|
HC CLOSED RX NAVICULAR FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 25622
|
| Hospital Charge Code |
76100164
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$241.07 |
| Max. Negotiated Rate |
$344.39 |
| Rate for Payer: Aetna Commercial |
$309.95
|
| Rate for Payer: ASR ASR |
$334.06
|
| Rate for Payer: BCBS Trust/PPO |
$267.01
|
| Rate for Payer: BCN Commercial |
$267.01
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$323.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Healthscope Commercial |
$344.39
|
| Rate for Payer: Healthscope Whirlpool |
$334.06
|
| Rate for Payer: Mclaren Commercial |
$309.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$303.06
|
|
|
HC CLOSED RX PATELLA FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
76100171
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$344.39 |
| Rate for Payer: Aetna Commercial |
$309.95
|
| Rate for Payer: Aetna Medicare |
$209.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: ASR ASR |
$334.06
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$267.01
|
| Rate for Payer: BCN Commercial |
$267.01
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$323.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$344.39
|
| Rate for Payer: Healthscope Whirlpool |
$334.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$309.95
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$230.58
|
| Rate for Payer: PHP Medicaid |
$114.66
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$222.68
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$178.14
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$303.06
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC CLOSED RX PATELLA FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
76100171
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$241.07 |
| Max. Negotiated Rate |
$344.39 |
| Rate for Payer: Aetna Commercial |
$309.95
|
| Rate for Payer: ASR ASR |
$334.06
|
| Rate for Payer: BCBS Trust/PPO |
$267.01
|
| Rate for Payer: BCN Commercial |
$267.01
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$323.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Healthscope Commercial |
$344.39
|
| Rate for Payer: Healthscope Whirlpool |
$334.06
|
| Rate for Payer: Mclaren Commercial |
$309.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$303.06
|
|
|
HC CLOSED RX POST HIP ARTHRPLAS DISLOC
|
Facility
|
IP
|
$622.66
|
|
|
Service Code
|
CPT 27265
|
| Hospital Charge Code |
76100363
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$435.86 |
| Max. Negotiated Rate |
$622.66 |
| Rate for Payer: Aetna Commercial |
$560.39
|
| Rate for Payer: ASR ASR |
$603.98
|
| Rate for Payer: BCBS Trust/PPO |
$482.75
|
| Rate for Payer: BCN Commercial |
$482.75
|
| Rate for Payer: Cash Price |
$498.13
|
| Rate for Payer: Cofinity Commercial |
$585.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$498.13
|
| Rate for Payer: Healthscope Commercial |
$622.66
|
| Rate for Payer: Healthscope Whirlpool |
$603.98
|
| Rate for Payer: Mclaren Commercial |
$560.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$529.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$435.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$547.94
|
|
|
HC CLOSED RX POST HIP ARTHRPLAS DISLOC
|
Facility
|
OP
|
$622.66
|
|
|
Service Code
|
CPT 27265
|
| Hospital Charge Code |
76100363
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$622.66 |
| Rate for Payer: Aetna Commercial |
$560.39
|
| Rate for Payer: Aetna Medicare |
$209.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: ASR ASR |
$603.98
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$482.75
|
| Rate for Payer: BCN Commercial |
$482.75
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$498.13
|
| Rate for Payer: Cash Price |
$498.13
|
| Rate for Payer: Cofinity Commercial |
$585.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$498.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$622.66
|
| Rate for Payer: Healthscope Whirlpool |
$603.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$560.39
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$529.26
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$230.58
|
| Rate for Payer: PHP Medicaid |
$114.66
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$435.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.45
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$203.56
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$547.94
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC CLOSED RX PROX HUMERUS FRACTURE
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
76100160
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$241.07 |
| Max. Negotiated Rate |
$344.39 |
| Rate for Payer: Aetna Commercial |
$309.95
|
| Rate for Payer: ASR ASR |
$334.06
|
| Rate for Payer: BCBS Trust/PPO |
$267.01
|
| Rate for Payer: BCN Commercial |
$267.01
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$323.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Healthscope Commercial |
$344.39
|
| Rate for Payer: Healthscope Whirlpool |
$334.06
|
| Rate for Payer: Mclaren Commercial |
$309.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$303.06
|
|
|
HC CLOSED RX PROX HUMERUS FRACTURE
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
76100160
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$344.39 |
| Rate for Payer: Aetna Commercial |
$309.95
|
| Rate for Payer: Aetna Medicare |
$209.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: ASR ASR |
$334.06
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$267.01
|
| Rate for Payer: BCN Commercial |
$267.01
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$323.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$344.39
|
| Rate for Payer: Healthscope Whirlpool |
$334.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$309.95
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$230.58
|
| Rate for Payer: PHP Medicaid |
$114.66
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$256.54
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$205.23
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$303.06
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC CLOSED RX PROX THIGH FX
|
Facility
|
IP
|
$609.96
|
|
|
Service Code
|
CPT 27230
|
| Hospital Charge Code |
76100317
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$426.97 |
| Max. Negotiated Rate |
$609.96 |
| Rate for Payer: Aetna Commercial |
$548.96
|
| Rate for Payer: ASR ASR |
$591.66
|
| Rate for Payer: BCBS Trust/PPO |
$472.90
|
| Rate for Payer: BCN Commercial |
$472.90
|
| Rate for Payer: Cash Price |
$487.97
|
| Rate for Payer: Cofinity Commercial |
$573.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$487.97
|
| Rate for Payer: Healthscope Commercial |
$609.96
|
| Rate for Payer: Healthscope Whirlpool |
$591.66
|
| Rate for Payer: Mclaren Commercial |
$548.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$426.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$536.76
|
|
|
HC CLOSED RX PROX THIGH FX
|
Facility
|
OP
|
$609.96
|
|
|
Service Code
|
CPT 27230
|
| Hospital Charge Code |
76100317
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$609.96 |
| Rate for Payer: Aetna Commercial |
$548.96
|
| Rate for Payer: Aetna Medicare |
$209.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: ASR ASR |
$591.66
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$472.90
|
| Rate for Payer: BCN Commercial |
$472.90
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$487.97
|
| Rate for Payer: Cash Price |
$487.97
|
| Rate for Payer: Cofinity Commercial |
$573.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$487.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$609.96
|
| Rate for Payer: Healthscope Whirlpool |
$591.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$548.96
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.47
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$230.58
|
| Rate for Payer: PHP Medicaid |
$114.66
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$426.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$555.06
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$433.07
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$536.76
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC CLOSED RX RADIAL HEAD/NECK FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
76100161
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$241.07 |
| Max. Negotiated Rate |
$344.39 |
| Rate for Payer: Aetna Commercial |
$309.95
|
| Rate for Payer: ASR ASR |
$334.06
|
| Rate for Payer: BCBS Trust/PPO |
$267.01
|
| Rate for Payer: BCN Commercial |
$267.01
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$323.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Healthscope Commercial |
$344.39
|
| Rate for Payer: Healthscope Whirlpool |
$334.06
|
| Rate for Payer: Mclaren Commercial |
$309.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$303.06
|
|
|
HC CLOSED RX RADIAL HEAD/NECK FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
76100161
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$344.39 |
| Rate for Payer: Aetna Commercial |
$309.95
|
| Rate for Payer: Aetna Medicare |
$209.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: ASR ASR |
$334.06
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$267.01
|
| Rate for Payer: BCN Commercial |
$267.01
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$323.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$344.39
|
| Rate for Payer: Healthscope Whirlpool |
$334.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$309.95
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$230.58
|
| Rate for Payer: PHP Medicaid |
$114.66
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$313.39
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$244.52
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$303.06
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC CLOSED RX RAD/ULNA SHAFT FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 25560
|
| Hospital Charge Code |
76100162
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$241.07 |
| Max. Negotiated Rate |
$344.39 |
| Rate for Payer: Aetna Commercial |
$309.95
|
| Rate for Payer: ASR ASR |
$334.06
|
| Rate for Payer: BCBS Trust/PPO |
$267.01
|
| Rate for Payer: BCN Commercial |
$267.01
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$323.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Healthscope Commercial |
$344.39
|
| Rate for Payer: Healthscope Whirlpool |
$334.06
|
| Rate for Payer: Mclaren Commercial |
$309.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$303.06
|
|
|
HC CLOSED RX RAD/ULNA SHAFT FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 25560
|
| Hospital Charge Code |
76100162
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$344.39 |
| Rate for Payer: Aetna Commercial |
$309.95
|
| Rate for Payer: Aetna Medicare |
$209.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: ASR ASR |
$334.06
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$267.01
|
| Rate for Payer: BCN Commercial |
$267.01
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$323.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$344.39
|
| Rate for Payer: Healthscope Whirlpool |
$334.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$309.95
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$230.58
|
| Rate for Payer: PHP Medicaid |
$114.66
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$313.39
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$244.52
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$303.06
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC CLOSED RX TIBIAL PLATEAU FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 27530
|
| Hospital Charge Code |
76100172
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$344.39 |
| Rate for Payer: Aetna Commercial |
$309.95
|
| Rate for Payer: Aetna Medicare |
$209.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: ASR ASR |
$334.06
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$267.01
|
| Rate for Payer: BCN Commercial |
$267.01
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$323.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$344.39
|
| Rate for Payer: Healthscope Whirlpool |
$334.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$309.95
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$230.58
|
| Rate for Payer: PHP Medicaid |
$114.66
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$313.39
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$244.52
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$303.06
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC CLOSED RX TIBIAL PLATEAU FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 27530
|
| Hospital Charge Code |
76100172
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$241.07 |
| Max. Negotiated Rate |
$344.39 |
| Rate for Payer: Aetna Commercial |
$309.95
|
| Rate for Payer: ASR ASR |
$334.06
|
| Rate for Payer: BCBS Trust/PPO |
$267.01
|
| Rate for Payer: BCN Commercial |
$267.01
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$323.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Healthscope Commercial |
$344.39
|
| Rate for Payer: Healthscope Whirlpool |
$334.06
|
| Rate for Payer: Mclaren Commercial |
$309.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$303.06
|
|
|
HC CLOSED RX TIBIA SHAFT FX
|
Facility
|
IP
|
$378.83
|
|
|
Service Code
|
CPT 27750
|
| Hospital Charge Code |
76100173
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$265.18 |
| Max. Negotiated Rate |
$378.83 |
| Rate for Payer: Aetna Commercial |
$340.95
|
| Rate for Payer: ASR ASR |
$367.47
|
| Rate for Payer: BCBS Trust/PPO |
$293.71
|
| Rate for Payer: BCN Commercial |
$293.71
|
| Rate for Payer: Cash Price |
$303.06
|
| Rate for Payer: Cofinity Commercial |
$356.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.06
|
| Rate for Payer: Healthscope Commercial |
$378.83
|
| Rate for Payer: Healthscope Whirlpool |
$367.47
|
| Rate for Payer: Mclaren Commercial |
$340.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$322.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$333.37
|
|
|
HC CLOSED RX TIBIA SHAFT FX
|
Facility
|
OP
|
$378.83
|
|
|
Service Code
|
CPT 27750
|
| Hospital Charge Code |
76100173
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$619.81 |
| Rate for Payer: Aetna Commercial |
$340.95
|
| Rate for Payer: Aetna Medicare |
$209.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: ASR ASR |
$367.47
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$293.71
|
| Rate for Payer: BCN Commercial |
$293.71
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$303.06
|
| Rate for Payer: Cash Price |
$303.06
|
| Rate for Payer: Cofinity Commercial |
$356.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$378.83
|
| Rate for Payer: Healthscope Whirlpool |
$367.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$340.95
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$322.01
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$230.58
|
| Rate for Payer: PHP Medicaid |
$114.66
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$619.81
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$495.85
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$333.37
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC CLOSED TREATMENT DISLOCATED SHOULDER W MANIP
|
Facility
|
OP
|
$622.20
|
|
|
Service Code
|
CPT 23650
|
| Hospital Charge Code |
76100436
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$622.20 |
| Rate for Payer: Aetna Commercial |
$559.98
|
| Rate for Payer: Aetna Medicare |
$209.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: ASR ASR |
$603.53
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$482.39
|
| Rate for Payer: BCN Commercial |
$482.39
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$497.76
|
| Rate for Payer: Cash Price |
$497.76
|
| Rate for Payer: Cofinity Commercial |
$584.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$497.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$622.20
|
| Rate for Payer: Healthscope Whirlpool |
$603.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$559.98
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$528.87
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$230.58
|
| Rate for Payer: PHP Medicaid |
$114.66
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$435.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$255.20
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$204.16
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$547.54
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC CLOSED TREATMENT DISLOCATED SHOULDER W MANIP
|
Facility
|
IP
|
$622.20
|
|
|
Service Code
|
CPT 23650
|
| Hospital Charge Code |
76100436
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$435.54 |
| Max. Negotiated Rate |
$622.20 |
| Rate for Payer: Aetna Commercial |
$559.98
|
| Rate for Payer: ASR ASR |
$603.53
|
| Rate for Payer: BCBS Trust/PPO |
$482.39
|
| Rate for Payer: BCN Commercial |
$482.39
|
| Rate for Payer: Cash Price |
$497.76
|
| Rate for Payer: Cofinity Commercial |
$584.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$497.76
|
| Rate for Payer: Healthscope Commercial |
$622.20
|
| Rate for Payer: Healthscope Whirlpool |
$603.53
|
| Rate for Payer: Mclaren Commercial |
$559.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$528.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$435.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$547.54
|
|
|
HC CLOSED TX ACETAB FX; W/O MANIP
|
Facility
|
IP
|
$374.34
|
|
|
Service Code
|
CPT 27220
|
| Hospital Charge Code |
76100286
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$262.04 |
| Max. Negotiated Rate |
$374.34 |
| Rate for Payer: Aetna Commercial |
$336.91
|
| Rate for Payer: ASR ASR |
$363.11
|
| Rate for Payer: BCBS Trust/PPO |
$290.23
|
| Rate for Payer: BCN Commercial |
$290.23
|
| Rate for Payer: Cash Price |
$299.47
|
| Rate for Payer: Cofinity Commercial |
$351.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.47
|
| Rate for Payer: Healthscope Commercial |
$374.34
|
| Rate for Payer: Healthscope Whirlpool |
$363.11
|
| Rate for Payer: Mclaren Commercial |
$336.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$318.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$329.42
|
|
|
HC CLOSED TX ACETAB FX; W/O MANIP
|
Facility
|
OP
|
$374.34
|
|
|
Service Code
|
CPT 27220
|
| Hospital Charge Code |
76100286
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$374.34 |
| Rate for Payer: Aetna Commercial |
$336.91
|
| Rate for Payer: Aetna Medicare |
$209.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: ASR ASR |
$363.11
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$290.23
|
| Rate for Payer: BCN Commercial |
$290.23
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$299.47
|
| Rate for Payer: Cash Price |
$299.47
|
| Rate for Payer: Cofinity Commercial |
$351.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$374.34
|
| Rate for Payer: Healthscope Whirlpool |
$363.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$336.91
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$318.19
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$230.58
|
| Rate for Payer: PHP Medicaid |
$114.66
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$340.65
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$265.78
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$329.42
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC CLOSED TX BIMALLEOLAR ANKLE FX W/O MANIP
|
Facility
|
OP
|
$613.92
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
76100492
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$613.92 |
| Rate for Payer: Aetna Commercial |
$552.53
|
| Rate for Payer: Aetna Medicare |
$209.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: ASR ASR |
$595.50
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$475.97
|
| Rate for Payer: BCN Commercial |
$475.97
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$491.14
|
| Rate for Payer: Cash Price |
$491.14
|
| Rate for Payer: Cofinity Commercial |
$577.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$613.92
|
| Rate for Payer: Healthscope Whirlpool |
$595.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$552.53
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$521.83
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$230.58
|
| Rate for Payer: PHP Medicaid |
$114.66
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$429.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$558.67
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$435.88
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$540.25
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC CLOSED TX BIMALLEOLAR ANKLE FX W/O MANIP
|
Facility
|
IP
|
$613.92
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
76100492
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$429.74 |
| Max. Negotiated Rate |
$613.92 |
| Rate for Payer: Aetna Commercial |
$552.53
|
| Rate for Payer: ASR ASR |
$595.50
|
| Rate for Payer: BCBS Trust/PPO |
$475.97
|
| Rate for Payer: BCN Commercial |
$475.97
|
| Rate for Payer: Cash Price |
$491.14
|
| Rate for Payer: Cofinity Commercial |
$577.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.14
|
| Rate for Payer: Healthscope Commercial |
$613.92
|
| Rate for Payer: Healthscope Whirlpool |
$595.50
|
| Rate for Payer: Mclaren Commercial |
$552.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$521.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$429.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$540.25
|
|
|
HC CLOSED TX BIMALLEOLAR FX W/MANIP
|
Facility
|
OP
|
$1,774.80
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
76100295
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$666.60 |
| Max. Negotiated Rate |
$1,785.76 |
| Rate for Payer: Aetna Commercial |
$1,597.32
|
| Rate for Payer: Aetna Medicare |
$1,428.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,785.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,785.76
|
| Rate for Payer: ASR ASR |
$1,721.56
|
| Rate for Payer: BCBS Complete |
$820.59
|
| Rate for Payer: BCBS MAPPO |
$1,428.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,376.00
|
| Rate for Payer: BCN Commercial |
$1,376.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,428.61
|
| Rate for Payer: Cash Price |
$1,419.84
|
| Rate for Payer: Cash Price |
$1,419.84
|
| Rate for Payer: Cofinity Commercial |
$1,668.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,419.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,428.61
|
| Rate for Payer: Healthscope Commercial |
$1,774.80
|
| Rate for Payer: Healthscope Whirlpool |
$1,721.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,428.61
|
| Rate for Payer: Mclaren Commercial |
$1,597.32
|
| Rate for Payer: Mclaren Medicaid |
$781.45
|
| Rate for Payer: Mclaren Medicare |
$1,428.61
|
| Rate for Payer: Meridian Medicaid |
$820.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,500.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,642.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,508.58
|
| Rate for Payer: PACE Medicare |
$1,357.18
|
| Rate for Payer: PACE SWMI |
$1,428.61
|
| Rate for Payer: PHP Commercial |
$1,571.47
|
| Rate for Payer: PHP Medicaid |
$781.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,428.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$781.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,242.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$833.25
|
| Rate for Payer: Priority Health Medicare |
$1,428.61
|
| Rate for Payer: Priority Health Narrow Network |
$666.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,428.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,561.82
|
| Rate for Payer: UHC Medicare Advantage |
$1,471.47
|
| Rate for Payer: VA VA |
$1,428.61
|
|
|
HC CLOSED TX BIMALLEOLAR FX W/MANIP
|
Facility
|
IP
|
$1,774.80
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
76100295
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,242.36 |
| Max. Negotiated Rate |
$1,774.80 |
| Rate for Payer: Aetna Commercial |
$1,597.32
|
| Rate for Payer: ASR ASR |
$1,721.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,376.00
|
| Rate for Payer: BCN Commercial |
$1,376.00
|
| Rate for Payer: Cash Price |
$1,419.84
|
| Rate for Payer: Cofinity Commercial |
$1,668.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,419.84
|
| Rate for Payer: Healthscope Commercial |
$1,774.80
|
| Rate for Payer: Healthscope Whirlpool |
$1,721.56
|
| Rate for Payer: Mclaren Commercial |
$1,597.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,508.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,242.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,561.82
|
|
