|
HC CLOSED TX PROX/MID PHALANX FX W/MANIP
|
Facility
|
IP
|
$329.93
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
76100232
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$230.95 |
| Max. Negotiated Rate |
$329.93 |
| Rate for Payer: Aetna Commercial |
$296.94
|
| Rate for Payer: ASR ASR |
$320.03
|
| Rate for Payer: BCBS Trust/PPO |
$255.79
|
| Rate for Payer: BCN Commercial |
$255.79
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$310.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Healthscope Commercial |
$329.93
|
| Rate for Payer: Healthscope Whirlpool |
$320.03
|
| Rate for Payer: Mclaren Commercial |
$296.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$290.34
|
|
|
HC CLOSED TX RADIAL SHAFT FRACTURE W/O MANIP
|
Facility
|
OP
|
$622.66
|
|
|
Service Code
|
CPT 25500
|
| Hospital Charge Code |
76100352
|
|
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 |
$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 |
$547.94
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC CLOSED TX RADIAL SHAFT FRACTURE W/O MANIP
|
Facility
|
IP
|
$622.66
|
|
|
Service Code
|
CPT 25500
|
| Hospital Charge Code |
76100352
|
|
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 TX SCAPULAR FX, W/O MANIP
|
Facility
|
IP
|
$329.93
|
|
|
Service Code
|
CPT 23570
|
| Hospital Charge Code |
76100273
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$230.95 |
| Max. Negotiated Rate |
$329.93 |
| Rate for Payer: Aetna Commercial |
$296.94
|
| Rate for Payer: ASR ASR |
$320.03
|
| Rate for Payer: BCBS Trust/PPO |
$255.79
|
| Rate for Payer: BCN Commercial |
$255.79
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$310.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Healthscope Commercial |
$329.93
|
| Rate for Payer: Healthscope Whirlpool |
$320.03
|
| Rate for Payer: Mclaren Commercial |
$296.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$290.34
|
|
|
HC CLOSED TX SCAPULAR FX, W/O MANIP
|
Facility
|
OP
|
$329.93
|
|
|
Service Code
|
CPT 23570
|
| Hospital Charge Code |
76100273
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$329.93 |
| Rate for Payer: Aetna Commercial |
$296.94
|
| 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 |
$320.03
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$255.79
|
| Rate for Payer: BCN Commercial |
$255.79
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$310.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$329.93
|
| Rate for Payer: Healthscope Whirlpool |
$320.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$296.94
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$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 |
$230.95
|
| 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 |
$290.34
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC CLOSED TX SESAMOID FX
|
Facility
|
OP
|
$315.48
|
|
|
Service Code
|
CPT 28530
|
| Hospital Charge Code |
76100322
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$315.48 |
| Rate for Payer: Aetna Commercial |
$283.93
|
| 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 |
$306.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$244.59
|
| Rate for Payer: BCN Commercial |
$244.59
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$252.38
|
| Rate for Payer: Cash Price |
$252.38
|
| Rate for Payer: Cofinity Commercial |
$296.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$315.48
|
| Rate for Payer: Healthscope Whirlpool |
$306.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$283.93
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$268.16
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$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 |
$220.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.09
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$223.99
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$277.62
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC CLOSED TX SESAMOID FX
|
Facility
|
IP
|
$315.48
|
|
|
Service Code
|
CPT 28530
|
| Hospital Charge Code |
76100322
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$220.84 |
| Max. Negotiated Rate |
$315.48 |
| Rate for Payer: Aetna Commercial |
$283.93
|
| Rate for Payer: ASR ASR |
$306.02
|
| Rate for Payer: BCBS Trust/PPO |
$244.59
|
| Rate for Payer: BCN Commercial |
$244.59
|
| Rate for Payer: Cash Price |
$252.38
|
| Rate for Payer: Cofinity Commercial |
$296.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.38
|
| Rate for Payer: Healthscope Commercial |
$315.48
|
| Rate for Payer: Healthscope Whirlpool |
$306.02
|
| Rate for Payer: Mclaren Commercial |
$283.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$268.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$277.62
|
|
|
HC CLOSED TX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/O MANIP
|
Facility
|
IP
|
$358.02
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
76100301
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$250.61 |
| Max. Negotiated Rate |
$358.02 |
| Rate for Payer: Aetna Commercial |
$322.22
|
| Rate for Payer: ASR ASR |
$347.28
|
| Rate for Payer: BCBS Trust/PPO |
$277.57
|
| Rate for Payer: BCN Commercial |
$277.57
|
| Rate for Payer: Cash Price |
$286.42
|
| Rate for Payer: Cofinity Commercial |
$336.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.42
|
| Rate for Payer: Healthscope Commercial |
$358.02
|
| Rate for Payer: Healthscope Whirlpool |
$347.28
|
| Rate for Payer: Mclaren Commercial |
$322.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$304.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$315.06
|
|
|
HC CLOSED TX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/O MANIP
|
Facility
|
OP
|
$358.02
|
|
|
Service Code
|
CPT 24530
|
| Hospital Charge Code |
76100301
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$358.02 |
| Rate for Payer: Aetna Commercial |
$322.22
|
| 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 |
$347.28
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$277.57
|
| Rate for Payer: BCN Commercial |
$277.57
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$286.42
|
| Rate for Payer: Cash Price |
$286.42
|
| Rate for Payer: Cofinity Commercial |
$336.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$358.02
|
| Rate for Payer: Healthscope Whirlpool |
$347.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$322.22
|
| 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 |
$304.32
|
| 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 |
$250.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$325.80
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$254.19
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$315.06
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC CLOSED TX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANIP
|
Facility
|
IP
|
$329.93
|
|
|
Service Code
|
CPT 27501
|
| Hospital Charge Code |
76100279
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$230.95 |
| Max. Negotiated Rate |
$329.93 |
| Rate for Payer: Aetna Commercial |
$296.94
|
| Rate for Payer: ASR ASR |
$320.03
|
| Rate for Payer: BCBS Trust/PPO |
$255.79
|
| Rate for Payer: BCN Commercial |
$255.79
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$310.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Healthscope Commercial |
$329.93
|
| Rate for Payer: Healthscope Whirlpool |
$320.03
|
| Rate for Payer: Mclaren Commercial |
$296.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$290.34
|
|
|
HC CLOSED TX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANIP
|
Facility
|
OP
|
$329.93
|
|
|
Service Code
|
CPT 27501
|
| Hospital Charge Code |
76100279
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$329.93 |
| Rate for Payer: Aetna Commercial |
$296.94
|
| 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 |
$320.03
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$255.79
|
| Rate for Payer: BCN Commercial |
$255.79
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$310.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$329.93
|
| Rate for Payer: Healthscope Whirlpool |
$320.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$296.94
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$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 |
$230.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$300.24
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$234.25
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$290.34
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC CLOSED TX TALUS FX; W/O MANIP
|
Facility
|
OP
|
$285.94
|
|
|
Service Code
|
CPT 28430
|
| Hospital Charge Code |
76100288
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$285.94 |
| Rate for Payer: Aetna Commercial |
$257.35
|
| 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 |
$277.36
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$221.69
|
| Rate for Payer: BCN Commercial |
$221.69
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$228.75
|
| Rate for Payer: Cash Price |
$228.75
|
| Rate for Payer: Cofinity Commercial |
$268.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$285.94
|
| Rate for Payer: Healthscope Whirlpool |
$277.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$257.35
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$243.05
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$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 |
$200.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.21
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$203.02
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$251.63
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC CLOSED TX TALUS FX; W/O MANIP
|
Facility
|
IP
|
$285.94
|
|
|
Service Code
|
CPT 28430
|
| Hospital Charge Code |
76100288
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$200.16 |
| Max. Negotiated Rate |
$285.94 |
| Rate for Payer: Aetna Commercial |
$257.35
|
| Rate for Payer: ASR ASR |
$277.36
|
| Rate for Payer: BCBS Trust/PPO |
$221.69
|
| Rate for Payer: BCN Commercial |
$221.69
|
| Rate for Payer: Cash Price |
$228.75
|
| Rate for Payer: Cofinity Commercial |
$268.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.75
|
| Rate for Payer: Healthscope Commercial |
$285.94
|
| Rate for Payer: Healthscope Whirlpool |
$277.36
|
| Rate for Payer: Mclaren Commercial |
$257.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$243.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$251.63
|
|
|
HC CLOSED TX TOE FX W MANIPULATION
|
Facility
|
IP
|
$610.45
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
76100438
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$427.32 |
| Max. Negotiated Rate |
$610.45 |
| Rate for Payer: Aetna Commercial |
$549.40
|
| Rate for Payer: ASR ASR |
$592.14
|
| Rate for Payer: BCBS Trust/PPO |
$473.28
|
| Rate for Payer: BCN Commercial |
$473.28
|
| Rate for Payer: Cash Price |
$488.36
|
| Rate for Payer: Cofinity Commercial |
$573.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$488.36
|
| Rate for Payer: Healthscope Commercial |
$610.45
|
| Rate for Payer: Healthscope Whirlpool |
$592.14
|
| Rate for Payer: Mclaren Commercial |
$549.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$537.20
|
|
|
HC CLOSED TX TOE FX W MANIPULATION
|
Facility
|
OP
|
$610.45
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
76100438
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$610.45 |
| Rate for Payer: Aetna Commercial |
$549.40
|
| 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 |
$592.14
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$473.28
|
| Rate for Payer: BCN Commercial |
$473.28
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$488.36
|
| Rate for Payer: Cash Price |
$488.36
|
| Rate for Payer: Cofinity Commercial |
$573.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$488.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$610.45
|
| Rate for Payer: Healthscope Whirlpool |
$592.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$549.40
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.88
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$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 |
$427.32
|
| 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 |
$537.20
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC CLOSED TX TOE FX WO MANIPULATION
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
76100176
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$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 TX TOE FX WO MANIPULATION
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
76100176
|
|
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 |
$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 |
$303.06
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC CLOSED TX ULNAR FX PROX END
|
Facility
|
IP
|
$2,073.75
|
|
|
Service Code
|
CPT 24675
|
| Hospital Charge Code |
76100236
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,451.62 |
| Max. Negotiated Rate |
$2,073.75 |
| Rate for Payer: Aetna Commercial |
$1,866.38
|
| Rate for Payer: ASR ASR |
$2,011.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,607.78
|
| Rate for Payer: BCN Commercial |
$1,607.78
|
| Rate for Payer: Cash Price |
$1,659.00
|
| Rate for Payer: Cofinity Commercial |
$1,949.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,659.00
|
| Rate for Payer: Healthscope Commercial |
$2,073.75
|
| Rate for Payer: Healthscope Whirlpool |
$2,011.54
|
| Rate for Payer: Mclaren Commercial |
$1,866.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,762.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,451.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,824.90
|
|
|
HC CLOSED TX ULNAR FX PROX END
|
Facility
|
OP
|
$2,073.75
|
|
|
Service Code
|
CPT 24675
|
| Hospital Charge Code |
76100236
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$781.45 |
| Max. Negotiated Rate |
$2,073.75 |
| Rate for Payer: Aetna Commercial |
$1,866.38
|
| 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 |
$2,011.54
|
| Rate for Payer: BCBS Complete |
$820.59
|
| Rate for Payer: BCBS MAPPO |
$1,428.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,607.78
|
| Rate for Payer: BCN Commercial |
$1,607.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,428.61
|
| Rate for Payer: Cash Price |
$1,659.00
|
| Rate for Payer: Cash Price |
$1,659.00
|
| Rate for Payer: Cofinity Commercial |
$1,949.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,659.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,428.61
|
| Rate for Payer: Healthscope Commercial |
$2,073.75
|
| Rate for Payer: Healthscope Whirlpool |
$2,011.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,428.61
|
| Rate for Payer: Mclaren Commercial |
$1,866.38
|
| Rate for Payer: Mclaren Medicaid |
$781.45
|
| Rate for Payer: Mclaren Medicare |
$1,428.61
|
| Rate for Payer: Meridian Medicaid |
$820.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,500.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,642.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,762.69
|
| Rate for Payer: PACE Medicare |
$1,357.18
|
| Rate for Payer: PACE SWMI |
$1,428.61
|
| Rate for Payer: PHP Commercial |
$1,571.47
|
| 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 |
$1,451.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,887.11
|
| Rate for Payer: Priority Health Medicare |
$1,428.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,472.36
|
| Rate for Payer: Railroad Medicare Medicare |
$1,428.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,824.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,471.47
|
| Rate for Payer: VA VA |
$1,428.61
|
|
|
HC CLOSED TX ULNAR FX, PROX END W/O MANIP
|
Facility
|
IP
|
$329.93
|
|
|
Service Code
|
CPT 24670
|
| Hospital Charge Code |
76100275
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$230.95 |
| Max. Negotiated Rate |
$329.93 |
| Rate for Payer: Aetna Commercial |
$296.94
|
| Rate for Payer: ASR ASR |
$320.03
|
| Rate for Payer: BCBS Trust/PPO |
$255.79
|
| Rate for Payer: BCN Commercial |
$255.79
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$310.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Healthscope Commercial |
$329.93
|
| Rate for Payer: Healthscope Whirlpool |
$320.03
|
| Rate for Payer: Mclaren Commercial |
$296.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$290.34
|
|
|
HC CLOSED TX ULNAR FX, PROX END W/O MANIP
|
Facility
|
OP
|
$329.93
|
|
|
Service Code
|
CPT 24670
|
| Hospital Charge Code |
76100275
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$329.93 |
| Rate for Payer: Aetna Commercial |
$296.94
|
| 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 |
$320.03
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$255.79
|
| Rate for Payer: BCN Commercial |
$255.79
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$310.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$329.93
|
| Rate for Payer: Healthscope Whirlpool |
$320.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$296.94
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$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 |
$230.95
|
| 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 |
$290.34
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC CLOSED TX ULNAR SHAFT FX, W/O MANIP
|
Facility
|
IP
|
$329.93
|
|
|
Service Code
|
CPT 25530
|
| Hospital Charge Code |
76100252
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$230.95 |
| Max. Negotiated Rate |
$329.93 |
| Rate for Payer: Aetna Commercial |
$296.94
|
| Rate for Payer: ASR ASR |
$320.03
|
| Rate for Payer: BCBS Trust/PPO |
$255.79
|
| Rate for Payer: BCN Commercial |
$255.79
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$310.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Healthscope Commercial |
$329.93
|
| Rate for Payer: Healthscope Whirlpool |
$320.03
|
| Rate for Payer: Mclaren Commercial |
$296.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$290.34
|
|
|
HC CLOSED TX ULNAR SHAFT FX, W/O MANIP
|
Facility
|
OP
|
$329.93
|
|
|
Service Code
|
CPT 25530
|
| Hospital Charge Code |
76100252
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$329.93 |
| Rate for Payer: Aetna Commercial |
$296.94
|
| 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 |
$320.03
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$255.79
|
| Rate for Payer: BCN Commercial |
$255.79
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cash Price |
$263.94
|
| Rate for Payer: Cofinity Commercial |
$310.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$329.93
|
| Rate for Payer: Healthscope Whirlpool |
$320.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$296.94
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.44
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$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 |
$230.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$228.84
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$183.07
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$290.34
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC CLOSED TX ULNAR STYLOID FX
|
Facility
|
OP
|
$315.48
|
|
|
Service Code
|
CPT 25650
|
| Hospital Charge Code |
76100311
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$315.48 |
| Rate for Payer: Aetna Commercial |
$283.93
|
| 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 |
$306.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$244.59
|
| Rate for Payer: BCN Commercial |
$244.59
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$252.38
|
| Rate for Payer: Cash Price |
$252.38
|
| Rate for Payer: Cofinity Commercial |
$296.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$315.48
|
| Rate for Payer: Healthscope Whirlpool |
$306.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$283.93
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$268.16
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$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 |
$220.84
|
| 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 |
$277.62
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC CLOSED TX ULNAR STYLOID FX
|
Facility
|
IP
|
$315.48
|
|
|
Service Code
|
CPT 25650
|
| Hospital Charge Code |
76100311
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$220.84 |
| Max. Negotiated Rate |
$315.48 |
| Rate for Payer: Aetna Commercial |
$283.93
|
| Rate for Payer: ASR ASR |
$306.02
|
| Rate for Payer: BCBS Trust/PPO |
$244.59
|
| Rate for Payer: BCN Commercial |
$244.59
|
| Rate for Payer: Cash Price |
$252.38
|
| Rate for Payer: Cofinity Commercial |
$296.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.38
|
| Rate for Payer: Healthscope Commercial |
$315.48
|
| Rate for Payer: Healthscope Whirlpool |
$306.02
|
| Rate for Payer: Mclaren Commercial |
$283.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$268.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$277.62
|
|
