|
HC CLOSED TX ULNAR SHAFT FX, W/O MANIP
|
Facility
|
IP
|
$343.26
|
|
|
Service Code
|
CPT 25530
|
| Hospital Charge Code |
76100252
|
|
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 ULNAR STYLOID FX
|
Facility
|
OP
|
$328.23
|
|
|
Service Code
|
CPT 25650
|
| Hospital Charge Code |
76100311
|
|
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 ULNAR STYLOID FX
|
Facility
|
IP
|
$328.23
|
|
|
Service Code
|
CPT 25650
|
| Hospital Charge Code |
76100311
|
|
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 VERT BODY FX, W/O MANIP, REQUIRING/INCL CAST/BRACE
|
Facility
|
OP
|
$437.21
|
|
|
Service Code
|
CPT 22310
|
| Hospital Charge Code |
76100300
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.54 |
| Max. Negotiated Rate |
$437.21 |
| Rate for Payer: Aetna Commercial |
$393.49
|
| 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 |
$424.09
|
| Rate for Payer: BCBS Complete |
$134.98
|
| Rate for Payer: BCBS MAPPO |
$245.78
|
| Rate for Payer: BCBS Trust/PPO |
$360.48
|
| Rate for Payer: BCN Commercial |
$360.48
|
| Rate for Payer: BCN Medicare Advantage |
$245.78
|
| Rate for Payer: Cash Price |
$349.77
|
| Rate for Payer: Cash Price |
$349.77
|
| Rate for Payer: Cofinity Commercial |
$410.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.78
|
| Rate for Payer: Healthscope Commercial |
$424.09
|
| Rate for Payer: Healthscope Whirlpool |
$437.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$245.78
|
| Rate for Payer: Mclaren Commercial |
$393.49
|
| 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 |
$371.63
|
| Rate for Payer: Nomi Health Commercial |
$358.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$327.91
|
| 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 |
$383.08
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$306.48
|
| Rate for Payer: Railroad Medicare Medicare |
$245.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$384.74
|
| 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 VERT BODY FX, W/O MANIP, REQUIRING/INCL CAST/BRACE
|
Facility
|
IP
|
$437.21
|
|
|
Service Code
|
CPT 22310
|
| Hospital Charge Code |
76100300
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$327.91 |
| Max. Negotiated Rate |
$437.21 |
| Rate for Payer: Aetna Commercial |
$393.49
|
| Rate for Payer: ASR ASR |
$424.09
|
| Rate for Payer: BCBS Trust/PPO |
$359.04
|
| Rate for Payer: BCN Commercial |
$359.04
|
| Rate for Payer: Cash Price |
$349.77
|
| Rate for Payer: Cofinity Commercial |
$410.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.77
|
| Rate for Payer: Healthscope Commercial |
$424.09
|
| Rate for Payer: Healthscope Whirlpool |
$437.21
|
| Rate for Payer: Mclaren Commercial |
$393.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.63
|
| Rate for Payer: Nomi Health Commercial |
$358.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$327.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$384.74
|
|
|
HC CLOSE RX DIST FINGR FX
|
Facility
|
OP
|
$370.54
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
76100170
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.54 |
| Max. Negotiated Rate |
$380.96 |
| Rate for Payer: Aetna Commercial |
$333.49
|
| 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 |
$359.42
|
| Rate for Payer: BCBS Complete |
$134.98
|
| Rate for Payer: BCBS MAPPO |
$245.78
|
| Rate for Payer: BCBS Trust/PPO |
$305.51
|
| Rate for Payer: BCN Commercial |
$305.51
|
| Rate for Payer: BCN Medicare Advantage |
$245.78
|
| Rate for Payer: Cash Price |
$296.43
|
| Rate for Payer: Cash Price |
$296.43
|
| Rate for Payer: Cofinity Commercial |
$348.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.78
|
| Rate for Payer: Healthscope Commercial |
$359.42
|
| Rate for Payer: Healthscope Whirlpool |
$370.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$245.78
|
| Rate for Payer: Mclaren Commercial |
$333.49
|
| 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 |
$314.96
|
| Rate for Payer: Nomi Health Commercial |
$303.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.90
|
| 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 |
$326.08
|
| 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 CLOSE RX DIST FINGR FX
|
Facility
|
IP
|
$370.54
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
76100170
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$277.90 |
| Max. Negotiated Rate |
$370.54 |
| Rate for Payer: Aetna Commercial |
$333.49
|
| Rate for Payer: ASR ASR |
$359.42
|
| Rate for Payer: BCBS Trust/PPO |
$304.29
|
| Rate for Payer: BCN Commercial |
$304.29
|
| Rate for Payer: Cash Price |
$296.43
|
| Rate for Payer: Cofinity Commercial |
$348.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.43
|
| Rate for Payer: Healthscope Commercial |
$359.42
|
| Rate for Payer: Healthscope Whirlpool |
$370.54
|
| Rate for Payer: Mclaren Commercial |
$333.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.96
|
| Rate for Payer: Nomi Health Commercial |
$303.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$326.08
|
|
|
HC CLOSE RX FINGR ARTICULAR FX
|
Facility
|
IP
|
$358.31
|
|
|
Service Code
|
CPT 26740
|
| Hospital Charge Code |
76100169
|
|
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 CLOSE RX FINGR ARTICULAR FX
|
Facility
|
OP
|
$358.31
|
|
|
Service Code
|
CPT 26740
|
| Hospital Charge Code |
76100169
|
|
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 CLOSE RX PROX/MID FING SHFT FX
|
Facility
|
IP
|
$358.31
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
76100168
|
|
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 CLOSE RX PROX/MID FING SHFT FX
|
Facility
|
OP
|
$358.31
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
76100168
|
|
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 |
$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 |
$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 CLOSURE DEVICE
|
Facility
|
OP
|
$1,161.23
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27200012
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$429.66 |
| Max. Negotiated Rate |
$1,161.23 |
| Rate for Payer: Aetna Commercial |
$1,045.11
|
| Rate for Payer: Aetna Medicare |
$429.66
|
| Rate for Payer: ASR ASR |
$1,126.39
|
| Rate for Payer: BCBS Complete |
$464.49
|
| Rate for Payer: BCBS Trust/PPO |
$957.43
|
| Rate for Payer: BCN Commercial |
$957.43
|
| Rate for Payer: Cash Price |
$928.98
|
| Rate for Payer: Cofinity Commercial |
$1,091.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.98
|
| Rate for Payer: Healthscope Commercial |
$1,126.39
|
| Rate for Payer: Healthscope Whirlpool |
$1,161.23
|
| Rate for Payer: Mclaren Commercial |
$1,045.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$928.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$987.05
|
| Rate for Payer: Nomi Health Commercial |
$952.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$870.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,017.47
|
| Rate for Payer: Priority Health Narrow Network |
$814.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,021.88
|
|
|
HC CLOSURE DEVICE
|
Facility
|
IP
|
$1,161.23
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27200012
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$870.92 |
| Max. Negotiated Rate |
$1,161.23 |
| Rate for Payer: Aetna Commercial |
$1,045.11
|
| Rate for Payer: ASR ASR |
$1,126.39
|
| Rate for Payer: BCBS Trust/PPO |
$953.60
|
| Rate for Payer: BCN Commercial |
$953.60
|
| Rate for Payer: Cash Price |
$928.98
|
| Rate for Payer: Cofinity Commercial |
$1,091.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.98
|
| Rate for Payer: Healthscope Commercial |
$1,126.39
|
| Rate for Payer: Healthscope Whirlpool |
$1,161.23
|
| Rate for Payer: Mclaren Commercial |
$1,045.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$987.05
|
| Rate for Payer: Nomi Health Commercial |
$952.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$870.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,021.88
|
|
|
HC CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<
|
Facility
|
OP
|
$719.00
|
|
|
Service Code
|
CPT 40830
|
| Hospital Charge Code |
76100545
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.43 |
| Max. Negotiated Rate |
$719.00 |
| Rate for Payer: Aetna Commercial |
$647.10
|
| Rate for Payer: Aetna Medicare |
$236.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$295.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$295.00
|
| Rate for Payer: ASR ASR |
$697.43
|
| Rate for Payer: BCBS Complete |
$129.61
|
| Rate for Payer: BCBS MAPPO |
$236.00
|
| Rate for Payer: BCBS Trust/PPO |
$592.82
|
| Rate for Payer: BCN Commercial |
$592.82
|
| Rate for Payer: BCN Medicare Advantage |
$236.00
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cofinity Commercial |
$675.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.00
|
| Rate for Payer: Healthscope Commercial |
$697.43
|
| Rate for Payer: Healthscope Whirlpool |
$719.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.00
|
| Rate for Payer: Mclaren Commercial |
$647.10
|
| Rate for Payer: Mclaren Medicaid |
$236.00
|
| Rate for Payer: Mclaren Medicare |
$236.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.80
|
| Rate for Payer: Meridian Medicaid |
$129.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$259.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.15
|
| Rate for Payer: Nomi Health Commercial |
$589.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.25
|
| Rate for Payer: PACE Medicare |
$224.20
|
| Rate for Payer: PACE SWMI |
$236.00
|
| Rate for Payer: PHP Commercial |
$259.60
|
| Rate for Payer: PHP Medicaid |
$126.50
|
| Rate for Payer: PHP Medicare Advantage |
$236.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$593.18
|
| Rate for Payer: Priority Health Medicare |
$236.00
|
| Rate for Payer: Priority Health Narrow Network |
$474.54
|
| Rate for Payer: Railroad Medicare Medicare |
$236.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$632.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$236.00
|
| Rate for Payer: UHC Exchange |
$365.80
|
| Rate for Payer: UHC Medicaid |
$123.43
|
| Rate for Payer: UHCCP DNSP |
$236.00
|
| Rate for Payer: UHCCP Medicaid |
$123.43
|
| Rate for Payer: VA VA |
$236.00
|
|
|
HC CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<
|
Facility
|
IP
|
$719.00
|
|
|
Service Code
|
CPT 40830
|
| Hospital Charge Code |
76100545
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$539.25 |
| Max. Negotiated Rate |
$719.00 |
| Rate for Payer: Aetna Commercial |
$647.10
|
| Rate for Payer: ASR ASR |
$697.43
|
| Rate for Payer: BCBS Trust/PPO |
$590.44
|
| Rate for Payer: BCN Commercial |
$590.44
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cofinity Commercial |
$675.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.20
|
| Rate for Payer: Healthscope Commercial |
$697.43
|
| Rate for Payer: Healthscope Whirlpool |
$719.00
|
| Rate for Payer: Mclaren Commercial |
$647.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.15
|
| Rate for Payer: Nomi Health Commercial |
$589.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$632.72
|
|
|
HC CLOZAPINE LEVEL
|
Facility
|
OP
|
$47.76
|
|
|
Service Code
|
CPT 80159
|
| Hospital Charge Code |
30100159
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.54 |
| Max. Negotiated Rate |
$47.76 |
| Rate for Payer: Aetna Commercial |
$42.98
|
| Rate for Payer: Aetna Medicare |
$20.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.19
|
| Rate for Payer: ASR ASR |
$46.33
|
| Rate for Payer: BCBS Complete |
$11.07
|
| Rate for Payer: BCBS MAPPO |
$20.15
|
| Rate for Payer: BCBS Trust/PPO |
$39.38
|
| Rate for Payer: BCN Commercial |
$39.38
|
| Rate for Payer: BCN Medicare Advantage |
$20.15
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$44.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.15
|
| Rate for Payer: Healthscope Commercial |
$46.33
|
| Rate for Payer: Healthscope Whirlpool |
$47.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$20.15
|
| Rate for Payer: Mclaren Commercial |
$42.98
|
| Rate for Payer: Mclaren Medicaid |
$20.15
|
| Rate for Payer: Mclaren Medicare |
$20.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.16
|
| Rate for Payer: Meridian Medicaid |
$11.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PACE Medicare |
$19.14
|
| Rate for Payer: PACE SWMI |
$20.15
|
| Rate for Payer: PHP Commercial |
$22.16
|
| Rate for Payer: PHP Medicaid |
$10.80
|
| Rate for Payer: PHP Medicare Advantage |
$20.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$28.47
|
| Rate for Payer: Priority Health Medicare |
$20.15
|
| Rate for Payer: Priority Health Narrow Network |
$22.77
|
| Rate for Payer: Railroad Medicare Medicare |
$20.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20.15
|
| Rate for Payer: UHC Exchange |
$31.23
|
| Rate for Payer: UHC Medicaid |
$10.54
|
| Rate for Payer: UHCCP DNSP |
$20.15
|
| Rate for Payer: UHCCP Medicaid |
$10.54
|
| Rate for Payer: VA VA |
$20.15
|
|
|
HC CLOZAPINE LEVEL
|
Facility
|
IP
|
$47.76
|
|
|
Service Code
|
CPT 80159
|
| Hospital Charge Code |
30100159
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.82 |
| Max. Negotiated Rate |
$47.76 |
| Rate for Payer: Aetna Commercial |
$42.98
|
| Rate for Payer: ASR ASR |
$46.33
|
| Rate for Payer: BCBS Trust/PPO |
$39.22
|
| Rate for Payer: BCN Commercial |
$39.22
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$44.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Healthscope Commercial |
$46.33
|
| Rate for Payer: Healthscope Whirlpool |
$47.76
|
| Rate for Payer: Mclaren Commercial |
$42.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.03
|
|
|
HC CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION
|
Facility
|
IP
|
$624.24
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
76100375
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$468.18 |
| Max. Negotiated Rate |
$624.24 |
| Rate for Payer: Aetna Commercial |
$561.82
|
| Rate for Payer: ASR ASR |
$605.51
|
| Rate for Payer: BCBS Trust/PPO |
$512.63
|
| Rate for Payer: BCN Commercial |
$512.63
|
| Rate for Payer: Cash Price |
$499.39
|
| Rate for Payer: Cofinity Commercial |
$586.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.39
|
| Rate for Payer: Healthscope Commercial |
$605.51
|
| Rate for Payer: Healthscope Whirlpool |
$624.24
|
| Rate for Payer: Mclaren Commercial |
$561.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.60
|
| Rate for Payer: Nomi Health Commercial |
$511.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$549.33
|
|
|
HC CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION
|
Facility
|
OP
|
$624.24
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
76100375
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.54 |
| Max. Negotiated Rate |
$624.24 |
| Rate for Payer: Aetna Commercial |
$561.82
|
| 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 |
$605.51
|
| Rate for Payer: BCBS Complete |
$134.98
|
| Rate for Payer: BCBS MAPPO |
$245.78
|
| Rate for Payer: BCBS Trust/PPO |
$514.69
|
| Rate for Payer: BCN Commercial |
$514.69
|
| Rate for Payer: BCN Medicare Advantage |
$245.78
|
| Rate for Payer: Cash Price |
$499.39
|
| Rate for Payer: Cash Price |
$499.39
|
| Rate for Payer: Cofinity Commercial |
$586.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.78
|
| Rate for Payer: Healthscope Commercial |
$605.51
|
| Rate for Payer: Healthscope Whirlpool |
$624.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$245.78
|
| Rate for Payer: Mclaren Commercial |
$561.82
|
| 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 |
$530.60
|
| Rate for Payer: Nomi Health Commercial |
$511.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.18
|
| 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 |
$546.96
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$437.59
|
| Rate for Payer: Railroad Medicare Medicare |
$245.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$549.33
|
| 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 CLSD TX IP JT DISLOCATION W/MANIP W/O ANES
|
Facility
|
OP
|
$647.81
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
76100360
|
|
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 |
$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 |
$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 CLSD TX IP JT DISLOCATION W/MANIP W/O ANES
|
Facility
|
IP
|
$647.81
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
76100360
|
|
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 CLSD TX PELVIC RING FX W/O MANIPULATION
|
Facility
|
OP
|
$647.81
|
|
|
Service Code
|
CPT 27197
|
| Hospital Charge Code |
76100361
|
|
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 |
$567.61
|
| Rate for Payer: Priority Health Medicare |
$245.78
|
| Rate for Payer: Priority Health Narrow Network |
$454.11
|
| 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 CLSD TX PELVIC RING FX W/O MANIPULATION
|
Facility
|
IP
|
$647.81
|
|
|
Service Code
|
CPT 27197
|
| Hospital Charge Code |
76100361
|
|
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 CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA
|
Facility
|
IP
|
$630.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
76100566
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$472.50 |
| Max. Negotiated Rate |
$630.00 |
| Rate for Payer: Aetna Commercial |
$567.00
|
| Rate for Payer: ASR ASR |
$611.10
|
| Rate for Payer: BCBS Trust/PPO |
$517.36
|
| Rate for Payer: BCN Commercial |
$517.36
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Cofinity Commercial |
$592.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$504.00
|
| Rate for Payer: Healthscope Commercial |
$611.10
|
| Rate for Payer: Healthscope Whirlpool |
$630.00
|
| Rate for Payer: Mclaren Commercial |
$567.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$535.50
|
| Rate for Payer: Nomi Health Commercial |
$516.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$472.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$554.40
|
|
|
HC CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA
|
Facility
|
OP
|
$630.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
76100566
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.54 |
| Max. Negotiated Rate |
$630.00 |
| Rate for Payer: Aetna Commercial |
$567.00
|
| 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 |
$611.10
|
| Rate for Payer: BCBS Complete |
$134.98
|
| Rate for Payer: BCBS MAPPO |
$245.78
|
| Rate for Payer: BCBS Trust/PPO |
$519.43
|
| Rate for Payer: BCN Commercial |
$519.43
|
| Rate for Payer: BCN Medicare Advantage |
$245.78
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Cofinity Commercial |
$592.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$504.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.78
|
| Rate for Payer: Healthscope Commercial |
$611.10
|
| Rate for Payer: Healthscope Whirlpool |
$630.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$245.78
|
| Rate for Payer: Mclaren Commercial |
$567.00
|
| 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 |
$535.50
|
| Rate for Payer: Nomi Health Commercial |
$516.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$472.50
|
| 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 |
$554.40
|
| 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
|
|
