|
HC CAST LONG LEG
|
Facility
|
IP
|
$403.61
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
70000005
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$282.53 |
| Max. Negotiated Rate |
$403.61 |
| Rate for Payer: Aetna Commercial |
$363.25
|
| Rate for Payer: ASR ASR |
$391.50
|
| Rate for Payer: BCBS Trust/PPO |
$312.92
|
| Rate for Payer: BCN Commercial |
$312.92
|
| Rate for Payer: Cash Price |
$322.89
|
| Rate for Payer: Cofinity Commercial |
$379.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$322.89
|
| Rate for Payer: Healthscope Commercial |
$403.61
|
| Rate for Payer: Healthscope Whirlpool |
$391.50
|
| Rate for Payer: Mclaren Commercial |
$363.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$343.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$282.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$355.18
|
|
|
HC CAST PANTALOON
|
Facility
|
IP
|
$900.56
|
|
|
Service Code
|
CPT 29305
|
| Hospital Charge Code |
70000003
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$630.39 |
| Max. Negotiated Rate |
$900.56 |
| Rate for Payer: Aetna Commercial |
$810.50
|
| Rate for Payer: ASR ASR |
$873.54
|
| Rate for Payer: BCBS Trust/PPO |
$698.20
|
| Rate for Payer: BCN Commercial |
$698.20
|
| Rate for Payer: Cash Price |
$720.45
|
| Rate for Payer: Cofinity Commercial |
$846.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.45
|
| Rate for Payer: Healthscope Commercial |
$900.56
|
| Rate for Payer: Healthscope Whirlpool |
$873.54
|
| Rate for Payer: Mclaren Commercial |
$810.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$765.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$792.49
|
|
|
HC CAST PANTALOON
|
Facility
|
OP
|
$900.56
|
|
|
Service Code
|
CPT 29305
|
| Hospital Charge Code |
70000003
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$130.58 |
| Max. Negotiated Rate |
$900.56 |
| Rate for Payer: Aetna Commercial |
$810.50
|
| Rate for Payer: Aetna Medicare |
$238.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$298.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$298.40
|
| Rate for Payer: ASR ASR |
$873.54
|
| Rate for Payer: BCBS Complete |
$137.12
|
| Rate for Payer: BCBS MAPPO |
$238.72
|
| Rate for Payer: BCBS Trust/PPO |
$698.20
|
| Rate for Payer: BCN Commercial |
$698.20
|
| Rate for Payer: BCN Medicare Advantage |
$238.72
|
| Rate for Payer: Cash Price |
$720.45
|
| Rate for Payer: Cash Price |
$720.45
|
| Rate for Payer: Cofinity Commercial |
$846.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.72
|
| Rate for Payer: Healthscope Commercial |
$900.56
|
| Rate for Payer: Healthscope Whirlpool |
$873.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$238.72
|
| Rate for Payer: Mclaren Commercial |
$810.50
|
| 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 |
$765.48
|
| Rate for Payer: PACE Medicare |
$226.78
|
| Rate for Payer: PACE SWMI |
$238.72
|
| Rate for Payer: PHP Commercial |
$262.59
|
| Rate for Payer: PHP Medicaid |
$130.58
|
| 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 |
$630.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$819.51
|
| Rate for Payer: Priority Health Medicare |
$238.72
|
| Rate for Payer: Priority Health Narrow Network |
$639.40
|
| Rate for Payer: Railroad Medicare Medicare |
$238.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$792.49
|
| Rate for Payer: UHC Medicare Advantage |
$245.88
|
| Rate for Payer: VA VA |
$238.72
|
|
|
HC CAST PTB WALKING
|
Facility
|
IP
|
$403.61
|
|
|
Service Code
|
CPT 29435
|
| Hospital Charge Code |
70000009
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$282.53 |
| Max. Negotiated Rate |
$403.61 |
| Rate for Payer: Aetna Commercial |
$363.25
|
| Rate for Payer: ASR ASR |
$391.50
|
| Rate for Payer: BCBS Trust/PPO |
$312.92
|
| Rate for Payer: BCN Commercial |
$312.92
|
| Rate for Payer: Cash Price |
$322.89
|
| Rate for Payer: Cofinity Commercial |
$379.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$322.89
|
| Rate for Payer: Healthscope Commercial |
$403.61
|
| Rate for Payer: Healthscope Whirlpool |
$391.50
|
| Rate for Payer: Mclaren Commercial |
$363.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$343.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$282.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$355.18
|
|
|
HC CAST PTB WALKING
|
Facility
|
OP
|
$403.61
|
|
|
Service Code
|
CPT 29435
|
| Hospital Charge Code |
70000009
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$130.58 |
| Max. Negotiated Rate |
$403.61 |
| Rate for Payer: Aetna Commercial |
$363.25
|
| Rate for Payer: Aetna Medicare |
$238.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$298.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$298.40
|
| Rate for Payer: ASR ASR |
$391.50
|
| Rate for Payer: BCBS Complete |
$137.12
|
| Rate for Payer: BCBS MAPPO |
$238.72
|
| Rate for Payer: BCBS Trust/PPO |
$312.92
|
| Rate for Payer: BCN Commercial |
$312.92
|
| Rate for Payer: BCN Medicare Advantage |
$238.72
|
| Rate for Payer: Cash Price |
$322.89
|
| Rate for Payer: Cash Price |
$322.89
|
| Rate for Payer: Cofinity Commercial |
$379.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$322.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.72
|
| Rate for Payer: Healthscope Commercial |
$403.61
|
| Rate for Payer: Healthscope Whirlpool |
$391.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$238.72
|
| Rate for Payer: Mclaren Commercial |
$363.25
|
| 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 |
$343.07
|
| Rate for Payer: PACE Medicare |
$226.78
|
| Rate for Payer: PACE SWMI |
$238.72
|
| Rate for Payer: PHP Commercial |
$262.59
|
| Rate for Payer: PHP Medicaid |
$130.58
|
| 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 |
$282.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$367.29
|
| Rate for Payer: Priority Health Medicare |
$238.72
|
| Rate for Payer: Priority Health Narrow Network |
$286.56
|
| Rate for Payer: Railroad Medicare Medicare |
$238.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$355.18
|
| Rate for Payer: UHC Medicare Advantage |
$245.88
|
| Rate for Payer: VA VA |
$238.72
|
|
|
HC CAST REPAIR
|
Facility
|
OP
|
$175.30
|
|
| Hospital Charge Code |
27000041
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$70.12 |
| Max. Negotiated Rate |
$175.30 |
| Rate for Payer: Aetna Commercial |
$157.77
|
| Rate for Payer: ASR ASR |
$170.04
|
| Rate for Payer: BCBS Complete |
$70.12
|
| Rate for Payer: BCBS Trust/PPO |
$135.91
|
| Rate for Payer: BCN Commercial |
$135.91
|
| Rate for Payer: Cash Price |
$140.24
|
| Rate for Payer: Cofinity Commercial |
$164.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.24
|
| Rate for Payer: Healthscope Commercial |
$175.30
|
| Rate for Payer: Healthscope Whirlpool |
$170.04
|
| Rate for Payer: Mclaren Commercial |
$157.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$149.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$159.52
|
| Rate for Payer: Priority Health Narrow Network |
$124.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$154.26
|
|
|
HC CAST REPAIR
|
Facility
|
IP
|
$175.30
|
|
| Hospital Charge Code |
27000041
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$122.71 |
| Max. Negotiated Rate |
$175.30 |
| Rate for Payer: Aetna Commercial |
$157.77
|
| Rate for Payer: ASR ASR |
$170.04
|
| Rate for Payer: BCBS Trust/PPO |
$135.91
|
| Rate for Payer: BCN Commercial |
$135.91
|
| Rate for Payer: Cash Price |
$140.24
|
| Rate for Payer: Cofinity Commercial |
$164.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.24
|
| Rate for Payer: Healthscope Commercial |
$175.30
|
| Rate for Payer: Healthscope Whirlpool |
$170.04
|
| Rate for Payer: Mclaren Commercial |
$157.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$149.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$154.26
|
|
|
HC CAST RISSER BODY ONLY
|
Facility
|
OP
|
$303.31
|
|
|
Service Code
|
CPT 29010
|
| Hospital Charge Code |
70000001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$130.58 |
| Max. Negotiated Rate |
$303.31 |
| Rate for Payer: Aetna Commercial |
$272.98
|
| Rate for Payer: Aetna Medicare |
$238.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$298.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$298.40
|
| Rate for Payer: ASR ASR |
$294.21
|
| Rate for Payer: BCBS Complete |
$137.12
|
| Rate for Payer: BCBS MAPPO |
$238.72
|
| Rate for Payer: BCBS Trust/PPO |
$235.16
|
| Rate for Payer: BCN Commercial |
$235.16
|
| Rate for Payer: BCN Medicare Advantage |
$238.72
|
| Rate for Payer: Cash Price |
$242.65
|
| Rate for Payer: Cash Price |
$242.65
|
| Rate for Payer: Cofinity Commercial |
$285.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.72
|
| Rate for Payer: Healthscope Commercial |
$303.31
|
| Rate for Payer: Healthscope Whirlpool |
$294.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$238.72
|
| Rate for Payer: Mclaren Commercial |
$272.98
|
| 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 |
$257.81
|
| Rate for Payer: PACE Medicare |
$226.78
|
| Rate for Payer: PACE SWMI |
$238.72
|
| Rate for Payer: PHP Commercial |
$262.59
|
| Rate for Payer: PHP Medicaid |
$130.58
|
| 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 |
$212.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$276.01
|
| Rate for Payer: Priority Health Medicare |
$238.72
|
| Rate for Payer: Priority Health Narrow Network |
$215.35
|
| Rate for Payer: Railroad Medicare Medicare |
$238.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$266.91
|
| Rate for Payer: UHC Medicare Advantage |
$245.88
|
| Rate for Payer: VA VA |
$238.72
|
|
|
HC CAST RISSER BODY ONLY
|
Facility
|
IP
|
$303.31
|
|
|
Service Code
|
CPT 29010
|
| Hospital Charge Code |
70000001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$212.32 |
| Max. Negotiated Rate |
$303.31 |
| Rate for Payer: Aetna Commercial |
$272.98
|
| Rate for Payer: ASR ASR |
$294.21
|
| Rate for Payer: BCBS Trust/PPO |
$235.16
|
| Rate for Payer: BCN Commercial |
$235.16
|
| Rate for Payer: Cash Price |
$242.65
|
| Rate for Payer: Cofinity Commercial |
$285.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.65
|
| Rate for Payer: Healthscope Commercial |
$303.31
|
| Rate for Payer: Healthscope Whirlpool |
$294.21
|
| Rate for Payer: Mclaren Commercial |
$272.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$257.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$266.91
|
|
|
HC CAST SHORT ARM
|
Facility
|
OP
|
$293.81
|
|
|
Service Code
|
CPT 29075
|
| Hospital Charge Code |
43000001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$130.58 |
| Max. Negotiated Rate |
$360.18 |
| Rate for Payer: Aetna Commercial |
$264.43
|
| Rate for Payer: Aetna Medicare |
$238.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$298.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$298.40
|
| Rate for Payer: ASR ASR |
$285.00
|
| Rate for Payer: BCBS Complete |
$137.12
|
| Rate for Payer: BCBS MAPPO |
$238.72
|
| Rate for Payer: BCBS Trust/PPO |
$227.79
|
| Rate for Payer: BCN Commercial |
$227.79
|
| 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 |
$276.18
|
| 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 |
$293.81
|
| Rate for Payer: Healthscope Whirlpool |
$285.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$238.72
|
| Rate for Payer: Mclaren Commercial |
$264.43
|
| 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 |
$262.59
|
| Rate for Payer: PHP Medicaid |
$130.58
|
| 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 |
$360.18
|
| Rate for Payer: Priority Health Medicare |
$238.72
|
| Rate for Payer: Priority Health Narrow Network |
$288.14
|
| Rate for Payer: Railroad Medicare Medicare |
$238.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$258.55
|
| Rate for Payer: UHC Medicare Advantage |
$245.88
|
| Rate for Payer: VA VA |
$238.72
|
|
|
HC CAST SHORT ARM
|
Facility
|
IP
|
$293.81
|
|
|
Service Code
|
CPT 29075
|
| Hospital Charge Code |
43000001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$205.67 |
| Max. Negotiated Rate |
$293.81 |
| Rate for Payer: Aetna Commercial |
$264.43
|
| Rate for Payer: ASR ASR |
$285.00
|
| Rate for Payer: BCBS Trust/PPO |
$227.79
|
| Rate for Payer: BCN Commercial |
$227.79
|
| Rate for Payer: Cash Price |
$235.05
|
| Rate for Payer: Cofinity Commercial |
$276.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$235.05
|
| Rate for Payer: Healthscope Commercial |
$293.81
|
| Rate for Payer: Healthscope Whirlpool |
$285.00
|
| Rate for Payer: Mclaren Commercial |
$264.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$249.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$258.55
|
|
|
HC CAST SHORT LEG
|
Facility
|
OP
|
$361.62
|
|
|
Service Code
|
CPT 29405
|
| Hospital Charge Code |
70000007
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$130.58 |
| Max. Negotiated Rate |
$361.62 |
| Rate for Payer: Aetna Commercial |
$325.46
|
| Rate for Payer: Aetna Medicare |
$238.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$298.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$298.40
|
| Rate for Payer: ASR ASR |
$350.77
|
| Rate for Payer: BCBS Complete |
$137.12
|
| Rate for Payer: BCBS MAPPO |
$238.72
|
| Rate for Payer: BCBS Trust/PPO |
$280.36
|
| Rate for Payer: BCN Commercial |
$280.36
|
| 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 |
$339.92
|
| 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 |
$361.62
|
| Rate for Payer: Healthscope Whirlpool |
$350.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$238.72
|
| Rate for Payer: Mclaren Commercial |
$325.46
|
| 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 |
$262.59
|
| Rate for Payer: PHP Medicaid |
$130.58
|
| 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 |
$360.18
|
| Rate for Payer: Priority Health Medicare |
$238.72
|
| Rate for Payer: Priority Health Narrow Network |
$288.14
|
| Rate for Payer: Railroad Medicare Medicare |
$238.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$318.23
|
| Rate for Payer: UHC Medicare Advantage |
$245.88
|
| Rate for Payer: VA VA |
$238.72
|
|
|
HC CAST SHORT LEG
|
Facility
|
IP
|
$361.62
|
|
|
Service Code
|
CPT 29405
|
| Hospital Charge Code |
70000007
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$253.13 |
| Max. Negotiated Rate |
$361.62 |
| Rate for Payer: Aetna Commercial |
$325.46
|
| Rate for Payer: ASR ASR |
$350.77
|
| Rate for Payer: BCBS Trust/PPO |
$280.36
|
| Rate for Payer: BCN Commercial |
$280.36
|
| Rate for Payer: Cash Price |
$289.30
|
| Rate for Payer: Cofinity Commercial |
$339.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.30
|
| Rate for Payer: Healthscope Commercial |
$361.62
|
| Rate for Payer: Healthscope Whirlpool |
$350.77
|
| Rate for Payer: Mclaren Commercial |
$325.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$307.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$318.23
|
|
|
HC CAST SHORT LEG WALKING
|
Facility
|
OP
|
$361.62
|
|
|
Service Code
|
CPT 29425
|
| Hospital Charge Code |
70000008
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$130.58 |
| Max. Negotiated Rate |
$361.62 |
| Rate for Payer: Aetna Commercial |
$325.46
|
| Rate for Payer: Aetna Medicare |
$238.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$298.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$298.40
|
| Rate for Payer: ASR ASR |
$350.77
|
| Rate for Payer: BCBS Complete |
$137.12
|
| Rate for Payer: BCBS MAPPO |
$238.72
|
| Rate for Payer: BCBS Trust/PPO |
$280.36
|
| Rate for Payer: BCN Commercial |
$280.36
|
| 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 |
$339.92
|
| 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 |
$361.62
|
| Rate for Payer: Healthscope Whirlpool |
$350.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$238.72
|
| Rate for Payer: Mclaren Commercial |
$325.46
|
| 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 |
$262.59
|
| Rate for Payer: PHP Medicaid |
$130.58
|
| 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 |
$329.07
|
| Rate for Payer: Priority Health Medicare |
$238.72
|
| Rate for Payer: Priority Health Narrow Network |
$256.75
|
| Rate for Payer: Railroad Medicare Medicare |
$238.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$318.23
|
| Rate for Payer: UHC Medicare Advantage |
$245.88
|
| Rate for Payer: VA VA |
$238.72
|
|
|
HC CAST SHORT LEG WALKING
|
Facility
|
IP
|
$361.62
|
|
|
Service Code
|
CPT 29425
|
| Hospital Charge Code |
70000008
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$253.13 |
| Max. Negotiated Rate |
$361.62 |
| Rate for Payer: Aetna Commercial |
$325.46
|
| Rate for Payer: ASR ASR |
$350.77
|
| Rate for Payer: BCBS Trust/PPO |
$280.36
|
| Rate for Payer: BCN Commercial |
$280.36
|
| Rate for Payer: Cash Price |
$289.30
|
| Rate for Payer: Cofinity Commercial |
$339.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.30
|
| Rate for Payer: Healthscope Commercial |
$361.62
|
| Rate for Payer: Healthscope Whirlpool |
$350.77
|
| Rate for Payer: Mclaren Commercial |
$325.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$307.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$318.23
|
|
|
HC CAST SUP LNG ARM SPLINT FBG
|
Facility
|
OP
|
$25.50
|
|
| Hospital Charge Code |
27200332
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.20 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Aetna Commercial |
$22.95
|
| Rate for Payer: ASR ASR |
$24.74
|
| Rate for Payer: BCBS Complete |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$19.77
|
| Rate for Payer: BCN Commercial |
$19.77
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$23.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$25.50
|
| Rate for Payer: Healthscope Whirlpool |
$24.74
|
| Rate for Payer: Mclaren Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.20
|
| Rate for Payer: Priority Health Narrow Network |
$18.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.44
|
|
|
HC CAST SUP LNG ARM SPLINT FBG
|
Facility
|
IP
|
$25.50
|
|
| Hospital Charge Code |
27200332
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.85 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Aetna Commercial |
$22.95
|
| Rate for Payer: ASR ASR |
$24.74
|
| Rate for Payer: BCBS Trust/PPO |
$19.77
|
| Rate for Payer: BCN Commercial |
$19.77
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$23.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$25.50
|
| Rate for Payer: Healthscope Whirlpool |
$24.74
|
| Rate for Payer: Mclaren Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.44
|
|
|
HC CAST SUP LNG ARM SPLNT PED F
|
Facility
|
OP
|
$24.48
|
|
| Hospital Charge Code |
27200333
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.79 |
| Max. Negotiated Rate |
$24.48 |
| Rate for Payer: Aetna Commercial |
$22.03
|
| Rate for Payer: ASR ASR |
$23.75
|
| Rate for Payer: BCBS Complete |
$9.79
|
| Rate for Payer: BCBS Trust/PPO |
$18.98
|
| Rate for Payer: BCN Commercial |
$18.98
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$23.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Healthscope Commercial |
$24.48
|
| Rate for Payer: Healthscope Whirlpool |
$23.75
|
| Rate for Payer: Mclaren Commercial |
$22.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.28
|
| Rate for Payer: Priority Health Narrow Network |
$17.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.54
|
|
|
HC CAST SUP LNG ARM SPLNT PED F
|
Facility
|
IP
|
$24.48
|
|
| Hospital Charge Code |
27200333
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.14 |
| Max. Negotiated Rate |
$24.48 |
| Rate for Payer: Aetna Commercial |
$22.03
|
| Rate for Payer: ASR ASR |
$23.75
|
| Rate for Payer: BCBS Trust/PPO |
$18.98
|
| Rate for Payer: BCN Commercial |
$18.98
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$23.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Healthscope Commercial |
$24.48
|
| Rate for Payer: Healthscope Whirlpool |
$23.75
|
| Rate for Payer: Mclaren Commercial |
$22.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.54
|
|
|
HC CAST SUP LNG LEG CYLNDR PED F
|
Facility
|
OP
|
$51.00
|
|
| Hospital Charge Code |
27200338
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS Trust/PPO |
$39.54
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$47.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.41
|
| Rate for Payer: Priority Health Narrow Network |
$36.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
|
|
HC CAST SUP LNG LEG CYLNDR PED F
|
Facility
|
IP
|
$51.00
|
|
| Hospital Charge Code |
27200338
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.70 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: BCBS Trust/PPO |
$39.54
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$47.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
|
|
HC CAST SUP LNG LEG PED FBRGLS
|
Facility
|
OP
|
$53.04
|
|
| Hospital Charge Code |
27200337
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.22 |
| Max. Negotiated Rate |
$53.04 |
| Rate for Payer: Aetna Commercial |
$47.74
|
| Rate for Payer: ASR ASR |
$51.45
|
| Rate for Payer: BCBS Complete |
$21.22
|
| Rate for Payer: BCBS Trust/PPO |
$41.12
|
| Rate for Payer: BCN Commercial |
$41.12
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$49.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Healthscope Commercial |
$53.04
|
| Rate for Payer: Healthscope Whirlpool |
$51.45
|
| Rate for Payer: Mclaren Commercial |
$47.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.27
|
| Rate for Payer: Priority Health Narrow Network |
$37.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.68
|
|
|
HC CAST SUP LNG LEG PED FBRGLS
|
Facility
|
IP
|
$53.04
|
|
| Hospital Charge Code |
27200337
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.13 |
| Max. Negotiated Rate |
$53.04 |
| Rate for Payer: Aetna Commercial |
$47.74
|
| Rate for Payer: ASR ASR |
$51.45
|
| Rate for Payer: BCBS Trust/PPO |
$41.12
|
| Rate for Payer: BCN Commercial |
$41.12
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$49.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Healthscope Commercial |
$53.04
|
| Rate for Payer: Healthscope Whirlpool |
$51.45
|
| Rate for Payer: Mclaren Commercial |
$47.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.68
|
|
|
HC CAST SUP LONG ARM ADULT FBRG
|
Facility
|
OP
|
$56.10
|
|
| Hospital Charge Code |
27200327
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.44 |
| Max. Negotiated Rate |
$56.10 |
| Rate for Payer: Aetna Commercial |
$50.49
|
| Rate for Payer: ASR ASR |
$54.42
|
| Rate for Payer: BCBS Complete |
$22.44
|
| Rate for Payer: BCBS Trust/PPO |
$43.49
|
| Rate for Payer: BCN Commercial |
$43.49
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$52.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Healthscope Commercial |
$56.10
|
| Rate for Payer: Healthscope Whirlpool |
$54.42
|
| Rate for Payer: Mclaren Commercial |
$50.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.05
|
| Rate for Payer: Priority Health Narrow Network |
$39.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.37
|
|
|
HC CAST SUP LONG ARM ADULT FBRG
|
Facility
|
IP
|
$56.10
|
|
| Hospital Charge Code |
27200327
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.27 |
| Max. Negotiated Rate |
$56.10 |
| Rate for Payer: Aetna Commercial |
$50.49
|
| Rate for Payer: ASR ASR |
$54.42
|
| Rate for Payer: BCBS Trust/PPO |
$43.49
|
| Rate for Payer: BCN Commercial |
$43.49
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$52.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Healthscope Commercial |
$56.10
|
| Rate for Payer: Healthscope Whirlpool |
$54.42
|
| Rate for Payer: Mclaren Commercial |
$50.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.37
|
|
