|
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 |
$836.62 |
| Max. Negotiated Rate |
$2,419.32 |
| Rate for Payer: Aetna Commercial |
$1,629.27
|
| Rate for Payer: Aetna Medicare |
$1,560.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,951.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,951.06
|
| Rate for Payer: ASR ASR |
$1,755.99
|
| Rate for Payer: ASR Commercial |
$1,755.99
|
| Rate for Payer: BCBS Complete |
$878.45
|
| Rate for Payer: BCBS MAPPO |
$1,560.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,482.45
|
| Rate for Payer: BCN Commercial |
$1,403.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,560.85
|
| 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 |
$1,560.85
|
| Rate for Payer: Healthscope Commercial |
$1,810.30
|
| Rate for Payer: Healthscope Whirlpool |
$1,755.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,560.85
|
| Rate for Payer: Mclaren Commercial |
$1,629.27
|
| Rate for Payer: Mclaren Medicaid |
$836.62
|
| Rate for Payer: Mclaren Medicare |
$1,560.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,638.89
|
| Rate for Payer: Meridian Medicaid |
$878.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,794.98
|
| 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 |
$1,482.81
|
| Rate for Payer: PACE SWMI |
$1,560.85
|
| Rate for Payer: PHP Commercial |
$1,716.93
|
| Rate for Payer: PHP Medicaid |
$836.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,560.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$836.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,176.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,586.18
|
| Rate for Payer: Priority Health Medicare |
$1,560.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,269.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,560.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,593.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,560.85
|
| Rate for Payer: UHC Exchange |
$2,419.32
|
| Rate for Payer: UHC Medicare Advantage |
$1,560.85
|
| Rate for Payer: UHCCP DNSP |
$1,560.85
|
| Rate for Payer: UHCCP Medicaid |
$836.62
|
| Rate for Payer: VA VA |
$1,560.85
|
|
|
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 |
$125.40 |
| Max. Negotiated Rate |
$362.62 |
| Rate for Payer: Aetna Commercial |
$302.88
|
| Rate for Payer: Aetna Medicare |
$233.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.44
|
| Rate for Payer: ASR ASR |
$326.43
|
| Rate for Payer: ASR Commercial |
$326.43
|
| Rate for Payer: BCBS Complete |
$131.67
|
| Rate for Payer: BCBS MAPPO |
$233.95
|
| Rate for Payer: BCBS Trust/PPO |
$275.58
|
| Rate for Payer: BCN Commercial |
$260.91
|
| Rate for Payer: BCN Medicare Advantage |
$233.95
|
| 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 |
$233.95
|
| Rate for Payer: Healthscope Commercial |
$336.53
|
| Rate for Payer: Healthscope Whirlpool |
$326.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$233.95
|
| Rate for Payer: Mclaren Commercial |
$302.88
|
| Rate for Payer: Mclaren Medicaid |
$125.40
|
| Rate for Payer: Mclaren Medicare |
$233.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.65
|
| Rate for Payer: Meridian Medicaid |
$131.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$269.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: Nomi Health Commercial |
$275.95
|
| Rate for Payer: PACE Medicare |
$222.25
|
| Rate for Payer: PACE SWMI |
$233.95
|
| Rate for Payer: PHP Commercial |
$257.35
|
| Rate for Payer: PHP Medicaid |
$125.40
|
| Rate for Payer: PHP Medicare Advantage |
$233.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.40
|
| 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 |
$233.95
|
| Rate for Payer: Priority Health Narrow Network |
$235.91
|
| Rate for Payer: Railroad Medicare Medicare |
$233.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$296.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.95
|
| Rate for Payer: UHC Exchange |
$362.62
|
| Rate for Payer: UHC Medicare Advantage |
$233.95
|
| Rate for Payer: UHCCP DNSP |
$233.95
|
| Rate for Payer: UHCCP Medicaid |
$125.40
|
| Rate for Payer: VA VA |
$233.95
|
|
|
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 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 |
$125.40 |
| Max. Negotiated Rate |
$362.62 |
| Rate for Payer: Aetna Commercial |
$302.85
|
| Rate for Payer: Aetna Medicare |
$233.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.44
|
| Rate for Payer: ASR ASR |
$326.40
|
| Rate for Payer: ASR Commercial |
$326.40
|
| Rate for Payer: BCBS Complete |
$131.67
|
| Rate for Payer: BCBS MAPPO |
$233.95
|
| Rate for Payer: BCBS Trust/PPO |
$275.56
|
| Rate for Payer: BCN Commercial |
$260.89
|
| Rate for Payer: BCN Medicare Advantage |
$233.95
|
| 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 |
$233.95
|
| Rate for Payer: Healthscope Commercial |
$336.50
|
| Rate for Payer: Healthscope Whirlpool |
$326.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$233.95
|
| Rate for Payer: Mclaren Commercial |
$302.85
|
| Rate for Payer: Mclaren Medicaid |
$125.40
|
| Rate for Payer: Mclaren Medicare |
$233.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.65
|
| Rate for Payer: Meridian Medicaid |
$131.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$269.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.02
|
| Rate for Payer: Nomi Health Commercial |
$275.93
|
| Rate for Payer: PACE Medicare |
$222.25
|
| Rate for Payer: PACE SWMI |
$233.95
|
| Rate for Payer: PHP Commercial |
$257.35
|
| Rate for Payer: PHP Medicaid |
$125.40
|
| Rate for Payer: PHP Medicare Advantage |
$233.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$294.84
|
| Rate for Payer: Priority Health Medicare |
$233.95
|
| Rate for Payer: Priority Health Narrow Network |
$235.89
|
| Rate for Payer: Railroad Medicare Medicare |
$233.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$296.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.95
|
| Rate for Payer: UHC Exchange |
$362.62
|
| Rate for Payer: UHC Medicare Advantage |
$233.95
|
| Rate for Payer: UHCCP DNSP |
$233.95
|
| Rate for Payer: UHCCP Medicaid |
$125.40
|
| Rate for Payer: VA VA |
$233.95
|
|
|
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 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 |
$836.62 |
| Max. Negotiated Rate |
$2,419.32 |
| Rate for Payer: Aetna Commercial |
$1,903.71
|
| Rate for Payer: Aetna Medicare |
$1,560.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,951.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,951.06
|
| Rate for Payer: ASR ASR |
$2,051.77
|
| Rate for Payer: ASR Commercial |
$2,051.77
|
| Rate for Payer: BCBS Complete |
$878.45
|
| Rate for Payer: BCBS MAPPO |
$1,560.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,732.16
|
| Rate for Payer: BCN Commercial |
$1,639.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,560.85
|
| 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 |
$1,560.85
|
| Rate for Payer: Healthscope Commercial |
$2,115.23
|
| Rate for Payer: Healthscope Whirlpool |
$2,051.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,560.85
|
| Rate for Payer: Mclaren Commercial |
$1,903.71
|
| Rate for Payer: Mclaren Medicaid |
$836.62
|
| Rate for Payer: Mclaren Medicare |
$1,560.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,638.89
|
| Rate for Payer: Meridian Medicaid |
$878.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,794.98
|
| 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 |
$1,482.81
|
| Rate for Payer: PACE SWMI |
$1,560.85
|
| Rate for Payer: PHP Commercial |
$1,716.93
|
| Rate for Payer: PHP Medicaid |
$836.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,560.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$836.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,374.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,853.36
|
| Rate for Payer: Priority Health Medicare |
$1,560.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,482.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,560.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,861.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,560.85
|
| Rate for Payer: UHC Exchange |
$2,419.32
|
| Rate for Payer: UHC Medicare Advantage |
$1,560.85
|
| Rate for Payer: UHCCP DNSP |
$1,560.85
|
| Rate for Payer: UHCCP Medicaid |
$836.62
|
| Rate for Payer: VA VA |
$1,560.85
|
|
|
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 |
$125.40 |
| Max. Negotiated Rate |
$365.18 |
| Rate for Payer: Aetna Commercial |
$328.66
|
| Rate for Payer: Aetna Medicare |
$233.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.44
|
| Rate for Payer: ASR ASR |
$354.22
|
| Rate for Payer: ASR Commercial |
$354.22
|
| Rate for Payer: BCBS Complete |
$131.67
|
| Rate for Payer: BCBS MAPPO |
$233.95
|
| Rate for Payer: BCBS Trust/PPO |
$299.05
|
| Rate for Payer: BCN Commercial |
$283.12
|
| Rate for Payer: BCN Medicare Advantage |
$233.95
|
| 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 |
$233.95
|
| Rate for Payer: Healthscope Commercial |
$365.18
|
| Rate for Payer: Healthscope Whirlpool |
$354.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$233.95
|
| Rate for Payer: Mclaren Commercial |
$328.66
|
| Rate for Payer: Mclaren Medicaid |
$125.40
|
| Rate for Payer: Mclaren Medicare |
$233.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.65
|
| Rate for Payer: Meridian Medicaid |
$131.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$269.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.40
|
| Rate for Payer: Nomi Health Commercial |
$299.45
|
| Rate for Payer: PACE Medicare |
$222.25
|
| Rate for Payer: PACE SWMI |
$233.95
|
| Rate for Payer: PHP Commercial |
$257.35
|
| Rate for Payer: PHP Medicaid |
$125.40
|
| Rate for Payer: PHP Medicare Advantage |
$233.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$319.97
|
| Rate for Payer: Priority Health Medicare |
$233.95
|
| Rate for Payer: Priority Health Narrow Network |
$255.99
|
| Rate for Payer: Railroad Medicare Medicare |
$233.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$321.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.95
|
| Rate for Payer: UHC Exchange |
$362.62
|
| Rate for Payer: UHC Medicare Advantage |
$233.95
|
| Rate for Payer: UHCCP DNSP |
$233.95
|
| Rate for Payer: UHCCP Medicaid |
$125.40
|
| Rate for Payer: VA VA |
$233.95
|
|
|
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 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 |
$125.40 |
| Max. Negotiated Rate |
$665.00 |
| Rate for Payer: Aetna Commercial |
$598.50
|
| Rate for Payer: Aetna Medicare |
$233.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.44
|
| Rate for Payer: ASR ASR |
$645.05
|
| Rate for Payer: ASR Commercial |
$645.05
|
| Rate for Payer: BCBS Complete |
$131.67
|
| Rate for Payer: BCBS MAPPO |
$233.95
|
| Rate for Payer: BCBS Trust/PPO |
$544.57
|
| Rate for Payer: BCN Commercial |
$515.57
|
| Rate for Payer: BCN Medicare Advantage |
$233.95
|
| 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 |
$233.95
|
| Rate for Payer: Healthscope Commercial |
$665.00
|
| Rate for Payer: Healthscope Whirlpool |
$645.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$233.95
|
| Rate for Payer: Mclaren Commercial |
$598.50
|
| Rate for Payer: Mclaren Medicaid |
$125.40
|
| Rate for Payer: Mclaren Medicare |
$233.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.65
|
| Rate for Payer: Meridian Medicaid |
$131.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$269.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$565.25
|
| Rate for Payer: Nomi Health Commercial |
$545.30
|
| Rate for Payer: PACE Medicare |
$222.25
|
| Rate for Payer: PACE SWMI |
$233.95
|
| Rate for Payer: PHP Commercial |
$257.35
|
| Rate for Payer: PHP Medicaid |
$125.40
|
| Rate for Payer: PHP Medicare Advantage |
$233.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.40
|
| 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 |
$233.95
|
| Rate for Payer: Priority Health Narrow Network |
$466.17
|
| Rate for Payer: Railroad Medicare Medicare |
$233.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$585.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.95
|
| Rate for Payer: UHC Exchange |
$362.62
|
| Rate for Payer: UHC Medicare Advantage |
$233.95
|
| Rate for Payer: UHCCP DNSP |
$233.95
|
| Rate for Payer: UHCCP Medicaid |
$125.40
|
| Rate for Payer: VA VA |
$233.95
|
|
|
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 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 |
$125.40 |
| Max. Negotiated Rate |
$362.62 |
| Rate for Payer: Aetna Commercial |
$302.88
|
| Rate for Payer: Aetna Medicare |
$233.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.44
|
| Rate for Payer: ASR ASR |
$326.43
|
| Rate for Payer: ASR Commercial |
$326.43
|
| Rate for Payer: BCBS Complete |
$131.67
|
| Rate for Payer: BCBS MAPPO |
$233.95
|
| Rate for Payer: BCBS Trust/PPO |
$275.58
|
| Rate for Payer: BCN Commercial |
$260.91
|
| Rate for Payer: BCN Medicare Advantage |
$233.95
|
| 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 |
$233.95
|
| Rate for Payer: Healthscope Commercial |
$336.53
|
| Rate for Payer: Healthscope Whirlpool |
$326.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$233.95
|
| Rate for Payer: Mclaren Commercial |
$302.88
|
| Rate for Payer: Mclaren Medicaid |
$125.40
|
| Rate for Payer: Mclaren Medicare |
$233.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.65
|
| Rate for Payer: Meridian Medicaid |
$131.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$269.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: Nomi Health Commercial |
$275.95
|
| Rate for Payer: PACE Medicare |
$222.25
|
| Rate for Payer: PACE SWMI |
$233.95
|
| Rate for Payer: PHP Commercial |
$257.35
|
| Rate for Payer: PHP Medicaid |
$125.40
|
| Rate for Payer: PHP Medicare Advantage |
$233.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.40
|
| 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 |
$233.95
|
| Rate for Payer: Priority Health Narrow Network |
$235.91
|
| Rate for Payer: Railroad Medicare Medicare |
$233.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$296.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.95
|
| Rate for Payer: UHC Exchange |
$362.62
|
| Rate for Payer: UHC Medicare Advantage |
$233.95
|
| Rate for Payer: UHCCP DNSP |
$233.95
|
| Rate for Payer: UHCCP Medicaid |
$125.40
|
| Rate for Payer: VA VA |
$233.95
|
|
|
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 |
$125.40 |
| Max. Negotiated Rate |
$362.62 |
| Rate for Payer: Aetna Commercial |
$302.88
|
| Rate for Payer: Aetna Medicare |
$233.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.44
|
| Rate for Payer: ASR ASR |
$326.43
|
| Rate for Payer: ASR Commercial |
$326.43
|
| Rate for Payer: BCBS Complete |
$131.67
|
| Rate for Payer: BCBS MAPPO |
$233.95
|
| Rate for Payer: BCBS Trust/PPO |
$275.58
|
| Rate for Payer: BCN Commercial |
$260.91
|
| Rate for Payer: BCN Medicare Advantage |
$233.95
|
| 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 |
$233.95
|
| Rate for Payer: Healthscope Commercial |
$336.53
|
| Rate for Payer: Healthscope Whirlpool |
$326.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$233.95
|
| Rate for Payer: Mclaren Commercial |
$302.88
|
| Rate for Payer: Mclaren Medicaid |
$125.40
|
| Rate for Payer: Mclaren Medicare |
$233.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.65
|
| Rate for Payer: Meridian Medicaid |
$131.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$269.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: Nomi Health Commercial |
$275.95
|
| Rate for Payer: PACE Medicare |
$222.25
|
| Rate for Payer: PACE SWMI |
$233.95
|
| Rate for Payer: PHP Commercial |
$257.35
|
| Rate for Payer: PHP Medicaid |
$125.40
|
| Rate for Payer: PHP Medicare Advantage |
$233.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.40
|
| 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 |
$233.95
|
| Rate for Payer: Priority Health Narrow Network |
$235.91
|
| Rate for Payer: Railroad Medicare Medicare |
$233.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$296.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.95
|
| Rate for Payer: UHC Exchange |
$362.62
|
| Rate for Payer: UHC Medicare Advantage |
$233.95
|
| Rate for Payer: UHCCP DNSP |
$233.95
|
| Rate for Payer: UHCCP Medicaid |
$125.40
|
| Rate for Payer: VA VA |
$233.95
|
|
|
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
|
|
|
HC CLOSED TX HUMERAL CONDYLAR FX, MED/LAT, W/O MANIP
|
Facility
|
OP
|
$336.53
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
76100260
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.40 |
| Max. Negotiated Rate |
$362.62 |
| Rate for Payer: Aetna Commercial |
$302.88
|
| Rate for Payer: Aetna Medicare |
$233.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.44
|
| Rate for Payer: ASR ASR |
$326.43
|
| Rate for Payer: ASR Commercial |
$326.43
|
| Rate for Payer: BCBS Complete |
$131.67
|
| Rate for Payer: BCBS MAPPO |
$233.95
|
| Rate for Payer: BCBS Trust/PPO |
$275.58
|
| Rate for Payer: BCN Commercial |
$260.91
|
| Rate for Payer: BCN Medicare Advantage |
$233.95
|
| 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 |
$233.95
|
| Rate for Payer: Healthscope Commercial |
$336.53
|
| Rate for Payer: Healthscope Whirlpool |
$326.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$233.95
|
| Rate for Payer: Mclaren Commercial |
$302.88
|
| Rate for Payer: Mclaren Medicaid |
$125.40
|
| Rate for Payer: Mclaren Medicare |
$233.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.65
|
| Rate for Payer: Meridian Medicaid |
$131.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$269.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: Nomi Health Commercial |
$275.95
|
| Rate for Payer: PACE Medicare |
$222.25
|
| Rate for Payer: PACE SWMI |
$233.95
|
| Rate for Payer: PHP Commercial |
$257.35
|
| Rate for Payer: PHP Medicaid |
$125.40
|
| Rate for Payer: PHP Medicare Advantage |
$233.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.40
|
| 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 |
$233.95
|
| Rate for Payer: Priority Health Narrow Network |
$235.91
|
| Rate for Payer: Railroad Medicare Medicare |
$233.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$296.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.95
|
| Rate for Payer: UHC Exchange |
$362.62
|
| Rate for Payer: UHC Medicare Advantage |
$233.95
|
| Rate for Payer: UHCCP DNSP |
$233.95
|
| Rate for Payer: UHCCP Medicaid |
$125.40
|
| Rate for Payer: VA VA |
$233.95
|
|
|
HC CLOSED TX HUMERAL CONDYLAR FX, MED/LAT, W/O MANIP
|
Facility
|
IP
|
$336.53
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
76100260
|
|
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 HUMERAL EPICONDYLAR FX MEDIAL/LATERAL W/O MANIP
|
Facility
|
IP
|
$336.53
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
76100241
|
|
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 HUMERAL EPICONDYLAR FX MEDIAL/LATERAL W/O MANIP
|
Facility
|
OP
|
$336.53
|
|
|
Service Code
|
CPT 24560
|
| Hospital Charge Code |
76100241
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.40 |
| Max. Negotiated Rate |
$362.62 |
| Rate for Payer: Aetna Commercial |
$302.88
|
| Rate for Payer: Aetna Medicare |
$233.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.44
|
| Rate for Payer: ASR ASR |
$326.43
|
| Rate for Payer: ASR Commercial |
$326.43
|
| Rate for Payer: BCBS Complete |
$131.67
|
| Rate for Payer: BCBS MAPPO |
$233.95
|
| Rate for Payer: BCBS Trust/PPO |
$275.58
|
| Rate for Payer: BCN Commercial |
$260.91
|
| Rate for Payer: BCN Medicare Advantage |
$233.95
|
| 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 |
$233.95
|
| Rate for Payer: Healthscope Commercial |
$336.53
|
| Rate for Payer: Healthscope Whirlpool |
$326.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$233.95
|
| Rate for Payer: Mclaren Commercial |
$302.88
|
| Rate for Payer: Mclaren Medicaid |
$125.40
|
| Rate for Payer: Mclaren Medicare |
$233.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.65
|
| Rate for Payer: Meridian Medicaid |
$131.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$269.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: Nomi Health Commercial |
$275.95
|
| Rate for Payer: PACE Medicare |
$222.25
|
| Rate for Payer: PACE SWMI |
$233.95
|
| Rate for Payer: PHP Commercial |
$257.35
|
| Rate for Payer: PHP Medicaid |
$125.40
|
| Rate for Payer: PHP Medicare Advantage |
$233.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.40
|
| 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 |
$233.95
|
| Rate for Payer: Priority Health Narrow Network |
$235.91
|
| Rate for Payer: Railroad Medicare Medicare |
$233.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$296.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.95
|
| Rate for Payer: UHC Exchange |
$362.62
|
| Rate for Payer: UHC Medicare Advantage |
$233.95
|
| Rate for Payer: UHCCP DNSP |
$233.95
|
| Rate for Payer: UHCCP Medicaid |
$125.40
|
| Rate for Payer: VA VA |
$233.95
|
|
|
HC CLOSED TX INTERPHALANGEAL JT DISLOC W MANIP REQUIRE ANESTH
|
Facility
|
IP
|
$760.00
|
|
|
Service Code
|
CPT 26775
|
| Hospital Charge Code |
76100524
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$494.00 |
| Max. Negotiated Rate |
$760.00 |
| Rate for Payer: Aetna Commercial |
$684.00
|
| Rate for Payer: ASR ASR |
$737.20
|
| Rate for Payer: ASR Commercial |
$737.20
|
| Rate for Payer: BCBS Trust/PPO |
$619.32
|
| Rate for Payer: BCN Commercial |
$589.23
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cofinity Commercial |
$714.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$608.00
|
| Rate for Payer: Healthscope Commercial |
$760.00
|
| Rate for Payer: Healthscope Whirlpool |
$737.20
|
| Rate for Payer: Mclaren Commercial |
$684.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$646.00
|
| Rate for Payer: Nomi Health Commercial |
$623.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$494.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$668.80
|
|
|
HC CLOSED TX INTERPHALANGEAL JT DISLOC W MANIP REQUIRE ANESTH
|
Facility
|
OP
|
$760.00
|
|
|
Service Code
|
CPT 26775
|
| Hospital Charge Code |
76100524
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$138.83 |
| Max. Negotiated Rate |
$760.00 |
| Rate for Payer: Aetna Commercial |
$684.00
|
| Rate for Payer: Aetna Medicare |
$259.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$323.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$323.76
|
| Rate for Payer: ASR ASR |
$737.20
|
| Rate for Payer: ASR Commercial |
$737.20
|
| Rate for Payer: BCBS Complete |
$145.77
|
| Rate for Payer: BCBS MAPPO |
$259.01
|
| Rate for Payer: BCBS Trust/PPO |
$622.36
|
| Rate for Payer: BCN Commercial |
$589.23
|
| Rate for Payer: BCN Medicare Advantage |
$259.01
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cofinity Commercial |
$714.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$608.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$259.01
|
| Rate for Payer: Healthscope Commercial |
$760.00
|
| Rate for Payer: Healthscope Whirlpool |
$737.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$259.01
|
| Rate for Payer: Mclaren Commercial |
$684.00
|
| Rate for Payer: Mclaren Medicaid |
$138.83
|
| Rate for Payer: Mclaren Medicare |
$259.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$271.96
|
| Rate for Payer: Meridian Medicaid |
$145.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$297.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$646.00
|
| Rate for Payer: Nomi Health Commercial |
$623.20
|
| Rate for Payer: PACE Medicare |
$246.06
|
| Rate for Payer: PACE SWMI |
$259.01
|
| Rate for Payer: PHP Commercial |
$284.91
|
| Rate for Payer: PHP Medicaid |
$138.83
|
| Rate for Payer: PHP Medicare Advantage |
$259.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$494.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$665.91
|
| Rate for Payer: Priority Health Medicare |
$259.01
|
| Rate for Payer: Priority Health Narrow Network |
$532.76
|
| Rate for Payer: Railroad Medicare Medicare |
$259.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$668.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$259.01
|
| Rate for Payer: UHC Exchange |
$401.47
|
| Rate for Payer: UHC Medicare Advantage |
$259.01
|
| Rate for Payer: UHCCP DNSP |
$259.01
|
| Rate for Payer: UHCCP Medicaid |
$138.83
|
| Rate for Payer: VA VA |
$259.01
|
|
|
HC CLOSED TX MED MALLEOLUS FX W/O MANIP
|
Facility
|
IP
|
$336.53
|
|
|
Service Code
|
CPT 27760
|
| Hospital Charge Code |
76100234
|
|
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 MED MALLEOLUS FX W/O MANIP
|
Facility
|
OP
|
$336.53
|
|
|
Service Code
|
CPT 27760
|
| Hospital Charge Code |
76100234
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.40 |
| Max. Negotiated Rate |
$362.62 |
| Rate for Payer: Aetna Commercial |
$302.88
|
| Rate for Payer: Aetna Medicare |
$233.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.44
|
| Rate for Payer: ASR ASR |
$326.43
|
| Rate for Payer: ASR Commercial |
$326.43
|
| Rate for Payer: BCBS Complete |
$131.67
|
| Rate for Payer: BCBS MAPPO |
$233.95
|
| Rate for Payer: BCBS Trust/PPO |
$275.58
|
| Rate for Payer: BCN Commercial |
$260.91
|
| Rate for Payer: BCN Medicare Advantage |
$233.95
|
| 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 |
$233.95
|
| Rate for Payer: Healthscope Commercial |
$336.53
|
| Rate for Payer: Healthscope Whirlpool |
$326.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$233.95
|
| Rate for Payer: Mclaren Commercial |
$302.88
|
| Rate for Payer: Mclaren Medicaid |
$125.40
|
| Rate for Payer: Mclaren Medicare |
$233.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.65
|
| Rate for Payer: Meridian Medicaid |
$131.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$269.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.05
|
| Rate for Payer: Nomi Health Commercial |
$275.95
|
| Rate for Payer: PACE Medicare |
$222.25
|
| Rate for Payer: PACE SWMI |
$233.95
|
| Rate for Payer: PHP Commercial |
$257.35
|
| Rate for Payer: PHP Medicaid |
$125.40
|
| Rate for Payer: PHP Medicare Advantage |
$233.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.40
|
| 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 |
$233.95
|
| Rate for Payer: Priority Health Narrow Network |
$235.91
|
| Rate for Payer: Railroad Medicare Medicare |
$233.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$296.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.95
|
| Rate for Payer: UHC Exchange |
$362.62
|
| Rate for Payer: UHC Medicare Advantage |
$233.95
|
| Rate for Payer: UHCCP DNSP |
$233.95
|
| Rate for Payer: UHCCP Medicaid |
$125.40
|
| Rate for Payer: VA VA |
$233.95
|
|
|
HC CLOSED TX NASAL BONE FX W/MNPJ W/O STABILIZ
|
Facility
|
IP
|
$3,009.00
|
|
|
Service Code
|
CPT 21315
|
| Hospital Charge Code |
76100447
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,955.85 |
| Max. Negotiated Rate |
$3,009.00 |
| Rate for Payer: Aetna Commercial |
$2,708.10
|
| Rate for Payer: ASR ASR |
$2,918.73
|
| Rate for Payer: ASR Commercial |
$2,918.73
|
| Rate for Payer: BCBS Trust/PPO |
$2,452.03
|
| Rate for Payer: BCN Commercial |
$2,332.88
|
| Rate for Payer: Cash Price |
$2,407.20
|
| Rate for Payer: Cofinity Commercial |
$2,828.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,407.20
|
| Rate for Payer: Healthscope Commercial |
$3,009.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,918.73
|
| Rate for Payer: Mclaren Commercial |
$2,708.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,557.65
|
| Rate for Payer: Nomi Health Commercial |
$2,467.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,955.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,647.92
|
|
|
HC CLOSED TX NASAL BONE FX W/MNPJ W/O STABILIZ
|
Facility
|
OP
|
$3,009.00
|
|
|
Service Code
|
CPT 21315
|
| Hospital Charge Code |
76100447
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$774.34 |
| Max. Negotiated Rate |
$3,009.00 |
| Rate for Payer: Aetna Commercial |
$2,708.10
|
| Rate for Payer: Aetna Medicare |
$1,444.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,805.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,805.83
|
| Rate for Payer: ASR ASR |
$2,918.73
|
| Rate for Payer: ASR Commercial |
$2,918.73
|
| Rate for Payer: BCBS Complete |
$813.05
|
| Rate for Payer: BCBS MAPPO |
$1,444.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,464.07
|
| Rate for Payer: BCN Commercial |
$2,332.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,444.66
|
| Rate for Payer: Cash Price |
$2,407.20
|
| Rate for Payer: Cash Price |
$2,407.20
|
| Rate for Payer: Cofinity Commercial |
$2,828.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,407.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,444.66
|
| Rate for Payer: Healthscope Commercial |
$3,009.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,918.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,444.66
|
| Rate for Payer: Mclaren Commercial |
$2,708.10
|
| Rate for Payer: Mclaren Medicaid |
$774.34
|
| Rate for Payer: Mclaren Medicare |
$1,444.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,516.89
|
| Rate for Payer: Meridian Medicaid |
$813.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,661.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,557.65
|
| Rate for Payer: Nomi Health Commercial |
$2,467.38
|
| Rate for Payer: PACE Medicare |
$1,372.43
|
| Rate for Payer: PACE SWMI |
$1,444.66
|
| Rate for Payer: PHP Commercial |
$1,589.13
|
| Rate for Payer: PHP Medicaid |
$774.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,444.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$774.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,955.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,636.49
|
| Rate for Payer: Priority Health Medicare |
$1,444.66
|
| Rate for Payer: Priority Health Narrow Network |
$2,109.31
|
| Rate for Payer: Railroad Medicare Medicare |
$1,444.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,647.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,444.66
|
| Rate for Payer: UHC Exchange |
$2,239.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,444.66
|
| Rate for Payer: UHCCP DNSP |
$1,444.66
|
| Rate for Payer: UHCCP Medicaid |
$774.34
|
| Rate for Payer: VA VA |
$1,444.66
|
|
