|
HC CAROTID/VERTEBRAL LIMITED
|
Facility
|
IP
|
$741.06
|
|
|
Service Code
|
CPT 93882
|
| Hospital Charge Code |
40200054
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$555.79 |
| Max. Negotiated Rate |
$741.06 |
| Rate for Payer: Aetna Commercial |
$666.95
|
| Rate for Payer: ASR ASR |
$718.83
|
| Rate for Payer: BCBS Trust/PPO |
$608.56
|
| Rate for Payer: BCN Commercial |
$608.56
|
| Rate for Payer: Cash Price |
$592.85
|
| Rate for Payer: Cofinity Commercial |
$696.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$592.85
|
| Rate for Payer: Healthscope Commercial |
$718.83
|
| Rate for Payer: Healthscope Whirlpool |
$741.06
|
| Rate for Payer: Mclaren Commercial |
$666.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$629.90
|
| Rate for Payer: Nomi Health Commercial |
$607.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$555.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$652.13
|
|
|
HC CAROTID/VERTEBRAL LIMITED
|
Facility
|
OP
|
$741.06
|
|
|
Service Code
|
CPT 93882
|
| Hospital Charge Code |
40200054
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$741.06 |
| Rate for Payer: Aetna Commercial |
$666.95
|
| Rate for Payer: Aetna Medicare |
$104.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: ASR ASR |
$718.83
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$611.00
|
| Rate for Payer: BCN Commercial |
$611.00
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$592.85
|
| Rate for Payer: Cash Price |
$592.85
|
| Rate for Payer: Cofinity Commercial |
$696.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$592.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$718.83
|
| Rate for Payer: Healthscope Whirlpool |
$741.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$666.95
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$57.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$629.90
|
| Rate for Payer: Nomi Health Commercial |
$607.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$555.79
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$114.59
|
| Rate for Payer: PHP Medicaid |
$55.84
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$375.27
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$300.22
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$652.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$161.46
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP DNSP |
$104.17
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC CAROTID/VERTEBRAL ULTRASOUND
|
Facility
|
IP
|
$1,409.73
|
|
|
Service Code
|
CPT 93880
|
| Hospital Charge Code |
92100001
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,057.30 |
| Max. Negotiated Rate |
$1,409.73 |
| Rate for Payer: Aetna Commercial |
$1,268.76
|
| Rate for Payer: ASR ASR |
$1,367.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,157.67
|
| Rate for Payer: BCN Commercial |
$1,157.67
|
| Rate for Payer: Cash Price |
$1,127.78
|
| Rate for Payer: Cofinity Commercial |
$1,325.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,127.78
|
| Rate for Payer: Healthscope Commercial |
$1,367.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,409.73
|
| Rate for Payer: Mclaren Commercial |
$1,268.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,198.27
|
| Rate for Payer: Nomi Health Commercial |
$1,155.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,057.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,240.56
|
|
|
HC CAROTID/VERTEBRAL ULTRASOUND
|
Facility
|
OP
|
$1,409.73
|
|
|
Service Code
|
CPT 93880
|
| Hospital Charge Code |
92100001
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,409.73 |
| Rate for Payer: Aetna Commercial |
$1,268.76
|
| Rate for Payer: Aetna Medicare |
$237.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: ASR ASR |
$1,367.44
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,162.32
|
| Rate for Payer: BCN Commercial |
$1,162.32
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,127.78
|
| Rate for Payer: Cash Price |
$1,127.78
|
| Rate for Payer: Cofinity Commercial |
$1,325.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,127.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,367.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,409.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,268.76
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$130.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,198.27
|
| Rate for Payer: Nomi Health Commercial |
$1,155.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,057.30
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$680.94
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$544.75
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,240.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC CART TRACE 24 IN
|
Facility
|
IP
|
$114.00
|
|
| Hospital Charge Code |
27000714
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$85.50 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$102.60
|
| Rate for Payer: ASR ASR |
$110.58
|
| Rate for Payer: BCBS Trust/PPO |
$93.62
|
| Rate for Payer: BCN Commercial |
$93.62
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cofinity Commercial |
$107.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.20
|
| Rate for Payer: Healthscope Commercial |
$110.58
|
| Rate for Payer: Healthscope Whirlpool |
$114.00
|
| Rate for Payer: Mclaren Commercial |
$102.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.90
|
| Rate for Payer: Nomi Health Commercial |
$93.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.32
|
|
|
HC CART TRACE 24 IN
|
Facility
|
OP
|
$114.00
|
|
| Hospital Charge Code |
27000714
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$42.18 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$102.60
|
| Rate for Payer: Aetna Medicare |
$42.18
|
| Rate for Payer: ASR ASR |
$110.58
|
| Rate for Payer: BCBS Complete |
$45.60
|
| Rate for Payer: BCBS Trust/PPO |
$93.99
|
| Rate for Payer: BCN Commercial |
$93.99
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cofinity Commercial |
$107.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.20
|
| Rate for Payer: Healthscope Commercial |
$110.58
|
| Rate for Payer: Healthscope Whirlpool |
$114.00
|
| Rate for Payer: Mclaren Commercial |
$102.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$91.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.90
|
| Rate for Payer: Nomi Health Commercial |
$93.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$99.89
|
| Rate for Payer: Priority Health Narrow Network |
$79.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.32
|
|
|
HC CASHEW IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200030
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC CASHEW IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200030
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC CASSETTE ADDITIVE
|
Facility
|
IP
|
$109.50
|
|
| Hospital Charge Code |
27000719
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$82.12 |
| Max. Negotiated Rate |
$109.50 |
| Rate for Payer: Aetna Commercial |
$98.55
|
| Rate for Payer: ASR ASR |
$106.22
|
| Rate for Payer: BCBS Trust/PPO |
$89.92
|
| Rate for Payer: BCN Commercial |
$89.92
|
| Rate for Payer: Cash Price |
$87.60
|
| Rate for Payer: Cofinity Commercial |
$102.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.60
|
| Rate for Payer: Healthscope Commercial |
$106.22
|
| Rate for Payer: Healthscope Whirlpool |
$109.50
|
| Rate for Payer: Mclaren Commercial |
$98.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.08
|
| Rate for Payer: Nomi Health Commercial |
$89.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.36
|
|
|
HC CASSETTE ADDITIVE
|
Facility
|
OP
|
$109.50
|
|
| Hospital Charge Code |
27000719
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$40.52 |
| Max. Negotiated Rate |
$109.50 |
| Rate for Payer: Aetna Commercial |
$98.55
|
| Rate for Payer: Aetna Medicare |
$40.52
|
| Rate for Payer: ASR ASR |
$106.22
|
| Rate for Payer: BCBS Complete |
$43.80
|
| Rate for Payer: BCBS Trust/PPO |
$90.28
|
| Rate for Payer: BCN Commercial |
$90.28
|
| Rate for Payer: Cash Price |
$87.60
|
| Rate for Payer: Cofinity Commercial |
$102.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.60
|
| Rate for Payer: Healthscope Commercial |
$106.22
|
| Rate for Payer: Healthscope Whirlpool |
$109.50
|
| Rate for Payer: Mclaren Commercial |
$98.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.08
|
| Rate for Payer: Nomi Health Commercial |
$89.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$95.94
|
| Rate for Payer: Priority Health Narrow Network |
$76.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.36
|
|
|
HC CASSETTES QUEST
|
Facility
|
IP
|
$78.03
|
|
| Hospital Charge Code |
27000458
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$58.52 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: BCBS Trust/PPO |
$64.08
|
| Rate for Payer: BCN Commercial |
$64.08
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$75.69
|
| Rate for Payer: Healthscope Whirlpool |
$78.03
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
|
|
HC CASSETTES QUEST
|
Facility
|
OP
|
$78.03
|
|
| Hospital Charge Code |
27000458
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.87 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: Aetna Medicare |
$28.87
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: BCBS Complete |
$31.21
|
| Rate for Payer: BCBS Trust/PPO |
$64.34
|
| Rate for Payer: BCN Commercial |
$64.34
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$75.69
|
| Rate for Payer: Healthscope Whirlpool |
$78.03
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$68.37
|
| Rate for Payer: Priority Health Narrow Network |
$54.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
|
|
HC CAST CLUB FOOT
|
Facility
|
OP
|
$430.97
|
|
|
Service Code
|
CPT 29450
|
| Hospital Charge Code |
70000011
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$84.68 |
| Max. Negotiated Rate |
$430.97 |
| Rate for Payer: Aetna Commercial |
$387.87
|
| Rate for Payer: Aetna Medicare |
$161.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$202.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$202.40
|
| Rate for Payer: ASR ASR |
$418.04
|
| Rate for Payer: BCBS Complete |
$88.93
|
| Rate for Payer: BCBS MAPPO |
$161.92
|
| Rate for Payer: BCBS Trust/PPO |
$355.33
|
| Rate for Payer: BCN Commercial |
$355.33
|
| Rate for Payer: BCN Medicare Advantage |
$161.92
|
| Rate for Payer: Cash Price |
$344.78
|
| Rate for Payer: Cash Price |
$344.78
|
| Rate for Payer: Cofinity Commercial |
$405.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.92
|
| Rate for Payer: Healthscope Commercial |
$418.04
|
| Rate for Payer: Healthscope Whirlpool |
$430.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$161.92
|
| Rate for Payer: Mclaren Commercial |
$387.87
|
| Rate for Payer: Mclaren Medicaid |
$161.92
|
| Rate for Payer: Mclaren Medicare |
$161.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.02
|
| Rate for Payer: Meridian Medicaid |
$88.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$178.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$366.32
|
| Rate for Payer: Nomi Health Commercial |
$353.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$323.23
|
| Rate for Payer: PACE Medicare |
$153.82
|
| Rate for Payer: PACE SWMI |
$161.92
|
| Rate for Payer: PHP Commercial |
$178.11
|
| Rate for Payer: PHP Medicaid |
$86.79
|
| Rate for Payer: PHP Medicare Advantage |
$161.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$377.62
|
| Rate for Payer: Priority Health Medicare |
$161.92
|
| Rate for Payer: Priority Health Narrow Network |
$302.11
|
| Rate for Payer: Railroad Medicare Medicare |
$161.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$379.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$161.92
|
| Rate for Payer: UHC Exchange |
$250.98
|
| Rate for Payer: UHC Medicaid |
$84.68
|
| Rate for Payer: UHCCP DNSP |
$161.92
|
| Rate for Payer: UHCCP Medicaid |
$84.68
|
| Rate for Payer: VA VA |
$161.92
|
|
|
HC CAST CLUB FOOT
|
Facility
|
IP
|
$430.97
|
|
|
Service Code
|
CPT 29450
|
| Hospital Charge Code |
70000011
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$323.23 |
| Max. Negotiated Rate |
$430.97 |
| Rate for Payer: Aetna Commercial |
$387.87
|
| Rate for Payer: ASR ASR |
$418.04
|
| Rate for Payer: BCBS Trust/PPO |
$353.91
|
| Rate for Payer: BCN Commercial |
$353.91
|
| Rate for Payer: Cash Price |
$344.78
|
| Rate for Payer: Cofinity Commercial |
$405.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.78
|
| Rate for Payer: Healthscope Commercial |
$418.04
|
| Rate for Payer: Healthscope Whirlpool |
$430.97
|
| Rate for Payer: Mclaren Commercial |
$387.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$366.32
|
| Rate for Payer: Nomi Health Commercial |
$353.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$323.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$379.25
|
|
|
HC CAST COLOR ROLL
|
Facility
|
IP
|
$62.78
|
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$47.09 |
| Max. Negotiated Rate |
$62.78 |
| Rate for Payer: Aetna Commercial |
$56.50
|
| Rate for Payer: ASR ASR |
$60.90
|
| Rate for Payer: BCBS Trust/PPO |
$51.55
|
| Rate for Payer: BCN Commercial |
$51.55
|
| Rate for Payer: Cash Price |
$50.22
|
| Rate for Payer: Cofinity Commercial |
$59.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.22
|
| Rate for Payer: Healthscope Commercial |
$60.90
|
| Rate for Payer: Healthscope Whirlpool |
$62.78
|
| Rate for Payer: Mclaren Commercial |
$56.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.36
|
| Rate for Payer: Nomi Health Commercial |
$51.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.25
|
|
|
HC CAST COLOR ROLL
|
Facility
|
OP
|
$62.78
|
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$23.23 |
| Max. Negotiated Rate |
$62.78 |
| Rate for Payer: Aetna Commercial |
$56.50
|
| Rate for Payer: Aetna Medicare |
$23.23
|
| Rate for Payer: ASR ASR |
$60.90
|
| Rate for Payer: BCBS Complete |
$25.11
|
| Rate for Payer: BCBS Trust/PPO |
$51.76
|
| Rate for Payer: BCN Commercial |
$51.76
|
| Rate for Payer: Cash Price |
$50.22
|
| Rate for Payer: Cofinity Commercial |
$59.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.22
|
| Rate for Payer: Healthscope Commercial |
$60.90
|
| Rate for Payer: Healthscope Whirlpool |
$62.78
|
| Rate for Payer: Mclaren Commercial |
$56.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.36
|
| Rate for Payer: Nomi Health Commercial |
$51.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$55.01
|
| Rate for Payer: Priority Health Narrow Network |
$44.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.25
|
|
|
HC CAST CYLINDER
|
Facility
|
IP
|
$416.23
|
|
|
Service Code
|
CPT 29365
|
| Hospital Charge Code |
70000006
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$312.17 |
| Max. Negotiated Rate |
$416.23 |
| Rate for Payer: Aetna Commercial |
$374.61
|
| Rate for Payer: ASR ASR |
$403.74
|
| Rate for Payer: BCBS Trust/PPO |
$341.81
|
| Rate for Payer: BCN Commercial |
$341.81
|
| Rate for Payer: Cash Price |
$332.98
|
| Rate for Payer: Cofinity Commercial |
$391.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.98
|
| Rate for Payer: Healthscope Commercial |
$403.74
|
| Rate for Payer: Healthscope Whirlpool |
$416.23
|
| Rate for Payer: Mclaren Commercial |
$374.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.80
|
| Rate for Payer: Nomi Health Commercial |
$341.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$366.28
|
|
|
HC CAST CYLINDER
|
Facility
|
OP
|
$416.23
|
|
|
Service Code
|
CPT 29365
|
| Hospital Charge Code |
70000006
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$145.75 |
| Max. Negotiated Rate |
$431.97 |
| Rate for Payer: Aetna Commercial |
$374.61
|
| Rate for Payer: Aetna Medicare |
$278.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.36
|
| Rate for Payer: ASR ASR |
$403.74
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$343.18
|
| Rate for Payer: BCN Commercial |
$343.18
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$332.98
|
| Rate for Payer: Cash Price |
$332.98
|
| Rate for Payer: Cofinity Commercial |
$391.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$403.74
|
| Rate for Payer: Healthscope Whirlpool |
$416.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$278.69
|
| Rate for Payer: Mclaren Commercial |
$374.61
|
| Rate for Payer: Mclaren Medicaid |
$278.69
|
| Rate for Payer: Mclaren Medicare |
$278.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.62
|
| Rate for Payer: Meridian Medicaid |
$153.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.80
|
| Rate for Payer: Nomi Health Commercial |
$341.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.17
|
| Rate for Payer: PACE Medicare |
$264.76
|
| Rate for Payer: PACE SWMI |
$278.69
|
| Rate for Payer: PHP Commercial |
$306.56
|
| Rate for Payer: PHP Medicaid |
$149.38
|
| Rate for Payer: PHP Medicare Advantage |
$278.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$364.70
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health Narrow Network |
$291.78
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$366.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.69
|
| Rate for Payer: UHC Exchange |
$431.97
|
| Rate for Payer: UHC Medicaid |
$145.75
|
| Rate for Payer: UHCCP DNSP |
$278.69
|
| Rate for Payer: UHCCP Medicaid |
$145.75
|
| Rate for Payer: VA VA |
$278.69
|
|
|
HC CAST FINGER (CONTRACTURE)
|
Facility
|
OP
|
$214.29
|
|
|
Service Code
|
CPT 29086
|
| Hospital Charge Code |
43000021
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$84.68 |
| Max. Negotiated Rate |
$250.98 |
| Rate for Payer: Aetna Commercial |
$192.86
|
| Rate for Payer: Aetna Medicare |
$161.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$202.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$202.40
|
| Rate for Payer: ASR ASR |
$207.86
|
| Rate for Payer: BCBS Complete |
$88.93
|
| Rate for Payer: BCBS MAPPO |
$161.92
|
| Rate for Payer: BCBS Trust/PPO |
$176.68
|
| Rate for Payer: BCN Commercial |
$176.68
|
| Rate for Payer: BCN Medicare Advantage |
$161.92
|
| Rate for Payer: Cash Price |
$171.43
|
| Rate for Payer: Cash Price |
$171.43
|
| Rate for Payer: Cofinity Commercial |
$201.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.92
|
| Rate for Payer: Healthscope Commercial |
$207.86
|
| Rate for Payer: Healthscope Whirlpool |
$214.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$161.92
|
| Rate for Payer: Mclaren Commercial |
$192.86
|
| Rate for Payer: Mclaren Medicaid |
$161.92
|
| Rate for Payer: Mclaren Medicare |
$161.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.02
|
| Rate for Payer: Meridian Medicaid |
$88.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$178.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.15
|
| Rate for Payer: Nomi Health Commercial |
$175.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.72
|
| Rate for Payer: PACE Medicare |
$153.82
|
| Rate for Payer: PACE SWMI |
$161.92
|
| Rate for Payer: PHP Commercial |
$178.11
|
| Rate for Payer: PHP Medicaid |
$86.79
|
| Rate for Payer: PHP Medicare Advantage |
$161.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$187.76
|
| Rate for Payer: Priority Health Medicare |
$161.92
|
| Rate for Payer: Priority Health Narrow Network |
$150.22
|
| Rate for Payer: Railroad Medicare Medicare |
$161.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$188.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$161.92
|
| Rate for Payer: UHC Exchange |
$250.98
|
| Rate for Payer: UHC Medicaid |
$84.68
|
| Rate for Payer: UHCCP DNSP |
$161.92
|
| Rate for Payer: UHCCP Medicaid |
$84.68
|
| Rate for Payer: VA VA |
$161.92
|
|
|
HC CAST FINGER (CONTRACTURE)
|
Facility
|
IP
|
$214.29
|
|
|
Service Code
|
CPT 29086
|
| Hospital Charge Code |
43000021
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$160.72 |
| Max. Negotiated Rate |
$214.29 |
| Rate for Payer: Aetna Commercial |
$192.86
|
| Rate for Payer: ASR ASR |
$207.86
|
| Rate for Payer: BCBS Trust/PPO |
$175.97
|
| Rate for Payer: BCN Commercial |
$175.97
|
| Rate for Payer: Cash Price |
$171.43
|
| Rate for Payer: Cofinity Commercial |
$201.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.43
|
| Rate for Payer: Healthscope Commercial |
$207.86
|
| Rate for Payer: Healthscope Whirlpool |
$214.29
|
| Rate for Payer: Mclaren Commercial |
$192.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.15
|
| Rate for Payer: Nomi Health Commercial |
$175.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$188.58
|
|
|
HC CAST GAUNTLET
|
Facility
|
OP
|
$242.90
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
42100002
|
|
Hospital Revenue Code
|
421
|
| Min. Negotiated Rate |
$84.68 |
| Max. Negotiated Rate |
$250.98 |
| Rate for Payer: Aetna Commercial |
$218.61
|
| Rate for Payer: Aetna Medicare |
$161.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$202.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$202.40
|
| Rate for Payer: ASR ASR |
$235.61
|
| Rate for Payer: BCBS Complete |
$88.93
|
| Rate for Payer: BCBS MAPPO |
$161.92
|
| Rate for Payer: BCBS Trust/PPO |
$200.27
|
| Rate for Payer: BCN Commercial |
$200.27
|
| Rate for Payer: BCN Medicare Advantage |
$161.92
|
| Rate for Payer: Cash Price |
$194.32
|
| Rate for Payer: Cash Price |
$194.32
|
| Rate for Payer: Cofinity Commercial |
$228.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.92
|
| Rate for Payer: Healthscope Commercial |
$235.61
|
| Rate for Payer: Healthscope Whirlpool |
$242.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$161.92
|
| Rate for Payer: Mclaren Commercial |
$218.61
|
| Rate for Payer: Mclaren Medicaid |
$161.92
|
| Rate for Payer: Mclaren Medicare |
$161.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.02
|
| Rate for Payer: Meridian Medicaid |
$88.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$178.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.47
|
| Rate for Payer: Nomi Health Commercial |
$199.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.18
|
| Rate for Payer: PACE Medicare |
$153.82
|
| Rate for Payer: PACE SWMI |
$161.92
|
| Rate for Payer: PHP Commercial |
$178.11
|
| Rate for Payer: PHP Medicaid |
$86.79
|
| Rate for Payer: PHP Medicare Advantage |
$161.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$189.42
|
| Rate for Payer: Priority Health Medicare |
$161.92
|
| Rate for Payer: Priority Health Narrow Network |
$151.54
|
| Rate for Payer: Railroad Medicare Medicare |
$161.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$213.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$161.92
|
| Rate for Payer: UHC Exchange |
$250.98
|
| Rate for Payer: UHC Medicaid |
$84.68
|
| Rate for Payer: UHCCP DNSP |
$161.92
|
| Rate for Payer: UHCCP Medicaid |
$84.68
|
| Rate for Payer: VA VA |
$161.92
|
|
|
HC CAST GAUNTLET
|
Facility
|
IP
|
$242.90
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
42100002
|
|
Hospital Revenue Code
|
421
|
| Min. Negotiated Rate |
$182.18 |
| Max. Negotiated Rate |
$242.90 |
| Rate for Payer: Aetna Commercial |
$218.61
|
| Rate for Payer: ASR ASR |
$235.61
|
| Rate for Payer: BCBS Trust/PPO |
$199.47
|
| Rate for Payer: BCN Commercial |
$199.47
|
| Rate for Payer: Cash Price |
$194.32
|
| Rate for Payer: Cofinity Commercial |
$228.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.32
|
| Rate for Payer: Healthscope Commercial |
$235.61
|
| Rate for Payer: Healthscope Whirlpool |
$242.90
|
| Rate for Payer: Mclaren Commercial |
$218.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.47
|
| Rate for Payer: Nomi Health Commercial |
$199.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$213.75
|
|
|
HC CAST HIP SPICA 1 AND 1 HALF OR BOTH
|
Facility
|
OP
|
$988.94
|
|
|
Service Code
|
CPT 29325
|
| Hospital Charge Code |
70000004
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$145.75 |
| Max. Negotiated Rate |
$988.94 |
| Rate for Payer: Aetna Commercial |
$890.05
|
| Rate for Payer: Aetna Medicare |
$278.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.36
|
| Rate for Payer: ASR ASR |
$959.27
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$815.38
|
| Rate for Payer: BCN Commercial |
$815.38
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$791.15
|
| Rate for Payer: Cash Price |
$791.15
|
| Rate for Payer: Cofinity Commercial |
$929.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$791.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$959.27
|
| Rate for Payer: Healthscope Whirlpool |
$988.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$278.69
|
| Rate for Payer: Mclaren Commercial |
$890.05
|
| Rate for Payer: Mclaren Medicaid |
$278.69
|
| Rate for Payer: Mclaren Medicare |
$278.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.62
|
| Rate for Payer: Meridian Medicaid |
$153.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$840.60
|
| Rate for Payer: Nomi Health Commercial |
$810.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$741.71
|
| Rate for Payer: PACE Medicare |
$264.76
|
| Rate for Payer: PACE SWMI |
$278.69
|
| Rate for Payer: PHP Commercial |
$306.56
|
| Rate for Payer: PHP Medicaid |
$149.38
|
| Rate for Payer: PHP Medicare Advantage |
$278.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$866.51
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health Narrow Network |
$693.25
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$870.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.69
|
| Rate for Payer: UHC Exchange |
$431.97
|
| Rate for Payer: UHC Medicaid |
$145.75
|
| Rate for Payer: UHCCP DNSP |
$278.69
|
| Rate for Payer: UHCCP Medicaid |
$145.75
|
| Rate for Payer: VA VA |
$278.69
|
|
|
HC CAST HIP SPICA 1 AND 1 HALF OR BOTH
|
Facility
|
IP
|
$988.94
|
|
|
Service Code
|
CPT 29325
|
| Hospital Charge Code |
70000004
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$741.71 |
| Max. Negotiated Rate |
$988.94 |
| Rate for Payer: Aetna Commercial |
$890.05
|
| Rate for Payer: ASR ASR |
$959.27
|
| Rate for Payer: BCBS Trust/PPO |
$812.12
|
| Rate for Payer: BCN Commercial |
$812.12
|
| Rate for Payer: Cash Price |
$791.15
|
| Rate for Payer: Cofinity Commercial |
$929.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$791.15
|
| Rate for Payer: Healthscope Commercial |
$959.27
|
| Rate for Payer: Healthscope Whirlpool |
$988.94
|
| Rate for Payer: Mclaren Commercial |
$890.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$840.60
|
| Rate for Payer: Nomi Health Commercial |
$810.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$741.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$870.27
|
|
|
HC CAST LONG ARM
|
Facility
|
IP
|
$348.51
|
|
|
Service Code
|
CPT 29065
|
| Hospital Charge Code |
42100001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$261.38 |
| Max. Negotiated Rate |
$348.51 |
| Rate for Payer: Aetna Commercial |
$313.66
|
| Rate for Payer: ASR ASR |
$338.05
|
| Rate for Payer: BCBS Trust/PPO |
$286.20
|
| Rate for Payer: BCN Commercial |
$286.20
|
| Rate for Payer: Cash Price |
$278.81
|
| Rate for Payer: Cofinity Commercial |
$327.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$278.81
|
| Rate for Payer: Healthscope Commercial |
$338.05
|
| Rate for Payer: Healthscope Whirlpool |
$348.51
|
| Rate for Payer: Mclaren Commercial |
$313.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$296.23
|
| Rate for Payer: Nomi Health Commercial |
$285.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$261.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$306.69
|
|
