|
HC CAST SUP LNG LEG PED FBRGLS
|
Facility
|
OP
|
$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 SPLINT ADULT FBRGLS
|
Facility
|
OP
|
$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 |
$65.03
|
| 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 SUP LNG LEG SPLINT ADULT FBRGLS
|
Facility
|
IP
|
$76.50
|
|
| Hospital Charge Code |
27200381
|
|
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 CAST SUP LNG LEG SPLINT PED FBRGLS
|
Facility
|
IP
|
$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 SUP LNG LEG SPLINT PED FBRGLS
|
Facility
|
OP
|
$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 SUPPLIES UNLISTED
|
Facility
|
OP
|
$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 SUPPLIES UNLISTED
|
Facility
|
IP
|
$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 SUP SHRT LEG ADULT FBRGLS
|
Facility
|
OP
|
$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 ADULT FBRGLS
|
Facility
|
IP
|
$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 PED FBRGLS
|
Facility
|
OP
|
$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 |
$10.93
|
| 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 SHRT LEG PED FBRGLS
|
Facility
|
IP
|
$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 SHT ARM ADULT FBRGLS
|
Facility
|
IP
|
$43.70
|
|
| Hospital Charge Code |
27200329
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.41 |
| 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 |
$37.15
|
| Rate for Payer: Nomi Health Commercial |
$35.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.46
|
|
|
HC CAST SUP SHT ARM ADULT FBRGLS
|
Facility
|
OP
|
$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 |
$37.15
|
| Rate for Payer: Nomi Health Commercial |
$35.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.41
|
| 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
|
OP
|
$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
|
|
|
HC CAST SUP SHT ARM PED FBRGLS
|
Facility
|
IP
|
$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 SPLINT ADULT FBRGLS
|
Facility
|
OP
|
$26.01
|
|
| Hospital Charge Code |
27200334
|
|
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 |
$13.01
|
| 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 SHT ARM SPLINT ADULT FBRGLS
|
Facility
|
IP
|
$26.01
|
|
| Hospital Charge Code |
27200334
|
|
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 SHT ARM SPLINT ADULT PLST
|
Facility
|
IP
|
$10.00
|
|
| Hospital Charge Code |
27200359
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$10.00 |
| Rate for Payer: Aetna Commercial |
$9.00
|
| Rate for Payer: ASR ASR |
$9.70
|
| Rate for Payer: ASR Commercial |
$9.70
|
| Rate for Payer: BCBS Trust/PPO |
$8.15
|
| Rate for Payer: BCN Commercial |
$7.75
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$9.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.00
|
| Rate for Payer: Healthscope Commercial |
$10.00
|
| Rate for Payer: Healthscope Whirlpool |
$9.70
|
| Rate for Payer: Mclaren Commercial |
$9.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.50
|
| Rate for Payer: Nomi Health Commercial |
$8.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8.80
|
|
|
HC CAST SUP SHT ARM SPLINT ADULT PLST
|
Facility
|
OP
|
$10.00
|
|
| Hospital Charge Code |
27200359
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$10.00 |
| Rate for Payer: Aetna Commercial |
$9.00
|
| Rate for Payer: Aetna Medicare |
$5.00
|
| Rate for Payer: ASR ASR |
$9.70
|
| Rate for Payer: ASR Commercial |
$9.70
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS Trust/PPO |
$8.19
|
| Rate for Payer: BCN Commercial |
$7.75
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$9.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.00
|
| Rate for Payer: Healthscope Commercial |
$10.00
|
| Rate for Payer: Healthscope Whirlpool |
$9.70
|
| Rate for Payer: Mclaren Commercial |
$9.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.50
|
| Rate for Payer: Nomi Health Commercial |
$8.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.76
|
| Rate for Payer: Priority Health Narrow Network |
$7.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8.80
|
|
|
HC CAST SUP SHT ARM SPLINT PED FBRGLS
|
Facility
|
OP
|
$28.09
|
|
| Hospital Charge Code |
27200335
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.24 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$25.28
|
| Rate for Payer: Aetna Medicare |
$14.04
|
| Rate for Payer: ASR ASR |
$27.25
|
| Rate for Payer: ASR Commercial |
$27.25
|
| Rate for Payer: BCBS Complete |
$11.24
|
| Rate for Payer: BCBS Trust/PPO |
$23.00
|
| Rate for Payer: BCN Commercial |
$21.78
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cofinity Commercial |
$26.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.47
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Healthscope Whirlpool |
$27.25
|
| Rate for Payer: Mclaren Commercial |
$25.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.88
|
| Rate for Payer: Nomi Health Commercial |
$23.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.61
|
| Rate for Payer: Priority Health Narrow Network |
$19.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.72
|
|
|
HC CAST SUP SHT ARM SPLINT PED FBRGLS
|
Facility
|
IP
|
$28.09
|
|
| Hospital Charge Code |
27200335
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.26 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$25.28
|
| Rate for Payer: ASR ASR |
$27.25
|
| Rate for Payer: ASR Commercial |
$27.25
|
| Rate for Payer: BCBS Trust/PPO |
$22.89
|
| Rate for Payer: BCN Commercial |
$21.78
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cofinity Commercial |
$26.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.47
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Healthscope Whirlpool |
$27.25
|
| Rate for Payer: Mclaren Commercial |
$25.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.88
|
| Rate for Payer: Nomi Health Commercial |
$23.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.72
|
|
|
HC CAST SUP SHT GAUNTLET FBRGLS
|
Facility
|
OP
|
$57.22
|
|
| Hospital Charge Code |
27200331
|
|
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 SHT GAUNTLET FBRGLS
|
Facility
|
IP
|
$57.22
|
|
| Hospital Charge Code |
27200331
|
|
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 SHT LEG SPLINT ADULT FBRGLS
|
Facility
|
IP
|
$31.21
|
|
| Hospital Charge Code |
27200341
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.29 |
| Max. Negotiated Rate |
$31.21 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: ASR ASR |
$30.27
|
| Rate for Payer: ASR Commercial |
$30.27
|
| Rate for Payer: BCBS Trust/PPO |
$25.43
|
| Rate for Payer: BCN Commercial |
$24.20
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$29.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$31.21
|
| Rate for Payer: Healthscope Whirlpool |
$30.27
|
| Rate for Payer: Mclaren Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.46
|
|
|
HC CAST SUP SHT LEG SPLINT ADULT FBRGLS
|
Facility
|
OP
|
$31.21
|
|
| Hospital Charge Code |
27200341
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.48 |
| Max. Negotiated Rate |
$31.21 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: Aetna Medicare |
$15.61
|
| Rate for Payer: ASR ASR |
$30.27
|
| Rate for Payer: ASR Commercial |
$30.27
|
| Rate for Payer: BCBS Complete |
$12.48
|
| Rate for Payer: BCBS Trust/PPO |
$25.56
|
| Rate for Payer: BCN Commercial |
$24.20
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$29.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$31.21
|
| Rate for Payer: Healthscope Whirlpool |
$30.27
|
| Rate for Payer: Mclaren Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.35
|
| Rate for Payer: Priority Health Narrow Network |
$21.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.46
|
|
