|
HC CAROTID/VERTEBRAL ULTRASOUND
|
Facility
|
OP
|
$1,382.09
|
|
|
Service Code
|
CPT 93880
|
| Hospital Charge Code |
92100001
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,382.09 |
| Rate for Payer: Aetna Commercial |
$1,243.88
|
| Rate for Payer: Aetna Medicare |
$235.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: ASR ASR |
$1,340.63
|
| Rate for Payer: ASR Commercial |
$1,340.63
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,131.79
|
| Rate for Payer: BCN Commercial |
$1,071.53
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,105.67
|
| Rate for Payer: Cash Price |
$1,105.67
|
| Rate for Payer: Cofinity Commercial |
$1,299.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,105.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,382.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,340.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Mclaren Commercial |
$1,243.88
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,174.78
|
| Rate for Payer: Nomi Health Commercial |
$1,133.31
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$259.31
|
| Rate for Payer: PHP Medicaid |
$126.36
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$898.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,210.99
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Narrow Network |
$968.85
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,216.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$365.40
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP DNSP |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC CASHEW IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200030
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC CASHEW IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200030
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC CASSETTES QUEST
|
Facility
|
IP
|
$76.50
|
|
| Hospital Charge Code |
27000458
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$49.73 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Trust/PPO |
$62.34
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
|
|
HC CASSETTES QUEST
|
Facility
|
OP
|
$76.50
|
|
| Hospital Charge Code |
27000458
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna Medicare |
$38.25
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Complete |
$30.60
|
| Rate for Payer: BCBS Trust/PPO |
$62.65
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.03
|
| Rate for Payer: Priority Health Narrow Network |
$53.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
|
|
HC CAST CLUB FOOT
|
Facility
|
OP
|
$422.52
|
|
|
Service Code
|
CPT 29450
|
| Hospital Charge Code |
70000011
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$82.49 |
| Max. Negotiated Rate |
$422.52 |
| Rate for Payer: Aetna Commercial |
$380.27
|
| Rate for Payer: Aetna Medicare |
$153.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$192.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$192.36
|
| Rate for Payer: ASR ASR |
$409.84
|
| Rate for Payer: ASR Commercial |
$409.84
|
| Rate for Payer: BCBS Complete |
$86.61
|
| Rate for Payer: BCBS MAPPO |
$153.89
|
| Rate for Payer: BCBS Trust/PPO |
$346.00
|
| Rate for Payer: BCN Commercial |
$327.58
|
| Rate for Payer: BCN Medicare Advantage |
$153.89
|
| Rate for Payer: Cash Price |
$338.02
|
| Rate for Payer: Cash Price |
$338.02
|
| Rate for Payer: Cofinity Commercial |
$397.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.89
|
| Rate for Payer: Healthscope Commercial |
$422.52
|
| Rate for Payer: Healthscope Whirlpool |
$409.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$153.89
|
| Rate for Payer: Mclaren Commercial |
$380.27
|
| Rate for Payer: Mclaren Medicaid |
$82.49
|
| Rate for Payer: Mclaren Medicare |
$153.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.58
|
| Rate for Payer: Meridian Medicaid |
$86.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.14
|
| Rate for Payer: Nomi Health Commercial |
$346.47
|
| Rate for Payer: PACE Medicare |
$146.20
|
| Rate for Payer: PACE SWMI |
$153.89
|
| Rate for Payer: PHP Commercial |
$169.28
|
| Rate for Payer: PHP Medicaid |
$82.49
|
| Rate for Payer: PHP Medicare Advantage |
$153.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$370.21
|
| Rate for Payer: Priority Health Medicare |
$153.89
|
| Rate for Payer: Priority Health Narrow Network |
$296.19
|
| Rate for Payer: Railroad Medicare Medicare |
$153.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$371.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.89
|
| Rate for Payer: UHC Exchange |
$238.53
|
| Rate for Payer: UHC Medicare Advantage |
$153.89
|
| Rate for Payer: UHCCP DNSP |
$153.89
|
| Rate for Payer: UHCCP Medicaid |
$82.49
|
| Rate for Payer: VA VA |
$153.89
|
|
|
HC CAST CLUB FOOT
|
Facility
|
IP
|
$422.52
|
|
|
Service Code
|
CPT 29450
|
| Hospital Charge Code |
70000011
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$274.64 |
| Max. Negotiated Rate |
$422.52 |
| Rate for Payer: Aetna Commercial |
$380.27
|
| Rate for Payer: ASR ASR |
$409.84
|
| Rate for Payer: ASR Commercial |
$409.84
|
| Rate for Payer: BCBS Trust/PPO |
$344.31
|
| Rate for Payer: BCN Commercial |
$327.58
|
| Rate for Payer: Cash Price |
$338.02
|
| Rate for Payer: Cofinity Commercial |
$397.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.02
|
| Rate for Payer: Healthscope Commercial |
$422.52
|
| Rate for Payer: Healthscope Whirlpool |
$409.84
|
| Rate for Payer: Mclaren Commercial |
$380.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.14
|
| Rate for Payer: Nomi Health Commercial |
$346.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$371.82
|
|
|
HC CAST COLOR ROLL
|
Facility
|
OP
|
$61.55
|
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.62 |
| Max. Negotiated Rate |
$61.55 |
| Rate for Payer: Aetna Commercial |
$55.40
|
| Rate for Payer: Aetna Medicare |
$30.77
|
| Rate for Payer: ASR ASR |
$59.70
|
| Rate for Payer: ASR Commercial |
$59.70
|
| Rate for Payer: BCBS Complete |
$24.62
|
| Rate for Payer: BCBS Trust/PPO |
$50.40
|
| Rate for Payer: BCN Commercial |
$47.72
|
| Rate for Payer: Cash Price |
$49.24
|
| Rate for Payer: Cofinity Commercial |
$57.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.24
|
| Rate for Payer: Healthscope Commercial |
$61.55
|
| Rate for Payer: Healthscope Whirlpool |
$59.70
|
| Rate for Payer: Mclaren Commercial |
$55.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.32
|
| Rate for Payer: Nomi Health Commercial |
$50.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.93
|
| Rate for Payer: Priority Health Narrow Network |
$43.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.16
|
|
|
HC CAST COLOR ROLL
|
Facility
|
IP
|
$61.55
|
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$40.01 |
| Max. Negotiated Rate |
$61.55 |
| Rate for Payer: Aetna Commercial |
$55.40
|
| Rate for Payer: ASR ASR |
$59.70
|
| Rate for Payer: ASR Commercial |
$59.70
|
| Rate for Payer: BCBS Trust/PPO |
$50.16
|
| Rate for Payer: BCN Commercial |
$47.72
|
| Rate for Payer: Cash Price |
$49.24
|
| Rate for Payer: Cofinity Commercial |
$57.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.24
|
| Rate for Payer: Healthscope Commercial |
$61.55
|
| Rate for Payer: Healthscope Whirlpool |
$59.70
|
| Rate for Payer: Mclaren Commercial |
$55.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.32
|
| Rate for Payer: Nomi Health Commercial |
$50.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.16
|
|
|
HC CAST CYLINDER
|
Facility
|
OP
|
$408.07
|
|
|
Service Code
|
CPT 29365
|
| Hospital Charge Code |
70000006
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$138.83 |
| Max. Negotiated Rate |
$408.07 |
| Rate for Payer: Aetna Commercial |
$367.26
|
| Rate for Payer: Aetna Medicare |
$259.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$323.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$323.76
|
| Rate for Payer: ASR ASR |
$395.83
|
| Rate for Payer: ASR Commercial |
$395.83
|
| Rate for Payer: BCBS Complete |
$145.77
|
| Rate for Payer: BCBS MAPPO |
$259.01
|
| Rate for Payer: BCBS Trust/PPO |
$334.17
|
| Rate for Payer: BCN Commercial |
$316.38
|
| Rate for Payer: BCN Medicare Advantage |
$259.01
|
| Rate for Payer: Cash Price |
$326.46
|
| Rate for Payer: Cash Price |
$326.46
|
| Rate for Payer: Cofinity Commercial |
$383.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$259.01
|
| Rate for Payer: Healthscope Commercial |
$408.07
|
| Rate for Payer: Healthscope Whirlpool |
$395.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$259.01
|
| Rate for Payer: Mclaren Commercial |
$367.26
|
| Rate for Payer: Mclaren Medicaid |
$138.83
|
| Rate for Payer: Mclaren Medicare |
$259.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$271.96
|
| Rate for Payer: Meridian Medicaid |
$145.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$297.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.86
|
| Rate for Payer: Nomi Health Commercial |
$334.62
|
| Rate for Payer: PACE Medicare |
$246.06
|
| Rate for Payer: PACE SWMI |
$259.01
|
| Rate for Payer: PHP Commercial |
$284.91
|
| Rate for Payer: PHP Medicaid |
$138.83
|
| Rate for Payer: PHP Medicare Advantage |
$259.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.55
|
| Rate for Payer: Priority Health Medicare |
$259.01
|
| Rate for Payer: Priority Health Narrow Network |
$286.06
|
| Rate for Payer: Railroad Medicare Medicare |
$259.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$359.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$259.01
|
| Rate for Payer: UHC Exchange |
$401.47
|
| Rate for Payer: UHC Medicare Advantage |
$259.01
|
| Rate for Payer: UHCCP DNSP |
$259.01
|
| Rate for Payer: UHCCP Medicaid |
$138.83
|
| Rate for Payer: VA VA |
$259.01
|
|
|
HC CAST CYLINDER
|
Facility
|
IP
|
$408.07
|
|
|
Service Code
|
CPT 29365
|
| Hospital Charge Code |
70000006
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$265.25 |
| Max. Negotiated Rate |
$408.07 |
| Rate for Payer: Aetna Commercial |
$367.26
|
| Rate for Payer: ASR ASR |
$395.83
|
| Rate for Payer: ASR Commercial |
$395.83
|
| Rate for Payer: BCBS Trust/PPO |
$332.54
|
| Rate for Payer: BCN Commercial |
$316.38
|
| Rate for Payer: Cash Price |
$326.46
|
| Rate for Payer: Cofinity Commercial |
$383.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.46
|
| Rate for Payer: Healthscope Commercial |
$408.07
|
| Rate for Payer: Healthscope Whirlpool |
$395.83
|
| Rate for Payer: Mclaren Commercial |
$367.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.86
|
| Rate for Payer: Nomi Health Commercial |
$334.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$359.10
|
|
|
HC CAST FINGER (CONTRACTURE)
|
Facility
|
IP
|
$210.09
|
|
|
Service Code
|
CPT 29086
|
| Hospital Charge Code |
43000021
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$136.56 |
| Max. Negotiated Rate |
$210.09 |
| Rate for Payer: Aetna Commercial |
$189.08
|
| Rate for Payer: ASR ASR |
$203.79
|
| Rate for Payer: ASR Commercial |
$203.79
|
| Rate for Payer: BCBS Trust/PPO |
$171.20
|
| Rate for Payer: BCN Commercial |
$162.88
|
| Rate for Payer: Cash Price |
$168.07
|
| Rate for Payer: Cofinity Commercial |
$197.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.07
|
| Rate for Payer: Healthscope Commercial |
$210.09
|
| Rate for Payer: Healthscope Whirlpool |
$203.79
|
| Rate for Payer: Mclaren Commercial |
$189.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.58
|
| Rate for Payer: Nomi Health Commercial |
$172.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.88
|
|
|
HC CAST FINGER (CONTRACTURE)
|
Facility
|
OP
|
$210.09
|
|
|
Service Code
|
CPT 29086
|
| Hospital Charge Code |
43000021
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$82.49 |
| Max. Negotiated Rate |
$238.53 |
| Rate for Payer: Aetna Commercial |
$189.08
|
| Rate for Payer: Aetna Medicare |
$153.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$192.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$192.36
|
| Rate for Payer: ASR ASR |
$203.79
|
| Rate for Payer: ASR Commercial |
$203.79
|
| Rate for Payer: BCBS Complete |
$86.61
|
| Rate for Payer: BCBS MAPPO |
$153.89
|
| Rate for Payer: BCBS Trust/PPO |
$172.04
|
| Rate for Payer: BCN Commercial |
$162.88
|
| Rate for Payer: BCN Medicare Advantage |
$153.89
|
| Rate for Payer: Cash Price |
$168.07
|
| Rate for Payer: Cash Price |
$168.07
|
| Rate for Payer: Cofinity Commercial |
$197.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.89
|
| Rate for Payer: Healthscope Commercial |
$210.09
|
| Rate for Payer: Healthscope Whirlpool |
$203.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$153.89
|
| Rate for Payer: Mclaren Commercial |
$189.08
|
| Rate for Payer: Mclaren Medicaid |
$82.49
|
| Rate for Payer: Mclaren Medicare |
$153.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.58
|
| Rate for Payer: Meridian Medicaid |
$86.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.58
|
| Rate for Payer: Nomi Health Commercial |
$172.27
|
| Rate for Payer: PACE Medicare |
$146.20
|
| Rate for Payer: PACE SWMI |
$153.89
|
| Rate for Payer: PHP Commercial |
$169.28
|
| Rate for Payer: PHP Medicaid |
$82.49
|
| Rate for Payer: PHP Medicare Advantage |
$153.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.08
|
| Rate for Payer: Priority Health Medicare |
$153.89
|
| Rate for Payer: Priority Health Narrow Network |
$147.27
|
| Rate for Payer: Railroad Medicare Medicare |
$153.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.89
|
| Rate for Payer: UHC Exchange |
$238.53
|
| Rate for Payer: UHC Medicare Advantage |
$153.89
|
| Rate for Payer: UHCCP DNSP |
$153.89
|
| Rate for Payer: UHCCP Medicaid |
$82.49
|
| Rate for Payer: VA VA |
$153.89
|
|
|
HC CAST GAUNTLET
|
Facility
|
OP
|
$238.14
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
42100002
|
|
Hospital Revenue Code
|
421
|
| Min. Negotiated Rate |
$82.49 |
| Max. Negotiated Rate |
$238.53 |
| Rate for Payer: Aetna Commercial |
$214.33
|
| Rate for Payer: Aetna Medicare |
$153.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$192.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$192.36
|
| Rate for Payer: ASR ASR |
$231.00
|
| Rate for Payer: ASR Commercial |
$231.00
|
| Rate for Payer: BCBS Complete |
$86.61
|
| Rate for Payer: BCBS MAPPO |
$153.89
|
| Rate for Payer: BCBS Trust/PPO |
$195.01
|
| Rate for Payer: BCN Commercial |
$184.63
|
| Rate for Payer: BCN Medicare Advantage |
$153.89
|
| Rate for Payer: Cash Price |
$190.51
|
| Rate for Payer: Cash Price |
$190.51
|
| Rate for Payer: Cofinity Commercial |
$223.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.89
|
| Rate for Payer: Healthscope Commercial |
$238.14
|
| Rate for Payer: Healthscope Whirlpool |
$231.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$153.89
|
| Rate for Payer: Mclaren Commercial |
$214.33
|
| Rate for Payer: Mclaren Medicaid |
$82.49
|
| Rate for Payer: Mclaren Medicare |
$153.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.58
|
| Rate for Payer: Meridian Medicaid |
$86.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.42
|
| Rate for Payer: Nomi Health Commercial |
$195.27
|
| Rate for Payer: PACE Medicare |
$146.20
|
| Rate for Payer: PACE SWMI |
$153.89
|
| Rate for Payer: PHP Commercial |
$169.28
|
| Rate for Payer: PHP Medicaid |
$82.49
|
| Rate for Payer: PHP Medicare Advantage |
$153.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.66
|
| Rate for Payer: Priority Health Medicare |
$153.89
|
| Rate for Payer: Priority Health Narrow Network |
$166.94
|
| Rate for Payer: Railroad Medicare Medicare |
$153.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$209.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.89
|
| Rate for Payer: UHC Exchange |
$238.53
|
| Rate for Payer: UHC Medicare Advantage |
$153.89
|
| Rate for Payer: UHCCP DNSP |
$153.89
|
| Rate for Payer: UHCCP Medicaid |
$82.49
|
| Rate for Payer: VA VA |
$153.89
|
|
|
HC CAST GAUNTLET
|
Facility
|
IP
|
$238.14
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
42100002
|
|
Hospital Revenue Code
|
421
|
| Min. Negotiated Rate |
$154.79 |
| Max. Negotiated Rate |
$238.14 |
| Rate for Payer: Aetna Commercial |
$214.33
|
| Rate for Payer: ASR ASR |
$231.00
|
| Rate for Payer: ASR Commercial |
$231.00
|
| Rate for Payer: BCBS Trust/PPO |
$194.06
|
| Rate for Payer: BCN Commercial |
$184.63
|
| Rate for Payer: Cash Price |
$190.51
|
| Rate for Payer: Cofinity Commercial |
$223.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.51
|
| Rate for Payer: Healthscope Commercial |
$238.14
|
| Rate for Payer: Healthscope Whirlpool |
$231.00
|
| Rate for Payer: Mclaren Commercial |
$214.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.42
|
| Rate for Payer: Nomi Health Commercial |
$195.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$209.56
|
|
|
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 |
$138.83 |
| Max. Negotiated Rate |
$969.55 |
| Rate for Payer: Aetna Commercial |
$872.60
|
| Rate for Payer: Aetna Medicare |
$259.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$323.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$323.76
|
| Rate for Payer: ASR ASR |
$940.46
|
| Rate for Payer: ASR Commercial |
$940.46
|
| Rate for Payer: BCBS Complete |
$145.77
|
| Rate for Payer: BCBS MAPPO |
$259.01
|
| Rate for Payer: BCBS Trust/PPO |
$793.96
|
| Rate for Payer: BCN Commercial |
$751.69
|
| Rate for Payer: BCN Medicare Advantage |
$259.01
|
| 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 |
$259.01
|
| Rate for Payer: Healthscope Commercial |
$969.55
|
| Rate for Payer: Healthscope Whirlpool |
$940.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$259.01
|
| Rate for Payer: Mclaren Commercial |
$872.60
|
| Rate for Payer: Mclaren Medicaid |
$138.83
|
| Rate for Payer: Mclaren Medicare |
$259.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$271.96
|
| Rate for Payer: Meridian Medicaid |
$145.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$297.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$824.12
|
| Rate for Payer: Nomi Health Commercial |
$795.03
|
| Rate for Payer: PACE Medicare |
$246.06
|
| Rate for Payer: PACE SWMI |
$259.01
|
| Rate for Payer: PHP Commercial |
$284.91
|
| Rate for Payer: PHP Medicaid |
$138.83
|
| Rate for Payer: PHP Medicare Advantage |
$259.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.83
|
| 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 |
$259.01
|
| Rate for Payer: Priority Health Narrow Network |
$679.65
|
| Rate for Payer: Railroad Medicare Medicare |
$259.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$853.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$259.01
|
| Rate for Payer: UHC Exchange |
$401.47
|
| Rate for Payer: UHC Medicare Advantage |
$259.01
|
| Rate for Payer: UHCCP DNSP |
$259.01
|
| Rate for Payer: UHCCP Medicaid |
$138.83
|
| Rate for Payer: VA VA |
$259.01
|
|
|
HC CAST LONG ARM
|
Facility
|
OP
|
$341.68
|
|
|
Service Code
|
CPT 29065
|
| Hospital Charge Code |
42100001
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$138.83 |
| Max. Negotiated Rate |
$401.47 |
| Rate for Payer: Aetna Commercial |
$307.51
|
| Rate for Payer: Aetna Medicare |
$259.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$323.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$323.76
|
| Rate for Payer: ASR ASR |
$331.43
|
| Rate for Payer: ASR Commercial |
$331.43
|
| Rate for Payer: BCBS Complete |
$145.77
|
| Rate for Payer: BCBS MAPPO |
$259.01
|
| Rate for Payer: BCBS Trust/PPO |
$279.80
|
| Rate for Payer: BCN Commercial |
$264.90
|
| Rate for Payer: BCN Medicare Advantage |
$259.01
|
| 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 |
$259.01
|
| Rate for Payer: Healthscope Commercial |
$341.68
|
| Rate for Payer: Healthscope Whirlpool |
$331.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$259.01
|
| Rate for Payer: Mclaren Commercial |
$307.51
|
| Rate for Payer: Mclaren Medicaid |
$138.83
|
| Rate for Payer: Mclaren Medicare |
$259.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$271.96
|
| Rate for Payer: Meridian Medicaid |
$145.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$297.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$290.43
|
| Rate for Payer: Nomi Health Commercial |
$280.18
|
| Rate for Payer: PACE Medicare |
$246.06
|
| Rate for Payer: PACE SWMI |
$259.01
|
| Rate for Payer: PHP Commercial |
$284.91
|
| Rate for Payer: PHP Medicaid |
$138.83
|
| Rate for Payer: PHP Medicare Advantage |
$259.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.83
|
| 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 |
$259.01
|
| Rate for Payer: Priority Health Narrow Network |
$239.52
|
| Rate for Payer: Railroad Medicare Medicare |
$259.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$300.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$259.01
|
| Rate for Payer: UHC Exchange |
$401.47
|
| Rate for Payer: UHC Medicare Advantage |
$259.01
|
| Rate for Payer: UHCCP DNSP |
$259.01
|
| Rate for Payer: UHCCP Medicaid |
$138.83
|
| Rate for Payer: VA VA |
$259.01
|
|
|
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 LEG
|
Facility
|
OP
|
$411.68
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
70000005
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$138.83 |
| Max. Negotiated Rate |
$411.68 |
| Rate for Payer: Aetna Commercial |
$370.51
|
| Rate for Payer: Aetna Medicare |
$259.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$323.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$323.76
|
| Rate for Payer: ASR ASR |
$399.33
|
| Rate for Payer: ASR Commercial |
$399.33
|
| Rate for Payer: BCBS Complete |
$145.77
|
| Rate for Payer: BCBS MAPPO |
$259.01
|
| Rate for Payer: BCBS Trust/PPO |
$337.12
|
| Rate for Payer: BCN Commercial |
$319.18
|
| Rate for Payer: BCN Medicare Advantage |
$259.01
|
| 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 |
$259.01
|
| Rate for Payer: Healthscope Commercial |
$411.68
|
| Rate for Payer: Healthscope Whirlpool |
$399.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$259.01
|
| Rate for Payer: Mclaren Commercial |
$370.51
|
| Rate for Payer: Mclaren Medicaid |
$138.83
|
| Rate for Payer: Mclaren Medicare |
$259.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$271.96
|
| Rate for Payer: Meridian Medicaid |
$145.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$297.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$349.93
|
| Rate for Payer: Nomi Health Commercial |
$337.58
|
| Rate for Payer: PACE Medicare |
$246.06
|
| Rate for Payer: PACE SWMI |
$259.01
|
| Rate for Payer: PHP Commercial |
$284.91
|
| Rate for Payer: PHP Medicaid |
$138.83
|
| Rate for Payer: PHP Medicare Advantage |
$259.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.83
|
| 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 |
$259.01
|
| Rate for Payer: Priority Health Narrow Network |
$288.59
|
| Rate for Payer: Railroad Medicare Medicare |
$259.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$362.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$259.01
|
| Rate for Payer: UHC Exchange |
$401.47
|
| Rate for Payer: UHC Medicare Advantage |
$259.01
|
| Rate for Payer: UHCCP DNSP |
$259.01
|
| Rate for Payer: UHCCP Medicaid |
$138.83
|
| Rate for Payer: VA VA |
$259.01
|
|
|
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 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 PANTALOON
|
Facility
|
OP
|
$918.57
|
|
|
Service Code
|
CPT 29305
|
| Hospital Charge Code |
70000003
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$138.83 |
| Max. Negotiated Rate |
$918.57 |
| Rate for Payer: Aetna Commercial |
$826.71
|
| Rate for Payer: Aetna Medicare |
$259.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$323.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$323.76
|
| Rate for Payer: ASR ASR |
$891.01
|
| Rate for Payer: ASR Commercial |
$891.01
|
| Rate for Payer: BCBS Complete |
$145.77
|
| Rate for Payer: BCBS MAPPO |
$259.01
|
| Rate for Payer: BCBS Trust/PPO |
$752.22
|
| Rate for Payer: BCN Commercial |
$712.17
|
| Rate for Payer: BCN Medicare Advantage |
$259.01
|
| 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 |
$259.01
|
| Rate for Payer: Healthscope Commercial |
$918.57
|
| Rate for Payer: Healthscope Whirlpool |
$891.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$259.01
|
| Rate for Payer: Mclaren Commercial |
$826.71
|
| Rate for Payer: Mclaren Medicaid |
$138.83
|
| Rate for Payer: Mclaren Medicare |
$259.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$271.96
|
| Rate for Payer: Meridian Medicaid |
$145.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$297.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$780.78
|
| Rate for Payer: Nomi Health Commercial |
$753.23
|
| Rate for Payer: PACE Medicare |
$246.06
|
| Rate for Payer: PACE SWMI |
$259.01
|
| Rate for Payer: PHP Commercial |
$284.91
|
| Rate for Payer: PHP Medicaid |
$138.83
|
| Rate for Payer: PHP Medicare Advantage |
$259.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.83
|
| 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 |
$259.01
|
| Rate for Payer: Priority Health Narrow Network |
$643.92
|
| Rate for Payer: Railroad Medicare Medicare |
$259.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$808.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$259.01
|
| Rate for Payer: UHC Exchange |
$401.47
|
| Rate for Payer: UHC Medicare Advantage |
$259.01
|
| Rate for Payer: UHCCP DNSP |
$259.01
|
| Rate for Payer: UHCCP Medicaid |
$138.83
|
| Rate for Payer: VA VA |
$259.01
|
|
|
HC CAST PTB WALKING
|
Facility
|
OP
|
$411.68
|
|
|
Service Code
|
CPT 29435
|
| Hospital Charge Code |
70000009
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$138.83 |
| Max. Negotiated Rate |
$411.68 |
| Rate for Payer: Aetna Commercial |
$370.51
|
| Rate for Payer: Aetna Medicare |
$259.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$323.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$323.76
|
| Rate for Payer: ASR ASR |
$399.33
|
| Rate for Payer: ASR Commercial |
$399.33
|
| Rate for Payer: BCBS Complete |
$145.77
|
| Rate for Payer: BCBS MAPPO |
$259.01
|
| Rate for Payer: BCBS Trust/PPO |
$337.12
|
| Rate for Payer: BCN Commercial |
$319.18
|
| Rate for Payer: BCN Medicare Advantage |
$259.01
|
| 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 |
$259.01
|
| Rate for Payer: Healthscope Commercial |
$411.68
|
| Rate for Payer: Healthscope Whirlpool |
$399.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$259.01
|
| Rate for Payer: Mclaren Commercial |
$370.51
|
| Rate for Payer: Mclaren Medicaid |
$138.83
|
| Rate for Payer: Mclaren Medicare |
$259.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$271.96
|
| Rate for Payer: Meridian Medicaid |
$145.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$297.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$349.93
|
| Rate for Payer: Nomi Health Commercial |
$337.58
|
| Rate for Payer: PACE Medicare |
$246.06
|
| Rate for Payer: PACE SWMI |
$259.01
|
| Rate for Payer: PHP Commercial |
$284.91
|
| Rate for Payer: PHP Medicaid |
$138.83
|
| Rate for Payer: PHP Medicare Advantage |
$259.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.83
|
| 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 |
$259.01
|
| Rate for Payer: Priority Health Narrow Network |
$288.59
|
| Rate for Payer: Railroad Medicare Medicare |
$259.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$362.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$259.01
|
| Rate for Payer: UHC Exchange |
$401.47
|
| Rate for Payer: UHC Medicare Advantage |
$259.01
|
| Rate for Payer: UHCCP DNSP |
$259.01
|
| Rate for Payer: UHCCP Medicaid |
$138.83
|
| Rate for Payer: VA VA |
$259.01
|
|
|
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
|
|
