|
HC CLOSED RX TIBIAL PLATEAU FX
|
Facility
|
OP
|
$351.28
|
|
|
Service Code
|
CPT 27530
|
| Hospital Charge Code |
76100172
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.98 |
| Max. Negotiated Rate |
$364.30 |
| Rate for Payer: Aetna Commercial |
$316.15
|
| Rate for Payer: Aetna Medicare |
$235.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: ASR ASR |
$340.74
|
| Rate for Payer: ASR Commercial |
$340.74
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$287.66
|
| Rate for Payer: BCN Commercial |
$272.35
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cash Price |
$281.02
|
| Rate for Payer: Cofinity Commercial |
$330.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$351.28
|
| Rate for Payer: Healthscope Whirlpool |
$340.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.03
|
| Rate for Payer: Mclaren Commercial |
$316.15
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.59
|
| Rate for Payer: Nomi Health Commercial |
$288.05
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$258.53
|
| Rate for Payer: PHP Medicaid |
$125.98
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.79
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$246.25
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$309.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$364.30
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP DNSP |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: VA VA |
$235.03
|
|
|
HC CLOSED RX TIBIA SHAFT FX
|
Facility
|
IP
|
$386.41
|
|
|
Service Code
|
CPT 27750
|
| Hospital Charge Code |
76100173
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$251.17 |
| Max. Negotiated Rate |
$386.41 |
| Rate for Payer: Aetna Commercial |
$347.77
|
| Rate for Payer: ASR ASR |
$374.82
|
| Rate for Payer: ASR Commercial |
$374.82
|
| Rate for Payer: BCBS Trust/PPO |
$314.89
|
| Rate for Payer: BCN Commercial |
$299.58
|
| Rate for Payer: Cash Price |
$309.13
|
| Rate for Payer: Cofinity Commercial |
$363.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$309.13
|
| Rate for Payer: Healthscope Commercial |
$386.41
|
| Rate for Payer: Healthscope Whirlpool |
$374.82
|
| Rate for Payer: Mclaren Commercial |
$347.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.45
|
| Rate for Payer: Nomi Health Commercial |
$316.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$340.04
|
|
|
HC CLOSED RX TIBIA SHAFT FX
|
Facility
|
OP
|
$386.41
|
|
|
Service Code
|
CPT 27750
|
| Hospital Charge Code |
76100173
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.98 |
| Max. Negotiated Rate |
$663.20 |
| Rate for Payer: Aetna Commercial |
$347.77
|
| Rate for Payer: Aetna Medicare |
$235.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: ASR ASR |
$374.82
|
| Rate for Payer: ASR Commercial |
$374.82
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$316.43
|
| Rate for Payer: BCN Commercial |
$299.58
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$309.13
|
| Rate for Payer: Cash Price |
$309.13
|
| Rate for Payer: Cofinity Commercial |
$363.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$309.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$386.41
|
| Rate for Payer: Healthscope Whirlpool |
$374.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.03
|
| Rate for Payer: Mclaren Commercial |
$347.77
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.45
|
| Rate for Payer: Nomi Health Commercial |
$316.86
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$258.53
|
| Rate for Payer: PHP Medicaid |
$125.98
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$663.20
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$530.56
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$340.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$364.30
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP DNSP |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: VA VA |
$235.03
|
|
|
HC CLOSED TREATMENT DISLOCATED SHOULDER W MANIP
|
Facility
|
OP
|
$634.64
|
|
|
Service Code
|
CPT 23650
|
| Hospital Charge Code |
76100436
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.98 |
| Max. Negotiated Rate |
$634.64 |
| Rate for Payer: Aetna Commercial |
$571.18
|
| Rate for Payer: Aetna Medicare |
$235.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: ASR ASR |
$615.60
|
| Rate for Payer: ASR Commercial |
$615.60
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$519.71
|
| Rate for Payer: BCN Commercial |
$492.04
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$507.71
|
| Rate for Payer: Cash Price |
$507.71
|
| Rate for Payer: Cofinity Commercial |
$596.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$507.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$634.64
|
| Rate for Payer: Healthscope Whirlpool |
$615.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.03
|
| Rate for Payer: Mclaren Commercial |
$571.18
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.44
|
| Rate for Payer: Nomi Health Commercial |
$520.40
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$258.53
|
| Rate for Payer: PHP Medicaid |
$125.98
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$273.06
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$218.45
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$558.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$364.30
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP DNSP |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: VA VA |
$235.03
|
|
|
HC CLOSED TREATMENT DISLOCATED SHOULDER W MANIP
|
Facility
|
IP
|
$634.64
|
|
|
Service Code
|
CPT 23650
|
| Hospital Charge Code |
76100436
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$412.52 |
| Max. Negotiated Rate |
$634.64 |
| Rate for Payer: Aetna Commercial |
$571.18
|
| Rate for Payer: ASR ASR |
$615.60
|
| Rate for Payer: ASR Commercial |
$615.60
|
| Rate for Payer: BCBS Trust/PPO |
$517.17
|
| Rate for Payer: BCN Commercial |
$492.04
|
| Rate for Payer: Cash Price |
$507.71
|
| Rate for Payer: Cofinity Commercial |
$596.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$507.71
|
| Rate for Payer: Healthscope Commercial |
$634.64
|
| Rate for Payer: Healthscope Whirlpool |
$615.60
|
| Rate for Payer: Mclaren Commercial |
$571.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.44
|
| Rate for Payer: Nomi Health Commercial |
$520.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$558.48
|
|
|
HC CLOSED TX ACETAB FX; W/O MANIP
|
Facility
|
IP
|
$381.83
|
|
|
Service Code
|
CPT 27220
|
| Hospital Charge Code |
76100286
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$248.19 |
| Max. Negotiated Rate |
$381.83 |
| Rate for Payer: Aetna Commercial |
$343.65
|
| Rate for Payer: ASR ASR |
$370.38
|
| Rate for Payer: ASR Commercial |
$370.38
|
| Rate for Payer: BCBS Trust/PPO |
$311.15
|
| Rate for Payer: BCN Commercial |
$296.03
|
| Rate for Payer: Cash Price |
$305.46
|
| Rate for Payer: Cofinity Commercial |
$358.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$305.46
|
| Rate for Payer: Healthscope Commercial |
$381.83
|
| Rate for Payer: Healthscope Whirlpool |
$370.38
|
| Rate for Payer: Mclaren Commercial |
$343.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$324.56
|
| Rate for Payer: Nomi Health Commercial |
$313.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$336.01
|
|
|
HC CLOSED TX ACETAB FX; W/O MANIP
|
Facility
|
OP
|
$381.83
|
|
|
Service Code
|
CPT 27220
|
| Hospital Charge Code |
76100286
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.98 |
| Max. Negotiated Rate |
$381.83 |
| Rate for Payer: Aetna Commercial |
$343.65
|
| Rate for Payer: Aetna Medicare |
$235.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: ASR ASR |
$370.38
|
| Rate for Payer: ASR Commercial |
$370.38
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$312.68
|
| Rate for Payer: BCN Commercial |
$296.03
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$305.46
|
| Rate for Payer: Cash Price |
$305.46
|
| Rate for Payer: Cofinity Commercial |
$358.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$305.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$381.83
|
| Rate for Payer: Healthscope Whirlpool |
$370.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.03
|
| Rate for Payer: Mclaren Commercial |
$343.65
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$324.56
|
| Rate for Payer: Nomi Health Commercial |
$313.10
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$258.53
|
| Rate for Payer: PHP Medicaid |
$125.98
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$334.56
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$267.66
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$336.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$364.30
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP DNSP |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: VA VA |
$235.03
|
|
|
HC CLOSED TX BIMALLEOLAR ANKLE FX W/O MANIP
|
Facility
|
OP
|
$626.20
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
76100492
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.98 |
| Max. Negotiated Rate |
$626.20 |
| Rate for Payer: Aetna Commercial |
$563.58
|
| Rate for Payer: Aetna Medicare |
$235.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: ASR ASR |
$607.41
|
| Rate for Payer: ASR Commercial |
$607.41
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$512.80
|
| Rate for Payer: BCN Commercial |
$485.49
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$500.96
|
| Rate for Payer: Cash Price |
$500.96
|
| Rate for Payer: Cofinity Commercial |
$588.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$500.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$626.20
|
| Rate for Payer: Healthscope Whirlpool |
$607.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.03
|
| Rate for Payer: Mclaren Commercial |
$563.58
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$532.27
|
| Rate for Payer: Nomi Health Commercial |
$513.48
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$258.53
|
| Rate for Payer: PHP Medicaid |
$125.98
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$407.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$548.68
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$438.97
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$551.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$364.30
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP DNSP |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: VA VA |
$235.03
|
|
|
HC CLOSED TX BIMALLEOLAR ANKLE FX W/O MANIP
|
Facility
|
IP
|
$626.20
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
76100492
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$407.03 |
| Max. Negotiated Rate |
$626.20 |
| Rate for Payer: Aetna Commercial |
$563.58
|
| Rate for Payer: ASR ASR |
$607.41
|
| Rate for Payer: ASR Commercial |
$607.41
|
| Rate for Payer: BCBS Trust/PPO |
$510.29
|
| Rate for Payer: BCN Commercial |
$485.49
|
| Rate for Payer: Cash Price |
$500.96
|
| Rate for Payer: Cofinity Commercial |
$588.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$500.96
|
| Rate for Payer: Healthscope Commercial |
$626.20
|
| Rate for Payer: Healthscope Whirlpool |
$607.41
|
| Rate for Payer: Mclaren Commercial |
$563.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$532.27
|
| Rate for Payer: Nomi Health Commercial |
$513.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$407.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$551.06
|
|
|
HC CLOSED TX BIMALLEOLAR FX W/MANIP
|
Facility
|
IP
|
$1,810.30
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
76100295
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,176.70 |
| Max. Negotiated Rate |
$1,810.30 |
| Rate for Payer: Aetna Commercial |
$1,629.27
|
| Rate for Payer: ASR ASR |
$1,755.99
|
| Rate for Payer: ASR Commercial |
$1,755.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,475.21
|
| Rate for Payer: BCN Commercial |
$1,403.53
|
| Rate for Payer: Cash Price |
$1,448.24
|
| Rate for Payer: Cofinity Commercial |
$1,701.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,448.24
|
| Rate for Payer: Healthscope Commercial |
$1,810.30
|
| Rate for Payer: Healthscope Whirlpool |
$1,755.99
|
| Rate for Payer: Mclaren Commercial |
$1,629.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,538.76
|
| Rate for Payer: Nomi Health Commercial |
$1,484.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,176.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,593.06
|
|
|
HC CLOSED TX BIMALLEOLAR FX W/MANIP
|
Facility
|
OP
|
$1,810.30
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
76100295
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$713.26 |
| Max. Negotiated Rate |
$2,430.48 |
| Rate for Payer: Aetna Commercial |
$1,629.27
|
| Rate for Payer: Aetna Medicare |
$1,568.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.06
|
| Rate for Payer: ASR ASR |
$1,755.99
|
| Rate for Payer: ASR Commercial |
$1,755.99
|
| Rate for Payer: BCBS Complete |
$882.50
|
| Rate for Payer: BCBS MAPPO |
$1,568.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,482.45
|
| Rate for Payer: BCN Commercial |
$1,403.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.05
|
| Rate for Payer: Cash Price |
$1,448.24
|
| Rate for Payer: Cash Price |
$1,448.24
|
| Rate for Payer: Cofinity Commercial |
$1,701.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,448.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.05
|
| Rate for Payer: Healthscope Commercial |
$1,810.30
|
| Rate for Payer: Healthscope Whirlpool |
$1,755.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,568.05
|
| Rate for Payer: Mclaren Commercial |
$1,629.27
|
| Rate for Payer: Mclaren Medicaid |
$840.47
|
| Rate for Payer: Mclaren Medicare |
$1,568.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.45
|
| Rate for Payer: Meridian Medicaid |
$882.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,538.76
|
| Rate for Payer: Nomi Health Commercial |
$1,484.45
|
| Rate for Payer: PACE Medicare |
$1,489.65
|
| Rate for Payer: PACE SWMI |
$1,568.05
|
| Rate for Payer: PHP Commercial |
$1,724.86
|
| Rate for Payer: PHP Medicaid |
$840.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,176.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$891.58
|
| Rate for Payer: Priority Health Medicare |
$1,568.05
|
| Rate for Payer: Priority Health Narrow Network |
$713.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,593.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.05
|
| Rate for Payer: UHC Exchange |
$2,430.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.05
|
| Rate for Payer: UHCCP DNSP |
$1,568.05
|
| Rate for Payer: UHCCP Medicaid |
$840.47
|
| Rate for Payer: VA VA |
$1,568.05
|
|
|
HC CLOSED TX CALCANEAL FX, W/O MANIP
|
Facility
|
IP
|
$336.53
|
|
|
Service Code
|
CPT 28400
|
| Hospital Charge Code |
76100267
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$218.74 |
| Max. Negotiated Rate |
$336.53 |
| Rate for Payer: Aetna Commercial |
$302.88
|
| Rate for Payer: ASR ASR |
$326.43
|
| Rate for Payer: ASR Commercial |
$326.43
|
| Rate for Payer: BCBS Trust/PPO |
$274.24
|
| Rate for Payer: BCN Commercial |
$260.91
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cofinity Commercial |
$316.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.22
|
| Rate for Payer: Healthscope Commercial |
$336.53
|
| Rate for Payer: Healthscope Whirlpool |
$326.43
|
| Rate for Payer: Mclaren Commercial |
$302.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: Nomi Health Commercial |
$275.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$296.15
|
|
|
HC CLOSED TX CALCANEAL FX, W/O MANIP
|
Facility
|
OP
|
$336.53
|
|
|
Service Code
|
CPT 28400
|
| Hospital Charge Code |
76100267
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.98 |
| Max. Negotiated Rate |
$364.30 |
| Rate for Payer: Aetna Commercial |
$302.88
|
| Rate for Payer: Aetna Medicare |
$235.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: ASR ASR |
$326.43
|
| Rate for Payer: ASR Commercial |
$326.43
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$275.58
|
| Rate for Payer: BCN Commercial |
$260.91
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cofinity Commercial |
$316.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$336.53
|
| Rate for Payer: Healthscope Whirlpool |
$326.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.03
|
| Rate for Payer: Mclaren Commercial |
$302.88
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: Nomi Health Commercial |
$275.95
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$258.53
|
| Rate for Payer: PHP Medicaid |
$125.98
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$273.41
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$218.73
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$296.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$364.30
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP DNSP |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: VA VA |
$235.03
|
|
|
HC CLOSED TX CLAVICLE FX W/O MANIP
|
Facility
|
IP
|
$336.50
|
|
|
Service Code
|
CPT 23500
|
| Hospital Charge Code |
76100229
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$218.72 |
| Max. Negotiated Rate |
$336.50 |
| Rate for Payer: Aetna Commercial |
$302.85
|
| Rate for Payer: ASR ASR |
$326.40
|
| Rate for Payer: ASR Commercial |
$326.40
|
| Rate for Payer: BCBS Trust/PPO |
$274.21
|
| Rate for Payer: BCN Commercial |
$260.89
|
| Rate for Payer: Cash Price |
$269.20
|
| Rate for Payer: Cofinity Commercial |
$316.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.20
|
| Rate for Payer: Healthscope Commercial |
$336.50
|
| Rate for Payer: Healthscope Whirlpool |
$326.40
|
| Rate for Payer: Mclaren Commercial |
$302.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.02
|
| Rate for Payer: Nomi Health Commercial |
$275.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$296.12
|
|
|
HC CLOSED TX CLAVICLE FX W/O MANIP
|
Facility
|
OP
|
$336.50
|
|
|
Service Code
|
CPT 23500
|
| Hospital Charge Code |
76100229
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.98 |
| Max. Negotiated Rate |
$364.30 |
| Rate for Payer: Aetna Commercial |
$302.85
|
| Rate for Payer: Aetna Medicare |
$235.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: ASR ASR |
$326.40
|
| Rate for Payer: ASR Commercial |
$326.40
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$275.56
|
| Rate for Payer: BCN Commercial |
$260.89
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$269.20
|
| Rate for Payer: Cash Price |
$269.20
|
| Rate for Payer: Cofinity Commercial |
$316.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$336.50
|
| Rate for Payer: Healthscope Whirlpool |
$326.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.03
|
| Rate for Payer: Mclaren Commercial |
$302.85
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.02
|
| Rate for Payer: Nomi Health Commercial |
$275.93
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$258.53
|
| Rate for Payer: PHP Medicaid |
$125.98
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$273.06
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$218.45
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$296.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$364.30
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP DNSP |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: VA VA |
$235.03
|
|
|
HC CLOSED TX DISTAL RADIAL FX/EPIPHYSEAL SEPARATION W/MANIP
|
Facility
|
OP
|
$2,115.23
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
76100240
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$665.84 |
| Max. Negotiated Rate |
$2,430.48 |
| Rate for Payer: Aetna Commercial |
$1,903.71
|
| Rate for Payer: Aetna Medicare |
$1,568.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.06
|
| Rate for Payer: ASR ASR |
$2,051.77
|
| Rate for Payer: ASR Commercial |
$2,051.77
|
| Rate for Payer: BCBS Complete |
$882.50
|
| Rate for Payer: BCBS MAPPO |
$1,568.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,732.16
|
| Rate for Payer: BCN Commercial |
$1,639.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.05
|
| Rate for Payer: Cash Price |
$1,692.18
|
| Rate for Payer: Cash Price |
$1,692.18
|
| Rate for Payer: Cofinity Commercial |
$1,988.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,692.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.05
|
| Rate for Payer: Healthscope Commercial |
$2,115.23
|
| Rate for Payer: Healthscope Whirlpool |
$2,051.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,568.05
|
| Rate for Payer: Mclaren Commercial |
$1,903.71
|
| Rate for Payer: Mclaren Medicaid |
$840.47
|
| Rate for Payer: Mclaren Medicare |
$1,568.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.45
|
| Rate for Payer: Meridian Medicaid |
$882.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,797.95
|
| Rate for Payer: Nomi Health Commercial |
$1,734.49
|
| Rate for Payer: PACE Medicare |
$1,489.65
|
| Rate for Payer: PACE SWMI |
$1,568.05
|
| Rate for Payer: PHP Commercial |
$1,724.86
|
| Rate for Payer: PHP Medicaid |
$840.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,374.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$832.30
|
| Rate for Payer: Priority Health Medicare |
$1,568.05
|
| Rate for Payer: Priority Health Narrow Network |
$665.84
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,861.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.05
|
| Rate for Payer: UHC Exchange |
$2,430.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.05
|
| Rate for Payer: UHCCP DNSP |
$1,568.05
|
| Rate for Payer: UHCCP Medicaid |
$840.47
|
| Rate for Payer: VA VA |
$1,568.05
|
|
|
HC CLOSED TX DISTAL RADIAL FX/EPIPHYSEAL SEPARATION W/MANIP
|
Facility
|
IP
|
$2,115.23
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
76100240
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,374.90 |
| Max. Negotiated Rate |
$2,115.23 |
| Rate for Payer: Aetna Commercial |
$1,903.71
|
| Rate for Payer: ASR ASR |
$2,051.77
|
| Rate for Payer: ASR Commercial |
$2,051.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,723.70
|
| Rate for Payer: BCN Commercial |
$1,639.94
|
| Rate for Payer: Cash Price |
$1,692.18
|
| Rate for Payer: Cofinity Commercial |
$1,988.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,692.18
|
| Rate for Payer: Healthscope Commercial |
$2,115.23
|
| Rate for Payer: Healthscope Whirlpool |
$2,051.77
|
| Rate for Payer: Mclaren Commercial |
$1,903.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,797.95
|
| Rate for Payer: Nomi Health Commercial |
$1,734.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,374.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,861.40
|
|
|
HC CLOSED TX FEMORAL FX, DISTAL END, MEDIAL/LAT CONDYLE W/O MANIP
|
Facility
|
IP
|
$365.18
|
|
|
Service Code
|
CPT 27508
|
| Hospital Charge Code |
76100299
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$237.37 |
| Max. Negotiated Rate |
$365.18 |
| Rate for Payer: Aetna Commercial |
$328.66
|
| Rate for Payer: ASR ASR |
$354.22
|
| Rate for Payer: ASR Commercial |
$354.22
|
| Rate for Payer: BCBS Trust/PPO |
$297.59
|
| Rate for Payer: BCN Commercial |
$283.12
|
| Rate for Payer: Cash Price |
$292.14
|
| Rate for Payer: Cofinity Commercial |
$343.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.14
|
| Rate for Payer: Healthscope Commercial |
$365.18
|
| Rate for Payer: Healthscope Whirlpool |
$354.22
|
| Rate for Payer: Mclaren Commercial |
$328.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.40
|
| Rate for Payer: Nomi Health Commercial |
$299.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$321.36
|
|
|
HC CLOSED TX FEMORAL FX, DISTAL END, MEDIAL/LAT CONDYLE W/O MANIP
|
Facility
|
OP
|
$365.18
|
|
|
Service Code
|
CPT 27508
|
| Hospital Charge Code |
76100299
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.98 |
| Max. Negotiated Rate |
$365.18 |
| Rate for Payer: Aetna Commercial |
$328.66
|
| Rate for Payer: Aetna Medicare |
$235.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: ASR ASR |
$354.22
|
| Rate for Payer: ASR Commercial |
$354.22
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$299.05
|
| Rate for Payer: BCN Commercial |
$283.12
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$292.14
|
| Rate for Payer: Cash Price |
$292.14
|
| Rate for Payer: Cofinity Commercial |
$343.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$365.18
|
| Rate for Payer: Healthscope Whirlpool |
$354.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.03
|
| Rate for Payer: Mclaren Commercial |
$328.66
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.40
|
| Rate for Payer: Nomi Health Commercial |
$299.45
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$258.53
|
| Rate for Payer: PHP Medicaid |
$125.98
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$238.27
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$190.62
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$321.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$364.30
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP DNSP |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: VA VA |
$235.03
|
|
|
HC CLOSED TX FRACTURE WB ARTICLR PRTN DSTL TIBIA WO MANIP
|
Facility
|
IP
|
$665.00
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
76100525
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$432.25 |
| Max. Negotiated Rate |
$665.00 |
| Rate for Payer: Aetna Commercial |
$598.50
|
| Rate for Payer: ASR ASR |
$645.05
|
| Rate for Payer: ASR Commercial |
$645.05
|
| Rate for Payer: BCBS Trust/PPO |
$541.91
|
| Rate for Payer: BCN Commercial |
$515.57
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cofinity Commercial |
$625.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$532.00
|
| Rate for Payer: Healthscope Commercial |
$665.00
|
| Rate for Payer: Healthscope Whirlpool |
$645.05
|
| Rate for Payer: Mclaren Commercial |
$598.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$565.25
|
| Rate for Payer: Nomi Health Commercial |
$545.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$432.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$585.20
|
|
|
HC CLOSED TX FRACTURE WB ARTICLR PRTN DSTL TIBIA WO MANIP
|
Facility
|
OP
|
$665.00
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
76100525
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.98 |
| Max. Negotiated Rate |
$665.00 |
| Rate for Payer: Aetna Commercial |
$598.50
|
| Rate for Payer: Aetna Medicare |
$235.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: ASR ASR |
$645.05
|
| Rate for Payer: ASR Commercial |
$645.05
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$544.57
|
| Rate for Payer: BCN Commercial |
$515.57
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cofinity Commercial |
$625.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$532.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$665.00
|
| Rate for Payer: Healthscope Whirlpool |
$645.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.03
|
| Rate for Payer: Mclaren Commercial |
$598.50
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$565.25
|
| Rate for Payer: Nomi Health Commercial |
$545.30
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$258.53
|
| Rate for Payer: PHP Medicaid |
$125.98
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$432.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$582.67
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$466.16
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$585.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$364.30
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP DNSP |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: VA VA |
$235.03
|
|
|
HC CLOSED TX GREAT TOE FX W/O MANIPULATION
|
Facility
|
IP
|
$336.53
|
|
|
Service Code
|
CPT 28490
|
| Hospital Charge Code |
76100237
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$218.74 |
| Max. Negotiated Rate |
$336.53 |
| Rate for Payer: Aetna Commercial |
$302.88
|
| Rate for Payer: ASR ASR |
$326.43
|
| Rate for Payer: ASR Commercial |
$326.43
|
| Rate for Payer: BCBS Trust/PPO |
$274.24
|
| Rate for Payer: BCN Commercial |
$260.91
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cofinity Commercial |
$316.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.22
|
| Rate for Payer: Healthscope Commercial |
$336.53
|
| Rate for Payer: Healthscope Whirlpool |
$326.43
|
| Rate for Payer: Mclaren Commercial |
$302.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: Nomi Health Commercial |
$275.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$296.15
|
|
|
HC CLOSED TX GREAT TOE FX W/O MANIPULATION
|
Facility
|
OP
|
$336.53
|
|
|
Service Code
|
CPT 28490
|
| Hospital Charge Code |
76100237
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.98 |
| Max. Negotiated Rate |
$364.30 |
| Rate for Payer: Aetna Commercial |
$302.88
|
| Rate for Payer: Aetna Medicare |
$235.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: ASR ASR |
$326.43
|
| Rate for Payer: ASR Commercial |
$326.43
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$275.58
|
| Rate for Payer: BCN Commercial |
$260.91
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cofinity Commercial |
$316.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$336.53
|
| Rate for Payer: Healthscope Whirlpool |
$326.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.03
|
| Rate for Payer: Mclaren Commercial |
$302.88
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: Nomi Health Commercial |
$275.95
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$258.53
|
| Rate for Payer: PHP Medicaid |
$125.98
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$273.06
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$218.45
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$296.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$364.30
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP DNSP |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: VA VA |
$235.03
|
|
|
HC CLOSED TX GR TROCHANTERIC FX W/O MANIP
|
Facility
|
OP
|
$336.53
|
|
|
Service Code
|
CPT 27246
|
| Hospital Charge Code |
76100262
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.98 |
| Max. Negotiated Rate |
$364.30 |
| Rate for Payer: Aetna Commercial |
$302.88
|
| Rate for Payer: Aetna Medicare |
$235.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: ASR ASR |
$326.43
|
| Rate for Payer: ASR Commercial |
$326.43
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$275.58
|
| Rate for Payer: BCN Commercial |
$260.91
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cofinity Commercial |
$316.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$336.53
|
| Rate for Payer: Healthscope Whirlpool |
$326.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.03
|
| Rate for Payer: Mclaren Commercial |
$302.88
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: Nomi Health Commercial |
$275.95
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$258.53
|
| Rate for Payer: PHP Medicaid |
$125.98
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$294.87
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$235.91
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$296.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$364.30
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP DNSP |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: VA VA |
$235.03
|
|
|
HC CLOSED TX GR TROCHANTERIC FX W/O MANIP
|
Facility
|
IP
|
$336.53
|
|
|
Service Code
|
CPT 27246
|
| Hospital Charge Code |
76100262
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$218.74 |
| Max. Negotiated Rate |
$336.53 |
| Rate for Payer: Aetna Commercial |
$302.88
|
| Rate for Payer: ASR ASR |
$326.43
|
| Rate for Payer: ASR Commercial |
$326.43
|
| Rate for Payer: BCBS Trust/PPO |
$274.24
|
| Rate for Payer: BCN Commercial |
$260.91
|
| Rate for Payer: Cash Price |
$269.22
|
| Rate for Payer: Cofinity Commercial |
$316.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.22
|
| Rate for Payer: Healthscope Commercial |
$336.53
|
| Rate for Payer: Healthscope Whirlpool |
$326.43
|
| Rate for Payer: Mclaren Commercial |
$302.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: Nomi Health Commercial |
$275.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$296.15
|
|
