|
HC CAST HIP SPICA 1 AND 1 HALF OR BOTH
|
Facility
|
IP
|
$969.55
|
|
|
Service Code
|
CPT 29325
|
| Hospital Charge Code |
70000004
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$630.21 |
| Max. Negotiated Rate |
$969.55 |
| Rate for Payer: Aetna Commercial |
$872.60
|
| Rate for Payer: ASR ASR |
$940.46
|
| Rate for Payer: ASR Commercial |
$940.46
|
| Rate for Payer: BCBS Trust/PPO |
$790.09
|
| Rate for Payer: BCN Commercial |
$751.69
|
| Rate for Payer: Cash Price |
$775.64
|
| Rate for Payer: Cofinity Commercial |
$911.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.64
|
| Rate for Payer: Healthscope Commercial |
$969.55
|
| Rate for Payer: Healthscope Whirlpool |
$940.46
|
| Rate for Payer: Mclaren Commercial |
$872.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$824.12
|
| Rate for Payer: Nomi Health Commercial |
$795.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$853.20
|
|
|
HC CAST HIP SPICA 1 AND 1 HALF OR BOTH
|
Facility
|
OP
|
$969.55
|
|
|
Service Code
|
CPT 29325
|
| Hospital Charge Code |
70000004
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$139.47 |
| Max. Negotiated Rate |
$969.55 |
| Rate for Payer: Aetna Commercial |
$872.60
|
| Rate for Payer: Aetna Medicare |
$260.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.26
|
| Rate for Payer: ASR ASR |
$940.46
|
| Rate for Payer: ASR Commercial |
$940.46
|
| Rate for Payer: BCBS Complete |
$146.45
|
| Rate for Payer: BCBS MAPPO |
$260.21
|
| Rate for Payer: BCBS Trust/PPO |
$793.96
|
| Rate for Payer: BCN Commercial |
$751.69
|
| Rate for Payer: BCN Medicare Advantage |
$260.21
|
| Rate for Payer: Cash Price |
$775.64
|
| Rate for Payer: Cash Price |
$775.64
|
| Rate for Payer: Cofinity Commercial |
$911.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.21
|
| Rate for Payer: Healthscope Commercial |
$969.55
|
| Rate for Payer: Healthscope Whirlpool |
$940.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$260.21
|
| Rate for Payer: Mclaren Commercial |
$872.60
|
| Rate for Payer: Mclaren Medicaid |
$139.47
|
| Rate for Payer: Mclaren Medicare |
$260.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.22
|
| Rate for Payer: Meridian Medicaid |
$146.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$824.12
|
| Rate for Payer: Nomi Health Commercial |
$795.03
|
| Rate for Payer: PACE Medicare |
$247.20
|
| Rate for Payer: PACE SWMI |
$260.21
|
| Rate for Payer: PHP Commercial |
$286.23
|
| Rate for Payer: PHP Medicaid |
$139.47
|
| Rate for Payer: PHP Medicare Advantage |
$260.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$849.52
|
| Rate for Payer: Priority Health Medicare |
$260.21
|
| Rate for Payer: Priority Health Narrow Network |
$679.65
|
| Rate for Payer: Railroad Medicare Medicare |
$260.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$853.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.21
|
| Rate for Payer: UHC Exchange |
$403.33
|
| Rate for Payer: UHC Medicare Advantage |
$260.21
|
| Rate for Payer: UHCCP DNSP |
$260.21
|
| Rate for Payer: UHCCP Medicaid |
$139.47
|
| Rate for Payer: VA VA |
$260.21
|
|
|
HC CAST LONG ARM
|
Facility
|
IP
|
$341.68
|
|
|
Service Code
|
CPT 29065
|
| Hospital Charge Code |
42100001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$222.09 |
| Max. Negotiated Rate |
$341.68 |
| Rate for Payer: Aetna Commercial |
$307.51
|
| Rate for Payer: ASR ASR |
$331.43
|
| Rate for Payer: ASR Commercial |
$331.43
|
| Rate for Payer: BCBS Trust/PPO |
$278.44
|
| Rate for Payer: BCN Commercial |
$264.90
|
| Rate for Payer: Cash Price |
$273.34
|
| Rate for Payer: Cofinity Commercial |
$321.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$273.34
|
| Rate for Payer: Healthscope Commercial |
$341.68
|
| Rate for Payer: Healthscope Whirlpool |
$331.43
|
| Rate for Payer: Mclaren Commercial |
$307.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$290.43
|
| Rate for Payer: Nomi Health Commercial |
$280.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$300.68
|
|
|
HC CAST LONG ARM
|
Facility
|
OP
|
$341.68
|
|
|
Service Code
|
CPT 29065
|
| Hospital Charge Code |
42100001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$139.47 |
| Max. Negotiated Rate |
$403.33 |
| Rate for Payer: Aetna Commercial |
$307.51
|
| Rate for Payer: Aetna Medicare |
$260.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.26
|
| Rate for Payer: ASR ASR |
$331.43
|
| Rate for Payer: ASR Commercial |
$331.43
|
| Rate for Payer: BCBS Complete |
$146.45
|
| Rate for Payer: BCBS MAPPO |
$260.21
|
| Rate for Payer: BCBS Trust/PPO |
$279.80
|
| Rate for Payer: BCN Commercial |
$264.90
|
| Rate for Payer: BCN Medicare Advantage |
$260.21
|
| Rate for Payer: Cash Price |
$273.34
|
| Rate for Payer: Cash Price |
$273.34
|
| Rate for Payer: Cofinity Commercial |
$321.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$273.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.21
|
| Rate for Payer: Healthscope Commercial |
$341.68
|
| Rate for Payer: Healthscope Whirlpool |
$331.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$260.21
|
| Rate for Payer: Mclaren Commercial |
$307.51
|
| Rate for Payer: Mclaren Medicaid |
$139.47
|
| Rate for Payer: Mclaren Medicare |
$260.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.22
|
| Rate for Payer: Meridian Medicaid |
$146.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$290.43
|
| Rate for Payer: Nomi Health Commercial |
$280.18
|
| Rate for Payer: PACE Medicare |
$247.20
|
| Rate for Payer: PACE SWMI |
$260.21
|
| Rate for Payer: PHP Commercial |
$286.23
|
| Rate for Payer: PHP Medicaid |
$139.47
|
| Rate for Payer: PHP Medicare Advantage |
$260.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$299.38
|
| Rate for Payer: Priority Health Medicare |
$260.21
|
| Rate for Payer: Priority Health Narrow Network |
$239.52
|
| Rate for Payer: Railroad Medicare Medicare |
$260.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$300.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.21
|
| Rate for Payer: UHC Exchange |
$403.33
|
| Rate for Payer: UHC Medicare Advantage |
$260.21
|
| Rate for Payer: UHCCP DNSP |
$260.21
|
| Rate for Payer: UHCCP Medicaid |
$139.47
|
| Rate for Payer: VA VA |
$260.21
|
|
|
HC CAST LONG LEG
|
Facility
|
IP
|
$411.68
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
70000005
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$267.59 |
| Max. Negotiated Rate |
$411.68 |
| Rate for Payer: Aetna Commercial |
$370.51
|
| Rate for Payer: ASR ASR |
$399.33
|
| Rate for Payer: ASR Commercial |
$399.33
|
| Rate for Payer: BCBS Trust/PPO |
$335.48
|
| Rate for Payer: BCN Commercial |
$319.18
|
| Rate for Payer: Cash Price |
$329.34
|
| Rate for Payer: Cofinity Commercial |
$386.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.34
|
| Rate for Payer: Healthscope Commercial |
$411.68
|
| Rate for Payer: Healthscope Whirlpool |
$399.33
|
| Rate for Payer: Mclaren Commercial |
$370.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$349.93
|
| Rate for Payer: Nomi Health Commercial |
$337.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$362.28
|
|
|
HC CAST LONG LEG
|
Facility
|
OP
|
$411.68
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
70000005
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$139.47 |
| Max. Negotiated Rate |
$411.68 |
| Rate for Payer: Aetna Commercial |
$370.51
|
| Rate for Payer: Aetna Medicare |
$260.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.26
|
| Rate for Payer: ASR ASR |
$399.33
|
| Rate for Payer: ASR Commercial |
$399.33
|
| Rate for Payer: BCBS Complete |
$146.45
|
| Rate for Payer: BCBS MAPPO |
$260.21
|
| Rate for Payer: BCBS Trust/PPO |
$337.12
|
| Rate for Payer: BCN Commercial |
$319.18
|
| Rate for Payer: BCN Medicare Advantage |
$260.21
|
| Rate for Payer: Cash Price |
$329.34
|
| Rate for Payer: Cash Price |
$329.34
|
| Rate for Payer: Cofinity Commercial |
$386.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.21
|
| Rate for Payer: Healthscope Commercial |
$411.68
|
| Rate for Payer: Healthscope Whirlpool |
$399.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$260.21
|
| Rate for Payer: Mclaren Commercial |
$370.51
|
| Rate for Payer: Mclaren Medicaid |
$139.47
|
| Rate for Payer: Mclaren Medicare |
$260.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.22
|
| Rate for Payer: Meridian Medicaid |
$146.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$349.93
|
| Rate for Payer: Nomi Health Commercial |
$337.58
|
| Rate for Payer: PACE Medicare |
$247.20
|
| Rate for Payer: PACE SWMI |
$260.21
|
| Rate for Payer: PHP Commercial |
$286.23
|
| Rate for Payer: PHP Medicaid |
$139.47
|
| Rate for Payer: PHP Medicare Advantage |
$260.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$360.71
|
| Rate for Payer: Priority Health Medicare |
$260.21
|
| Rate for Payer: Priority Health Narrow Network |
$288.59
|
| Rate for Payer: Railroad Medicare Medicare |
$260.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$362.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.21
|
| Rate for Payer: UHC Exchange |
$403.33
|
| Rate for Payer: UHC Medicare Advantage |
$260.21
|
| Rate for Payer: UHCCP DNSP |
$260.21
|
| Rate for Payer: UHCCP Medicaid |
$139.47
|
| Rate for Payer: VA VA |
$260.21
|
|
|
HC CAST PANTALOON
|
Facility
|
OP
|
$918.57
|
|
|
Service Code
|
CPT 29305
|
| Hospital Charge Code |
70000003
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$139.47 |
| Max. Negotiated Rate |
$918.57 |
| Rate for Payer: Aetna Commercial |
$826.71
|
| Rate for Payer: Aetna Medicare |
$260.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.26
|
| Rate for Payer: ASR ASR |
$891.01
|
| Rate for Payer: ASR Commercial |
$891.01
|
| Rate for Payer: BCBS Complete |
$146.45
|
| Rate for Payer: BCBS MAPPO |
$260.21
|
| Rate for Payer: BCBS Trust/PPO |
$752.22
|
| Rate for Payer: BCN Commercial |
$712.17
|
| Rate for Payer: BCN Medicare Advantage |
$260.21
|
| Rate for Payer: Cash Price |
$734.86
|
| Rate for Payer: Cash Price |
$734.86
|
| Rate for Payer: Cofinity Commercial |
$863.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.21
|
| Rate for Payer: Healthscope Commercial |
$918.57
|
| Rate for Payer: Healthscope Whirlpool |
$891.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$260.21
|
| Rate for Payer: Mclaren Commercial |
$826.71
|
| Rate for Payer: Mclaren Medicaid |
$139.47
|
| Rate for Payer: Mclaren Medicare |
$260.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.22
|
| Rate for Payer: Meridian Medicaid |
$146.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$780.78
|
| Rate for Payer: Nomi Health Commercial |
$753.23
|
| Rate for Payer: PACE Medicare |
$247.20
|
| Rate for Payer: PACE SWMI |
$260.21
|
| Rate for Payer: PHP Commercial |
$286.23
|
| Rate for Payer: PHP Medicaid |
$139.47
|
| Rate for Payer: PHP Medicare Advantage |
$260.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$804.85
|
| Rate for Payer: Priority Health Medicare |
$260.21
|
| Rate for Payer: Priority Health Narrow Network |
$643.92
|
| Rate for Payer: Railroad Medicare Medicare |
$260.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$808.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.21
|
| Rate for Payer: UHC Exchange |
$403.33
|
| Rate for Payer: UHC Medicare Advantage |
$260.21
|
| Rate for Payer: UHCCP DNSP |
$260.21
|
| Rate for Payer: UHCCP Medicaid |
$139.47
|
| Rate for Payer: VA VA |
$260.21
|
|
|
HC CAST PANTALOON
|
Facility
|
IP
|
$918.57
|
|
|
Service Code
|
CPT 29305
|
| Hospital Charge Code |
70000003
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$597.07 |
| Max. Negotiated Rate |
$918.57 |
| Rate for Payer: Aetna Commercial |
$826.71
|
| Rate for Payer: ASR ASR |
$891.01
|
| Rate for Payer: ASR Commercial |
$891.01
|
| Rate for Payer: BCBS Trust/PPO |
$748.54
|
| Rate for Payer: BCN Commercial |
$712.17
|
| Rate for Payer: Cash Price |
$734.86
|
| Rate for Payer: Cofinity Commercial |
$863.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.86
|
| Rate for Payer: Healthscope Commercial |
$918.57
|
| Rate for Payer: Healthscope Whirlpool |
$891.01
|
| Rate for Payer: Mclaren Commercial |
$826.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$780.78
|
| Rate for Payer: Nomi Health Commercial |
$753.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$808.34
|
|
|
HC CAST PTB WALKING
|
Facility
|
OP
|
$411.68
|
|
|
Service Code
|
CPT 29435
|
| Hospital Charge Code |
70000009
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$139.47 |
| Max. Negotiated Rate |
$411.68 |
| Rate for Payer: Aetna Commercial |
$370.51
|
| Rate for Payer: Aetna Medicare |
$260.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.26
|
| Rate for Payer: ASR ASR |
$399.33
|
| Rate for Payer: ASR Commercial |
$399.33
|
| Rate for Payer: BCBS Complete |
$146.45
|
| Rate for Payer: BCBS MAPPO |
$260.21
|
| Rate for Payer: BCBS Trust/PPO |
$337.12
|
| Rate for Payer: BCN Commercial |
$319.18
|
| Rate for Payer: BCN Medicare Advantage |
$260.21
|
| Rate for Payer: Cash Price |
$329.34
|
| Rate for Payer: Cash Price |
$329.34
|
| Rate for Payer: Cofinity Commercial |
$386.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.21
|
| Rate for Payer: Healthscope Commercial |
$411.68
|
| Rate for Payer: Healthscope Whirlpool |
$399.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$260.21
|
| Rate for Payer: Mclaren Commercial |
$370.51
|
| Rate for Payer: Mclaren Medicaid |
$139.47
|
| Rate for Payer: Mclaren Medicare |
$260.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.22
|
| Rate for Payer: Meridian Medicaid |
$146.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$349.93
|
| Rate for Payer: Nomi Health Commercial |
$337.58
|
| Rate for Payer: PACE Medicare |
$247.20
|
| Rate for Payer: PACE SWMI |
$260.21
|
| Rate for Payer: PHP Commercial |
$286.23
|
| Rate for Payer: PHP Medicaid |
$139.47
|
| Rate for Payer: PHP Medicare Advantage |
$260.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$360.71
|
| Rate for Payer: Priority Health Medicare |
$260.21
|
| Rate for Payer: Priority Health Narrow Network |
$288.59
|
| Rate for Payer: Railroad Medicare Medicare |
$260.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$362.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.21
|
| Rate for Payer: UHC Exchange |
$403.33
|
| Rate for Payer: UHC Medicare Advantage |
$260.21
|
| Rate for Payer: UHCCP DNSP |
$260.21
|
| Rate for Payer: UHCCP Medicaid |
$139.47
|
| Rate for Payer: VA VA |
$260.21
|
|
|
HC CAST PTB WALKING
|
Facility
|
IP
|
$411.68
|
|
|
Service Code
|
CPT 29435
|
| Hospital Charge Code |
70000009
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$267.59 |
| Max. Negotiated Rate |
$411.68 |
| Rate for Payer: Aetna Commercial |
$370.51
|
| Rate for Payer: ASR ASR |
$399.33
|
| Rate for Payer: ASR Commercial |
$399.33
|
| Rate for Payer: BCBS Trust/PPO |
$335.48
|
| Rate for Payer: BCN Commercial |
$319.18
|
| Rate for Payer: Cash Price |
$329.34
|
| Rate for Payer: Cofinity Commercial |
$386.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.34
|
| Rate for Payer: Healthscope Commercial |
$411.68
|
| Rate for Payer: Healthscope Whirlpool |
$399.33
|
| Rate for Payer: Mclaren Commercial |
$370.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$349.93
|
| Rate for Payer: Nomi Health Commercial |
$337.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$362.28
|
|
|
HC CAST REPAIR
|
Facility
|
OP
|
$178.81
|
|
| Hospital Charge Code |
27000041
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$71.52 |
| Max. Negotiated Rate |
$178.81 |
| Rate for Payer: Aetna Commercial |
$160.93
|
| Rate for Payer: Aetna Medicare |
$89.40
|
| Rate for Payer: ASR ASR |
$173.45
|
| Rate for Payer: ASR Commercial |
$173.45
|
| Rate for Payer: BCBS Complete |
$71.52
|
| Rate for Payer: BCBS Trust/PPO |
$146.43
|
| Rate for Payer: BCN Commercial |
$138.63
|
| Rate for Payer: Cash Price |
$143.05
|
| Rate for Payer: Cofinity Commercial |
$168.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.05
|
| Rate for Payer: Healthscope Commercial |
$178.81
|
| Rate for Payer: Healthscope Whirlpool |
$173.45
|
| Rate for Payer: Mclaren Commercial |
$160.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.99
|
| Rate for Payer: Nomi Health Commercial |
$146.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$156.67
|
| Rate for Payer: Priority Health Narrow Network |
$125.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$157.35
|
|
|
HC CAST REPAIR
|
Facility
|
IP
|
$178.81
|
|
| Hospital Charge Code |
27000041
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$116.23 |
| Max. Negotiated Rate |
$178.81 |
| Rate for Payer: Aetna Commercial |
$160.93
|
| Rate for Payer: ASR ASR |
$173.45
|
| Rate for Payer: ASR Commercial |
$173.45
|
| Rate for Payer: BCBS Trust/PPO |
$145.71
|
| Rate for Payer: BCN Commercial |
$138.63
|
| Rate for Payer: Cash Price |
$143.05
|
| Rate for Payer: Cofinity Commercial |
$168.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.05
|
| Rate for Payer: Healthscope Commercial |
$178.81
|
| Rate for Payer: Healthscope Whirlpool |
$173.45
|
| Rate for Payer: Mclaren Commercial |
$160.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.99
|
| Rate for Payer: Nomi Health Commercial |
$146.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$157.35
|
|
|
HC CAST RISSER BODY ONLY
|
Facility
|
IP
|
$309.38
|
|
|
Service Code
|
CPT 29010
|
| Hospital Charge Code |
70000001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$201.10 |
| Max. Negotiated Rate |
$309.38 |
| Rate for Payer: Aetna Commercial |
$278.44
|
| Rate for Payer: ASR ASR |
$300.10
|
| Rate for Payer: ASR Commercial |
$300.10
|
| Rate for Payer: BCBS Trust/PPO |
$252.11
|
| Rate for Payer: BCN Commercial |
$239.86
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Cofinity Commercial |
$290.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.50
|
| Rate for Payer: Healthscope Commercial |
$309.38
|
| Rate for Payer: Healthscope Whirlpool |
$300.10
|
| Rate for Payer: Mclaren Commercial |
$278.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.97
|
| Rate for Payer: Nomi Health Commercial |
$253.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$272.25
|
|
|
HC CAST RISSER BODY ONLY
|
Facility
|
OP
|
$309.38
|
|
|
Service Code
|
CPT 29010
|
| Hospital Charge Code |
70000001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$139.47 |
| Max. Negotiated Rate |
$403.33 |
| Rate for Payer: Aetna Commercial |
$278.44
|
| Rate for Payer: Aetna Medicare |
$260.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.26
|
| Rate for Payer: ASR ASR |
$300.10
|
| Rate for Payer: ASR Commercial |
$300.10
|
| Rate for Payer: BCBS Complete |
$146.45
|
| Rate for Payer: BCBS MAPPO |
$260.21
|
| Rate for Payer: BCBS Trust/PPO |
$253.35
|
| Rate for Payer: BCN Commercial |
$239.86
|
| Rate for Payer: BCN Medicare Advantage |
$260.21
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Cofinity Commercial |
$290.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.21
|
| Rate for Payer: Healthscope Commercial |
$309.38
|
| Rate for Payer: Healthscope Whirlpool |
$300.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$260.21
|
| Rate for Payer: Mclaren Commercial |
$278.44
|
| Rate for Payer: Mclaren Medicaid |
$139.47
|
| Rate for Payer: Mclaren Medicare |
$260.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.22
|
| Rate for Payer: Meridian Medicaid |
$146.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.97
|
| Rate for Payer: Nomi Health Commercial |
$253.69
|
| Rate for Payer: PACE Medicare |
$247.20
|
| Rate for Payer: PACE SWMI |
$260.21
|
| Rate for Payer: PHP Commercial |
$286.23
|
| Rate for Payer: PHP Medicaid |
$139.47
|
| Rate for Payer: PHP Medicare Advantage |
$260.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.08
|
| Rate for Payer: Priority Health Medicare |
$260.21
|
| Rate for Payer: Priority Health Narrow Network |
$216.88
|
| Rate for Payer: Railroad Medicare Medicare |
$260.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$272.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.21
|
| Rate for Payer: UHC Exchange |
$403.33
|
| Rate for Payer: UHC Medicare Advantage |
$260.21
|
| Rate for Payer: UHCCP DNSP |
$260.21
|
| Rate for Payer: UHCCP Medicaid |
$139.47
|
| Rate for Payer: VA VA |
$260.21
|
|
|
HC CAST SHORT ARM
|
Facility
|
OP
|
$300.18
|
|
|
Service Code
|
CPT 29075
|
| Hospital Charge Code |
43000001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$139.47 |
| Max. Negotiated Rate |
$403.33 |
| Rate for Payer: Aetna Commercial |
$270.16
|
| Rate for Payer: Aetna Medicare |
$260.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.26
|
| Rate for Payer: ASR ASR |
$291.17
|
| Rate for Payer: ASR Commercial |
$291.17
|
| Rate for Payer: BCBS Complete |
$146.45
|
| Rate for Payer: BCBS MAPPO |
$260.21
|
| Rate for Payer: BCBS Trust/PPO |
$245.82
|
| Rate for Payer: BCN Commercial |
$232.73
|
| Rate for Payer: BCN Medicare Advantage |
$260.21
|
| Rate for Payer: Cash Price |
$240.14
|
| Rate for Payer: Cash Price |
$240.14
|
| Rate for Payer: Cofinity Commercial |
$282.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.21
|
| Rate for Payer: Healthscope Commercial |
$300.18
|
| Rate for Payer: Healthscope Whirlpool |
$291.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$260.21
|
| Rate for Payer: Mclaren Commercial |
$270.16
|
| Rate for Payer: Mclaren Medicaid |
$139.47
|
| Rate for Payer: Mclaren Medicare |
$260.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.22
|
| Rate for Payer: Meridian Medicaid |
$146.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.15
|
| Rate for Payer: Nomi Health Commercial |
$246.15
|
| Rate for Payer: PACE Medicare |
$247.20
|
| Rate for Payer: PACE SWMI |
$260.21
|
| Rate for Payer: PHP Commercial |
$286.23
|
| Rate for Payer: PHP Medicaid |
$139.47
|
| Rate for Payer: PHP Medicare Advantage |
$260.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$385.39
|
| Rate for Payer: Priority Health Medicare |
$260.21
|
| Rate for Payer: Priority Health Narrow Network |
$308.31
|
| Rate for Payer: Railroad Medicare Medicare |
$260.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$264.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.21
|
| Rate for Payer: UHC Exchange |
$403.33
|
| Rate for Payer: UHC Medicare Advantage |
$260.21
|
| Rate for Payer: UHCCP DNSP |
$260.21
|
| Rate for Payer: UHCCP Medicaid |
$139.47
|
| Rate for Payer: VA VA |
$260.21
|
|
|
HC CAST SHORT ARM
|
Facility
|
IP
|
$300.18
|
|
|
Service Code
|
CPT 29075
|
| Hospital Charge Code |
43000001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$195.12 |
| Max. Negotiated Rate |
$300.18 |
| Rate for Payer: Aetna Commercial |
$270.16
|
| Rate for Payer: ASR ASR |
$291.17
|
| Rate for Payer: ASR Commercial |
$291.17
|
| Rate for Payer: BCBS Trust/PPO |
$244.62
|
| Rate for Payer: BCN Commercial |
$232.73
|
| Rate for Payer: Cash Price |
$240.14
|
| Rate for Payer: Cofinity Commercial |
$282.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.14
|
| Rate for Payer: Healthscope Commercial |
$300.18
|
| Rate for Payer: Healthscope Whirlpool |
$291.17
|
| Rate for Payer: Mclaren Commercial |
$270.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.15
|
| Rate for Payer: Nomi Health Commercial |
$246.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$264.16
|
|
|
HC CAST SHORT LEG
|
Facility
|
OP
|
$368.85
|
|
|
Service Code
|
CPT 29405
|
| Hospital Charge Code |
70000007
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$139.47 |
| Max. Negotiated Rate |
$403.33 |
| Rate for Payer: Aetna Commercial |
$331.96
|
| Rate for Payer: Aetna Medicare |
$260.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.26
|
| Rate for Payer: ASR ASR |
$357.78
|
| Rate for Payer: ASR Commercial |
$357.78
|
| Rate for Payer: BCBS Complete |
$146.45
|
| Rate for Payer: BCBS MAPPO |
$260.21
|
| Rate for Payer: BCBS Trust/PPO |
$302.05
|
| Rate for Payer: BCN Commercial |
$285.97
|
| Rate for Payer: BCN Medicare Advantage |
$260.21
|
| Rate for Payer: Cash Price |
$295.08
|
| Rate for Payer: Cash Price |
$295.08
|
| Rate for Payer: Cofinity Commercial |
$346.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$295.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.21
|
| Rate for Payer: Healthscope Commercial |
$368.85
|
| Rate for Payer: Healthscope Whirlpool |
$357.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$260.21
|
| Rate for Payer: Mclaren Commercial |
$331.96
|
| Rate for Payer: Mclaren Medicaid |
$139.47
|
| Rate for Payer: Mclaren Medicare |
$260.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.22
|
| Rate for Payer: Meridian Medicaid |
$146.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.52
|
| Rate for Payer: Nomi Health Commercial |
$302.46
|
| Rate for Payer: PACE Medicare |
$247.20
|
| Rate for Payer: PACE SWMI |
$260.21
|
| Rate for Payer: PHP Commercial |
$286.23
|
| Rate for Payer: PHP Medicaid |
$139.47
|
| Rate for Payer: PHP Medicare Advantage |
$260.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$239.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$385.39
|
| Rate for Payer: Priority Health Medicare |
$260.21
|
| Rate for Payer: Priority Health Narrow Network |
$308.31
|
| Rate for Payer: Railroad Medicare Medicare |
$260.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$324.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.21
|
| Rate for Payer: UHC Exchange |
$403.33
|
| Rate for Payer: UHC Medicare Advantage |
$260.21
|
| Rate for Payer: UHCCP DNSP |
$260.21
|
| Rate for Payer: UHCCP Medicaid |
$139.47
|
| Rate for Payer: VA VA |
$260.21
|
|
|
HC CAST SHORT LEG
|
Facility
|
IP
|
$368.85
|
|
|
Service Code
|
CPT 29405
|
| Hospital Charge Code |
70000007
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$239.75 |
| Max. Negotiated Rate |
$368.85 |
| Rate for Payer: Aetna Commercial |
$331.96
|
| Rate for Payer: ASR ASR |
$357.78
|
| Rate for Payer: ASR Commercial |
$357.78
|
| Rate for Payer: BCBS Trust/PPO |
$300.58
|
| Rate for Payer: BCN Commercial |
$285.97
|
| Rate for Payer: Cash Price |
$295.08
|
| Rate for Payer: Cofinity Commercial |
$346.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$295.08
|
| Rate for Payer: Healthscope Commercial |
$368.85
|
| Rate for Payer: Healthscope Whirlpool |
$357.78
|
| Rate for Payer: Mclaren Commercial |
$331.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.52
|
| Rate for Payer: Nomi Health Commercial |
$302.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$239.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$324.59
|
|
|
HC CAST SHORT LEG WALKING
|
Facility
|
OP
|
$368.85
|
|
|
Service Code
|
CPT 29425
|
| Hospital Charge Code |
70000008
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$139.47 |
| Max. Negotiated Rate |
$403.33 |
| Rate for Payer: Aetna Commercial |
$331.96
|
| Rate for Payer: Aetna Medicare |
$260.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.26
|
| Rate for Payer: ASR ASR |
$357.78
|
| Rate for Payer: ASR Commercial |
$357.78
|
| Rate for Payer: BCBS Complete |
$146.45
|
| Rate for Payer: BCBS MAPPO |
$260.21
|
| Rate for Payer: BCBS Trust/PPO |
$302.05
|
| Rate for Payer: BCN Commercial |
$285.97
|
| Rate for Payer: BCN Medicare Advantage |
$260.21
|
| Rate for Payer: Cash Price |
$295.08
|
| Rate for Payer: Cash Price |
$295.08
|
| Rate for Payer: Cofinity Commercial |
$346.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$295.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.21
|
| Rate for Payer: Healthscope Commercial |
$368.85
|
| Rate for Payer: Healthscope Whirlpool |
$357.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$260.21
|
| Rate for Payer: Mclaren Commercial |
$331.96
|
| Rate for Payer: Mclaren Medicaid |
$139.47
|
| Rate for Payer: Mclaren Medicare |
$260.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.22
|
| Rate for Payer: Meridian Medicaid |
$146.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.52
|
| Rate for Payer: Nomi Health Commercial |
$302.46
|
| Rate for Payer: PACE Medicare |
$247.20
|
| Rate for Payer: PACE SWMI |
$260.21
|
| Rate for Payer: PHP Commercial |
$286.23
|
| Rate for Payer: PHP Medicaid |
$139.47
|
| Rate for Payer: PHP Medicare Advantage |
$260.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$239.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$323.19
|
| Rate for Payer: Priority Health Medicare |
$260.21
|
| Rate for Payer: Priority Health Narrow Network |
$258.56
|
| Rate for Payer: Railroad Medicare Medicare |
$260.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$324.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.21
|
| Rate for Payer: UHC Exchange |
$403.33
|
| Rate for Payer: UHC Medicare Advantage |
$260.21
|
| Rate for Payer: UHCCP DNSP |
$260.21
|
| Rate for Payer: UHCCP Medicaid |
$139.47
|
| Rate for Payer: VA VA |
$260.21
|
|
|
HC CAST SHORT LEG WALKING
|
Facility
|
IP
|
$368.85
|
|
|
Service Code
|
CPT 29425
|
| Hospital Charge Code |
70000008
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$239.75 |
| Max. Negotiated Rate |
$368.85 |
| Rate for Payer: Aetna Commercial |
$331.96
|
| Rate for Payer: ASR ASR |
$357.78
|
| Rate for Payer: ASR Commercial |
$357.78
|
| Rate for Payer: BCBS Trust/PPO |
$300.58
|
| Rate for Payer: BCN Commercial |
$285.97
|
| Rate for Payer: Cash Price |
$295.08
|
| Rate for Payer: Cofinity Commercial |
$346.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$295.08
|
| Rate for Payer: Healthscope Commercial |
$368.85
|
| Rate for Payer: Healthscope Whirlpool |
$357.78
|
| Rate for Payer: Mclaren Commercial |
$331.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.52
|
| Rate for Payer: Nomi Health Commercial |
$302.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$239.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$324.59
|
|
|
HC CAST SUP LNG ARM ADULT FBRGLS
|
Facility
|
IP
|
$57.22
|
|
| Hospital Charge Code |
27200327
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.19 |
| Max. Negotiated Rate |
$57.22 |
| Rate for Payer: Aetna Commercial |
$51.50
|
| Rate for Payer: ASR ASR |
$55.50
|
| Rate for Payer: ASR Commercial |
$55.50
|
| Rate for Payer: BCBS Trust/PPO |
$46.63
|
| Rate for Payer: BCN Commercial |
$44.36
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$53.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Healthscope Commercial |
$57.22
|
| Rate for Payer: Healthscope Whirlpool |
$55.50
|
| Rate for Payer: Mclaren Commercial |
$51.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$46.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.35
|
|
|
HC CAST SUP LNG ARM ADULT FBRGLS
|
Facility
|
OP
|
$57.22
|
|
| Hospital Charge Code |
27200327
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.89 |
| Max. Negotiated Rate |
$57.22 |
| Rate for Payer: Aetna Commercial |
$51.50
|
| Rate for Payer: Aetna Medicare |
$28.61
|
| Rate for Payer: ASR ASR |
$55.50
|
| Rate for Payer: ASR Commercial |
$55.50
|
| Rate for Payer: BCBS Complete |
$22.89
|
| Rate for Payer: BCBS Trust/PPO |
$46.86
|
| Rate for Payer: BCN Commercial |
$44.36
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$53.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Healthscope Commercial |
$57.22
|
| Rate for Payer: Healthscope Whirlpool |
$55.50
|
| Rate for Payer: Mclaren Commercial |
$51.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$46.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.14
|
| Rate for Payer: Priority Health Narrow Network |
$40.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.35
|
|
|
HC CAST SUP LNG ARM PED FBRGLS
|
Facility
|
OP
|
$26.01
|
|
| Hospital Charge Code |
27200328
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: Aetna Medicare |
$13.00
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$21.30
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.79
|
| Rate for Payer: Priority Health Narrow Network |
$18.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
|
|
HC CAST SUP LNG ARM PED FBRGLS
|
Facility
|
IP
|
$26.01
|
|
| Hospital Charge Code |
27200328
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Trust/PPO |
$21.20
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
|
|
HC CAST SUP LNG ARM SPLINT ADULT FBRGLS
|
Facility
|
IP
|
$26.01
|
|
| Hospital Charge Code |
27200332
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Trust/PPO |
$21.20
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
|
