|
HC CAST SUP LONG ARM PED FBRGLS
|
Facility
|
IP
|
$25.50
|
|
| Hospital Charge Code |
27200328
|
|
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 LONG ARM PED FBRGLS
|
Facility
|
OP
|
$25.50
|
|
| Hospital Charge Code |
27200328
|
|
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 LONG LEG FIBERGLASS
|
Facility
|
OP
|
$116.28
|
|
| Hospital Charge Code |
27200336
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.51 |
| Max. Negotiated Rate |
$116.28 |
| Rate for Payer: Aetna Commercial |
$104.65
|
| Rate for Payer: ASR ASR |
$112.79
|
| Rate for Payer: BCBS Complete |
$46.51
|
| Rate for Payer: BCBS Trust/PPO |
$90.15
|
| Rate for Payer: BCN Commercial |
$90.15
|
| Rate for Payer: Cash Price |
$93.02
|
| Rate for Payer: Cofinity Commercial |
$109.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.02
|
| Rate for Payer: Healthscope Commercial |
$116.28
|
| Rate for Payer: Healthscope Whirlpool |
$112.79
|
| Rate for Payer: Mclaren Commercial |
$104.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$98.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$105.81
|
| Rate for Payer: Priority Health Narrow Network |
$82.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$102.33
|
|
|
HC CAST SUP LONG LEG FIBERGLASS
|
Facility
|
IP
|
$116.28
|
|
| Hospital Charge Code |
27200336
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.40 |
| Max. Negotiated Rate |
$116.28 |
| Rate for Payer: Aetna Commercial |
$104.65
|
| Rate for Payer: ASR ASR |
$112.79
|
| Rate for Payer: BCBS Trust/PPO |
$90.15
|
| Rate for Payer: BCN Commercial |
$90.15
|
| Rate for Payer: Cash Price |
$93.02
|
| Rate for Payer: Cofinity Commercial |
$109.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.02
|
| Rate for Payer: Healthscope Commercial |
$116.28
|
| Rate for Payer: Healthscope Whirlpool |
$112.79
|
| Rate for Payer: Mclaren Commercial |
$104.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$98.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$102.33
|
|
|
HC CAST SUPPLIES UNLISTED
|
Facility
|
IP
|
$102.00
|
|
| Hospital Charge Code |
27200343
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$71.40 |
| Max. Negotiated Rate |
$102.00 |
| Rate for Payer: Aetna Commercial |
$91.80
|
| Rate for Payer: ASR ASR |
$98.94
|
| Rate for Payer: BCBS Trust/PPO |
$79.08
|
| Rate for Payer: BCN Commercial |
$79.08
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$95.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Healthscope Commercial |
$102.00
|
| Rate for Payer: Healthscope Whirlpool |
$98.94
|
| Rate for Payer: Mclaren Commercial |
$91.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$89.76
|
|
|
HC CAST SUPPLIES UNLISTED
|
Facility
|
OP
|
$102.00
|
|
| Hospital Charge Code |
27200343
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.80 |
| Max. Negotiated Rate |
$102.00 |
| Rate for Payer: Aetna Commercial |
$91.80
|
| Rate for Payer: ASR ASR |
$98.94
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: BCBS Trust/PPO |
$79.08
|
| Rate for Payer: BCN Commercial |
$79.08
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$95.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Healthscope Commercial |
$102.00
|
| Rate for Payer: Healthscope Whirlpool |
$98.94
|
| Rate for Payer: Mclaren Commercial |
$91.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.82
|
| Rate for Payer: Priority Health Narrow Network |
$72.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$89.76
|
|
|
HC CAST SUP SHRT LEG FIBERGLASS
|
Facility
|
IP
|
$61.20
|
|
| Hospital Charge Code |
27200339
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.84 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Aetna Commercial |
$55.08
|
| Rate for Payer: ASR ASR |
$59.36
|
| Rate for Payer: BCBS Trust/PPO |
$47.45
|
| Rate for Payer: BCN Commercial |
$47.45
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$57.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$61.20
|
| Rate for Payer: Healthscope Whirlpool |
$59.36
|
| Rate for Payer: Mclaren Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.86
|
|
|
HC CAST SUP SHRT LEG FIBERGLASS
|
Facility
|
OP
|
$61.20
|
|
| Hospital Charge Code |
27200339
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.48 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Aetna Commercial |
$55.08
|
| Rate for Payer: ASR ASR |
$59.36
|
| Rate for Payer: BCBS Complete |
$24.48
|
| Rate for Payer: BCBS Trust/PPO |
$47.45
|
| Rate for Payer: BCN Commercial |
$47.45
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$57.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$61.20
|
| Rate for Payer: Healthscope Whirlpool |
$59.36
|
| Rate for Payer: Mclaren Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.69
|
| Rate for Payer: Priority Health Narrow Network |
$43.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.86
|
|
|
HC CAST SUP SHRT LEG PED FBRGLS
|
Facility
|
IP
|
$21.42
|
|
| Hospital Charge Code |
27200340
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.99 |
| Max. Negotiated Rate |
$21.42 |
| Rate for Payer: Aetna Commercial |
$19.28
|
| Rate for Payer: ASR ASR |
$20.78
|
| Rate for Payer: BCBS Trust/PPO |
$16.61
|
| Rate for Payer: BCN Commercial |
$16.61
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$20.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Healthscope Commercial |
$21.42
|
| Rate for Payer: Healthscope Whirlpool |
$20.78
|
| Rate for Payer: Mclaren Commercial |
$19.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.85
|
|
|
HC CAST SUP SHRT LEG PED FBRGLS
|
Facility
|
OP
|
$21.42
|
|
| Hospital Charge Code |
27200340
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.57 |
| Max. Negotiated Rate |
$21.42 |
| Rate for Payer: Aetna Commercial |
$19.28
|
| Rate for Payer: ASR ASR |
$20.78
|
| Rate for Payer: BCBS Complete |
$8.57
|
| Rate for Payer: BCBS Trust/PPO |
$16.61
|
| Rate for Payer: BCN Commercial |
$16.61
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$20.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Healthscope Commercial |
$21.42
|
| Rate for Payer: Healthscope Whirlpool |
$20.78
|
| Rate for Payer: Mclaren Commercial |
$19.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.49
|
| Rate for Payer: Priority Health Narrow Network |
$15.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.85
|
|
|
HC CAST SUP SHT ARM ADULT FBRGL
|
Facility
|
IP
|
$42.84
|
|
| Hospital Charge Code |
27200329
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.99 |
| Max. Negotiated Rate |
$42.84 |
| Rate for Payer: Aetna Commercial |
$38.56
|
| Rate for Payer: ASR ASR |
$41.55
|
| Rate for Payer: BCBS Trust/PPO |
$33.21
|
| Rate for Payer: BCN Commercial |
$33.21
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.27
|
| Rate for Payer: Healthscope Commercial |
$42.84
|
| Rate for Payer: Healthscope Whirlpool |
$41.55
|
| Rate for Payer: Mclaren Commercial |
$38.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.70
|
|
|
HC CAST SUP SHT ARM ADULT FBRGL
|
Facility
|
OP
|
$42.84
|
|
| Hospital Charge Code |
27200329
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.14 |
| Max. Negotiated Rate |
$42.84 |
| Rate for Payer: Aetna Commercial |
$38.56
|
| Rate for Payer: ASR ASR |
$41.55
|
| Rate for Payer: BCBS Complete |
$17.14
|
| Rate for Payer: BCBS Trust/PPO |
$33.21
|
| Rate for Payer: BCN Commercial |
$33.21
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.27
|
| Rate for Payer: Healthscope Commercial |
$42.84
|
| Rate for Payer: Healthscope Whirlpool |
$41.55
|
| Rate for Payer: Mclaren Commercial |
$38.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.98
|
| Rate for Payer: Priority Health Narrow Network |
$30.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.70
|
|
|
HC CAST SUP SHT ARM PED FBRGLAS
|
Facility
|
IP
|
$20.40
|
|
| Hospital Charge Code |
27200330
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$20.40 |
| Rate for Payer: Aetna Commercial |
$18.36
|
| Rate for Payer: ASR ASR |
$19.79
|
| Rate for Payer: BCBS Trust/PPO |
$15.82
|
| Rate for Payer: BCN Commercial |
$15.82
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$19.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$20.40
|
| Rate for Payer: Healthscope Whirlpool |
$19.79
|
| Rate for Payer: Mclaren Commercial |
$18.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.95
|
|
|
HC CAST SUP SHT ARM PED FBRGLAS
|
Facility
|
OP
|
$20.40
|
|
| Hospital Charge Code |
27200330
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.16 |
| Max. Negotiated Rate |
$20.40 |
| Rate for Payer: Aetna Commercial |
$18.36
|
| Rate for Payer: ASR ASR |
$19.79
|
| Rate for Payer: BCBS Complete |
$8.16
|
| Rate for Payer: BCBS Trust/PPO |
$15.82
|
| Rate for Payer: BCN Commercial |
$15.82
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$19.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$20.40
|
| Rate for Payer: Healthscope Whirlpool |
$19.79
|
| Rate for Payer: Mclaren Commercial |
$18.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.56
|
| Rate for Payer: Priority Health Narrow Network |
$14.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.95
|
|
|
HC CAST SUP SHT ARM SPLINT FBRG
|
Facility
|
OP
|
$25.50
|
|
| Hospital Charge Code |
27200334
|
|
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 SHT ARM SPLINT FBRG
|
Facility
|
IP
|
$25.50
|
|
| Hospital Charge Code |
27200334
|
|
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 SHT ARM SPLNT PED F
|
Facility
|
IP
|
$27.54
|
|
| Hospital Charge Code |
27200335
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.28 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$24.79
|
| Rate for Payer: ASR ASR |
$26.71
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: Cash Price |
$22.03
|
| Rate for Payer: Cofinity Commercial |
$25.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.03
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Healthscope Whirlpool |
$26.71
|
| Rate for Payer: Mclaren Commercial |
$24.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.24
|
|
|
HC CAST SUP SHT ARM SPLNT PED F
|
Facility
|
OP
|
$27.54
|
|
| Hospital Charge Code |
27200335
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.02 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$24.79
|
| Rate for Payer: ASR ASR |
$26.71
|
| Rate for Payer: BCBS Complete |
$11.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: Cash Price |
$22.03
|
| Rate for Payer: Cofinity Commercial |
$25.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.03
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Healthscope Whirlpool |
$26.71
|
| Rate for Payer: Mclaren Commercial |
$24.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.06
|
| Rate for Payer: Priority Health Narrow Network |
$19.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.24
|
|
|
HC CAST SUP SHT GAUNTLET FIBERGLASS
|
Facility
|
IP
|
$56.10
|
|
| Hospital Charge Code |
27200331
|
|
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
|
|
|
HC CAST SUP SHT GAUNTLET FIBERGLASS
|
Facility
|
OP
|
$56.10
|
|
| Hospital Charge Code |
27200331
|
|
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 SHT LEG SPLNT FBRGL
|
Facility
|
IP
|
$30.60
|
|
| Hospital Charge Code |
27200341
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.42 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$27.54
|
| Rate for Payer: ASR ASR |
$29.68
|
| Rate for Payer: BCBS Trust/PPO |
$23.72
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$28.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Whirlpool |
$29.68
|
| Rate for Payer: Mclaren Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.93
|
|
|
HC CAST SUP SHT LEG SPLNT FBRGL
|
Facility
|
OP
|
$30.60
|
|
| Hospital Charge Code |
27200341
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.24 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$27.54
|
| Rate for Payer: ASR ASR |
$29.68
|
| Rate for Payer: BCBS Complete |
$12.24
|
| Rate for Payer: BCBS Trust/PPO |
$23.72
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$28.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Whirlpool |
$29.68
|
| Rate for Payer: Mclaren Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.85
|
| Rate for Payer: Priority Health Narrow Network |
$21.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.93
|
|
|
HC CAST SUP SHT LEG SPLNT PED F
|
Facility
|
OP
|
$25.50
|
|
| Hospital Charge Code |
27200342
|
|
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 SHT LEG SPLNT PED F
|
Facility
|
IP
|
$25.50
|
|
| Hospital Charge Code |
27200342
|
|
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 TOTAL CONTACT
|
Facility
|
OP
|
$488.11
|
|
|
Service Code
|
CPT 29445
|
| Hospital Charge Code |
70000021
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$130.58 |
| Max. Negotiated Rate |
$488.11 |
| Rate for Payer: Aetna Commercial |
$439.30
|
| 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 |
$473.47
|
| Rate for Payer: BCBS Complete |
$137.12
|
| Rate for Payer: BCBS MAPPO |
$238.72
|
| Rate for Payer: BCBS Trust/PPO |
$378.43
|
| Rate for Payer: BCN Commercial |
$378.43
|
| Rate for Payer: BCN Medicare Advantage |
$238.72
|
| Rate for Payer: Cash Price |
$390.49
|
| Rate for Payer: Cash Price |
$390.49
|
| Rate for Payer: Cofinity Commercial |
$458.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$390.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.72
|
| Rate for Payer: Healthscope Commercial |
$488.11
|
| Rate for Payer: Healthscope Whirlpool |
$473.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$238.72
|
| Rate for Payer: Mclaren Commercial |
$439.30
|
| 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 |
$414.89
|
| 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 |
$341.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$444.18
|
| Rate for Payer: Priority Health Medicare |
$238.72
|
| Rate for Payer: Priority Health Narrow Network |
$346.56
|
| Rate for Payer: Railroad Medicare Medicare |
$238.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$429.54
|
| Rate for Payer: UHC Medicare Advantage |
$245.88
|
| Rate for Payer: VA VA |
$238.72
|
|
