Bronson South Haven Hospital

All Charges

Charge

Type

Setting

Price

HC CAST SUP LNG ARM SPLINT ADULT FBRGLS

Facility

$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

HC CAST SUP LNG ARM SPLINT ADULT PLST

Facility

$43.00

Hospital Charge Code	27200392
Hospital Revenue Code	270
Min. Negotiated Rate	$17.20
Max. Negotiated Rate	$43.00
Rate for Payer: Aetna Commercial	$38.70
Rate for Payer: Aetna Medicare	$21.50
Rate for Payer: ASR ASR	$41.71
Rate for Payer: ASR Commercial	$41.71
Rate for Payer: BCBS Complete	$17.20
Rate for Payer: BCBS Trust/PPO	$35.21
Rate for Payer: BCN Commercial	$33.34
Rate for Payer: Cash Price	$34.40
Rate for Payer: Cofinity Commercial	$40.42
Rate for Payer: Encore Health Key Benefits Commercial	$34.40
Rate for Payer: Healthscope Commercial	$43.00
Rate for Payer: Healthscope Whirlpool	$41.71
Rate for Payer: Mclaren Commercial	$38.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$36.55
Rate for Payer: Nomi Health Commercial	$35.26
Rate for Payer: Priority Health Cigna Priority Health	$27.95
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$37.68
Rate for Payer: Priority Health Narrow Network	$30.14
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$37.84

HC CAST SUP LNG ARM SPLINT ADULT PLST

Facility

$43.00

Hospital Charge Code	27200392
Hospital Revenue Code	270
Min. Negotiated Rate	$27.95
Max. Negotiated Rate	$43.00
Rate for Payer: Aetna Commercial	$38.70
Rate for Payer: ASR ASR	$41.71
Rate for Payer: ASR Commercial	$41.71
Rate for Payer: BCBS Trust/PPO	$35.04
Rate for Payer: BCN Commercial	$33.34
Rate for Payer: Cash Price	$34.40
Rate for Payer: Cofinity Commercial	$40.42
Rate for Payer: Encore Health Key Benefits Commercial	$34.40
Rate for Payer: Healthscope Commercial	$43.00
Rate for Payer: Healthscope Whirlpool	$41.71
Rate for Payer: Mclaren Commercial	$38.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$36.55
Rate for Payer: Nomi Health Commercial	$35.26
Rate for Payer: Priority Health Cigna Priority Health	$27.95
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$37.84

HC CAST SUP LNG ARM SPLNT PED FBRGLS

Facility

$24.97

Hospital Charge Code	27200333
Hospital Revenue Code	270
Min. Negotiated Rate	$9.99
Max. Negotiated Rate	$24.97
Rate for Payer: Aetna Commercial	$22.47
Rate for Payer: Aetna Medicare	$12.48
Rate for Payer: ASR ASR	$24.22
Rate for Payer: ASR Commercial	$24.22
Rate for Payer: BCBS Complete	$9.99
Rate for Payer: BCBS Trust/PPO	$20.45
Rate for Payer: BCN Commercial	$19.36
Rate for Payer: Cash Price	$19.98
Rate for Payer: Cofinity Commercial	$23.47
Rate for Payer: Encore Health Key Benefits Commercial	$19.98
Rate for Payer: Healthscope Commercial	$24.97
Rate for Payer: Healthscope Whirlpool	$24.22
Rate for Payer: Mclaren Commercial	$22.47
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$21.22
Rate for Payer: Nomi Health Commercial	$20.48
Rate for Payer: Priority Health Cigna Priority Health	$16.23
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$21.88
Rate for Payer: Priority Health Narrow Network	$17.50
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$21.97

HC CAST SUP LNG ARM SPLNT PED FBRGLS

Facility

$24.97

Hospital Charge Code	27200333
Hospital Revenue Code	270
Min. Negotiated Rate	$16.23
Max. Negotiated Rate	$24.97
Rate for Payer: Aetna Commercial	$22.47
Rate for Payer: ASR ASR	$24.22
Rate for Payer: ASR Commercial	$24.22
Rate for Payer: BCBS Trust/PPO	$20.35
Rate for Payer: BCN Commercial	$19.36
Rate for Payer: Cash Price	$19.98
Rate for Payer: Cofinity Commercial	$23.47
Rate for Payer: Encore Health Key Benefits Commercial	$19.98
Rate for Payer: Healthscope Commercial	$24.97
Rate for Payer: Healthscope Whirlpool	$24.22
Rate for Payer: Mclaren Commercial	$22.47
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$21.22
Rate for Payer: Nomi Health Commercial	$20.48
Rate for Payer: Priority Health Cigna Priority Health	$16.23
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$21.97

HC CAST SUP LNG LEG ADULT FBRGLS

Facility

$118.61

Hospital Charge Code	27200336
Hospital Revenue Code	270
Min. Negotiated Rate	$77.10
Max. Negotiated Rate	$118.61
Rate for Payer: Aetna Commercial	$106.75
Rate for Payer: ASR ASR	$115.05
Rate for Payer: ASR Commercial	$115.05
Rate for Payer: BCBS Trust/PPO	$96.66
Rate for Payer: BCN Commercial	$91.96
Rate for Payer: Cash Price	$94.89
Rate for Payer: Cofinity Commercial	$111.49
Rate for Payer: Encore Health Key Benefits Commercial	$94.89
Rate for Payer: Healthscope Commercial	$118.61
Rate for Payer: Healthscope Whirlpool	$115.05
Rate for Payer: Mclaren Commercial	$106.75
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$100.82
Rate for Payer: Nomi Health Commercial	$97.26
Rate for Payer: Priority Health Cigna Priority Health	$77.10
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$104.38

HC CAST SUP LNG LEG ADULT FBRGLS

Facility

$118.61

Hospital Charge Code	27200336
Hospital Revenue Code	270
Min. Negotiated Rate	$47.44
Max. Negotiated Rate	$118.61
Rate for Payer: Aetna Commercial	$106.75
Rate for Payer: Aetna Medicare	$59.30
Rate for Payer: ASR ASR	$115.05
Rate for Payer: ASR Commercial	$115.05
Rate for Payer: BCBS Complete	$47.44
Rate for Payer: BCBS Trust/PPO	$97.13
Rate for Payer: BCN Commercial	$91.96
Rate for Payer: Cash Price	$94.89
Rate for Payer: Cofinity Commercial	$111.49
Rate for Payer: Encore Health Key Benefits Commercial	$94.89
Rate for Payer: Healthscope Commercial	$118.61
Rate for Payer: Healthscope Whirlpool	$115.05
Rate for Payer: Mclaren Commercial	$106.75
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$100.82
Rate for Payer: Nomi Health Commercial	$97.26
Rate for Payer: Priority Health Cigna Priority Health	$77.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$103.93
Rate for Payer: Priority Health Narrow Network	$83.15
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$104.38

HC CAST SUP LNG LEG CYLNDR PED FBRGLS

Facility

$52.02

Hospital Charge Code	27200338
Hospital Revenue Code	270
Min. Negotiated Rate	$20.81
Max. Negotiated Rate	$52.02
Rate for Payer: Aetna Commercial	$46.82
Rate for Payer: Aetna Medicare	$26.01
Rate for Payer: ASR ASR	$50.46
Rate for Payer: ASR Commercial	$50.46
Rate for Payer: BCBS Complete	$20.81
Rate for Payer: BCBS Trust/PPO	$42.60
Rate for Payer: BCN Commercial	$40.33
Rate for Payer: Cash Price	$41.62
Rate for Payer: Cofinity Commercial	$48.90
Rate for Payer: Encore Health Key Benefits Commercial	$41.62
Rate for Payer: Healthscope Commercial	$52.02
Rate for Payer: Healthscope Whirlpool	$50.46
Rate for Payer: Mclaren Commercial	$46.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$44.22
Rate for Payer: Nomi Health Commercial	$42.66
Rate for Payer: Priority Health Cigna Priority Health	$33.81
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$45.58
Rate for Payer: Priority Health Narrow Network	$36.47
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$45.78

HC CAST SUP LNG LEG CYLNDR PED FBRGLS

Facility

$52.02

Hospital Charge Code	27200338
Hospital Revenue Code	270
Min. Negotiated Rate	$33.81
Max. Negotiated Rate	$52.02
Rate for Payer: Aetna Commercial	$46.82
Rate for Payer: ASR ASR	$50.46
Rate for Payer: ASR Commercial	$50.46
Rate for Payer: BCBS Trust/PPO	$42.39
Rate for Payer: BCN Commercial	$40.33
Rate for Payer: Cash Price	$41.62
Rate for Payer: Cofinity Commercial	$48.90
Rate for Payer: Encore Health Key Benefits Commercial	$41.62
Rate for Payer: Healthscope Commercial	$52.02
Rate for Payer: Healthscope Whirlpool	$50.46
Rate for Payer: Mclaren Commercial	$46.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$44.22
Rate for Payer: Nomi Health Commercial	$42.66
Rate for Payer: Priority Health Cigna Priority Health	$33.81
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$45.78

HC CAST SUP LNG LEG PED FBRGLS

Facility

$54.10

Hospital Charge Code	27200337
Hospital Revenue Code	270
Min. Negotiated Rate	$21.64
Max. Negotiated Rate	$54.10
Rate for Payer: Aetna Commercial	$48.69
Rate for Payer: Aetna Medicare	$27.05
Rate for Payer: ASR ASR	$52.48
Rate for Payer: ASR Commercial	$52.48
Rate for Payer: BCBS Complete	$21.64
Rate for Payer: BCBS Trust/PPO	$44.30
Rate for Payer: BCN Commercial	$41.94
Rate for Payer: Cash Price	$43.28
Rate for Payer: Cofinity Commercial	$50.85
Rate for Payer: Encore Health Key Benefits Commercial	$43.28
Rate for Payer: Healthscope Commercial	$54.10
Rate for Payer: Healthscope Whirlpool	$52.48
Rate for Payer: Mclaren Commercial	$48.69
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$45.98
Rate for Payer: Nomi Health Commercial	$44.36
Rate for Payer: Priority Health Cigna Priority Health	$35.16
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$47.40
Rate for Payer: Priority Health Narrow Network	$37.92
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$47.61

HC CAST SUP LNG LEG PED FBRGLS

Facility

$54.10

Hospital Charge Code	27200337
Hospital Revenue Code	270
Min. Negotiated Rate	$35.16
Max. Negotiated Rate	$54.10
Rate for Payer: Aetna Commercial	$48.69
Rate for Payer: ASR ASR	$52.48
Rate for Payer: ASR Commercial	$52.48
Rate for Payer: BCBS Trust/PPO	$44.09
Rate for Payer: BCN Commercial	$41.94
Rate for Payer: Cash Price	$43.28
Rate for Payer: Cofinity Commercial	$50.85
Rate for Payer: Encore Health Key Benefits Commercial	$43.28
Rate for Payer: Healthscope Commercial	$54.10
Rate for Payer: Healthscope Whirlpool	$52.48
Rate for Payer: Mclaren Commercial	$48.69
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$45.98
Rate for Payer: Nomi Health Commercial	$44.36
Rate for Payer: Priority Health Cigna Priority Health	$35.16
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$47.61

HC CAST SUP LNG LEG SPLINT ADULT FBRGLS

Facility

$76.50

Hospital Charge Code	27200381
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	$65.02
Rate for Payer: Nomi Health Commercial	$62.73
Rate for Payer: Priority Health Cigna Priority Health	$49.72
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 SUP LNG LEG SPLINT ADULT FBRGLS

Facility

$76.50

Hospital Charge Code	27200381
Hospital Revenue Code	270
Min. Negotiated Rate	$49.72
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	$65.02
Rate for Payer: Nomi Health Commercial	$62.73
Rate for Payer: Priority Health Cigna Priority Health	$49.72
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$67.32

HC CAST SUP LNG LEG SPLINT PED FBRGLS

Facility

$38.76

Hospital Charge Code	27200382
Hospital Revenue Code	270
Min. Negotiated Rate	$15.50
Max. Negotiated Rate	$38.76
Rate for Payer: Aetna Commercial	$34.88
Rate for Payer: Aetna Medicare	$19.38
Rate for Payer: ASR ASR	$37.60
Rate for Payer: ASR Commercial	$37.60
Rate for Payer: BCBS Complete	$15.50
Rate for Payer: BCBS Trust/PPO	$31.74
Rate for Payer: BCN Commercial	$30.05
Rate for Payer: Cash Price	$31.01
Rate for Payer: Cofinity Commercial	$36.43
Rate for Payer: Encore Health Key Benefits Commercial	$31.01
Rate for Payer: Healthscope Commercial	$38.76
Rate for Payer: Healthscope Whirlpool	$37.60
Rate for Payer: Mclaren Commercial	$34.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$32.95
Rate for Payer: Nomi Health Commercial	$31.78
Rate for Payer: Priority Health Cigna Priority Health	$25.19
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$33.96
Rate for Payer: Priority Health Narrow Network	$27.17
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$34.11

HC CAST SUP LNG LEG SPLINT PED FBRGLS

Facility

$38.76

Hospital Charge Code	27200382
Hospital Revenue Code	270
Min. Negotiated Rate	$25.19
Max. Negotiated Rate	$38.76
Rate for Payer: Aetna Commercial	$34.88
Rate for Payer: ASR ASR	$37.60
Rate for Payer: ASR Commercial	$37.60
Rate for Payer: BCBS Trust/PPO	$31.59
Rate for Payer: BCN Commercial	$30.05
Rate for Payer: Cash Price	$31.01
Rate for Payer: Cofinity Commercial	$36.43
Rate for Payer: Encore Health Key Benefits Commercial	$31.01
Rate for Payer: Healthscope Commercial	$38.76
Rate for Payer: Healthscope Whirlpool	$37.60
Rate for Payer: Mclaren Commercial	$34.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$32.95
Rate for Payer: Nomi Health Commercial	$31.78
Rate for Payer: Priority Health Cigna Priority Health	$25.19
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$34.11

HC CAST SUPPLIES UNLISTED

Facility

$104.04

Hospital Charge Code	27200343
Hospital Revenue Code	270
Min. Negotiated Rate	$67.63
Max. Negotiated Rate	$104.04
Rate for Payer: Aetna Commercial	$93.64
Rate for Payer: ASR ASR	$100.92
Rate for Payer: ASR Commercial	$100.92
Rate for Payer: BCBS Trust/PPO	$84.78
Rate for Payer: BCN Commercial	$80.66
Rate for Payer: Cash Price	$83.23
Rate for Payer: Cofinity Commercial	$97.80
Rate for Payer: Encore Health Key Benefits Commercial	$83.23
Rate for Payer: Healthscope Commercial	$104.04
Rate for Payer: Healthscope Whirlpool	$100.92
Rate for Payer: Mclaren Commercial	$93.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$88.43
Rate for Payer: Nomi Health Commercial	$85.31
Rate for Payer: Priority Health Cigna Priority Health	$67.63
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$91.56

HC CAST SUPPLIES UNLISTED

Facility

$104.04

Hospital Charge Code	27200343
Hospital Revenue Code	270
Min. Negotiated Rate	$41.62
Max. Negotiated Rate	$104.04
Rate for Payer: Aetna Commercial	$93.64
Rate for Payer: Aetna Medicare	$52.02
Rate for Payer: ASR ASR	$100.92
Rate for Payer: ASR Commercial	$100.92
Rate for Payer: BCBS Complete	$41.62
Rate for Payer: BCBS Trust/PPO	$85.20
Rate for Payer: BCN Commercial	$80.66
Rate for Payer: Cash Price	$83.23
Rate for Payer: Cofinity Commercial	$97.80
Rate for Payer: Encore Health Key Benefits Commercial	$83.23
Rate for Payer: Healthscope Commercial	$104.04
Rate for Payer: Healthscope Whirlpool	$100.92
Rate for Payer: Mclaren Commercial	$93.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$88.43
Rate for Payer: Nomi Health Commercial	$85.31
Rate for Payer: Priority Health Cigna Priority Health	$67.63
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$91.16
Rate for Payer: Priority Health Narrow Network	$72.93
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$91.56

HC CAST SUP SHRT LEG ADULT FBRGLS

Facility

$62.42

Hospital Charge Code	27200339
Hospital Revenue Code	270
Min. Negotiated Rate	$40.57
Max. Negotiated Rate	$62.42
Rate for Payer: Aetna Commercial	$56.18
Rate for Payer: ASR ASR	$60.55
Rate for Payer: ASR Commercial	$60.55
Rate for Payer: BCBS Trust/PPO	$50.87
Rate for Payer: BCN Commercial	$48.39
Rate for Payer: Cash Price	$49.94
Rate for Payer: Cofinity Commercial	$58.67
Rate for Payer: Encore Health Key Benefits Commercial	$49.94
Rate for Payer: Healthscope Commercial	$62.42
Rate for Payer: Healthscope Whirlpool	$60.55
Rate for Payer: Mclaren Commercial	$56.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$53.06
Rate for Payer: Nomi Health Commercial	$51.18
Rate for Payer: Priority Health Cigna Priority Health	$40.57
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$54.93

HC CAST SUP SHRT LEG ADULT FBRGLS

Facility

$62.42

Hospital Charge Code	27200339
Hospital Revenue Code	270
Min. Negotiated Rate	$24.97
Max. Negotiated Rate	$62.42
Rate for Payer: Aetna Commercial	$56.18
Rate for Payer: Aetna Medicare	$31.21
Rate for Payer: ASR ASR	$60.55
Rate for Payer: ASR Commercial	$60.55
Rate for Payer: BCBS Complete	$24.97
Rate for Payer: BCBS Trust/PPO	$51.12
Rate for Payer: BCN Commercial	$48.39
Rate for Payer: Cash Price	$49.94
Rate for Payer: Cofinity Commercial	$58.67
Rate for Payer: Encore Health Key Benefits Commercial	$49.94
Rate for Payer: Healthscope Commercial	$62.42
Rate for Payer: Healthscope Whirlpool	$60.55
Rate for Payer: Mclaren Commercial	$56.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$53.06
Rate for Payer: Nomi Health Commercial	$51.18
Rate for Payer: Priority Health Cigna Priority Health	$40.57
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$54.69
Rate for Payer: Priority Health Narrow Network	$43.76
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$54.93

HC CAST SUP SHRT LEG PED FBRGLS

Facility

$21.85

Hospital Charge Code	27200340
Hospital Revenue Code	270
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$21.85
Rate for Payer: Aetna Commercial	$19.66
Rate for Payer: ASR ASR	$21.19
Rate for Payer: ASR Commercial	$21.19
Rate for Payer: BCBS Trust/PPO	$17.81
Rate for Payer: BCN Commercial	$16.94
Rate for Payer: Cash Price	$17.48
Rate for Payer: Cofinity Commercial	$20.54
Rate for Payer: Encore Health Key Benefits Commercial	$17.48
Rate for Payer: Healthscope Commercial	$21.85
Rate for Payer: Healthscope Whirlpool	$21.19
Rate for Payer: Mclaren Commercial	$19.66
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$18.57
Rate for Payer: Nomi Health Commercial	$17.92
Rate for Payer: Priority Health Cigna Priority Health	$14.20
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$19.23

HC CAST SUP SHRT LEG PED FBRGLS

Facility

$21.85

Hospital Charge Code	27200340
Hospital Revenue Code	270
Min. Negotiated Rate	$8.74
Max. Negotiated Rate	$21.85
Rate for Payer: Aetna Commercial	$19.66
Rate for Payer: Aetna Medicare	$10.92
Rate for Payer: ASR ASR	$21.19
Rate for Payer: ASR Commercial	$21.19
Rate for Payer: BCBS Complete	$8.74
Rate for Payer: BCBS Trust/PPO	$17.89
Rate for Payer: BCN Commercial	$16.94
Rate for Payer: Cash Price	$17.48
Rate for Payer: Cofinity Commercial	$20.54
Rate for Payer: Encore Health Key Benefits Commercial	$17.48
Rate for Payer: Healthscope Commercial	$21.85
Rate for Payer: Healthscope Whirlpool	$21.19
Rate for Payer: Mclaren Commercial	$19.66
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$18.57
Rate for Payer: Nomi Health Commercial	$17.92
Rate for Payer: Priority Health Cigna Priority Health	$14.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$19.14
Rate for Payer: Priority Health Narrow Network	$15.32
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$19.23

HC CAST SUP SHT ARM ADULT FBRGLS

Facility

$43.70

Hospital Charge Code	27200329
Hospital Revenue Code	270
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$43.70
Rate for Payer: Aetna Commercial	$39.33
Rate for Payer: ASR ASR	$42.39
Rate for Payer: ASR Commercial	$42.39
Rate for Payer: BCBS Trust/PPO	$35.61
Rate for Payer: BCN Commercial	$33.88
Rate for Payer: Cash Price	$34.96
Rate for Payer: Cofinity Commercial	$41.08
Rate for Payer: Encore Health Key Benefits Commercial	$34.96
Rate for Payer: Healthscope Commercial	$43.70
Rate for Payer: Healthscope Whirlpool	$42.39
Rate for Payer: Mclaren Commercial	$39.33
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$37.14
Rate for Payer: Nomi Health Commercial	$35.83
Rate for Payer: Priority Health Cigna Priority Health	$28.40
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$38.46

HC CAST SUP SHT ARM ADULT FBRGLS

Facility

$43.70

Hospital Charge Code	27200329
Hospital Revenue Code	270
Min. Negotiated Rate	$17.48
Max. Negotiated Rate	$43.70
Rate for Payer: Aetna Commercial	$39.33
Rate for Payer: Aetna Medicare	$21.85
Rate for Payer: ASR ASR	$42.39
Rate for Payer: ASR Commercial	$42.39
Rate for Payer: BCBS Complete	$17.48
Rate for Payer: BCBS Trust/PPO	$35.79
Rate for Payer: BCN Commercial	$33.88
Rate for Payer: Cash Price	$34.96
Rate for Payer: Cofinity Commercial	$41.08
Rate for Payer: Encore Health Key Benefits Commercial	$34.96
Rate for Payer: Healthscope Commercial	$43.70
Rate for Payer: Healthscope Whirlpool	$42.39
Rate for Payer: Mclaren Commercial	$39.33
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$37.14
Rate for Payer: Nomi Health Commercial	$35.83
Rate for Payer: Priority Health Cigna Priority Health	$28.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$38.29
Rate for Payer: Priority Health Narrow Network	$30.63
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$38.46

HC CAST SUP SHT ARM PED FBRGLS

Facility

$20.81

Hospital Charge Code	27200330
Hospital Revenue Code	270
Min. Negotiated Rate	$13.53
Max. Negotiated Rate	$20.81
Rate for Payer: Aetna Commercial	$18.73
Rate for Payer: ASR ASR	$20.19
Rate for Payer: ASR Commercial	$20.19
Rate for Payer: BCBS Trust/PPO	$16.96
Rate for Payer: BCN Commercial	$16.13
Rate for Payer: Cash Price	$16.65
Rate for Payer: Cofinity Commercial	$19.56
Rate for Payer: Encore Health Key Benefits Commercial	$16.65
Rate for Payer: Healthscope Commercial	$20.81
Rate for Payer: Healthscope Whirlpool	$20.19
Rate for Payer: Mclaren Commercial	$18.73
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$17.69
Rate for Payer: Nomi Health Commercial	$17.06
Rate for Payer: Priority Health Cigna Priority Health	$13.53
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$18.31

HC CAST SUP SHT ARM PED FBRGLS

Facility

$20.81

Hospital Charge Code	27200330
Hospital Revenue Code	270
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$20.81
Rate for Payer: Aetna Commercial	$18.73
Rate for Payer: Aetna Medicare	$10.40
Rate for Payer: ASR ASR	$20.19
Rate for Payer: ASR Commercial	$20.19
Rate for Payer: BCBS Complete	$8.32
Rate for Payer: BCBS Trust/PPO	$17.04
Rate for Payer: BCN Commercial	$16.13
Rate for Payer: Cash Price	$16.65
Rate for Payer: Cofinity Commercial	$19.56
Rate for Payer: Encore Health Key Benefits Commercial	$16.65
Rate for Payer: Healthscope Commercial	$20.81
Rate for Payer: Healthscope Whirlpool	$20.19
Rate for Payer: Mclaren Commercial	$18.73
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$17.69
Rate for Payer: Nomi Health Commercial	$17.06
Rate for Payer: Priority Health Cigna Priority Health	$13.53
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$18.23
Rate for Payer: Priority Health Narrow Network	$14.59
Rate for Payer: UHC All Payor (Choice/PPO) + Core	$18.31

Know your out-of-pocket cost for care.

All Charges