|
HC CLOSED TX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANIP
|
Facility
|
OP
|
$329.93
|
|
|
Service Code
|
CPT 27501
|
| Hospital Charge Code |
76100279
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$214.45
|
| Rate for Payer: Aetna Commercial |
$280.44
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$187.09
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$283.74
|
| Rate for Payer: Cofinity Commercial |
$230.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$296.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$230.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.45
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$280.44
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$207.86
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$499.35
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$122.07
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.45
|
|
|
HC CLOSED TX TALUS FX; W/O MANIP
|
Facility
|
OP
|
$285.94
|
|
|
Service Code
|
CPT 28430
|
| Hospital Charge Code |
76100288
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.80 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$185.86
|
| Rate for Payer: Aetna Commercial |
$243.05
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$136.31
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$228.75
|
| Rate for Payer: Cash Price |
$228.75
|
| Rate for Payer: Cofinity Commercial |
$245.91
|
| Rate for Payer: Cofinity Commercial |
$200.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$257.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$200.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.46
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$243.05
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$243.05
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$180.14
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$235.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$214.47
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$105.80
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.46
|
|
|
HC CLOSED TX TALUS FX; W/O MANIP
|
Facility
|
IP
|
$285.94
|
|
|
Service Code
|
CPT 28430
|
| Hospital Charge Code |
76100288
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.81 |
| Max. Negotiated Rate |
$257.35 |
| Rate for Payer: Aetna American Axle |
$185.86
|
| Rate for Payer: Aetna Commercial |
$243.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.86
|
| Rate for Payer: Cash Price |
$228.75
|
| Rate for Payer: Cofinity Commercial |
$200.16
|
| Rate for Payer: Cofinity Commercial |
$245.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.75
|
| Rate for Payer: Healthscope Commercial |
$257.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$200.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$243.05
|
| Rate for Payer: PHP Commercial |
$243.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.16
|
| Rate for Payer: Priority Health SBD |
$180.14
|
| Rate for Payer: UMR Bronson Commercial |
$125.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.46
|
|
|
HC CLOSED TX TOE FX W MANIPULATION
|
Facility
|
OP
|
$610.45
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
76100438
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$396.79
|
| Rate for Payer: Aetna Commercial |
$518.88
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$396.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$268.38
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$488.36
|
| Rate for Payer: Cash Price |
$488.36
|
| Rate for Payer: Cofinity Commercial |
$427.32
|
| Rate for Payer: Cofinity Commercial |
$524.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$488.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$549.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$427.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$457.84
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.88
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$518.88
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$384.58
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$145.71
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$225.87
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$457.84
|
|
|
HC CLOSED TX TOE FX W MANIPULATION
|
Facility
|
IP
|
$610.45
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
76100438
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$268.60 |
| Max. Negotiated Rate |
$549.40 |
| Rate for Payer: Aetna American Axle |
$396.79
|
| Rate for Payer: Aetna Commercial |
$518.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$396.79
|
| Rate for Payer: Cash Price |
$488.36
|
| Rate for Payer: Cofinity Commercial |
$427.32
|
| Rate for Payer: Cofinity Commercial |
$524.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$488.36
|
| Rate for Payer: Healthscope Commercial |
$549.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$427.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$457.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.88
|
| Rate for Payer: PHP Commercial |
$518.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.32
|
| Rate for Payer: Priority Health SBD |
$384.58
|
| Rate for Payer: UMR Bronson Commercial |
$268.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$457.84
|
|
|
HC CLOSED TX TOE FX WO MANIPULATION
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
76100176
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$90.91 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$90.91
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$122.79
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$127.42
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED TX TOE FX WO MANIPULATION
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
76100176
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$151.53 |
| Max. Negotiated Rate |
$309.95 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: UMR Bronson Commercial |
$151.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED TX ULNAR FX PROX END
|
Facility
|
IP
|
$2,073.75
|
|
|
Service Code
|
CPT 24675
|
| Hospital Charge Code |
76100236
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$912.45 |
| Max. Negotiated Rate |
$1,866.38 |
| Rate for Payer: Aetna American Axle |
$1,347.94
|
| Rate for Payer: Aetna Commercial |
$1,762.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,347.94
|
| Rate for Payer: Cash Price |
$1,659.00
|
| Rate for Payer: Cofinity Commercial |
$1,783.42
|
| Rate for Payer: Cofinity Commercial |
$1,451.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,659.00
|
| Rate for Payer: Healthscope Commercial |
$1,866.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,451.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,555.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,762.69
|
| Rate for Payer: PHP Commercial |
$1,762.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,451.62
|
| Rate for Payer: Priority Health SBD |
$1,306.46
|
| Rate for Payer: UMR Bronson Commercial |
$912.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,555.31
|
|
|
HC CLOSED TX ULNAR FX PROX END
|
Facility
|
OP
|
$2,073.75
|
|
|
Service Code
|
CPT 24675
|
| Hospital Charge Code |
76100236
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$424.69 |
| Max. Negotiated Rate |
$4,497.31 |
| Rate for Payer: Aetna American Axle |
$1,347.94
|
| Rate for Payer: Aetna Commercial |
$1,762.69
|
| Rate for Payer: Aetna Medicare |
$1,485.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,347.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,785.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,785.76
|
| Rate for Payer: BCBS Complete |
$820.59
|
| Rate for Payer: BCBS MAPPO |
$1,428.61
|
| Rate for Payer: BCBS Trust/PPO |
$758.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,428.61
|
| Rate for Payer: Cash Price |
$1,659.00
|
| Rate for Payer: Cash Price |
$1,659.00
|
| Rate for Payer: Cofinity Commercial |
$1,451.62
|
| Rate for Payer: Cofinity Commercial |
$1,783.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,659.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,428.61
|
| Rate for Payer: Healthscope Commercial |
$1,866.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,451.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,555.31
|
| Rate for Payer: Mclaren Medicaid |
$781.45
|
| Rate for Payer: Mclaren Medicare |
$1,428.61
|
| Rate for Payer: Meridian Medicaid |
$820.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,500.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,642.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,762.69
|
| Rate for Payer: PACE Medicare |
$1,357.18
|
| Rate for Payer: PACE SWMI |
$1,428.61
|
| Rate for Payer: PHP Commercial |
$1,762.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,428.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$781.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,451.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,497.31
|
| Rate for Payer: Priority Health Medicare |
$1,428.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,597.85
|
| Rate for Payer: Priority Health SBD |
$1,306.46
|
| Rate for Payer: Railroad Medicare Medicare |
$1,428.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$467.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,428.61
|
| Rate for Payer: UHC Exchange |
$424.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,471.47
|
| Rate for Payer: UMR Bronson Commercial |
$767.29
|
| Rate for Payer: VA VA |
$1,428.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,555.31
|
|
|
HC CLOSED TX ULNAR FX, PROX END W/O MANIP
|
Facility
|
OP
|
$329.93
|
|
|
Service Code
|
CPT 24670
|
| Hospital Charge Code |
76100275
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$214.45
|
| Rate for Payer: Aetna Commercial |
$280.44
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$160.37
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$230.95
|
| Rate for Payer: Cofinity Commercial |
$283.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$296.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$230.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.45
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$280.44
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$207.86
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$275.05
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$122.07
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.45
|
|
|
HC CLOSED TX ULNAR FX, PROX END W/O MANIP
|
Facility
|
IP
|
$329.93
|
|
|
Service Code
|
CPT 24670
|
| Hospital Charge Code |
76100275
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$145.17 |
| Max. Negotiated Rate |
$296.94 |
| Rate for Payer: Aetna American Axle |
$214.45
|
| Rate for Payer: Aetna Commercial |
$280.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.45
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$230.95
|
| Rate for Payer: Cofinity Commercial |
$283.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Healthscope Commercial |
$296.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$230.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: PHP Commercial |
$280.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.95
|
| Rate for Payer: Priority Health SBD |
$207.86
|
| Rate for Payer: UMR Bronson Commercial |
$145.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.45
|
|
|
HC CLOSED TX ULNAR SHAFT FX, W/O MANIP
|
Facility
|
OP
|
$329.93
|
|
|
Service Code
|
CPT 25530
|
| Hospital Charge Code |
76100252
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$214.45
|
| Rate for Payer: Aetna Commercial |
$280.44
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$136.31
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$283.74
|
| Rate for Payer: Cofinity Commercial |
$230.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$296.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$230.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.45
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$280.44
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$207.86
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$275.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$250.49
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$122.07
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.45
|
|
|
HC CLOSED TX ULNAR SHAFT FX, W/O MANIP
|
Facility
|
IP
|
$329.93
|
|
|
Service Code
|
CPT 25530
|
| Hospital Charge Code |
76100252
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$145.17 |
| Max. Negotiated Rate |
$296.94 |
| Rate for Payer: Aetna American Axle |
$214.45
|
| Rate for Payer: Aetna Commercial |
$280.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.45
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$230.95
|
| Rate for Payer: Cofinity Commercial |
$283.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Healthscope Commercial |
$296.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$230.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: PHP Commercial |
$280.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.95
|
| Rate for Payer: Priority Health SBD |
$207.86
|
| Rate for Payer: UMR Bronson Commercial |
$145.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.45
|
|
|
HC CLOSED TX ULNAR STYLOID FX
|
Facility
|
OP
|
$315.48
|
|
|
Service Code
|
CPT 25650
|
| Hospital Charge Code |
76100311
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$205.06
|
| Rate for Payer: Aetna Commercial |
$268.16
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$136.31
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$252.38
|
| Rate for Payer: Cash Price |
$252.38
|
| Rate for Payer: Cofinity Commercial |
$220.84
|
| Rate for Payer: Cofinity Commercial |
$271.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$283.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$220.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.61
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$268.16
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$268.16
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$198.75
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$345.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$313.69
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$116.73
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.61
|
|
|
HC CLOSED TX ULNAR STYLOID FX
|
Facility
|
IP
|
$315.48
|
|
|
Service Code
|
CPT 25650
|
| Hospital Charge Code |
76100311
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$138.81 |
| Max. Negotiated Rate |
$283.93 |
| Rate for Payer: Aetna American Axle |
$205.06
|
| Rate for Payer: Aetna Commercial |
$268.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.06
|
| Rate for Payer: Cash Price |
$252.38
|
| Rate for Payer: Cofinity Commercial |
$220.84
|
| Rate for Payer: Cofinity Commercial |
$271.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.38
|
| Rate for Payer: Healthscope Commercial |
$283.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$220.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$268.16
|
| Rate for Payer: PHP Commercial |
$268.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.84
|
| Rate for Payer: Priority Health SBD |
$198.75
|
| Rate for Payer: UMR Bronson Commercial |
$138.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.61
|
|
|
HC CLOSED TX VERT BODY FX, W/O MANIP, REQUIRING/INCL CAST/BRACE
|
Facility
|
OP
|
$420.24
|
|
|
Service Code
|
CPT 22310
|
| Hospital Charge Code |
76100300
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$273.16
|
| Rate for Payer: Aetna Commercial |
$357.20
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$170.14
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$336.19
|
| Rate for Payer: Cash Price |
$336.19
|
| Rate for Payer: Cofinity Commercial |
$361.41
|
| Rate for Payer: Cofinity Commercial |
$294.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$378.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$294.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$315.18
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$357.20
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$357.20
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$264.75
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$327.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$297.97
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$155.49
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$315.18
|
|
|
HC CLOSED TX VERT BODY FX, W/O MANIP, REQUIRING/INCL CAST/BRACE
|
Facility
|
IP
|
$420.24
|
|
|
Service Code
|
CPT 22310
|
| Hospital Charge Code |
76100300
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$184.91 |
| Max. Negotiated Rate |
$378.22 |
| Rate for Payer: Aetna American Axle |
$273.16
|
| Rate for Payer: Aetna Commercial |
$357.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.16
|
| Rate for Payer: Cash Price |
$336.19
|
| Rate for Payer: Cofinity Commercial |
$361.41
|
| Rate for Payer: Cofinity Commercial |
$294.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.19
|
| Rate for Payer: Healthscope Commercial |
$378.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$294.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$315.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$357.20
|
| Rate for Payer: PHP Commercial |
$357.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.17
|
| Rate for Payer: Priority Health SBD |
$264.75
|
| Rate for Payer: UMR Bronson Commercial |
$184.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$315.18
|
|
|
HC CLOSE RX DIST FINGR FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
76100170
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$187.99
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$196.47
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$127.42
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSE RX DIST FINGR FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
76100170
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$151.53 |
| Max. Negotiated Rate |
$309.95 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: UMR Bronson Commercial |
$151.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSE RX FINGR ARTICULAR FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 26740
|
| Hospital Charge Code |
76100169
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$136.31
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$227.24
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$127.42
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSE RX FINGR ARTICULAR FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 26740
|
| Hospital Charge Code |
76100169
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$151.53 |
| Max. Negotiated Rate |
$309.95 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: UMR Bronson Commercial |
$151.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSE RX PROX/MID FING SHFT FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
76100168
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$151.53 |
| Max. Negotiated Rate |
$309.95 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: UMR Bronson Commercial |
$151.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSE RX PROX/MID FING SHFT FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
76100168
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$165.39
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$195.48
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$127.42
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSURE DEVICE
|
Facility
|
IP
|
$1,116.14
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27200012
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$491.10 |
| Max. Negotiated Rate |
$1,004.53 |
| Rate for Payer: Aetna American Axle |
$725.49
|
| Rate for Payer: Aetna Commercial |
$948.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$725.49
|
| Rate for Payer: Cash Price |
$892.91
|
| Rate for Payer: Cofinity Commercial |
$781.30
|
| Rate for Payer: Cofinity Commercial |
$959.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$892.91
|
| Rate for Payer: Healthscope Commercial |
$1,004.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$781.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$837.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$948.72
|
| Rate for Payer: PHP Commercial |
$948.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$781.30
|
| Rate for Payer: Priority Health SBD |
$703.17
|
| Rate for Payer: UMR Bronson Commercial |
$491.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$837.10
|
|
|
HC CLOSURE DEVICE
|
Facility
|
OP
|
$1,116.14
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27200012
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$412.97 |
| Max. Negotiated Rate |
$1,004.53 |
| Rate for Payer: Aetna American Axle |
$725.49
|
| Rate for Payer: Aetna Commercial |
$948.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$725.49
|
| Rate for Payer: BCBS Complete |
$446.46
|
| Rate for Payer: Cash Price |
$892.91
|
| Rate for Payer: Cofinity Commercial |
$781.30
|
| Rate for Payer: Cofinity Commercial |
$959.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$892.91
|
| Rate for Payer: Healthscope Commercial |
$1,004.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$781.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$837.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$948.72
|
| Rate for Payer: PHP Commercial |
$948.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$781.30
|
| Rate for Payer: Priority Health SBD |
$703.17
|
| Rate for Payer: UMR Bronson Commercial |
$412.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$837.10
|
|
