|
HC CAST REPAIR
|
Facility
|
OP
|
$178.81
|
|
| Hospital Charge Code |
27000041
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$66.16 |
| Max. Negotiated Rate |
$160.93 |
| Rate for Payer: Aetna American Axle |
$116.23
|
| Rate for Payer: Aetna Commercial |
$151.99
|
| Rate for Payer: Aetna Medicare |
$89.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.23
|
| Rate for Payer: BCBS Complete |
$71.52
|
| Rate for Payer: Cash Price |
$143.05
|
| Rate for Payer: Cofinity Commercial |
$125.17
|
| Rate for Payer: Cofinity Commercial |
$153.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$125.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.05
|
| Rate for Payer: Healthscope Commercial |
$160.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$125.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$134.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.99
|
| Rate for Payer: PHP Commercial |
$151.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.23
|
| Rate for Payer: Priority Health SBD |
$112.65
|
| Rate for Payer: UMR Bronson Commercial |
$66.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$134.11
|
|
|
HC CAST REPAIR
|
Facility
|
IP
|
$178.81
|
|
| Hospital Charge Code |
27000041
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$78.68 |
| Max. Negotiated Rate |
$160.93 |
| Rate for Payer: Aetna American Axle |
$116.23
|
| Rate for Payer: Aetna Commercial |
$151.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.23
|
| Rate for Payer: Cash Price |
$143.05
|
| Rate for Payer: Cofinity Commercial |
$125.17
|
| Rate for Payer: Cofinity Commercial |
$153.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$125.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.05
|
| Rate for Payer: Healthscope Commercial |
$160.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$125.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$134.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.99
|
| Rate for Payer: PHP Commercial |
$151.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.23
|
| Rate for Payer: Priority Health SBD |
$112.65
|
| Rate for Payer: UMR Bronson Commercial |
$78.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$134.11
|
|
|
HC CAST RISSER BODY ONLY
|
Facility
|
OP
|
$309.38
|
|
|
Service Code
|
CPT 29010
|
| Hospital Charge Code |
70000001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$114.47 |
| Max. Negotiated Rate |
$729.09 |
| Rate for Payer: Aetna American Axle |
$201.10
|
| Rate for Payer: Aetna Commercial |
$262.97
|
| Rate for Payer: Aetna Medicare |
$269.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$323.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$323.76
|
| Rate for Payer: BCBS Complete |
$145.77
|
| Rate for Payer: BCBS MAPPO |
$259.01
|
| Rate for Payer: BCN Medicare Advantage |
$259.01
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Cofinity Commercial |
$216.57
|
| Rate for Payer: Cofinity Commercial |
$266.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$216.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$259.01
|
| Rate for Payer: Healthscope Commercial |
$278.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$216.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.03
|
| Rate for Payer: Mclaren Medicaid |
$138.83
|
| Rate for Payer: Mclaren Medicare |
$259.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$271.96
|
| Rate for Payer: Meridian Medicaid |
$145.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$297.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.97
|
| Rate for Payer: PACE Medicare |
$246.06
|
| Rate for Payer: PACE SWMI |
$259.01
|
| Rate for Payer: PHP Commercial |
$262.97
|
| Rate for Payer: PHP Medicare Advantage |
$259.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.10
|
| Rate for Payer: Priority Health Medicare |
$259.01
|
| Rate for Payer: Priority Health SBD |
$194.91
|
| Rate for Payer: Railroad Medicare Medicare |
$259.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$729.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$259.01
|
| Rate for Payer: UHC Exchange |
$494.99
|
| Rate for Payer: UHC Medicare Advantage |
$259.01
|
| Rate for Payer: UHCCP Medicaid |
$138.83
|
| Rate for Payer: UMR Bronson Commercial |
$114.47
|
| Rate for Payer: VA VA |
$259.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.03
|
|
|
HC CAST RISSER BODY ONLY
|
Facility
|
IP
|
$309.38
|
|
|
Service Code
|
CPT 29010
|
| Hospital Charge Code |
70000001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$136.13 |
| Max. Negotiated Rate |
$278.44 |
| Rate for Payer: Aetna American Axle |
$201.10
|
| Rate for Payer: Aetna Commercial |
$262.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.10
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Cofinity Commercial |
$216.57
|
| Rate for Payer: Cofinity Commercial |
$266.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$216.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.50
|
| Rate for Payer: Healthscope Commercial |
$278.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$216.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.97
|
| Rate for Payer: PHP Commercial |
$262.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.10
|
| Rate for Payer: Priority Health SBD |
$194.91
|
| Rate for Payer: UMR Bronson Commercial |
$136.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.03
|
|
|
HC CAST SHORT ARM
|
Facility
|
IP
|
$300.18
|
|
|
Service Code
|
CPT 29075
|
| Hospital Charge Code |
43000001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$132.08 |
| Max. Negotiated Rate |
$270.16 |
| Rate for Payer: Aetna American Axle |
$195.12
|
| Rate for Payer: Aetna Commercial |
$255.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.12
|
| Rate for Payer: Cash Price |
$240.14
|
| Rate for Payer: Cofinity Commercial |
$210.13
|
| Rate for Payer: Cofinity Commercial |
$258.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$210.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.14
|
| Rate for Payer: Healthscope Commercial |
$270.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$210.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.15
|
| Rate for Payer: PHP Commercial |
$255.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.12
|
| Rate for Payer: Priority Health SBD |
$189.11
|
| Rate for Payer: UMR Bronson Commercial |
$132.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.13
|
|
|
HC CAST SHORT ARM
|
Facility
|
OP
|
$300.18
|
|
|
Service Code
|
CPT 29075
|
| Hospital Charge Code |
43000001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$111.07 |
| Max. Negotiated Rate |
$729.09 |
| Rate for Payer: Aetna American Axle |
$195.12
|
| Rate for Payer: Aetna Commercial |
$255.15
|
| Rate for Payer: Aetna Medicare |
$269.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$323.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$323.76
|
| Rate for Payer: BCBS Complete |
$145.77
|
| Rate for Payer: BCBS MAPPO |
$259.01
|
| Rate for Payer: BCN Medicare Advantage |
$259.01
|
| Rate for Payer: Cash Price |
$240.14
|
| Rate for Payer: Cash Price |
$240.14
|
| Rate for Payer: Cofinity Commercial |
$258.15
|
| Rate for Payer: Cofinity Commercial |
$210.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$210.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$259.01
|
| Rate for Payer: Healthscope Commercial |
$270.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$210.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.13
|
| Rate for Payer: Mclaren Medicaid |
$138.83
|
| Rate for Payer: Mclaren Medicare |
$259.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$271.96
|
| Rate for Payer: Meridian Medicaid |
$145.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$297.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.15
|
| Rate for Payer: PACE Medicare |
$246.06
|
| Rate for Payer: PACE SWMI |
$259.01
|
| Rate for Payer: PHP Commercial |
$255.15
|
| Rate for Payer: PHP Medicare Advantage |
$259.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.12
|
| Rate for Payer: Priority Health Medicare |
$259.01
|
| Rate for Payer: Priority Health SBD |
$189.11
|
| Rate for Payer: Railroad Medicare Medicare |
$259.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$729.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$259.01
|
| Rate for Payer: UHC Exchange |
$494.99
|
| Rate for Payer: UHC Medicare Advantage |
$259.01
|
| Rate for Payer: UHCCP Medicaid |
$138.83
|
| Rate for Payer: UMR Bronson Commercial |
$111.07
|
| Rate for Payer: VA VA |
$259.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.13
|
|
|
HC CAST SHORT LEG
|
Facility
|
OP
|
$368.85
|
|
|
Service Code
|
CPT 29405
|
| Hospital Charge Code |
70000007
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$136.47 |
| Max. Negotiated Rate |
$729.09 |
| Rate for Payer: Aetna American Axle |
$239.75
|
| Rate for Payer: Aetna Commercial |
$313.52
|
| Rate for Payer: Aetna Medicare |
$269.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$323.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$323.76
|
| Rate for Payer: BCBS Complete |
$145.77
|
| Rate for Payer: BCBS MAPPO |
$259.01
|
| Rate for Payer: BCN Medicare Advantage |
$259.01
|
| Rate for Payer: Cash Price |
$295.08
|
| Rate for Payer: Cash Price |
$295.08
|
| Rate for Payer: Cofinity Commercial |
$317.21
|
| Rate for Payer: Cofinity Commercial |
$258.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$258.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$295.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$259.01
|
| Rate for Payer: Healthscope Commercial |
$331.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$258.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.64
|
| Rate for Payer: Mclaren Medicaid |
$138.83
|
| Rate for Payer: Mclaren Medicare |
$259.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$271.96
|
| Rate for Payer: Meridian Medicaid |
$145.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$297.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.52
|
| Rate for Payer: PACE Medicare |
$246.06
|
| Rate for Payer: PACE SWMI |
$259.01
|
| Rate for Payer: PHP Commercial |
$313.52
|
| Rate for Payer: PHP Medicare Advantage |
$259.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$239.75
|
| Rate for Payer: Priority Health Medicare |
$259.01
|
| Rate for Payer: Priority Health SBD |
$232.38
|
| Rate for Payer: Railroad Medicare Medicare |
$259.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$729.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$259.01
|
| Rate for Payer: UHC Exchange |
$494.99
|
| Rate for Payer: UHC Medicare Advantage |
$259.01
|
| Rate for Payer: UHCCP Medicaid |
$138.83
|
| Rate for Payer: UMR Bronson Commercial |
$136.47
|
| Rate for Payer: VA VA |
$259.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.64
|
|
|
HC CAST SHORT LEG
|
Facility
|
IP
|
$368.85
|
|
|
Service Code
|
CPT 29405
|
| Hospital Charge Code |
70000007
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$162.29 |
| Max. Negotiated Rate |
$331.96 |
| Rate for Payer: Aetna American Axle |
$239.75
|
| Rate for Payer: Aetna Commercial |
$313.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.75
|
| Rate for Payer: Cash Price |
$295.08
|
| Rate for Payer: Cofinity Commercial |
$258.19
|
| Rate for Payer: Cofinity Commercial |
$317.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$258.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$295.08
|
| Rate for Payer: Healthscope Commercial |
$331.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$258.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.52
|
| Rate for Payer: PHP Commercial |
$313.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$239.75
|
| Rate for Payer: Priority Health SBD |
$232.38
|
| Rate for Payer: UMR Bronson Commercial |
$162.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.64
|
|
|
HC CAST SHORT LEG WALKING
|
Facility
|
IP
|
$368.85
|
|
|
Service Code
|
CPT 29425
|
| Hospital Charge Code |
70000008
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$162.29 |
| Max. Negotiated Rate |
$331.96 |
| Rate for Payer: Aetna American Axle |
$239.75
|
| Rate for Payer: Aetna Commercial |
$313.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.75
|
| Rate for Payer: Cash Price |
$295.08
|
| Rate for Payer: Cofinity Commercial |
$258.19
|
| Rate for Payer: Cofinity Commercial |
$317.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$258.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$295.08
|
| Rate for Payer: Healthscope Commercial |
$331.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$258.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.52
|
| Rate for Payer: PHP Commercial |
$313.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$239.75
|
| Rate for Payer: Priority Health SBD |
$232.38
|
| Rate for Payer: UMR Bronson Commercial |
$162.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.64
|
|
|
HC CAST SHORT LEG WALKING
|
Facility
|
OP
|
$368.85
|
|
|
Service Code
|
CPT 29425
|
| Hospital Charge Code |
70000008
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$136.47 |
| Max. Negotiated Rate |
$729.09 |
| Rate for Payer: Aetna American Axle |
$239.75
|
| Rate for Payer: Aetna Commercial |
$313.52
|
| Rate for Payer: Aetna Medicare |
$269.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$323.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$323.76
|
| Rate for Payer: BCBS Complete |
$145.77
|
| Rate for Payer: BCBS MAPPO |
$259.01
|
| Rate for Payer: BCN Medicare Advantage |
$259.01
|
| Rate for Payer: Cash Price |
$295.08
|
| Rate for Payer: Cash Price |
$295.08
|
| Rate for Payer: Cofinity Commercial |
$317.21
|
| Rate for Payer: Cofinity Commercial |
$258.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$258.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$295.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$259.01
|
| Rate for Payer: Healthscope Commercial |
$331.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$258.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.64
|
| Rate for Payer: Mclaren Medicaid |
$138.83
|
| Rate for Payer: Mclaren Medicare |
$259.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$271.96
|
| Rate for Payer: Meridian Medicaid |
$145.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$297.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.52
|
| Rate for Payer: PACE Medicare |
$246.06
|
| Rate for Payer: PACE SWMI |
$259.01
|
| Rate for Payer: PHP Commercial |
$313.52
|
| Rate for Payer: PHP Medicare Advantage |
$259.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$239.75
|
| Rate for Payer: Priority Health Medicare |
$259.01
|
| Rate for Payer: Priority Health SBD |
$232.38
|
| Rate for Payer: Railroad Medicare Medicare |
$259.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$729.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$259.01
|
| Rate for Payer: UHC Exchange |
$494.99
|
| Rate for Payer: UHC Medicare Advantage |
$259.01
|
| Rate for Payer: UHCCP Medicaid |
$138.83
|
| Rate for Payer: UMR Bronson Commercial |
$136.47
|
| Rate for Payer: VA VA |
$259.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.64
|
|
|
HC CAST SUP LNG ARM ADULT FBRGLS
|
Facility
|
OP
|
$57.22
|
|
| Hospital Charge Code |
27200327
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.17 |
| Max. Negotiated Rate |
$51.50 |
| Rate for Payer: Aetna American Axle |
$37.19
|
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: Aetna Medicare |
$28.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.19
|
| Rate for Payer: BCBS Complete |
$22.89
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$40.05
|
| Rate for Payer: Cofinity Commercial |
$49.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: PHP Commercial |
$48.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.19
|
| Rate for Payer: Priority Health SBD |
$36.05
|
| Rate for Payer: UMR Bronson Commercial |
$21.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.91
|
|
|
HC CAST SUP LNG ARM ADULT FBRGLS
|
Facility
|
IP
|
$57.22
|
|
| Hospital Charge Code |
27200327
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$25.18 |
| Max. Negotiated Rate |
$51.50 |
| Rate for Payer: Aetna American Axle |
$37.19
|
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.19
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$40.05
|
| Rate for Payer: Cofinity Commercial |
$49.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: PHP Commercial |
$48.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.19
|
| Rate for Payer: Priority Health SBD |
$36.05
|
| Rate for Payer: UMR Bronson Commercial |
$25.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.91
|
|
|
HC CAST SUP LNG ARM PED FBRGLS
|
Facility
|
IP
|
$26.01
|
|
| Hospital Charge Code |
27200328
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.44 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna American Axle |
$16.91
|
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: UMR Bronson Commercial |
$11.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC CAST SUP LNG ARM PED FBRGLS
|
Facility
|
OP
|
$26.01
|
|
| Hospital Charge Code |
27200328
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.62 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna American Axle |
$16.91
|
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$13.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: UMR Bronson Commercial |
$9.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC CAST SUP LNG ARM SPLINT ADULT FBRGLS
|
Facility
|
IP
|
$26.01
|
|
| Hospital Charge Code |
27200332
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.44 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna American Axle |
$16.91
|
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: UMR Bronson Commercial |
$11.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC CAST SUP LNG ARM SPLINT ADULT FBRGLS
|
Facility
|
OP
|
$26.01
|
|
| Hospital Charge Code |
27200332
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.62 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna American Axle |
$16.91
|
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$13.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: UMR Bronson Commercial |
$9.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC CAST SUP LNG ARM SPLINT ADULT PLST
|
Facility
|
OP
|
$43.00
|
|
| Hospital Charge Code |
27200392
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.91 |
| Max. Negotiated Rate |
$38.70 |
| Rate for Payer: Aetna American Axle |
$27.95
|
| Rate for Payer: Aetna Commercial |
$36.55
|
| Rate for Payer: Aetna Medicare |
$21.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.95
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$30.10
|
| Rate for Payer: Cofinity Commercial |
$36.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.40
|
| Rate for Payer: Healthscope Commercial |
$38.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.55
|
| Rate for Payer: PHP Commercial |
$36.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health SBD |
$27.09
|
| Rate for Payer: UMR Bronson Commercial |
$15.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.25
|
|
|
HC CAST SUP LNG ARM SPLINT ADULT PLST
|
Facility
|
IP
|
$43.00
|
|
| Hospital Charge Code |
27200392
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.92 |
| Max. Negotiated Rate |
$38.70 |
| Rate for Payer: Aetna American Axle |
$27.95
|
| Rate for Payer: Aetna Commercial |
$36.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.95
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$30.10
|
| Rate for Payer: Cofinity Commercial |
$36.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.40
|
| Rate for Payer: Healthscope Commercial |
$38.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.55
|
| Rate for Payer: PHP Commercial |
$36.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health SBD |
$27.09
|
| Rate for Payer: UMR Bronson Commercial |
$18.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.25
|
|
|
HC CAST SUP LNG ARM SPLNT PED FBRGLS
|
Facility
|
IP
|
$24.97
|
|
| Hospital Charge Code |
27200333
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.99 |
| Max. Negotiated Rate |
$22.47 |
| Rate for Payer: Aetna American Axle |
$16.23
|
| Rate for Payer: Aetna Commercial |
$21.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.23
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Commercial |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$21.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Healthscope Commercial |
$22.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: PHP Commercial |
$21.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.23
|
| Rate for Payer: Priority Health SBD |
$15.73
|
| Rate for Payer: UMR Bronson Commercial |
$10.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.73
|
|
|
HC CAST SUP LNG ARM SPLNT PED FBRGLS
|
Facility
|
OP
|
$24.97
|
|
| Hospital Charge Code |
27200333
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.24 |
| Max. Negotiated Rate |
$22.47 |
| Rate for Payer: Aetna American Axle |
$16.23
|
| Rate for Payer: Aetna Commercial |
$21.22
|
| Rate for Payer: Aetna Medicare |
$12.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.23
|
| Rate for Payer: BCBS Complete |
$9.99
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Commercial |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$21.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Healthscope Commercial |
$22.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: PHP Commercial |
$21.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.23
|
| Rate for Payer: Priority Health SBD |
$15.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.73
|
|
|
HC CAST SUP LNG LEG ADULT FBRGLS
|
Facility
|
IP
|
$118.61
|
|
| Hospital Charge Code |
27200336
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$52.19 |
| Max. Negotiated Rate |
$106.75 |
| Rate for Payer: Aetna American Axle |
$77.10
|
| Rate for Payer: Aetna Commercial |
$100.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.10
|
| Rate for Payer: Cash Price |
$94.89
|
| Rate for Payer: Cofinity Commercial |
$102.00
|
| Rate for Payer: Cofinity Commercial |
$83.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$83.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.89
|
| Rate for Payer: Healthscope Commercial |
$106.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.82
|
| Rate for Payer: PHP Commercial |
$100.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.10
|
| Rate for Payer: Priority Health SBD |
$74.72
|
| Rate for Payer: UMR Bronson Commercial |
$52.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.96
|
|
|
HC CAST SUP LNG LEG ADULT FBRGLS
|
Facility
|
OP
|
$118.61
|
|
| Hospital Charge Code |
27200336
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$43.89 |
| Max. Negotiated Rate |
$106.75 |
| Rate for Payer: Aetna American Axle |
$77.10
|
| Rate for Payer: Aetna Commercial |
$100.82
|
| Rate for Payer: Aetna Medicare |
$59.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.10
|
| Rate for Payer: BCBS Complete |
$47.44
|
| Rate for Payer: Cash Price |
$94.89
|
| Rate for Payer: Cofinity Commercial |
$102.00
|
| Rate for Payer: Cofinity Commercial |
$83.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$83.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.89
|
| Rate for Payer: Healthscope Commercial |
$106.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.82
|
| Rate for Payer: PHP Commercial |
$100.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.10
|
| Rate for Payer: Priority Health SBD |
$74.72
|
| Rate for Payer: UMR Bronson Commercial |
$43.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.96
|
|
|
HC CAST SUP LNG LEG CYLNDR PED FBRGLS
|
Facility
|
IP
|
$52.02
|
|
| Hospital Charge Code |
27200338
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.89 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: UMR Bronson Commercial |
$22.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC CAST SUP LNG LEG CYLNDR PED FBRGLS
|
Facility
|
OP
|
$52.02
|
|
| Hospital Charge Code |
27200338
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.25 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$26.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: BCBS Complete |
$20.81
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: UMR Bronson Commercial |
$19.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC CAST SUP LNG LEG PED FBRGLS
|
Facility
|
IP
|
$54.10
|
|
| Hospital Charge Code |
27200337
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$23.80 |
| Max. Negotiated Rate |
$48.69 |
| Rate for Payer: Aetna American Axle |
$35.16
|
| Rate for Payer: Aetna Commercial |
$45.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.16
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$37.87
|
| Rate for Payer: Cofinity Commercial |
$46.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Healthscope Commercial |
$48.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: PHP Commercial |
$45.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.16
|
| Rate for Payer: Priority Health SBD |
$34.08
|
| Rate for Payer: UMR Bronson Commercial |
$23.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.58
|
|
