|
HC CAST LONG ARM
|
Facility
|
OP
|
$348.51
|
|
|
Service Code
|
CPT 29065
|
| Hospital Charge Code |
42100001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$145.75 |
| Max. Negotiated Rate |
$431.97 |
| Rate for Payer: Aetna Commercial |
$313.66
|
| 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 |
$338.05
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$287.35
|
| Rate for Payer: BCN Commercial |
$287.35
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$278.81
|
| 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: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$338.05
|
| Rate for Payer: Healthscope Whirlpool |
$348.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$278.69
|
| Rate for Payer: Mclaren Commercial |
$313.66
|
| 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 |
$296.23
|
| Rate for Payer: Nomi Health Commercial |
$285.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$261.38
|
| 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 |
$305.36
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health Narrow Network |
$244.31
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$306.69
|
| 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 LONG LEG
|
Facility
|
IP
|
$419.91
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
70000005
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$314.93 |
| Max. Negotiated Rate |
$419.91 |
| Rate for Payer: Aetna Commercial |
$377.92
|
| Rate for Payer: ASR ASR |
$407.31
|
| Rate for Payer: BCBS Trust/PPO |
$344.83
|
| Rate for Payer: BCN Commercial |
$344.83
|
| Rate for Payer: Cash Price |
$335.93
|
| Rate for Payer: Cofinity Commercial |
$394.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.93
|
| Rate for Payer: Healthscope Commercial |
$407.31
|
| Rate for Payer: Healthscope Whirlpool |
$419.91
|
| Rate for Payer: Mclaren Commercial |
$377.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$356.92
|
| Rate for Payer: Nomi Health Commercial |
$344.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$314.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$369.52
|
|
|
HC CAST LONG LEG
|
Facility
|
OP
|
$419.91
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
70000005
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$145.75 |
| Max. Negotiated Rate |
$431.97 |
| Rate for Payer: Aetna Commercial |
$377.92
|
| 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 |
$407.31
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$346.22
|
| Rate for Payer: BCN Commercial |
$346.22
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$335.93
|
| Rate for Payer: Cash Price |
$335.93
|
| Rate for Payer: Cofinity Commercial |
$394.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$407.31
|
| Rate for Payer: Healthscope Whirlpool |
$419.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$278.69
|
| Rate for Payer: Mclaren Commercial |
$377.92
|
| 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 |
$356.92
|
| Rate for Payer: Nomi Health Commercial |
$344.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$314.93
|
| 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 |
$367.93
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health Narrow Network |
$294.36
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$369.52
|
| 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 PANTALOON
|
Facility
|
IP
|
$936.94
|
|
|
Service Code
|
CPT 29305
|
| Hospital Charge Code |
70000003
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$702.71 |
| Max. Negotiated Rate |
$936.94 |
| Rate for Payer: Aetna Commercial |
$843.25
|
| Rate for Payer: ASR ASR |
$908.83
|
| Rate for Payer: BCBS Trust/PPO |
$769.42
|
| Rate for Payer: BCN Commercial |
$769.42
|
| Rate for Payer: Cash Price |
$749.55
|
| Rate for Payer: Cofinity Commercial |
$880.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$749.55
|
| Rate for Payer: Healthscope Commercial |
$908.83
|
| Rate for Payer: Healthscope Whirlpool |
$936.94
|
| Rate for Payer: Mclaren Commercial |
$843.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$796.40
|
| Rate for Payer: Nomi Health Commercial |
$768.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$702.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$824.51
|
|
|
HC CAST PANTALOON
|
Facility
|
OP
|
$936.94
|
|
|
Service Code
|
CPT 29305
|
| Hospital Charge Code |
70000003
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$145.75 |
| Max. Negotiated Rate |
$936.94 |
| Rate for Payer: Aetna Commercial |
$843.25
|
| 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 |
$908.83
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$772.51
|
| Rate for Payer: BCN Commercial |
$772.51
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$749.55
|
| Rate for Payer: Cash Price |
$749.55
|
| Rate for Payer: Cofinity Commercial |
$880.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$749.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$908.83
|
| Rate for Payer: Healthscope Whirlpool |
$936.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$278.69
|
| Rate for Payer: Mclaren Commercial |
$843.25
|
| 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 |
$796.40
|
| Rate for Payer: Nomi Health Commercial |
$768.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$702.71
|
| 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 |
$820.95
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health Narrow Network |
$656.79
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$824.51
|
| 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 PTB WALKING
|
Facility
|
OP
|
$419.91
|
|
|
Service Code
|
CPT 29435
|
| Hospital Charge Code |
70000009
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$145.75 |
| Max. Negotiated Rate |
$431.97 |
| Rate for Payer: Aetna Commercial |
$377.92
|
| 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 |
$407.31
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$346.22
|
| Rate for Payer: BCN Commercial |
$346.22
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$335.93
|
| Rate for Payer: Cash Price |
$335.93
|
| Rate for Payer: Cofinity Commercial |
$394.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$407.31
|
| Rate for Payer: Healthscope Whirlpool |
$419.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$278.69
|
| Rate for Payer: Mclaren Commercial |
$377.92
|
| 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 |
$356.92
|
| Rate for Payer: Nomi Health Commercial |
$344.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$314.93
|
| 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 |
$367.93
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health Narrow Network |
$294.36
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$369.52
|
| 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 PTB WALKING
|
Facility
|
IP
|
$419.91
|
|
|
Service Code
|
CPT 29435
|
| Hospital Charge Code |
70000009
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$314.93 |
| Max. Negotiated Rate |
$419.91 |
| Rate for Payer: Aetna Commercial |
$377.92
|
| Rate for Payer: ASR ASR |
$407.31
|
| Rate for Payer: BCBS Trust/PPO |
$344.83
|
| Rate for Payer: BCN Commercial |
$344.83
|
| Rate for Payer: Cash Price |
$335.93
|
| Rate for Payer: Cofinity Commercial |
$394.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.93
|
| Rate for Payer: Healthscope Commercial |
$407.31
|
| Rate for Payer: Healthscope Whirlpool |
$419.91
|
| Rate for Payer: Mclaren Commercial |
$377.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$356.92
|
| Rate for Payer: Nomi Health Commercial |
$344.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$314.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$369.52
|
|
|
HC CAST REPAIR
|
Facility
|
OP
|
$182.39
|
|
| Hospital Charge Code |
27000041
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$67.48 |
| Max. Negotiated Rate |
$182.39 |
| Rate for Payer: Aetna Commercial |
$164.15
|
| Rate for Payer: Aetna Medicare |
$67.48
|
| Rate for Payer: ASR ASR |
$176.92
|
| Rate for Payer: BCBS Complete |
$72.96
|
| Rate for Payer: BCBS Trust/PPO |
$150.38
|
| Rate for Payer: BCN Commercial |
$150.38
|
| Rate for Payer: Cash Price |
$145.91
|
| Rate for Payer: Cofinity Commercial |
$171.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.91
|
| Rate for Payer: Healthscope Commercial |
$176.92
|
| Rate for Payer: Healthscope Whirlpool |
$182.39
|
| Rate for Payer: Mclaren Commercial |
$164.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$155.03
|
| Rate for Payer: Nomi Health Commercial |
$149.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$159.81
|
| Rate for Payer: Priority Health Narrow Network |
$127.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$160.50
|
|
|
HC CAST REPAIR
|
Facility
|
IP
|
$182.39
|
|
| Hospital Charge Code |
27000041
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$136.79 |
| Max. Negotiated Rate |
$182.39 |
| Rate for Payer: Aetna Commercial |
$164.15
|
| Rate for Payer: ASR ASR |
$176.92
|
| Rate for Payer: BCBS Trust/PPO |
$149.78
|
| Rate for Payer: BCN Commercial |
$149.78
|
| Rate for Payer: Cash Price |
$145.91
|
| Rate for Payer: Cofinity Commercial |
$171.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.91
|
| Rate for Payer: Healthscope Commercial |
$176.92
|
| Rate for Payer: Healthscope Whirlpool |
$182.39
|
| Rate for Payer: Mclaren Commercial |
$164.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$155.03
|
| Rate for Payer: Nomi Health Commercial |
$149.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$160.50
|
|
|
HC CAST RISSER BODY ONLY
|
Facility
|
OP
|
$315.57
|
|
|
Service Code
|
CPT 29010
|
| Hospital Charge Code |
70000001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$145.75 |
| Max. Negotiated Rate |
$431.97 |
| Rate for Payer: Aetna Commercial |
$284.01
|
| 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 |
$306.10
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$260.19
|
| Rate for Payer: BCN Commercial |
$260.19
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$252.46
|
| Rate for Payer: Cash Price |
$252.46
|
| Rate for Payer: Cofinity Commercial |
$296.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$306.10
|
| Rate for Payer: Healthscope Whirlpool |
$315.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$278.69
|
| Rate for Payer: Mclaren Commercial |
$284.01
|
| 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 |
$268.23
|
| Rate for Payer: Nomi Health Commercial |
$258.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.68
|
| 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 |
$276.50
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health Narrow Network |
$221.21
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$277.70
|
| 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 RISSER BODY ONLY
|
Facility
|
IP
|
$315.57
|
|
|
Service Code
|
CPT 29010
|
| Hospital Charge Code |
70000001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$236.68 |
| Max. Negotiated Rate |
$315.57 |
| Rate for Payer: Aetna Commercial |
$284.01
|
| Rate for Payer: ASR ASR |
$306.10
|
| Rate for Payer: BCBS Trust/PPO |
$259.15
|
| Rate for Payer: BCN Commercial |
$259.15
|
| Rate for Payer: Cash Price |
$252.46
|
| Rate for Payer: Cofinity Commercial |
$296.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.46
|
| Rate for Payer: Healthscope Commercial |
$306.10
|
| Rate for Payer: Healthscope Whirlpool |
$315.57
|
| Rate for Payer: Mclaren Commercial |
$284.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.23
|
| Rate for Payer: Nomi Health Commercial |
$258.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$277.70
|
|
|
HC CAST SHORT ARM
|
Facility
|
OP
|
$306.18
|
|
|
Service Code
|
CPT 29075
|
| Hospital Charge Code |
43000001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$145.75 |
| Max. Negotiated Rate |
$431.97 |
| Rate for Payer: Aetna Commercial |
$275.56
|
| 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 |
$296.99
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$252.45
|
| Rate for Payer: BCN Commercial |
$252.45
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$244.94
|
| Rate for Payer: Cash Price |
$244.94
|
| Rate for Payer: Cofinity Commercial |
$287.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$296.99
|
| Rate for Payer: Healthscope Whirlpool |
$306.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$278.69
|
| Rate for Payer: Mclaren Commercial |
$275.56
|
| 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 |
$260.25
|
| Rate for Payer: Nomi Health Commercial |
$251.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$229.63
|
| 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 |
$424.89
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health Narrow Network |
$339.91
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$269.44
|
| 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 SHORT ARM
|
Facility
|
IP
|
$306.18
|
|
|
Service Code
|
CPT 29075
|
| Hospital Charge Code |
43000001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$229.63 |
| Max. Negotiated Rate |
$306.18 |
| Rate for Payer: Aetna Commercial |
$275.56
|
| Rate for Payer: ASR ASR |
$296.99
|
| Rate for Payer: BCBS Trust/PPO |
$251.44
|
| Rate for Payer: BCN Commercial |
$251.44
|
| Rate for Payer: Cash Price |
$244.94
|
| Rate for Payer: Cofinity Commercial |
$287.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.94
|
| Rate for Payer: Healthscope Commercial |
$296.99
|
| Rate for Payer: Healthscope Whirlpool |
$306.18
|
| Rate for Payer: Mclaren Commercial |
$275.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.25
|
| Rate for Payer: Nomi Health Commercial |
$251.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$229.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$269.44
|
|
|
HC CAST SHORT LEG
|
Facility
|
IP
|
$376.23
|
|
|
Service Code
|
CPT 29405
|
| Hospital Charge Code |
70000007
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$282.17 |
| Max. Negotiated Rate |
$376.23 |
| Rate for Payer: Aetna Commercial |
$338.61
|
| Rate for Payer: ASR ASR |
$364.94
|
| Rate for Payer: BCBS Trust/PPO |
$308.96
|
| Rate for Payer: BCN Commercial |
$308.96
|
| Rate for Payer: Cash Price |
$300.98
|
| Rate for Payer: Cofinity Commercial |
$353.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.98
|
| Rate for Payer: Healthscope Commercial |
$364.94
|
| Rate for Payer: Healthscope Whirlpool |
$376.23
|
| Rate for Payer: Mclaren Commercial |
$338.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.80
|
| Rate for Payer: Nomi Health Commercial |
$308.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$331.08
|
|
|
HC CAST SHORT LEG
|
Facility
|
OP
|
$376.23
|
|
|
Service Code
|
CPT 29405
|
| Hospital Charge Code |
70000007
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$145.75 |
| Max. Negotiated Rate |
$431.97 |
| Rate for Payer: Aetna Commercial |
$338.61
|
| 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 |
$364.94
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$310.20
|
| Rate for Payer: BCN Commercial |
$310.20
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$300.98
|
| Rate for Payer: Cash Price |
$300.98
|
| Rate for Payer: Cofinity Commercial |
$353.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$364.94
|
| Rate for Payer: Healthscope Whirlpool |
$376.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$278.69
|
| Rate for Payer: Mclaren Commercial |
$338.61
|
| 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 |
$319.80
|
| Rate for Payer: Nomi Health Commercial |
$308.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.17
|
| 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 |
$424.89
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health Narrow Network |
$339.91
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$331.08
|
| 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 SHORT LEG WALKING
|
Facility
|
OP
|
$376.23
|
|
|
Service Code
|
CPT 29425
|
| Hospital Charge Code |
70000008
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$145.75 |
| Max. Negotiated Rate |
$431.97 |
| Rate for Payer: Aetna Commercial |
$338.61
|
| 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 |
$364.94
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$310.20
|
| Rate for Payer: BCN Commercial |
$310.20
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$300.98
|
| Rate for Payer: Cash Price |
$300.98
|
| Rate for Payer: Cofinity Commercial |
$353.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$364.94
|
| Rate for Payer: Healthscope Whirlpool |
$376.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$278.69
|
| Rate for Payer: Mclaren Commercial |
$338.61
|
| 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 |
$319.80
|
| Rate for Payer: Nomi Health Commercial |
$308.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.17
|
| 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 |
$329.65
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health Narrow Network |
$263.74
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$331.08
|
| 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 SHORT LEG WALKING
|
Facility
|
IP
|
$376.23
|
|
|
Service Code
|
CPT 29425
|
| Hospital Charge Code |
70000008
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$282.17 |
| Max. Negotiated Rate |
$376.23 |
| Rate for Payer: Aetna Commercial |
$338.61
|
| Rate for Payer: ASR ASR |
$364.94
|
| Rate for Payer: BCBS Trust/PPO |
$308.96
|
| Rate for Payer: BCN Commercial |
$308.96
|
| Rate for Payer: Cash Price |
$300.98
|
| Rate for Payer: Cofinity Commercial |
$353.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.98
|
| Rate for Payer: Healthscope Commercial |
$364.94
|
| Rate for Payer: Healthscope Whirlpool |
$376.23
|
| Rate for Payer: Mclaren Commercial |
$338.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.80
|
| Rate for Payer: Nomi Health Commercial |
$308.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$331.08
|
|
|
HC CAST SUP LNG ARM ADULT FBRGLS
|
Facility
|
OP
|
$58.36
|
|
| Hospital Charge Code |
27200327
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.59 |
| Max. Negotiated Rate |
$58.36 |
| Rate for Payer: Aetna Commercial |
$52.52
|
| Rate for Payer: Aetna Medicare |
$21.59
|
| Rate for Payer: ASR ASR |
$56.61
|
| Rate for Payer: BCBS Complete |
$23.34
|
| Rate for Payer: BCBS Trust/PPO |
$48.12
|
| Rate for Payer: BCN Commercial |
$48.12
|
| Rate for Payer: Cash Price |
$46.69
|
| Rate for Payer: Cofinity Commercial |
$54.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.69
|
| Rate for Payer: Healthscope Commercial |
$56.61
|
| Rate for Payer: Healthscope Whirlpool |
$58.36
|
| Rate for Payer: Mclaren Commercial |
$52.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.61
|
| Rate for Payer: Nomi Health Commercial |
$47.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$51.14
|
| Rate for Payer: Priority Health Narrow Network |
$40.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.36
|
|
|
HC CAST SUP LNG ARM ADULT FBRGLS
|
Facility
|
IP
|
$58.36
|
|
| Hospital Charge Code |
27200327
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$43.77 |
| Max. Negotiated Rate |
$58.36 |
| Rate for Payer: Aetna Commercial |
$52.52
|
| Rate for Payer: ASR ASR |
$56.61
|
| Rate for Payer: BCBS Trust/PPO |
$47.93
|
| Rate for Payer: BCN Commercial |
$47.93
|
| Rate for Payer: Cash Price |
$46.69
|
| Rate for Payer: Cofinity Commercial |
$54.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.69
|
| Rate for Payer: Healthscope Commercial |
$56.61
|
| Rate for Payer: Healthscope Whirlpool |
$58.36
|
| Rate for Payer: Mclaren Commercial |
$52.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.61
|
| Rate for Payer: Nomi Health Commercial |
$47.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.36
|
|
|
HC CAST SUP LNG ARM PED FBRGLS
|
Facility
|
IP
|
$26.53
|
|
| Hospital Charge Code |
27200328
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.90 |
| Max. Negotiated Rate |
$26.53 |
| Rate for Payer: Aetna Commercial |
$23.88
|
| Rate for Payer: ASR ASR |
$25.73
|
| Rate for Payer: BCBS Trust/PPO |
$21.79
|
| Rate for Payer: BCN Commercial |
$21.79
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$24.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$25.73
|
| Rate for Payer: Healthscope Whirlpool |
$26.53
|
| Rate for Payer: Mclaren Commercial |
$23.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.35
|
|
|
HC CAST SUP LNG ARM PED FBRGLS
|
Facility
|
OP
|
$26.53
|
|
| Hospital Charge Code |
27200328
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.82 |
| Max. Negotiated Rate |
$26.53 |
| Rate for Payer: Aetna Commercial |
$23.88
|
| Rate for Payer: Aetna Medicare |
$9.82
|
| Rate for Payer: ASR ASR |
$25.73
|
| Rate for Payer: BCBS Complete |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$21.87
|
| Rate for Payer: BCN Commercial |
$21.87
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$24.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$25.73
|
| Rate for Payer: Healthscope Whirlpool |
$26.53
|
| Rate for Payer: Mclaren Commercial |
$23.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$23.25
|
| Rate for Payer: Priority Health Narrow Network |
$18.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.35
|
|
|
HC CAST SUP LNG ARM SPLINT ADULT FBRGLS
|
Facility
|
IP
|
$26.53
|
|
| Hospital Charge Code |
27200332
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.90 |
| Max. Negotiated Rate |
$26.53 |
| Rate for Payer: Aetna Commercial |
$23.88
|
| Rate for Payer: ASR ASR |
$25.73
|
| Rate for Payer: BCBS Trust/PPO |
$21.79
|
| Rate for Payer: BCN Commercial |
$21.79
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$24.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$25.73
|
| Rate for Payer: Healthscope Whirlpool |
$26.53
|
| Rate for Payer: Mclaren Commercial |
$23.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.35
|
|
|
HC CAST SUP LNG ARM SPLINT ADULT FBRGLS
|
Facility
|
OP
|
$26.53
|
|
| Hospital Charge Code |
27200332
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.82 |
| Max. Negotiated Rate |
$26.53 |
| Rate for Payer: Aetna Commercial |
$23.88
|
| Rate for Payer: Aetna Medicare |
$9.82
|
| Rate for Payer: ASR ASR |
$25.73
|
| Rate for Payer: BCBS Complete |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$21.87
|
| Rate for Payer: BCN Commercial |
$21.87
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$24.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$25.73
|
| Rate for Payer: Healthscope Whirlpool |
$26.53
|
| Rate for Payer: Mclaren Commercial |
$23.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$23.25
|
| Rate for Payer: Priority Health Narrow Network |
$18.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.35
|
|
|
HC CAST SUP LNG ARM SPLINT ADULT PLST
|
Facility
|
OP
|
$43.86
|
|
| Hospital Charge Code |
27200392
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.23 |
| Max. Negotiated Rate |
$43.86 |
| Rate for Payer: Aetna Commercial |
$39.47
|
| Rate for Payer: Aetna Medicare |
$16.23
|
| Rate for Payer: ASR ASR |
$42.54
|
| Rate for Payer: BCBS Complete |
$17.54
|
| Rate for Payer: BCBS Trust/PPO |
$36.16
|
| Rate for Payer: BCN Commercial |
$36.16
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$42.54
|
| Rate for Payer: Healthscope Whirlpool |
$43.86
|
| Rate for Payer: Mclaren Commercial |
$39.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.28
|
| Rate for Payer: Nomi Health Commercial |
$35.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$38.43
|
| Rate for Payer: Priority Health Narrow Network |
$30.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.60
|
|
|
HC CAST SUP LNG ARM SPLINT ADULT PLST
|
Facility
|
IP
|
$43.86
|
|
| Hospital Charge Code |
27200392
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$32.90 |
| Max. Negotiated Rate |
$43.86 |
| Rate for Payer: Aetna Commercial |
$39.47
|
| Rate for Payer: ASR ASR |
$42.54
|
| Rate for Payer: BCBS Trust/PPO |
$36.02
|
| Rate for Payer: BCN Commercial |
$36.02
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$42.54
|
| Rate for Payer: Healthscope Whirlpool |
$43.86
|
| Rate for Payer: Mclaren Commercial |
$39.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.28
|
| Rate for Payer: Nomi Health Commercial |
$35.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.60
|
|
