|
HC CLOSED RX POST HIP ARTHRPLAS DISLOC
|
Facility
|
IP
|
$647.81
|
|
|
Service Code
|
CPT 27265
|
| Hospital Charge Code |
76100363
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$485.86 |
| Max. Negotiated Rate |
$647.81 |
| Rate for Payer: Aetna Commercial |
$583.03
|
| Rate for Payer: ASR ASR |
$628.38
|
| Rate for Payer: BCBS Trust/PPO |
$531.98
|
| Rate for Payer: BCN Commercial |
$531.98
|
| Rate for Payer: Cash Price |
$518.25
|
| Rate for Payer: Cofinity Commercial |
$608.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$518.25
|
| Rate for Payer: Healthscope Commercial |
$628.38
|
| Rate for Payer: Healthscope Whirlpool |
$647.81
|
| Rate for Payer: Mclaren Commercial |
$583.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$550.64
|
| Rate for Payer: Nomi Health Commercial |
$531.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$485.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$570.07
|
|
|
HC CLOSED RX POST HIP ARTHRPLAS DISLOC
|
Facility
|
OP
|
$647.81
|
|
|
Service Code
|
CPT 27265
|
| Hospital Charge Code |
76100363
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.54 |
| Max. Negotiated Rate |
$647.81 |
| Rate for Payer: Aetna Commercial |
$583.03
|
| Rate for Payer: Aetna Medicare |
$245.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$307.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$307.23
|
| Rate for Payer: ASR ASR |
$628.38
|
| Rate for Payer: BCBS Complete |
$134.98
|
| Rate for Payer: BCBS MAPPO |
$245.78
|
| Rate for Payer: BCBS Trust/PPO |
$534.12
|
| Rate for Payer: BCN Commercial |
$534.12
|
| Rate for Payer: BCN Medicare Advantage |
$245.78
|
| Rate for Payer: Cash Price |
$518.25
|
| Rate for Payer: Cash Price |
$518.25
|
| Rate for Payer: Cofinity Commercial |
$608.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$518.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.78
|
| Rate for Payer: Healthscope Commercial |
$628.38
|
| Rate for Payer: Healthscope Whirlpool |
$647.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$245.78
|
| Rate for Payer: Mclaren Commercial |
$583.03
|
| Rate for Payer: Mclaren Medicaid |
$245.78
|
| Rate for Payer: Mclaren Medicare |
$245.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.07
|
| Rate for Payer: Meridian Medicaid |
$134.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$282.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$270.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$550.64
|
| Rate for Payer: Nomi Health Commercial |
$531.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$485.86
|
| Rate for Payer: PACE Medicare |
$233.49
|
| Rate for Payer: PACE SWMI |
$245.78
|
| Rate for Payer: PHP Commercial |
$270.36
|
| Rate for Payer: PHP Medicaid |
$131.74
|
| Rate for Payer: PHP Medicare Advantage |
$245.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$300.16
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$240.13
|
| Rate for Payer: Railroad Medicare Medicare |
$245.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$570.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$245.78
|
| Rate for Payer: UHC Exchange |
$380.96
|
| Rate for Payer: UHC Medicaid |
$128.54
|
| Rate for Payer: UHCCP DNSP |
$245.78
|
| Rate for Payer: UHCCP Medicaid |
$128.54
|
| Rate for Payer: VA VA |
$245.78
|
|
|
HC CLOSED RX PROX HUMERUS FRACTURE
|
Facility
|
IP
|
$358.31
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
76100160
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$268.73 |
| Max. Negotiated Rate |
$358.31 |
| Rate for Payer: Aetna Commercial |
$322.48
|
| Rate for Payer: ASR ASR |
$347.56
|
| Rate for Payer: BCBS Trust/PPO |
$294.24
|
| Rate for Payer: BCN Commercial |
$294.24
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Cofinity Commercial |
$336.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.65
|
| Rate for Payer: Healthscope Commercial |
$347.56
|
| Rate for Payer: Healthscope Whirlpool |
$358.31
|
| Rate for Payer: Mclaren Commercial |
$322.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.56
|
| Rate for Payer: Nomi Health Commercial |
$293.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$315.31
|
|
|
HC CLOSED RX PROX HUMERUS FRACTURE
|
Facility
|
OP
|
$358.31
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
76100160
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.54 |
| Max. Negotiated Rate |
$380.96 |
| Rate for Payer: Aetna Commercial |
$322.48
|
| Rate for Payer: Aetna Medicare |
$245.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$307.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$307.23
|
| Rate for Payer: ASR ASR |
$347.56
|
| Rate for Payer: BCBS Complete |
$134.98
|
| Rate for Payer: BCBS MAPPO |
$245.78
|
| Rate for Payer: BCBS Trust/PPO |
$295.43
|
| Rate for Payer: BCN Commercial |
$295.43
|
| Rate for Payer: BCN Medicare Advantage |
$245.78
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Cofinity Commercial |
$336.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.78
|
| Rate for Payer: Healthscope Commercial |
$347.56
|
| Rate for Payer: Healthscope Whirlpool |
$358.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$245.78
|
| Rate for Payer: Mclaren Commercial |
$322.48
|
| Rate for Payer: Mclaren Medicaid |
$245.78
|
| Rate for Payer: Mclaren Medicare |
$245.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.07
|
| Rate for Payer: Meridian Medicaid |
$134.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$282.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$270.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.56
|
| Rate for Payer: Nomi Health Commercial |
$293.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.73
|
| Rate for Payer: PACE Medicare |
$233.49
|
| Rate for Payer: PACE SWMI |
$245.78
|
| Rate for Payer: PHP Commercial |
$270.36
|
| Rate for Payer: PHP Medicaid |
$131.74
|
| Rate for Payer: PHP Medicare Advantage |
$245.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$302.64
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$242.11
|
| Rate for Payer: Railroad Medicare Medicare |
$245.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$315.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$245.78
|
| Rate for Payer: UHC Exchange |
$380.96
|
| Rate for Payer: UHC Medicaid |
$128.54
|
| Rate for Payer: UHCCP DNSP |
$245.78
|
| Rate for Payer: UHCCP Medicaid |
$128.54
|
| Rate for Payer: VA VA |
$245.78
|
|
|
HC CLOSED RX PROX THIGH FX
|
Facility
|
OP
|
$634.60
|
|
|
Service Code
|
CPT 27230
|
| Hospital Charge Code |
76100317
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.54 |
| Max. Negotiated Rate |
$634.60 |
| Rate for Payer: Aetna Commercial |
$571.14
|
| Rate for Payer: Aetna Medicare |
$245.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$307.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$307.23
|
| Rate for Payer: ASR ASR |
$615.56
|
| Rate for Payer: BCBS Complete |
$134.98
|
| Rate for Payer: BCBS MAPPO |
$245.78
|
| Rate for Payer: BCBS Trust/PPO |
$523.23
|
| Rate for Payer: BCN Commercial |
$523.23
|
| Rate for Payer: BCN Medicare Advantage |
$245.78
|
| Rate for Payer: Cash Price |
$507.68
|
| Rate for Payer: Cash Price |
$507.68
|
| Rate for Payer: Cofinity Commercial |
$596.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$507.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.78
|
| Rate for Payer: Healthscope Commercial |
$615.56
|
| Rate for Payer: Healthscope Whirlpool |
$634.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$245.78
|
| Rate for Payer: Mclaren Commercial |
$571.14
|
| Rate for Payer: Mclaren Medicaid |
$245.78
|
| Rate for Payer: Mclaren Medicare |
$245.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.07
|
| Rate for Payer: Meridian Medicaid |
$134.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$282.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$270.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.41
|
| Rate for Payer: Nomi Health Commercial |
$520.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$475.95
|
| Rate for Payer: PACE Medicare |
$233.49
|
| Rate for Payer: PACE SWMI |
$245.78
|
| Rate for Payer: PHP Commercial |
$270.36
|
| Rate for Payer: PHP Medicaid |
$131.74
|
| Rate for Payer: PHP Medicare Advantage |
$245.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$556.04
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$444.85
|
| Rate for Payer: Railroad Medicare Medicare |
$245.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$558.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$245.78
|
| Rate for Payer: UHC Exchange |
$380.96
|
| Rate for Payer: UHC Medicaid |
$128.54
|
| Rate for Payer: UHCCP DNSP |
$245.78
|
| Rate for Payer: UHCCP Medicaid |
$128.54
|
| Rate for Payer: VA VA |
$245.78
|
|
|
HC CLOSED RX PROX THIGH FX
|
Facility
|
IP
|
$634.60
|
|
|
Service Code
|
CPT 27230
|
| Hospital Charge Code |
76100317
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$475.95 |
| Max. Negotiated Rate |
$634.60 |
| Rate for Payer: Aetna Commercial |
$571.14
|
| Rate for Payer: ASR ASR |
$615.56
|
| Rate for Payer: BCBS Trust/PPO |
$521.13
|
| Rate for Payer: BCN Commercial |
$521.13
|
| Rate for Payer: Cash Price |
$507.68
|
| Rate for Payer: Cofinity Commercial |
$596.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$507.68
|
| Rate for Payer: Healthscope Commercial |
$615.56
|
| Rate for Payer: Healthscope Whirlpool |
$634.60
|
| Rate for Payer: Mclaren Commercial |
$571.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.41
|
| Rate for Payer: Nomi Health Commercial |
$520.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$475.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$558.45
|
|
|
HC CLOSED RX RADIAL HEAD/NECK FX
|
Facility
|
OP
|
$358.31
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
76100161
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.54 |
| Max. Negotiated Rate |
$380.96 |
| Rate for Payer: Aetna Commercial |
$322.48
|
| Rate for Payer: Aetna Medicare |
$245.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$307.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$307.23
|
| Rate for Payer: ASR ASR |
$347.56
|
| Rate for Payer: BCBS Complete |
$134.98
|
| Rate for Payer: BCBS MAPPO |
$245.78
|
| Rate for Payer: BCBS Trust/PPO |
$295.43
|
| Rate for Payer: BCN Commercial |
$295.43
|
| Rate for Payer: BCN Medicare Advantage |
$245.78
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Cofinity Commercial |
$336.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.78
|
| Rate for Payer: Healthscope Commercial |
$347.56
|
| Rate for Payer: Healthscope Whirlpool |
$358.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$245.78
|
| Rate for Payer: Mclaren Commercial |
$322.48
|
| Rate for Payer: Mclaren Medicaid |
$245.78
|
| Rate for Payer: Mclaren Medicare |
$245.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.07
|
| Rate for Payer: Meridian Medicaid |
$134.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$282.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$270.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.56
|
| Rate for Payer: Nomi Health Commercial |
$293.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.73
|
| Rate for Payer: PACE Medicare |
$233.49
|
| Rate for Payer: PACE SWMI |
$245.78
|
| Rate for Payer: PHP Commercial |
$270.36
|
| Rate for Payer: PHP Medicaid |
$131.74
|
| Rate for Payer: PHP Medicare Advantage |
$245.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$313.95
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$251.18
|
| Rate for Payer: Railroad Medicare Medicare |
$245.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$315.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$245.78
|
| Rate for Payer: UHC Exchange |
$380.96
|
| Rate for Payer: UHC Medicaid |
$128.54
|
| Rate for Payer: UHCCP DNSP |
$245.78
|
| Rate for Payer: UHCCP Medicaid |
$128.54
|
| Rate for Payer: VA VA |
$245.78
|
|
|
HC CLOSED RX RADIAL HEAD/NECK FX
|
Facility
|
IP
|
$358.31
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
76100161
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$268.73 |
| Max. Negotiated Rate |
$358.31 |
| Rate for Payer: Aetna Commercial |
$322.48
|
| Rate for Payer: ASR ASR |
$347.56
|
| Rate for Payer: BCBS Trust/PPO |
$294.24
|
| Rate for Payer: BCN Commercial |
$294.24
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Cofinity Commercial |
$336.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.65
|
| Rate for Payer: Healthscope Commercial |
$347.56
|
| Rate for Payer: Healthscope Whirlpool |
$358.31
|
| Rate for Payer: Mclaren Commercial |
$322.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.56
|
| Rate for Payer: Nomi Health Commercial |
$293.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$315.31
|
|
|
HC CLOSED RX RAD/ULNA SHAFT FX
|
Facility
|
IP
|
$358.31
|
|
|
Service Code
|
CPT 25560
|
| Hospital Charge Code |
76100162
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$268.73 |
| Max. Negotiated Rate |
$358.31 |
| Rate for Payer: Aetna Commercial |
$322.48
|
| Rate for Payer: ASR ASR |
$347.56
|
| Rate for Payer: BCBS Trust/PPO |
$294.24
|
| Rate for Payer: BCN Commercial |
$294.24
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Cofinity Commercial |
$336.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.65
|
| Rate for Payer: Healthscope Commercial |
$347.56
|
| Rate for Payer: Healthscope Whirlpool |
$358.31
|
| Rate for Payer: Mclaren Commercial |
$322.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.56
|
| Rate for Payer: Nomi Health Commercial |
$293.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$315.31
|
|
|
HC CLOSED RX RAD/ULNA SHAFT FX
|
Facility
|
OP
|
$358.31
|
|
|
Service Code
|
CPT 25560
|
| Hospital Charge Code |
76100162
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.54 |
| Max. Negotiated Rate |
$380.96 |
| Rate for Payer: Aetna Commercial |
$322.48
|
| Rate for Payer: Aetna Medicare |
$245.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$307.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$307.23
|
| Rate for Payer: ASR ASR |
$347.56
|
| Rate for Payer: BCBS Complete |
$134.98
|
| Rate for Payer: BCBS MAPPO |
$245.78
|
| Rate for Payer: BCBS Trust/PPO |
$295.43
|
| Rate for Payer: BCN Commercial |
$295.43
|
| Rate for Payer: BCN Medicare Advantage |
$245.78
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Cofinity Commercial |
$336.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.78
|
| Rate for Payer: Healthscope Commercial |
$347.56
|
| Rate for Payer: Healthscope Whirlpool |
$358.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$245.78
|
| Rate for Payer: Mclaren Commercial |
$322.48
|
| Rate for Payer: Mclaren Medicaid |
$245.78
|
| Rate for Payer: Mclaren Medicare |
$245.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.07
|
| Rate for Payer: Meridian Medicaid |
$134.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$282.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$270.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.56
|
| Rate for Payer: Nomi Health Commercial |
$293.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.73
|
| Rate for Payer: PACE Medicare |
$233.49
|
| Rate for Payer: PACE SWMI |
$245.78
|
| Rate for Payer: PHP Commercial |
$270.36
|
| Rate for Payer: PHP Medicaid |
$131.74
|
| Rate for Payer: PHP Medicare Advantage |
$245.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$313.95
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$251.18
|
| Rate for Payer: Railroad Medicare Medicare |
$245.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$315.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$245.78
|
| Rate for Payer: UHC Exchange |
$380.96
|
| Rate for Payer: UHC Medicaid |
$128.54
|
| Rate for Payer: UHCCP DNSP |
$245.78
|
| Rate for Payer: UHCCP Medicaid |
$128.54
|
| Rate for Payer: VA VA |
$245.78
|
|
|
HC CLOSED RX TIBIAL PLATEAU FX
|
Facility
|
OP
|
$358.31
|
|
|
Service Code
|
CPT 27530
|
| Hospital Charge Code |
76100172
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.54 |
| Max. Negotiated Rate |
$380.96 |
| Rate for Payer: Aetna Commercial |
$322.48
|
| Rate for Payer: Aetna Medicare |
$245.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$307.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$307.23
|
| Rate for Payer: ASR ASR |
$347.56
|
| Rate for Payer: BCBS Complete |
$134.98
|
| Rate for Payer: BCBS MAPPO |
$245.78
|
| Rate for Payer: BCBS Trust/PPO |
$295.43
|
| Rate for Payer: BCN Commercial |
$295.43
|
| Rate for Payer: BCN Medicare Advantage |
$245.78
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Cofinity Commercial |
$336.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.78
|
| Rate for Payer: Healthscope Commercial |
$347.56
|
| Rate for Payer: Healthscope Whirlpool |
$358.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$245.78
|
| Rate for Payer: Mclaren Commercial |
$322.48
|
| Rate for Payer: Mclaren Medicaid |
$245.78
|
| Rate for Payer: Mclaren Medicare |
$245.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.07
|
| Rate for Payer: Meridian Medicaid |
$134.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$282.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$270.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.56
|
| Rate for Payer: Nomi Health Commercial |
$293.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.73
|
| Rate for Payer: PACE Medicare |
$233.49
|
| Rate for Payer: PACE SWMI |
$245.78
|
| Rate for Payer: PHP Commercial |
$270.36
|
| Rate for Payer: PHP Medicaid |
$131.74
|
| Rate for Payer: PHP Medicare Advantage |
$245.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$313.95
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$251.18
|
| Rate for Payer: Railroad Medicare Medicare |
$245.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$315.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$245.78
|
| Rate for Payer: UHC Exchange |
$380.96
|
| Rate for Payer: UHC Medicaid |
$128.54
|
| Rate for Payer: UHCCP DNSP |
$245.78
|
| Rate for Payer: UHCCP Medicaid |
$128.54
|
| Rate for Payer: VA VA |
$245.78
|
|
|
HC CLOSED RX TIBIAL PLATEAU FX
|
Facility
|
IP
|
$358.31
|
|
|
Service Code
|
CPT 27530
|
| Hospital Charge Code |
76100172
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$268.73 |
| Max. Negotiated Rate |
$358.31 |
| Rate for Payer: Aetna Commercial |
$322.48
|
| Rate for Payer: ASR ASR |
$347.56
|
| Rate for Payer: BCBS Trust/PPO |
$294.24
|
| Rate for Payer: BCN Commercial |
$294.24
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Cofinity Commercial |
$336.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.65
|
| Rate for Payer: Healthscope Commercial |
$347.56
|
| Rate for Payer: Healthscope Whirlpool |
$358.31
|
| Rate for Payer: Mclaren Commercial |
$322.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.56
|
| Rate for Payer: Nomi Health Commercial |
$293.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$315.31
|
|
|
HC CLOSED RX TIBIA SHAFT FX
|
Facility
|
OP
|
$394.14
|
|
|
Service Code
|
CPT 27750
|
| Hospital Charge Code |
76100173
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.54 |
| Max. Negotiated Rate |
$731.18 |
| Rate for Payer: Aetna Commercial |
$354.73
|
| Rate for Payer: Aetna Medicare |
$245.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$307.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$307.23
|
| Rate for Payer: ASR ASR |
$382.32
|
| Rate for Payer: BCBS Complete |
$134.98
|
| Rate for Payer: BCBS MAPPO |
$245.78
|
| Rate for Payer: BCBS Trust/PPO |
$324.97
|
| Rate for Payer: BCN Commercial |
$324.97
|
| Rate for Payer: BCN Medicare Advantage |
$245.78
|
| Rate for Payer: Cash Price |
$315.31
|
| Rate for Payer: Cash Price |
$315.31
|
| Rate for Payer: Cofinity Commercial |
$370.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.78
|
| Rate for Payer: Healthscope Commercial |
$382.32
|
| Rate for Payer: Healthscope Whirlpool |
$394.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$245.78
|
| Rate for Payer: Mclaren Commercial |
$354.73
|
| Rate for Payer: Mclaren Medicaid |
$245.78
|
| Rate for Payer: Mclaren Medicare |
$245.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.07
|
| Rate for Payer: Meridian Medicaid |
$134.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$282.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$270.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$335.02
|
| Rate for Payer: Nomi Health Commercial |
$323.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$295.61
|
| Rate for Payer: PACE Medicare |
$233.49
|
| Rate for Payer: PACE SWMI |
$245.78
|
| Rate for Payer: PHP Commercial |
$270.36
|
| Rate for Payer: PHP Medicaid |
$131.74
|
| Rate for Payer: PHP Medicare Advantage |
$245.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$731.18
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$584.94
|
| Rate for Payer: Railroad Medicare Medicare |
$245.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$346.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$245.78
|
| Rate for Payer: UHC Exchange |
$380.96
|
| Rate for Payer: UHC Medicaid |
$128.54
|
| Rate for Payer: UHCCP DNSP |
$245.78
|
| Rate for Payer: UHCCP Medicaid |
$128.54
|
| Rate for Payer: VA VA |
$245.78
|
|
|
HC CLOSED RX TIBIA SHAFT FX
|
Facility
|
IP
|
$394.14
|
|
|
Service Code
|
CPT 27750
|
| Hospital Charge Code |
76100173
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$295.61 |
| Max. Negotiated Rate |
$394.14 |
| Rate for Payer: Aetna Commercial |
$354.73
|
| Rate for Payer: ASR ASR |
$382.32
|
| Rate for Payer: BCBS Trust/PPO |
$323.67
|
| Rate for Payer: BCN Commercial |
$323.67
|
| Rate for Payer: Cash Price |
$315.31
|
| Rate for Payer: Cofinity Commercial |
$370.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.31
|
| Rate for Payer: Healthscope Commercial |
$382.32
|
| Rate for Payer: Healthscope Whirlpool |
$394.14
|
| Rate for Payer: Mclaren Commercial |
$354.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$335.02
|
| Rate for Payer: Nomi Health Commercial |
$323.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$295.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$346.84
|
|
|
HC CLOSED TREATMENT DISLOCATED SHOULDER W MANIP
|
Facility
|
OP
|
$647.33
|
|
|
Service Code
|
CPT 23650
|
| Hospital Charge Code |
76100436
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.54 |
| Max. Negotiated Rate |
$647.33 |
| Rate for Payer: Aetna Commercial |
$582.60
|
| Rate for Payer: Aetna Medicare |
$245.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$307.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$307.23
|
| Rate for Payer: ASR ASR |
$627.91
|
| Rate for Payer: BCBS Complete |
$134.98
|
| Rate for Payer: BCBS MAPPO |
$245.78
|
| Rate for Payer: BCBS Trust/PPO |
$533.72
|
| Rate for Payer: BCN Commercial |
$533.72
|
| Rate for Payer: BCN Medicare Advantage |
$245.78
|
| Rate for Payer: Cash Price |
$517.86
|
| Rate for Payer: Cash Price |
$517.86
|
| Rate for Payer: Cofinity Commercial |
$608.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$517.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.78
|
| Rate for Payer: Healthscope Commercial |
$627.91
|
| Rate for Payer: Healthscope Whirlpool |
$647.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$245.78
|
| Rate for Payer: Mclaren Commercial |
$582.60
|
| Rate for Payer: Mclaren Medicaid |
$245.78
|
| Rate for Payer: Mclaren Medicare |
$245.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.07
|
| Rate for Payer: Meridian Medicaid |
$134.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$282.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$270.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$550.23
|
| Rate for Payer: Nomi Health Commercial |
$530.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$485.50
|
| Rate for Payer: PACE Medicare |
$233.49
|
| Rate for Payer: PACE SWMI |
$245.78
|
| Rate for Payer: PHP Commercial |
$270.36
|
| Rate for Payer: PHP Medicaid |
$131.74
|
| Rate for Payer: PHP Medicare Advantage |
$245.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$301.05
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$240.84
|
| Rate for Payer: Railroad Medicare Medicare |
$245.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$569.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$245.78
|
| Rate for Payer: UHC Exchange |
$380.96
|
| Rate for Payer: UHC Medicaid |
$128.54
|
| Rate for Payer: UHCCP DNSP |
$245.78
|
| Rate for Payer: UHCCP Medicaid |
$128.54
|
| Rate for Payer: VA VA |
$245.78
|
|
|
HC CLOSED TREATMENT DISLOCATED SHOULDER W MANIP
|
Facility
|
IP
|
$647.33
|
|
|
Service Code
|
CPT 23650
|
| Hospital Charge Code |
76100436
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$485.50 |
| Max. Negotiated Rate |
$647.33 |
| Rate for Payer: Aetna Commercial |
$582.60
|
| Rate for Payer: ASR ASR |
$627.91
|
| Rate for Payer: BCBS Trust/PPO |
$531.59
|
| Rate for Payer: BCN Commercial |
$531.59
|
| Rate for Payer: Cash Price |
$517.86
|
| Rate for Payer: Cofinity Commercial |
$608.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$517.86
|
| Rate for Payer: Healthscope Commercial |
$627.91
|
| Rate for Payer: Healthscope Whirlpool |
$647.33
|
| Rate for Payer: Mclaren Commercial |
$582.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$550.23
|
| Rate for Payer: Nomi Health Commercial |
$530.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$485.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$569.65
|
|
|
HC CLOSED TX ACETAB FX; W/O MANIP
|
Facility
|
OP
|
$389.47
|
|
|
Service Code
|
CPT 27220
|
| Hospital Charge Code |
76100286
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.54 |
| Max. Negotiated Rate |
$389.47 |
| Rate for Payer: Aetna Commercial |
$350.52
|
| Rate for Payer: Aetna Medicare |
$245.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$307.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$307.23
|
| Rate for Payer: ASR ASR |
$377.79
|
| Rate for Payer: BCBS Complete |
$134.98
|
| Rate for Payer: BCBS MAPPO |
$245.78
|
| Rate for Payer: BCBS Trust/PPO |
$321.12
|
| Rate for Payer: BCN Commercial |
$321.12
|
| Rate for Payer: BCN Medicare Advantage |
$245.78
|
| Rate for Payer: Cash Price |
$311.58
|
| Rate for Payer: Cash Price |
$311.58
|
| Rate for Payer: Cofinity Commercial |
$366.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$311.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.78
|
| Rate for Payer: Healthscope Commercial |
$377.79
|
| Rate for Payer: Healthscope Whirlpool |
$389.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$245.78
|
| Rate for Payer: Mclaren Commercial |
$350.52
|
| Rate for Payer: Mclaren Medicaid |
$245.78
|
| Rate for Payer: Mclaren Medicare |
$245.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.07
|
| Rate for Payer: Meridian Medicaid |
$134.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$282.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$270.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.05
|
| Rate for Payer: Nomi Health Commercial |
$319.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$292.10
|
| Rate for Payer: PACE Medicare |
$233.49
|
| Rate for Payer: PACE SWMI |
$245.78
|
| Rate for Payer: PHP Commercial |
$270.36
|
| Rate for Payer: PHP Medicaid |
$131.74
|
| Rate for Payer: PHP Medicare Advantage |
$245.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$341.25
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$273.02
|
| Rate for Payer: Railroad Medicare Medicare |
$245.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$342.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$245.78
|
| Rate for Payer: UHC Exchange |
$380.96
|
| Rate for Payer: UHC Medicaid |
$128.54
|
| Rate for Payer: UHCCP DNSP |
$245.78
|
| Rate for Payer: UHCCP Medicaid |
$128.54
|
| Rate for Payer: VA VA |
$245.78
|
|
|
HC CLOSED TX ACETAB FX; W/O MANIP
|
Facility
|
IP
|
$389.47
|
|
|
Service Code
|
CPT 27220
|
| Hospital Charge Code |
76100286
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$292.10 |
| Max. Negotiated Rate |
$389.47 |
| Rate for Payer: Aetna Commercial |
$350.52
|
| Rate for Payer: ASR ASR |
$377.79
|
| Rate for Payer: BCBS Trust/PPO |
$319.83
|
| Rate for Payer: BCN Commercial |
$319.83
|
| Rate for Payer: Cash Price |
$311.58
|
| Rate for Payer: Cofinity Commercial |
$366.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$311.58
|
| Rate for Payer: Healthscope Commercial |
$377.79
|
| Rate for Payer: Healthscope Whirlpool |
$389.47
|
| Rate for Payer: Mclaren Commercial |
$350.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.05
|
| Rate for Payer: Nomi Health Commercial |
$319.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$292.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$342.73
|
|
|
HC CLOSED TX BIMALLEOLAR ANKLE FX W/O MANIP
|
Facility
|
OP
|
$638.72
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
76100492
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.54 |
| Max. Negotiated Rate |
$638.72 |
| Rate for Payer: Aetna Commercial |
$574.85
|
| Rate for Payer: Aetna Medicare |
$245.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$307.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$307.23
|
| Rate for Payer: ASR ASR |
$619.56
|
| Rate for Payer: BCBS Complete |
$134.98
|
| Rate for Payer: BCBS MAPPO |
$245.78
|
| Rate for Payer: BCBS Trust/PPO |
$526.62
|
| Rate for Payer: BCN Commercial |
$526.62
|
| Rate for Payer: BCN Medicare Advantage |
$245.78
|
| Rate for Payer: Cash Price |
$510.98
|
| Rate for Payer: Cash Price |
$510.98
|
| Rate for Payer: Cofinity Commercial |
$600.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$510.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.78
|
| Rate for Payer: Healthscope Commercial |
$619.56
|
| Rate for Payer: Healthscope Whirlpool |
$638.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$245.78
|
| Rate for Payer: Mclaren Commercial |
$574.85
|
| Rate for Payer: Mclaren Medicaid |
$245.78
|
| Rate for Payer: Mclaren Medicare |
$245.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.07
|
| Rate for Payer: Meridian Medicaid |
$134.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$282.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$270.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$542.91
|
| Rate for Payer: Nomi Health Commercial |
$523.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$479.04
|
| Rate for Payer: PACE Medicare |
$233.49
|
| Rate for Payer: PACE SWMI |
$245.78
|
| Rate for Payer: PHP Commercial |
$270.36
|
| Rate for Payer: PHP Medicaid |
$131.74
|
| Rate for Payer: PHP Medicare Advantage |
$245.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$559.65
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$447.74
|
| Rate for Payer: Railroad Medicare Medicare |
$245.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$562.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$245.78
|
| Rate for Payer: UHC Exchange |
$380.96
|
| Rate for Payer: UHC Medicaid |
$128.54
|
| Rate for Payer: UHCCP DNSP |
$245.78
|
| Rate for Payer: UHCCP Medicaid |
$128.54
|
| Rate for Payer: VA VA |
$245.78
|
|
|
HC CLOSED TX BIMALLEOLAR ANKLE FX W/O MANIP
|
Facility
|
IP
|
$638.72
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
76100492
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$479.04 |
| Max. Negotiated Rate |
$638.72 |
| Rate for Payer: Aetna Commercial |
$574.85
|
| Rate for Payer: ASR ASR |
$619.56
|
| Rate for Payer: BCBS Trust/PPO |
$524.52
|
| Rate for Payer: BCN Commercial |
$524.52
|
| Rate for Payer: Cash Price |
$510.98
|
| Rate for Payer: Cofinity Commercial |
$600.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$510.98
|
| Rate for Payer: Healthscope Commercial |
$619.56
|
| Rate for Payer: Healthscope Whirlpool |
$638.72
|
| Rate for Payer: Mclaren Commercial |
$574.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$542.91
|
| Rate for Payer: Nomi Health Commercial |
$523.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$479.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$562.07
|
|
|
HC CLOSED TX BIMALLEOLAR FX W/MANIP
|
Facility
|
IP
|
$1,846.51
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
76100295
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,384.88 |
| Max. Negotiated Rate |
$1,846.51 |
| Rate for Payer: Aetna Commercial |
$1,661.86
|
| Rate for Payer: ASR ASR |
$1,791.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,516.35
|
| Rate for Payer: BCN Commercial |
$1,516.35
|
| Rate for Payer: Cash Price |
$1,477.21
|
| Rate for Payer: Cofinity Commercial |
$1,735.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,477.21
|
| Rate for Payer: Healthscope Commercial |
$1,791.11
|
| Rate for Payer: Healthscope Whirlpool |
$1,846.51
|
| Rate for Payer: Mclaren Commercial |
$1,661.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,569.53
|
| Rate for Payer: Nomi Health Commercial |
$1,514.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,384.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,624.93
|
|
|
HC CLOSED TX BIMALLEOLAR FX W/MANIP
|
Facility
|
OP
|
$1,846.51
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
76100295
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$786.37 |
| Max. Negotiated Rate |
$2,483.43 |
| Rate for Payer: Aetna Commercial |
$1,661.86
|
| Rate for Payer: Aetna Medicare |
$1,602.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,002.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,002.76
|
| Rate for Payer: ASR ASR |
$1,791.11
|
| Rate for Payer: BCBS Complete |
$879.93
|
| Rate for Payer: BCBS MAPPO |
$1,602.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,522.45
|
| Rate for Payer: BCN Commercial |
$1,522.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,602.21
|
| Rate for Payer: Cash Price |
$1,477.21
|
| Rate for Payer: Cash Price |
$1,477.21
|
| Rate for Payer: Cofinity Commercial |
$1,735.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,477.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,602.21
|
| Rate for Payer: Healthscope Commercial |
$1,791.11
|
| Rate for Payer: Healthscope Whirlpool |
$1,846.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,602.21
|
| Rate for Payer: Mclaren Commercial |
$1,661.86
|
| Rate for Payer: Mclaren Medicaid |
$1,602.21
|
| Rate for Payer: Mclaren Medicare |
$1,602.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,682.32
|
| Rate for Payer: Meridian Medicaid |
$879.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,842.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,762.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,569.53
|
| Rate for Payer: Nomi Health Commercial |
$1,514.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,384.88
|
| Rate for Payer: PACE Medicare |
$1,522.10
|
| Rate for Payer: PACE SWMI |
$1,602.21
|
| Rate for Payer: PHP Commercial |
$1,762.43
|
| Rate for Payer: PHP Medicaid |
$858.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,602.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$982.97
|
| Rate for Payer: Priority Health Medicare |
$1,602.21
|
| Rate for Payer: Priority Health Narrow Network |
$786.37
|
| Rate for Payer: Railroad Medicare Medicare |
$1,602.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,624.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,602.21
|
| Rate for Payer: UHC Exchange |
$2,483.43
|
| Rate for Payer: UHC Medicaid |
$837.96
|
| Rate for Payer: UHCCP DNSP |
$1,602.21
|
| Rate for Payer: UHCCP Medicaid |
$837.96
|
| Rate for Payer: VA VA |
$1,602.21
|
|
|
HC CLOSED TX CALCANEAL FX, W/O MANIP
|
Facility
|
OP
|
$343.26
|
|
|
Service Code
|
CPT 28400
|
| Hospital Charge Code |
76100267
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.54 |
| Max. Negotiated Rate |
$380.96 |
| Rate for Payer: Aetna Commercial |
$308.93
|
| Rate for Payer: Aetna Medicare |
$245.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$307.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$307.23
|
| Rate for Payer: ASR ASR |
$332.96
|
| Rate for Payer: BCBS Complete |
$134.98
|
| Rate for Payer: BCBS MAPPO |
$245.78
|
| Rate for Payer: BCBS Trust/PPO |
$283.02
|
| Rate for Payer: BCN Commercial |
$283.02
|
| Rate for Payer: BCN Medicare Advantage |
$245.78
|
| Rate for Payer: Cash Price |
$274.61
|
| Rate for Payer: Cash Price |
$274.61
|
| Rate for Payer: Cofinity Commercial |
$322.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.78
|
| Rate for Payer: Healthscope Commercial |
$332.96
|
| Rate for Payer: Healthscope Whirlpool |
$343.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$245.78
|
| Rate for Payer: Mclaren Commercial |
$308.93
|
| Rate for Payer: Mclaren Medicaid |
$245.78
|
| Rate for Payer: Mclaren Medicare |
$245.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.07
|
| Rate for Payer: Meridian Medicaid |
$134.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$282.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$270.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.77
|
| Rate for Payer: Nomi Health Commercial |
$281.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.44
|
| Rate for Payer: PACE Medicare |
$233.49
|
| Rate for Payer: PACE SWMI |
$245.78
|
| Rate for Payer: PHP Commercial |
$270.36
|
| Rate for Payer: PHP Medicaid |
$131.74
|
| Rate for Payer: PHP Medicare Advantage |
$245.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$301.43
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$241.15
|
| Rate for Payer: Railroad Medicare Medicare |
$245.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$302.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$245.78
|
| Rate for Payer: UHC Exchange |
$380.96
|
| Rate for Payer: UHC Medicaid |
$128.54
|
| Rate for Payer: UHCCP DNSP |
$245.78
|
| Rate for Payer: UHCCP Medicaid |
$128.54
|
| Rate for Payer: VA VA |
$245.78
|
|
|
HC CLOSED TX CALCANEAL FX, W/O MANIP
|
Facility
|
IP
|
$343.26
|
|
|
Service Code
|
CPT 28400
|
| Hospital Charge Code |
76100267
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$257.44 |
| Max. Negotiated Rate |
$343.26 |
| Rate for Payer: Aetna Commercial |
$308.93
|
| Rate for Payer: ASR ASR |
$332.96
|
| Rate for Payer: BCBS Trust/PPO |
$281.89
|
| Rate for Payer: BCN Commercial |
$281.89
|
| Rate for Payer: Cash Price |
$274.61
|
| Rate for Payer: Cofinity Commercial |
$322.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.61
|
| Rate for Payer: Healthscope Commercial |
$332.96
|
| Rate for Payer: Healthscope Whirlpool |
$343.26
|
| Rate for Payer: Mclaren Commercial |
$308.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.77
|
| Rate for Payer: Nomi Health Commercial |
$281.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$302.07
|
|
|
HC CLOSED TX CLAVICLE FX W/O MANIP
|
Facility
|
IP
|
$343.23
|
|
|
Service Code
|
CPT 23500
|
| Hospital Charge Code |
76100229
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$257.42 |
| Max. Negotiated Rate |
$343.23 |
| Rate for Payer: Aetna Commercial |
$308.91
|
| Rate for Payer: ASR ASR |
$332.93
|
| Rate for Payer: BCBS Trust/PPO |
$281.86
|
| Rate for Payer: BCN Commercial |
$281.86
|
| Rate for Payer: Cash Price |
$274.58
|
| Rate for Payer: Cofinity Commercial |
$322.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.58
|
| Rate for Payer: Healthscope Commercial |
$332.93
|
| Rate for Payer: Healthscope Whirlpool |
$343.23
|
| Rate for Payer: Mclaren Commercial |
$308.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.75
|
| Rate for Payer: Nomi Health Commercial |
$281.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$302.04
|
|
