|
HC CLOSED TX CLAVICLE FX W/O MANIP
|
Facility
|
OP
|
$343.23
|
|
|
Service Code
|
CPT 23500
|
| Hospital Charge Code |
76100229
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.54 |
| Max. Negotiated Rate |
$380.96 |
| Rate for Payer: Aetna Commercial |
$308.91
|
| 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 |
$332.93
|
| Rate for Payer: BCBS Complete |
$134.98
|
| Rate for Payer: BCBS MAPPO |
$245.78
|
| Rate for Payer: BCBS Trust/PPO |
$282.99
|
| Rate for Payer: BCN Commercial |
$282.99
|
| Rate for Payer: BCN Medicare Advantage |
$245.78
|
| Rate for Payer: Cash Price |
$274.58
|
| 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: Health Alliance Plan Medicare Advantage |
$245.78
|
| Rate for Payer: Healthscope Commercial |
$332.93
|
| Rate for Payer: Healthscope Whirlpool |
$343.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$245.78
|
| Rate for Payer: Mclaren Commercial |
$308.91
|
| 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 |
$291.75
|
| Rate for Payer: Nomi Health Commercial |
$281.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.42
|
| 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 |
$302.04
|
| 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 DISTAL RADIAL FX/EPIPHYSEAL SEPARATION W/MANIP
|
Facility
|
OP
|
$2,157.53
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
76100240
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$734.09 |
| Max. Negotiated Rate |
$2,483.43 |
| Rate for Payer: Aetna Commercial |
$1,941.78
|
| 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 |
$2,092.80
|
| Rate for Payer: BCBS Complete |
$879.93
|
| Rate for Payer: BCBS MAPPO |
$1,602.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,778.88
|
| Rate for Payer: BCN Commercial |
$1,778.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,602.21
|
| Rate for Payer: Cash Price |
$1,726.02
|
| Rate for Payer: Cash Price |
$1,726.02
|
| Rate for Payer: Cofinity Commercial |
$2,028.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,726.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,602.21
|
| Rate for Payer: Healthscope Commercial |
$2,092.80
|
| Rate for Payer: Healthscope Whirlpool |
$2,157.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,602.21
|
| Rate for Payer: Mclaren Commercial |
$1,941.78
|
| 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 |
$1,833.90
|
| Rate for Payer: Nomi Health Commercial |
$1,769.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,618.15
|
| 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 |
$917.62
|
| Rate for Payer: Priority Health Medicare |
$1,602.21
|
| Rate for Payer: Priority Health Narrow Network |
$734.09
|
| Rate for Payer: Railroad Medicare Medicare |
$1,602.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,898.63
|
| 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 DISTAL RADIAL FX/EPIPHYSEAL SEPARATION W/MANIP
|
Facility
|
IP
|
$2,157.53
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
76100240
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,618.15 |
| Max. Negotiated Rate |
$2,157.53 |
| Rate for Payer: Aetna Commercial |
$1,941.78
|
| Rate for Payer: ASR ASR |
$2,092.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,771.76
|
| Rate for Payer: BCN Commercial |
$1,771.76
|
| Rate for Payer: Cash Price |
$1,726.02
|
| Rate for Payer: Cofinity Commercial |
$2,028.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,726.02
|
| Rate for Payer: Healthscope Commercial |
$2,092.80
|
| Rate for Payer: Healthscope Whirlpool |
$2,157.53
|
| Rate for Payer: Mclaren Commercial |
$1,941.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,833.90
|
| Rate for Payer: Nomi Health Commercial |
$1,769.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,618.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,898.63
|
|
|
HC CLOSED TX FEMORAL FX, DISTAL END, MEDIAL/LAT CONDYLE W/O MANIP
|
Facility
|
IP
|
$372.48
|
|
|
Service Code
|
CPT 27508
|
| Hospital Charge Code |
76100299
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$279.36 |
| Max. Negotiated Rate |
$372.48 |
| Rate for Payer: Aetna Commercial |
$335.23
|
| Rate for Payer: ASR ASR |
$361.31
|
| Rate for Payer: BCBS Trust/PPO |
$305.88
|
| Rate for Payer: BCN Commercial |
$305.88
|
| Rate for Payer: Cash Price |
$297.98
|
| Rate for Payer: Cofinity Commercial |
$350.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.98
|
| Rate for Payer: Healthscope Commercial |
$361.31
|
| Rate for Payer: Healthscope Whirlpool |
$372.48
|
| Rate for Payer: Mclaren Commercial |
$335.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.61
|
| Rate for Payer: Nomi Health Commercial |
$305.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$279.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$327.78
|
|
|
HC CLOSED TX FEMORAL FX, DISTAL END, MEDIAL/LAT CONDYLE W/O MANIP
|
Facility
|
OP
|
$372.48
|
|
|
Service Code
|
CPT 27508
|
| Hospital Charge Code |
76100299
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.54 |
| Max. Negotiated Rate |
$380.96 |
| Rate for Payer: Aetna Commercial |
$335.23
|
| 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 |
$361.31
|
| Rate for Payer: BCBS Complete |
$134.98
|
| Rate for Payer: BCBS MAPPO |
$245.78
|
| Rate for Payer: BCBS Trust/PPO |
$307.11
|
| Rate for Payer: BCN Commercial |
$307.11
|
| Rate for Payer: BCN Medicare Advantage |
$245.78
|
| Rate for Payer: Cash Price |
$297.98
|
| Rate for Payer: Cash Price |
$297.98
|
| Rate for Payer: Cofinity Commercial |
$350.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.78
|
| Rate for Payer: Healthscope Commercial |
$361.31
|
| Rate for Payer: Healthscope Whirlpool |
$372.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$245.78
|
| Rate for Payer: Mclaren Commercial |
$335.23
|
| 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 |
$316.61
|
| Rate for Payer: Nomi Health Commercial |
$305.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$279.36
|
| 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 |
$262.69
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$210.15
|
| Rate for Payer: Railroad Medicare Medicare |
$245.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$327.78
|
| 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 FRACTURE WB ARTICLR PRTN DSTL TIBIA WO MANIP
|
Facility
|
OP
|
$678.30
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
76100525
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.54 |
| Max. Negotiated Rate |
$678.30 |
| Rate for Payer: Aetna Commercial |
$610.47
|
| 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 |
$657.95
|
| Rate for Payer: BCBS Complete |
$134.98
|
| Rate for Payer: BCBS MAPPO |
$245.78
|
| Rate for Payer: BCBS Trust/PPO |
$559.26
|
| Rate for Payer: BCN Commercial |
$559.26
|
| Rate for Payer: BCN Medicare Advantage |
$245.78
|
| Rate for Payer: Cash Price |
$542.64
|
| Rate for Payer: Cash Price |
$542.64
|
| Rate for Payer: Cofinity Commercial |
$637.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$542.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.78
|
| Rate for Payer: Healthscope Commercial |
$657.95
|
| Rate for Payer: Healthscope Whirlpool |
$678.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$245.78
|
| Rate for Payer: Mclaren Commercial |
$610.47
|
| 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 |
$576.55
|
| Rate for Payer: Nomi Health Commercial |
$556.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$508.73
|
| 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 |
$594.33
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$475.49
|
| Rate for Payer: Railroad Medicare Medicare |
$245.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$596.90
|
| 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 FRACTURE WB ARTICLR PRTN DSTL TIBIA WO MANIP
|
Facility
|
IP
|
$678.30
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
76100525
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$508.73 |
| Max. Negotiated Rate |
$678.30 |
| Rate for Payer: Aetna Commercial |
$610.47
|
| Rate for Payer: ASR ASR |
$657.95
|
| Rate for Payer: BCBS Trust/PPO |
$557.02
|
| Rate for Payer: BCN Commercial |
$557.02
|
| Rate for Payer: Cash Price |
$542.64
|
| Rate for Payer: Cofinity Commercial |
$637.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$542.64
|
| Rate for Payer: Healthscope Commercial |
$657.95
|
| Rate for Payer: Healthscope Whirlpool |
$678.30
|
| Rate for Payer: Mclaren Commercial |
$610.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$576.55
|
| Rate for Payer: Nomi Health Commercial |
$556.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$508.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$596.90
|
|
|
HC CLOSED TX GREAT TOE FX W/O MANIPULATION
|
Facility
|
IP
|
$343.26
|
|
|
Service Code
|
CPT 28490
|
| Hospital Charge Code |
76100237
|
|
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 GREAT TOE FX W/O MANIPULATION
|
Facility
|
OP
|
$343.26
|
|
|
Service Code
|
CPT 28490
|
| Hospital Charge Code |
76100237
|
|
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 |
$301.05
|
| 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 |
$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 GR TROCHANTERIC FX W/O MANIP
|
Facility
|
IP
|
$343.26
|
|
|
Service Code
|
CPT 27246
|
| Hospital Charge Code |
76100262
|
|
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 GR TROCHANTERIC FX W/O MANIP
|
Facility
|
OP
|
$343.26
|
|
|
Service Code
|
CPT 27246
|
| Hospital Charge Code |
76100262
|
|
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 |
$300.76
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$240.63
|
| 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 HUMERAL CONDYLAR FX, MED/LAT, W/O MANIP
|
Facility
|
OP
|
$343.26
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
76100260
|
|
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 |
$300.76
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$240.63
|
| 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 HUMERAL CONDYLAR FX, MED/LAT, W/O MANIP
|
Facility
|
IP
|
$343.26
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
76100260
|
|
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 HUMERAL EPICONDYLAR FX MEDIAL/LATERAL W/O MANIP
|
Facility
|
OP
|
$343.26
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
76100241
|
|
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 |
$300.76
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$240.63
|
| 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 HUMERAL EPICONDYLAR FX MEDIAL/LATERAL W/O MANIP
|
Facility
|
IP
|
$343.26
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
76100241
|
|
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 INTERPHALANGEAL JT DISLOC W MANIP REQUIRE ANESTH
|
Facility
|
IP
|
$775.20
|
|
|
Service Code
|
CPT 26775
|
| Hospital Charge Code |
76100524
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$581.40 |
| Max. Negotiated Rate |
$775.20 |
| Rate for Payer: Aetna Commercial |
$697.68
|
| Rate for Payer: ASR ASR |
$751.94
|
| Rate for Payer: BCBS Trust/PPO |
$636.59
|
| Rate for Payer: BCN Commercial |
$636.59
|
| Rate for Payer: Cash Price |
$620.16
|
| Rate for Payer: Cofinity Commercial |
$728.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$620.16
|
| Rate for Payer: Healthscope Commercial |
$751.94
|
| Rate for Payer: Healthscope Whirlpool |
$775.20
|
| Rate for Payer: Mclaren Commercial |
$697.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$658.92
|
| Rate for Payer: Nomi Health Commercial |
$635.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$581.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$682.18
|
|
|
HC CLOSED TX INTERPHALANGEAL JT DISLOC W MANIP REQUIRE ANESTH
|
Facility
|
OP
|
$775.20
|
|
|
Service Code
|
CPT 26775
|
| Hospital Charge Code |
76100524
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$145.75 |
| Max. Negotiated Rate |
$2,822.00 |
| Rate for Payer: Aetna Commercial |
$697.68
|
| 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 |
$751.94
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$639.15
|
| Rate for Payer: BCN Commercial |
$639.15
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$620.16
|
| Rate for Payer: Cash Price |
$620.16
|
| Rate for Payer: Cofinity Commercial |
$728.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$620.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$751.94
|
| Rate for Payer: Healthscope Whirlpool |
$775.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$278.69
|
| Rate for Payer: Mclaren Commercial |
$697.68
|
| 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 |
$658.92
|
| Rate for Payer: Nomi Health Commercial |
$635.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$581.40
|
| 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 |
$2,822.00
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,257.60
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$682.18
|
| 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 CLOSED TX MED MALLEOLUS FX W/O MANIP
|
Facility
|
OP
|
$343.26
|
|
|
Service Code
|
CPT 27760
|
| Hospital Charge Code |
76100234
|
|
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 |
$262.69
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$210.15
|
| 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 MED MALLEOLUS FX W/O MANIP
|
Facility
|
IP
|
$343.26
|
|
|
Service Code
|
CPT 27760
|
| Hospital Charge Code |
76100234
|
|
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 NASAL BONE FX W/MNPJ W/O STABILIZ
|
Facility
|
IP
|
$3,069.18
|
|
|
Service Code
|
CPT 21315
|
| Hospital Charge Code |
76100447
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,301.89 |
| Max. Negotiated Rate |
$3,069.18 |
| Rate for Payer: Aetna Commercial |
$2,762.26
|
| Rate for Payer: ASR ASR |
$2,977.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,520.41
|
| Rate for Payer: BCN Commercial |
$2,520.41
|
| Rate for Payer: Cash Price |
$2,455.34
|
| Rate for Payer: Cofinity Commercial |
$2,885.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,455.34
|
| Rate for Payer: Healthscope Commercial |
$2,977.10
|
| Rate for Payer: Healthscope Whirlpool |
$3,069.18
|
| Rate for Payer: Mclaren Commercial |
$2,762.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,608.80
|
| Rate for Payer: Nomi Health Commercial |
$2,516.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,301.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,700.88
|
|
|
HC CLOSED TX NASAL BONE FX W/MNPJ W/O STABILIZ
|
Facility
|
OP
|
$3,069.18
|
|
|
Service Code
|
CPT 21315
|
| Hospital Charge Code |
76100447
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$808.56 |
| Max. Negotiated Rate |
$3,069.18 |
| Rate for Payer: Aetna Commercial |
$2,762.26
|
| Rate for Payer: Aetna Medicare |
$1,546.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,932.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,932.50
|
| Rate for Payer: ASR ASR |
$2,977.10
|
| Rate for Payer: BCBS Complete |
$849.06
|
| Rate for Payer: BCBS MAPPO |
$1,546.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,530.54
|
| Rate for Payer: BCN Commercial |
$2,530.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,546.00
|
| Rate for Payer: Cash Price |
$2,455.34
|
| Rate for Payer: Cash Price |
$2,455.34
|
| Rate for Payer: Cofinity Commercial |
$2,885.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,455.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,546.00
|
| Rate for Payer: Healthscope Commercial |
$2,977.10
|
| Rate for Payer: Healthscope Whirlpool |
$3,069.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,546.00
|
| Rate for Payer: Mclaren Commercial |
$2,762.26
|
| Rate for Payer: Mclaren Medicaid |
$1,546.00
|
| Rate for Payer: Mclaren Medicare |
$1,546.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,623.30
|
| Rate for Payer: Meridian Medicaid |
$849.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,777.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,700.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,608.80
|
| Rate for Payer: Nomi Health Commercial |
$2,516.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,301.89
|
| Rate for Payer: PACE Medicare |
$1,468.70
|
| Rate for Payer: PACE SWMI |
$1,546.00
|
| Rate for Payer: PHP Commercial |
$1,700.60
|
| Rate for Payer: PHP Medicaid |
$828.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,546.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$808.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,890.81
|
| Rate for Payer: Priority Health Medicare |
$1,546.00
|
| Rate for Payer: Priority Health Narrow Network |
$2,312.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,546.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,700.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,546.00
|
| Rate for Payer: UHC Exchange |
$2,396.30
|
| Rate for Payer: UHC Medicaid |
$808.56
|
| Rate for Payer: UHCCP DNSP |
$1,546.00
|
| Rate for Payer: UHCCP Medicaid |
$808.56
|
| Rate for Payer: VA VA |
$1,546.00
|
|
|
HC CLOSED TX POST MALLEOLUS FX W/O MANIP
|
Facility
|
IP
|
$328.23
|
|
|
Service Code
|
CPT 27767
|
| Hospital Charge Code |
76100302
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$246.17 |
| Max. Negotiated Rate |
$328.23 |
| Rate for Payer: Aetna Commercial |
$295.41
|
| Rate for Payer: ASR ASR |
$318.38
|
| Rate for Payer: BCBS Trust/PPO |
$269.54
|
| Rate for Payer: BCN Commercial |
$269.54
|
| Rate for Payer: Cash Price |
$262.58
|
| Rate for Payer: Cofinity Commercial |
$308.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.58
|
| Rate for Payer: Healthscope Commercial |
$318.38
|
| Rate for Payer: Healthscope Whirlpool |
$328.23
|
| Rate for Payer: Mclaren Commercial |
$295.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.00
|
| Rate for Payer: Nomi Health Commercial |
$269.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$246.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$288.84
|
|
|
HC CLOSED TX POST MALLEOLUS FX W/O MANIP
|
Facility
|
OP
|
$328.23
|
|
|
Service Code
|
CPT 27767
|
| Hospital Charge Code |
76100302
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.54 |
| Max. Negotiated Rate |
$380.96 |
| Rate for Payer: Aetna Commercial |
$295.41
|
| 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 |
$318.38
|
| Rate for Payer: BCBS Complete |
$134.98
|
| Rate for Payer: BCBS MAPPO |
$245.78
|
| Rate for Payer: BCBS Trust/PPO |
$270.63
|
| Rate for Payer: BCN Commercial |
$270.63
|
| Rate for Payer: BCN Medicare Advantage |
$245.78
|
| Rate for Payer: Cash Price |
$262.58
|
| Rate for Payer: Cash Price |
$262.58
|
| Rate for Payer: Cofinity Commercial |
$308.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.78
|
| Rate for Payer: Healthscope Commercial |
$318.38
|
| Rate for Payer: Healthscope Whirlpool |
$328.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$245.78
|
| Rate for Payer: Mclaren Commercial |
$295.41
|
| 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 |
$279.00
|
| Rate for Payer: Nomi Health Commercial |
$269.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$246.17
|
| 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 |
$262.69
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$210.15
|
| Rate for Payer: Railroad Medicare Medicare |
$245.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$288.84
|
| 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 TX PROX FIBULA/SHFT FX W/O MANJ
|
Facility
|
IP
|
$647.81
|
|
|
Service Code
|
CPT 27780
|
| Hospital Charge Code |
76100351
|
|
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 TX PROX FIBULA/SHFT FX W/O MANJ
|
Facility
|
OP
|
$647.81
|
|
|
Service Code
|
CPT 27780
|
| Hospital Charge Code |
76100351
|
|
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 |
$262.69
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$210.15
|
| 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
|
|
