare |
$238.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.72
|
| Rate for Payer: UHC Exchange |
$57.96
|
| Rate for Payer: UHC Medicare Advantage |
$245.88
|
| Rate for Payer: UMR Bronson Commercial |
$133.80
|
| Rate for Payer: VA VA |
$238.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$271.22
|
|
|
HC CAST SHORT LEG WALKING
|
Facility
|
IP
|
$361.62
|
|
|
Service Code
|
CPT 29425
|
| Hospital Charge Code |
70000008
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$159.11 |
| Max. Negotiated Rate |
$325.46 |
| Rate for Payer: Aetna American Axle |
$235.05
|
| Rate for Payer: Aetna Commercial |
$307.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.05
|
| Rate for Payer: Cash Price |
$289.30
|
| Rate for Payer: Cofinity Commercial |
$253.13
|
| Rate for Payer: Cofinity Commercial |
$310.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.30
|
| Rate for Payer: Healthscope Commercial |
$325.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$253.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$271.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$307.38
|
| Rate for Payer: PHP Commercial |
$307.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.13
|
| Rate for Payer: Priority Health SBD |
$227.82
|
| Rate for Payer: UMR Bronson Commercial |
$159.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$271.22
|
|
|
HC CAST SHORT LEG WALKING
|
Facility
|
OP
|
$361.62
|
|
|
Service Code
|
CPT 29425
|
| Hospital Charge Code |
70000008
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$53.37 |
| Max. Negotiated Rate |
$751.49 |
| Rate for Payer: Aetna American Axle |
$235.05
|
| Rate for Payer: Aetna Commercial |
$307.38
|
| Rate for Payer: Aetna Medicare |
$248.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$298.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$298.40
|
| Rate for Payer: BCBS Complete |
$137.12
|
| Rate for Payer: BCBS MAPPO |
$238.72
|
| Rate for Payer: BCBS Trust/PPO |
$256.56
|
| Rate for Payer: BCN Medicare Advantage |
$238.72
|
| Rate for Payer: Cash Price |
$289.30
|
| Rate for Payer: Cash Price |
$289.30
|
| Rate for Payer: Cofinity Commercial |
$310.99
|
| Rate for Payer: Cofinity Commercial |
$253.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.72
|
| Rate for Payer: Healthscope Commercial |
$325.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$253.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$271.22
|
| Rate for Payer: Mclaren Medicaid |
$130.58
|
| Rate for Payer: Mclaren Medicare |
$238.72
|
| Rate for Payer: Meridian Medicaid |
$137.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$250.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$307.38
|
| Rate for Payer: PACE Medicare |
$226.78
|
| Rate for Payer: PACE SWMI |
$238.72
|
| Rate for Payer: PHP Commercial |
$307.38
|
| Rate for Payer: PHP Medicare Advantage |
$238.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$751.49
|
| Rate for Payer: Priority Health Medicare |
$238.72
|
| Rate for Payer: Priority Health Narrow Network |
$601.19
|
| Rate for Payer: Priority Health SBD |
$227.82
|
| Rate for Payer: Railroad Medicare Medicare |
$238.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.72
|
| Rate for Payer: UHC Exchange |
$53.37
|
| Rate for Payer: UHC Medicare Advantage |
$245.88
|
| Rate for Payer: UMR Bronson Commercial |
$133.80
|
| Rate for Payer: VA VA |
$238.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$271.22
|
|
|
HC CAST SUP LNG ARM SPLINT FBG
|
Facility
|
OP
|
$25.50
|
|
| Hospital Charge Code |
27200332
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.44 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna American Axle |
$16.58
|
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: BCBS Complete |
$10.20
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health SBD |
$16.06
|
| Rate for Payer: UMR Bronson Commercial |
$9.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC CAST SUP LNG ARM SPLINT FBG
|
Facility
|
IP
|
$25.50
|
|
| Hospital Charge Code |
27200332
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.22 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna American Axle |
$16.58
|
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health SBD |
$16.06
|
| Rate for Payer: UMR Bronson Commercial |
$11.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC CAST SUP LNG ARM SPLNT PED F
|
Facility
|
OP
|
$24.48
|
|
| Hospital Charge Code |
27200333
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.06 |
| Max. Negotiated Rate |
$22.03 |
| Rate for Payer: Aetna American Axle |
$15.91
|
| Rate for Payer: Aetna Commercial |
$20.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.91
|
| Rate for Payer: BCBS Complete |
$9.79
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$21.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Healthscope Commercial |
$22.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.81
|
| Rate for Payer: PHP Commercial |
$20.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.14
|
| Rate for Payer: Priority Health SBD |
$15.42
|
| Rate for Payer: UMR Bronson Commercial |
$9.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.36
|
|
|
HC CAST SUP LNG ARM SPLNT PED F
|
Facility
|
IP
|
$24.48
|
|
| Hospital Charge Code |
27200333
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.77 |
| Max. Negotiated Rate |
$22.03 |
| Rate for Payer: Aetna American Axle |
$15.91
|
| Rate for Payer: Aetna Commercial |
$20.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.91
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$21.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Healthscope Commercial |
$22.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.81
|
| Rate for Payer: PHP Commercial |
$20.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.14
|
| Rate for Payer: Priority Health SBD |
$15.42
|
| Rate for Payer: UMR Bronson Commercial |
$10.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.36
|
|
|
HC CAST SUP LNG LEG CYLNDR PED F
|
Facility
|
IP
|
$51.00
|
|
| Hospital Charge Code |
27200338
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.44 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: UMR Bronson Commercial |
$22.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC CAST SUP LNG LEG CYLNDR PED F
|
Facility
|
OP
|
$51.00
|
|
| Hospital Charge Code |
27200338
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.87 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: UMR Bronson Commercial |
$18.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC CAST SUP LNG LEG PED FBRGLS
|
Facility
|
OP
|
$53.04
|
|
| Hospital Charge Code |
27200337
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.62 |
| Max. Negotiated Rate |
$47.74 |
| Rate for Payer: Aetna American Axle |
$34.48
|
| Rate for Payer: Aetna Commercial |
$45.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.48
|
| Rate for Payer: BCBS Complete |
$21.22
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$37.13
|
| Rate for Payer: Cofinity Commercial |
$45.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Healthscope Commercial |
$47.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.08
|
| Rate for Payer: PHP Commercial |
$45.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.13
|
| Rate for Payer: Priority Health SBD |
$33.42
|
| Rate for Payer: UMR Bronson Commercial |
$19.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.78
|
|
|
HC CAST SUP LNG LEG PED FBRGLS
|
Facility
|
IP
|
$53.04
|
|
| Hospital Charge Code |
27200337
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.34 |
| Max. Negotiated Rate |
$47.74 |
| Rate for Payer: Aetna American Axle |
$34.48
|
| Rate for Payer: Aetna Commercial |
$45.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.48
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$37.13
|
| Rate for Payer: Cofinity Commercial |
$45.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Healthscope Commercial |
$47.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.08
|
| Rate for Payer: PHP Commercial |
$45.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.13
|
| Rate for Payer: Priority Health SBD |
$33.42
|
| Rate for Payer: UMR Bronson Commercial |
$23.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.78
|
|
|
HC CAST SUP LONG ARM ADULT FBRG
|
Facility
|
IP
|
$56.10
|
|
| Hospital Charge Code |
27200327
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.68 |
| Max. Negotiated Rate |
$50.49 |
| Rate for Payer: Aetna American Axle |
$36.46
|
| Rate for Payer: Aetna Commercial |
$47.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.46
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$39.27
|
| Rate for Payer: Cofinity Commercial |
$48.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Healthscope Commercial |
$50.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.68
|
| Rate for Payer: PHP Commercial |
$47.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.27
|
| Rate for Payer: Priority Health SBD |
$35.34
|
| Rate for Payer: UMR Bronson Commercial |
$24.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.08
|
|
|
HC CAST SUP LONG ARM ADULT FBRG
|
Facility
|
OP
|
$56.10
|
|
| Hospital Charge Code |
27200327
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.76 |
| Max. Negotiated Rate |
$50.49 |
| Rate for Payer: Aetna American Axle |
$36.46
|
| Rate for Payer: Aetna Commercial |
$47.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.46
|
| Rate for Payer: BCBS Complete |
$22.44
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$39.27
|
| Rate for Payer: Cofinity Commercial |
$48.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Healthscope Commercial |
$50.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.68
|
| Rate for Payer: PHP Commercial |
$47.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.27
|
| Rate for Payer: Priority Health SBD |
$35.34
|
| Rate for Payer: UMR Bronson Commercial |
$20.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.08
|
|
|
HC CAST SUP LONG ARM PED FBRGLS
|
Facility
|
OP
|
$25.50
|
|
| Hospital Charge Code |
27200328
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.44 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna American Axle |
$16.58
|
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: BCBS Complete |
$10.20
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health SBD |
$16.06
|
| Rate for Payer: UMR Bronson Commercial |
$9.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC CAST SUP LONG ARM PED FBRGLS
|
Facility
|
IP
|
$25.50
|
|
| Hospital Charge Code |
27200328
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.22 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna American Axle |
$16.58
|
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health SBD |
$16.06
|
| Rate for Payer: UMR Bronson Commercial |
$11.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC CAST SUP LONG LEG FIBERGLASS
|
Facility
|
IP
|
$116.28
|
|
| Hospital Charge Code |
27200336
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.16 |
| Max. Negotiated Rate |
$104.65 |
| Rate for Payer: Aetna American Axle |
$75.58
|
| Rate for Payer: Aetna Commercial |
$98.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.58
|
| Rate for Payer: Cash Price |
$93.02
|
| Rate for Payer: Cofinity Commercial |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$81.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.02
|
| Rate for Payer: Healthscope Commercial |
$104.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$98.84
|
| Rate for Payer: PHP Commercial |
$98.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.40
|
| Rate for Payer: Priority Health SBD |
$73.26
|
| Rate for Payer: UMR Bronson Commercial |
$51.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.21
|
|
|
HC CAST SUP LONG LEG FIBERGLASS
|
Facility
|
OP
|
$116.28
|
|
| Hospital Charge Code |
27200336
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.02 |
| Max. Negotiated Rate |
$104.65 |
| Rate for Payer: Aetna American Axle |
$75.58
|
| Rate for Payer: Aetna Commercial |
$98.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.58
|
| Rate for Payer: BCBS Complete |
$46.51
|
| Rate for Payer: Cash Price |
$93.02
|
| Rate for Payer: Cofinity Commercial |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$81.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.02
|
| Rate for Payer: Healthscope Commercial |
$104.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$98.84
|
| Rate for Payer: PHP Commercial |
$98.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.40
|
| Rate for Payer: Priority Health SBD |
$73.26
|
| Rate for Payer: UMR Bronson Commercial |
$43.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.21
|
|
|
HC CAST SUPPLIES UNLISTED
|
Facility
|
OP
|
$102.00
|
|
| Hospital Charge Code |
27200343
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.74 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna American Axle |
$66.30
|
| Rate for Payer: Aetna Commercial |
$86.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.30
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$71.40
|
| Rate for Payer: Cofinity Commercial |
$87.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.70
|
| Rate for Payer: PHP Commercial |
$86.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: Priority Health SBD |
$64.26
|
| Rate for Payer: UMR Bronson Commercial |
$37.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.50
|
|
|
HC CAST SUPPLIES UNLISTED
|
Facility
|
IP
|
$102.00
|
|
| Hospital Charge Code |
27200343
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.88 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna American Axle |
$66.30
|
| Rate for Payer: Aetna Commercial |
$86.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.30
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$71.40
|
| Rate for Payer: Cofinity Commercial |
$87.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.70
|
| Rate for Payer: PHP Commercial |
$86.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: Priority Health SBD |
$64.26
|
| Rate for Payer: UMR Bronson Commercial |
$44.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.50
|
|
|
HC CAST SUP SHRT LEG FIBERGLASS
|
Facility
|
OP
|
$61.20
|
|
| Hospital Charge Code |
27200339
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.64 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna American Axle |
$39.78
|
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: BCBS Complete |
$24.48
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health SBD |
$38.56
|
| Rate for Payer: UMR Bronson Commercial |
$22.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC CAST SUP SHRT LEG FIBERGLASS
|
Facility
|
IP
|
$61.20
|
|
| Hospital Charge Code |
27200339
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.93 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna American Axle |
$39.78
|
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health SBD |
$38.56
|
| Rate for Payer: UMR Bronson Commercial |
$26.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC CAST SUP SHRT LEG PED FBRGLS
|
Facility
|
IP
|
$21.42
|
|
| Hospital Charge Code |
27200340
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.42 |
| Max. Negotiated Rate |
$19.28 |
| Rate for Payer: Aetna American Axle |
$13.92
|
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.92
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$14.99
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.21
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.99
|
| Rate for Payer: Priority Health SBD |
$13.49
|
| Rate for Payer: UMR Bronson Commercial |
$9.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.06
|
|
|
HC CAST SUP SHRT LEG PED FBRGLS
|
Facility
|
OP
|
$21.42
|
|
| Hospital Charge Code |
27200340
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.93 |
| Max. Negotiated Rate |
$19.28 |
| Rate for Payer: Aetna American Axle |
$13.92
|
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.92
|
| Rate for Payer: BCBS Complete |
$8.57
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$14.99
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.21
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.99
|
| Rate for Payer: Priority Health SBD |
$13.49
|
| Rate for Payer: UMR Bronson Commercial |
$7.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.06
|
|
