|
HC SPINE THORACIC W CON
|
Facility
|
OP
|
$2,199.20
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200008
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,199.20 |
| Rate for Payer: Aetna Commercial |
$1,979.28
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: ASR ASR |
$2,133.22
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,705.04
|
| Rate for Payer: BCN Commercial |
$1,705.04
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$1,759.36
|
| Rate for Payer: Cash Price |
$1,759.36
|
| Rate for Payer: Cofinity Commercial |
$2,067.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,759.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,199.20
|
| Rate for Payer: Healthscope Whirlpool |
$2,133.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$1,979.28
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,869.32
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,539.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,698.84
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,359.07
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,935.30
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC SPINE THORACIC W CON
|
Facility
|
IP
|
$2,199.20
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200008
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,539.44 |
| Max. Negotiated Rate |
$2,199.20 |
| Rate for Payer: Aetna Commercial |
$1,979.28
|
| Rate for Payer: ASR ASR |
$2,133.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,705.04
|
| Rate for Payer: BCN Commercial |
$1,705.04
|
| Rate for Payer: Cash Price |
$1,759.36
|
| Rate for Payer: Cofinity Commercial |
$2,067.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,759.36
|
| Rate for Payer: Healthscope Commercial |
$2,199.20
|
| Rate for Payer: Healthscope Whirlpool |
$2,133.22
|
| Rate for Payer: Mclaren Commercial |
$1,979.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,869.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,539.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,935.30
|
|
|
HC SP INJECTION TENDON SHEATH
|
Facility
|
OP
|
$314.06
|
|
|
Service Code
|
CPT 20550
|
| Hospital Charge Code |
36100320
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$144.01 |
| Max. Negotiated Rate |
$377.64 |
| Rate for Payer: Aetna Commercial |
$282.65
|
| Rate for Payer: Aetna Medicare |
$263.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
| Rate for Payer: ASR ASR |
$304.64
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$243.49
|
| Rate for Payer: BCN Commercial |
$243.49
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$251.25
|
| Rate for Payer: Cash Price |
$251.25
|
| Rate for Payer: Cofinity Commercial |
$295.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$251.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$314.06
|
| Rate for Payer: Healthscope Whirlpool |
$304.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$263.27
|
| Rate for Payer: Mclaren Commercial |
$282.65
|
| Rate for Payer: Mclaren Medicaid |
$144.01
|
| Rate for Payer: Mclaren Medicare |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$151.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$266.95
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$289.60
|
| Rate for Payer: PHP Medicaid |
$144.01
|
| Rate for Payer: PHP Medicare Advantage |
$263.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$377.64
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$302.11
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$276.37
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: VA VA |
$263.27
|
|
|
HC SP INJECTION TENDON SHEATH
|
Facility
|
IP
|
$314.06
|
|
|
Service Code
|
CPT 20550
|
| Hospital Charge Code |
36100320
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$219.84 |
| Max. Negotiated Rate |
$314.06 |
| Rate for Payer: Aetna Commercial |
$282.65
|
| Rate for Payer: ASR ASR |
$304.64
|
| Rate for Payer: BCBS Trust/PPO |
$243.49
|
| Rate for Payer: BCN Commercial |
$243.49
|
| Rate for Payer: Cash Price |
$251.25
|
| Rate for Payer: Cofinity Commercial |
$295.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$251.25
|
| Rate for Payer: Healthscope Commercial |
$314.06
|
| Rate for Payer: Healthscope Whirlpool |
$304.64
|
| Rate for Payer: Mclaren Commercial |
$282.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$266.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$276.37
|
|
|
HC SP INSERTION IVC FILTER
|
Facility
|
OP
|
$7,147.16
|
|
|
Service Code
|
CPT 37191
|
| Hospital Charge Code |
36100351
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,671.93 |
| Max. Negotiated Rate |
$7,147.16 |
| Rate for Payer: Aetna Commercial |
$6,432.44
|
| Rate for Payer: Aetna Medicare |
$4,884.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,105.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,105.86
|
| Rate for Payer: ASR ASR |
$6,932.75
|
| Rate for Payer: BCBS Complete |
$2,805.77
|
| Rate for Payer: BCBS MAPPO |
$4,884.69
|
| Rate for Payer: BCBS Trust/PPO |
$5,541.19
|
| Rate for Payer: BCN Commercial |
$5,541.19
|
| Rate for Payer: BCN Medicare Advantage |
$4,884.69
|
| Rate for Payer: Cash Price |
$5,717.73
|
| Rate for Payer: Cash Price |
$5,717.73
|
| Rate for Payer: Cofinity Commercial |
$6,718.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,717.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,884.69
|
| Rate for Payer: Healthscope Commercial |
$7,147.16
|
| Rate for Payer: Healthscope Whirlpool |
$6,932.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$4,884.69
|
| Rate for Payer: Mclaren Commercial |
$6,432.44
|
| Rate for Payer: Mclaren Medicaid |
$2,671.93
|
| Rate for Payer: Mclaren Medicare |
$4,884.69
|
| Rate for Payer: Meridian Medicaid |
$2,805.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,128.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,617.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,075.09
|
| Rate for Payer: PACE Medicare |
$4,640.46
|
| Rate for Payer: PACE SWMI |
$4,884.69
|
| Rate for Payer: PHP Commercial |
$5,373.16
|
| Rate for Payer: PHP Medicaid |
$2,671.93
|
| Rate for Payer: PHP Medicare Advantage |
$4,884.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,671.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,003.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,503.92
|
| Rate for Payer: Priority Health Medicare |
$4,884.69
|
| Rate for Payer: Priority Health Narrow Network |
$5,074.48
|
| Rate for Payer: Railroad Medicare Medicare |
$4,884.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,289.50
|
| Rate for Payer: UHC Medicare Advantage |
$5,031.23
|
| Rate for Payer: VA VA |
$4,884.69
|
|
|
HC SP INSERTION IVC FILTER
|
Facility
|
IP
|
$7,147.16
|
|
|
Service Code
|
CPT 37191
|
| Hospital Charge Code |
36100351
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,003.01 |
| Max. Negotiated Rate |
$7,147.16 |
| Rate for Payer: Aetna Commercial |
$6,432.44
|
| Rate for Payer: ASR ASR |
$6,932.75
|
| Rate for Payer: BCBS Trust/PPO |
$5,541.19
|
| Rate for Payer: BCN Commercial |
$5,541.19
|
| Rate for Payer: Cash Price |
$5,717.73
|
| Rate for Payer: Cofinity Commercial |
$6,718.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,717.73
|
| Rate for Payer: Healthscope Commercial |
$7,147.16
|
| Rate for Payer: Healthscope Whirlpool |
$6,932.75
|
| Rate for Payer: Mclaren Commercial |
$6,432.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,075.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,003.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,289.50
|
|
|
HC SPIROMETRY
|
Facility
|
OP
|
$314.79
|
|
|
Service Code
|
CPT 94010
|
| Hospital Charge Code |
46000014
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$75.95 |
| Max. Negotiated Rate |
$314.79 |
| Rate for Payer: Aetna Commercial |
$283.31
|
| Rate for Payer: Aetna Medicare |
$138.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.56
|
| Rate for Payer: ASR ASR |
$305.35
|
| Rate for Payer: BCBS Complete |
$79.76
|
| Rate for Payer: BCBS MAPPO |
$138.85
|
| Rate for Payer: BCBS Trust/PPO |
$244.06
|
| Rate for Payer: BCN Commercial |
$244.06
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$251.83
|
| Rate for Payer: Cash Price |
$251.83
|
| Rate for Payer: Cofinity Commercial |
$295.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$251.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$314.79
|
| Rate for Payer: Healthscope Whirlpool |
$305.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$138.85
|
| Rate for Payer: Mclaren Commercial |
$283.31
|
| Rate for Payer: Mclaren Medicaid |
$75.95
|
| Rate for Payer: Mclaren Medicare |
$138.85
|
| Rate for Payer: Meridian Medicaid |
$79.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$267.57
|
| Rate for Payer: PACE Medicare |
$131.91
|
| Rate for Payer: PACE SWMI |
$138.85
|
| Rate for Payer: PHP Commercial |
$152.74
|
| Rate for Payer: PHP Medicaid |
$75.95
|
| Rate for Payer: PHP Medicare Advantage |
$138.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.61
|
| Rate for Payer: Priority Health Medicare |
$138.85
|
| Rate for Payer: Priority Health Narrow Network |
$113.29
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$277.02
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: VA VA |
$138.85
|
|
|
HC SPIROMETRY
|
Facility
|
IP
|
$314.79
|
|
|
Service Code
|
CPT 94010
|
| Hospital Charge Code |
46000014
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$220.35 |
| Max. Negotiated Rate |
$314.79 |
| Rate for Payer: Aetna Commercial |
$283.31
|
| Rate for Payer: ASR ASR |
$305.35
|
| Rate for Payer: BCBS Trust/PPO |
$244.06
|
| Rate for Payer: BCN Commercial |
$244.06
|
| Rate for Payer: Cash Price |
$251.83
|
| Rate for Payer: Cofinity Commercial |
$295.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$251.83
|
| Rate for Payer: Healthscope Commercial |
$314.79
|
| Rate for Payer: Healthscope Whirlpool |
$305.35
|
| Rate for Payer: Mclaren Commercial |
$283.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$267.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$277.02
|
|
|
HC SPIROMETRY W/DRUG
|
Facility
|
IP
|
$555.21
|
|
|
Service Code
|
CPT 94060
|
| Hospital Charge Code |
46000002
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$388.65 |
| Max. Negotiated Rate |
$555.21 |
| Rate for Payer: Aetna Commercial |
$499.69
|
| Rate for Payer: ASR ASR |
$538.55
|
| Rate for Payer: BCBS Trust/PPO |
$430.45
|
| Rate for Payer: BCN Commercial |
$430.45
|
| Rate for Payer: Cash Price |
$444.17
|
| Rate for Payer: Cofinity Commercial |
$521.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$444.17
|
| Rate for Payer: Healthscope Commercial |
$555.21
|
| Rate for Payer: Healthscope Whirlpool |
$538.55
|
| Rate for Payer: Mclaren Commercial |
$499.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$471.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$488.58
|
|
|
HC SPIROMETRY W/DRUG
|
Facility
|
OP
|
$555.21
|
|
|
Service Code
|
CPT 94060
|
| Hospital Charge Code |
46000002
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$152.61 |
| Max. Negotiated Rate |
$555.21 |
| Rate for Payer: Aetna Commercial |
$499.69
|
| Rate for Payer: Aetna Medicare |
$279.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: ASR ASR |
$538.55
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$430.45
|
| Rate for Payer: BCN Commercial |
$430.45
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$444.17
|
| Rate for Payer: Cash Price |
$444.17
|
| Rate for Payer: Cofinity Commercial |
$521.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$444.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$555.21
|
| Rate for Payer: Healthscope Whirlpool |
$538.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$279.00
|
| Rate for Payer: Mclaren Commercial |
$499.69
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$471.93
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$306.90
|
| Rate for Payer: PHP Medicaid |
$152.61
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$383.79
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$307.03
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$488.58
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: VA VA |
$279.00
|
|
|
HC SPLENOPORTOGRAPHY
|
Facility
|
IP
|
$4,118.56
|
|
|
Service Code
|
CPT 75810
|
| Hospital Charge Code |
32000318
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,882.99 |
| Max. Negotiated Rate |
$4,118.56 |
| Rate for Payer: Aetna Commercial |
$3,706.70
|
| Rate for Payer: ASR ASR |
$3,995.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,193.12
|
| Rate for Payer: BCN Commercial |
$3,193.12
|
| Rate for Payer: Cash Price |
$3,294.85
|
| Rate for Payer: Cofinity Commercial |
$3,871.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,294.85
|
| Rate for Payer: Healthscope Commercial |
$4,118.56
|
| Rate for Payer: Healthscope Whirlpool |
$3,995.00
|
| Rate for Payer: Mclaren Commercial |
$3,706.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,500.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,882.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,624.33
|
|
|
HC SPLENOPORTOGRAPHY
|
Facility
|
OP
|
$4,118.56
|
|
|
Service Code
|
CPT 75810
|
| Hospital Charge Code |
32000318
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,549.81 |
| Max. Negotiated Rate |
$4,118.56 |
| Rate for Payer: Aetna Commercial |
$3,706.70
|
| Rate for Payer: Aetna Medicare |
$2,833.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: ASR ASR |
$3,995.00
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$3,193.12
|
| Rate for Payer: BCN Commercial |
$3,193.12
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$3,294.85
|
| Rate for Payer: Cash Price |
$3,294.85
|
| Rate for Payer: Cofinity Commercial |
$3,871.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,294.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$4,118.56
|
| Rate for Payer: Healthscope Whirlpool |
$3,995.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$3,706.70
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,500.78
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,116.62
|
| Rate for Payer: PHP Medicaid |
$1,549.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,882.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,747.89
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,924.18
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,624.33
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC SPLINT FINGER DYNAMIC
|
Facility
|
IP
|
$137.49
|
|
|
Service Code
|
CPT 29131
|
| Hospital Charge Code |
43000005
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$96.24 |
| Max. Negotiated Rate |
$137.49 |
| Rate for Payer: Aetna Commercial |
$123.74
|
| Rate for Payer: ASR ASR |
$133.37
|
| Rate for Payer: BCBS Trust/PPO |
$106.60
|
| Rate for Payer: BCN Commercial |
$106.60
|
| Rate for Payer: Cash Price |
$109.99
|
| Rate for Payer: Cofinity Commercial |
$129.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.99
|
| Rate for Payer: Healthscope Commercial |
$137.49
|
| Rate for Payer: Healthscope Whirlpool |
$133.37
|
| Rate for Payer: Mclaren Commercial |
$123.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$116.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$120.99
|
|
|
HC SPLINT FINGER DYNAMIC
|
Facility
|
OP
|
$137.49
|
|
|
Service Code
|
CPT 29131
|
| Hospital Charge Code |
43000005
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$29.74 |
| Max. Negotiated Rate |
$160.57 |
| Rate for Payer: Aetna Commercial |
$123.74
|
| Rate for Payer: Aetna Medicare |
$54.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: ASR ASR |
$133.37
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$106.60
|
| Rate for Payer: BCN Commercial |
$106.60
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$109.99
|
| Rate for Payer: Cash Price |
$109.99
|
| Rate for Payer: Cofinity Commercial |
$129.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$137.49
|
| Rate for Payer: Healthscope Whirlpool |
$133.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$54.37
|
| Rate for Payer: Mclaren Commercial |
$123.74
|
| Rate for Payer: Mclaren Medicaid |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$116.87
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$59.81
|
| Rate for Payer: PHP Medicaid |
$29.74
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.57
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$128.46
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$120.99
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: VA VA |
$54.37
|
|
|
HC SPLINT FINGER STATIC
|
Facility
|
IP
|
$137.49
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
43000004
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$96.24 |
| Max. Negotiated Rate |
$137.49 |
| Rate for Payer: Aetna Commercial |
$123.74
|
| Rate for Payer: ASR ASR |
$133.37
|
| Rate for Payer: BCBS Trust/PPO |
$106.60
|
| Rate for Payer: BCN Commercial |
$106.60
|
| Rate for Payer: Cash Price |
$109.99
|
| Rate for Payer: Cofinity Commercial |
$129.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.99
|
| Rate for Payer: Healthscope Commercial |
$137.49
|
| Rate for Payer: Healthscope Whirlpool |
$133.37
|
| Rate for Payer: Mclaren Commercial |
$123.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$116.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$120.99
|
|
|
HC SPLINT FINGER STATIC
|
Facility
|
OP
|
$137.49
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
43000004
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$160.57 |
| Rate for Payer: Aetna Commercial |
$123.74
|
| Rate for Payer: Aetna Medicare |
$113.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: ASR ASR |
$133.37
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$106.60
|
| Rate for Payer: BCN Commercial |
$106.60
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$109.99
|
| Rate for Payer: Cash Price |
$109.99
|
| Rate for Payer: Cofinity Commercial |
$129.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$137.49
|
| Rate for Payer: Healthscope Whirlpool |
$133.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$113.55
|
| Rate for Payer: Mclaren Commercial |
$123.74
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$116.87
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$124.90
|
| Rate for Payer: PHP Medicaid |
$62.11
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.57
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$128.46
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$120.99
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: VA VA |
$113.55
|
|
|
HC SPLINT LONG ARM
|
Facility
|
IP
|
$389.19
|
|
|
Service Code
|
CPT 29105
|
| Hospital Charge Code |
70000002
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$272.43 |
| Max. Negotiated Rate |
$389.19 |
| Rate for Payer: Aetna Commercial |
$350.27
|
| Rate for Payer: ASR ASR |
$377.51
|
| Rate for Payer: BCBS Trust/PPO |
$301.74
|
| Rate for Payer: BCN Commercial |
$301.74
|
| Rate for Payer: Cash Price |
$311.35
|
| Rate for Payer: Cofinity Commercial |
$365.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$311.35
|
| Rate for Payer: Healthscope Commercial |
$389.19
|
| Rate for Payer: Healthscope Whirlpool |
$377.51
|
| Rate for Payer: Mclaren Commercial |
$350.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$330.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$272.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$342.49
|
|
|
HC SPLINT LONG ARM
|
Facility
|
OP
|
$389.19
|
|
|
Service Code
|
CPT 29105
|
| Hospital Charge Code |
70000002
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$76.61 |
| Max. Negotiated Rate |
$389.19 |
| Rate for Payer: Aetna Commercial |
$350.27
|
| Rate for Payer: Aetna Medicare |
$140.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.08
|
| Rate for Payer: ASR ASR |
$377.51
|
| Rate for Payer: BCBS Complete |
$80.45
|
| Rate for Payer: BCBS MAPPO |
$140.06
|
| Rate for Payer: BCBS Trust/PPO |
$301.74
|
| Rate for Payer: BCN Commercial |
$301.74
|
| Rate for Payer: BCN Medicare Advantage |
$140.06
|
| Rate for Payer: Cash Price |
$311.35
|
| Rate for Payer: Cash Price |
$311.35
|
| Rate for Payer: Cofinity Commercial |
$365.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$311.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.06
|
| Rate for Payer: Healthscope Commercial |
$389.19
|
| Rate for Payer: Healthscope Whirlpool |
$377.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$140.06
|
| Rate for Payer: Mclaren Commercial |
$350.27
|
| Rate for Payer: Mclaren Medicaid |
$76.61
|
| Rate for Payer: Mclaren Medicare |
$140.06
|
| Rate for Payer: Meridian Medicaid |
$80.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$330.81
|
| Rate for Payer: PACE Medicare |
$133.06
|
| Rate for Payer: PACE SWMI |
$140.06
|
| Rate for Payer: PHP Commercial |
$154.07
|
| Rate for Payer: PHP Medicaid |
$76.61
|
| Rate for Payer: PHP Medicare Advantage |
$140.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$272.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.57
|
| Rate for Payer: Priority Health Medicare |
$140.06
|
| Rate for Payer: Priority Health Narrow Network |
$128.46
|
| Rate for Payer: Railroad Medicare Medicare |
$140.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$342.49
|
| Rate for Payer: UHC Medicare Advantage |
$144.26
|
| Rate for Payer: VA VA |
$140.06
|
|
|
HC SPLINT LONG LEG
|
Facility
|
OP
|
$350.37
|
|
|
Service Code
|
CPT 29505
|
| Hospital Charge Code |
70000012
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$76.61 |
| Max. Negotiated Rate |
$350.37 |
| Rate for Payer: Aetna Commercial |
$315.33
|
| Rate for Payer: Aetna Medicare |
$140.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.08
|
| Rate for Payer: ASR ASR |
$339.86
|
| Rate for Payer: BCBS Complete |
$80.45
|
| Rate for Payer: BCBS MAPPO |
$140.06
|
| Rate for Payer: BCBS Trust/PPO |
$271.64
|
| Rate for Payer: BCN Commercial |
$271.64
|
| Rate for Payer: BCN Medicare Advantage |
$140.06
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cofinity Commercial |
$329.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.06
|
| Rate for Payer: Healthscope Commercial |
$350.37
|
| Rate for Payer: Healthscope Whirlpool |
$339.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$140.06
|
| Rate for Payer: Mclaren Commercial |
$315.33
|
| Rate for Payer: Mclaren Medicaid |
$76.61
|
| Rate for Payer: Mclaren Medicare |
$140.06
|
| Rate for Payer: Meridian Medicaid |
$80.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.81
|
| Rate for Payer: PACE Medicare |
$133.06
|
| Rate for Payer: PACE SWMI |
$140.06
|
| Rate for Payer: PHP Commercial |
$154.07
|
| Rate for Payer: PHP Medicaid |
$76.61
|
| Rate for Payer: PHP Medicare Advantage |
$140.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.57
|
| Rate for Payer: Priority Health Medicare |
$140.06
|
| Rate for Payer: Priority Health Narrow Network |
$128.46
|
| Rate for Payer: Railroad Medicare Medicare |
$140.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.33
|
| Rate for Payer: UHC Medicare Advantage |
$144.26
|
| Rate for Payer: VA VA |
$140.06
|
|
|
HC SPLINT LONG LEG
|
Facility
|
IP
|
$350.37
|
|
|
Service Code
|
CPT 29505
|
| Hospital Charge Code |
70000012
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$245.26 |
| Max. Negotiated Rate |
$350.37 |
| Rate for Payer: Aetna Commercial |
$315.33
|
| Rate for Payer: ASR ASR |
$339.86
|
| Rate for Payer: BCBS Trust/PPO |
$271.64
|
| Rate for Payer: BCN Commercial |
$271.64
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cofinity Commercial |
$329.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.30
|
| Rate for Payer: Healthscope Commercial |
$350.37
|
| Rate for Payer: Healthscope Whirlpool |
$339.86
|
| Rate for Payer: Mclaren Commercial |
$315.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.33
|
|
|
HC SPLINT SHORT ARM DYNAMIC
|
Facility
|
OP
|
$541.49
|
|
|
Service Code
|
CPT 29126
|
| Hospital Charge Code |
43000003
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$541.49 |
| Rate for Payer: Aetna Commercial |
$487.34
|
| Rate for Payer: Aetna Medicare |
$113.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: ASR ASR |
$525.25
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$419.82
|
| Rate for Payer: BCN Commercial |
$419.82
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$433.19
|
| Rate for Payer: Cash Price |
$433.19
|
| Rate for Payer: Cofinity Commercial |
$509.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$541.49
|
| Rate for Payer: Healthscope Whirlpool |
$525.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$113.55
|
| Rate for Payer: Mclaren Commercial |
$487.34
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$460.27
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$124.90
|
| Rate for Payer: PHP Medicaid |
$62.11
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$492.76
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$384.46
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$476.51
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: VA VA |
$113.55
|
|
|
HC SPLINT SHORT ARM DYNAMIC
|
Facility
|
IP
|
$541.49
|
|
|
Service Code
|
CPT 29126
|
| Hospital Charge Code |
43000003
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$379.04 |
| Max. Negotiated Rate |
$541.49 |
| Rate for Payer: Aetna Commercial |
$487.34
|
| Rate for Payer: ASR ASR |
$525.25
|
| Rate for Payer: BCBS Trust/PPO |
$419.82
|
| Rate for Payer: BCN Commercial |
$419.82
|
| Rate for Payer: Cash Price |
$433.19
|
| Rate for Payer: Cofinity Commercial |
$509.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.19
|
| Rate for Payer: Healthscope Commercial |
$541.49
|
| Rate for Payer: Healthscope Whirlpool |
$525.25
|
| Rate for Payer: Mclaren Commercial |
$487.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$460.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$476.51
|
|
|
HC SPLINT SHORT ARM STATIC
|
Facility
|
IP
|
$234.60
|
|
|
Service Code
|
CPT 29125
|
| Hospital Charge Code |
43000002
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$164.22 |
| Max. Negotiated Rate |
$234.60 |
| Rate for Payer: Aetna Commercial |
$211.14
|
| Rate for Payer: ASR ASR |
$227.56
|
| Rate for Payer: BCBS Trust/PPO |
$181.89
|
| Rate for Payer: BCN Commercial |
$181.89
|
| Rate for Payer: Cash Price |
$187.68
|
| Rate for Payer: Cofinity Commercial |
$220.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.68
|
| Rate for Payer: Healthscope Commercial |
$234.60
|
| Rate for Payer: Healthscope Whirlpool |
$227.56
|
| Rate for Payer: Mclaren Commercial |
$211.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$199.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$206.45
|
|
|
HC SPLINT SHORT ARM STATIC
|
Facility
|
OP
|
$234.60
|
|
|
Service Code
|
CPT 29125
|
| Hospital Charge Code |
43000002
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$234.60 |
| Rate for Payer: Aetna Commercial |
$211.14
|
| Rate for Payer: Aetna Medicare |
$113.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: ASR ASR |
$227.56
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$181.89
|
| Rate for Payer: BCN Commercial |
$181.89
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$187.68
|
| Rate for Payer: Cash Price |
$187.68
|
| Rate for Payer: Cofinity Commercial |
$220.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$234.60
|
| Rate for Payer: Healthscope Whirlpool |
$227.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$113.55
|
| Rate for Payer: Mclaren Commercial |
$211.14
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$199.41
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$124.90
|
| Rate for Payer: PHP Medicaid |
$62.11
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.57
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$128.46
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$206.45
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: VA VA |
$113.55
|
|
|
HC SPLINT SHORT LEG
|
Facility
|
IP
|
$370.34
|
|
|
Service Code
|
CPT 29515
|
| Hospital Charge Code |
70000013
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$259.24 |
| Max. Negotiated Rate |
$370.34 |
| Rate for Payer: Aetna Commercial |
$333.31
|
| Rate for Payer: ASR ASR |
$359.23
|
| Rate for Payer: BCBS Trust/PPO |
$287.12
|
| Rate for Payer: BCN Commercial |
$287.12
|
| Rate for Payer: Cash Price |
$296.27
|
| Rate for Payer: Cofinity Commercial |
$348.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.27
|
| Rate for Payer: Healthscope Commercial |
$370.34
|
| Rate for Payer: Healthscope Whirlpool |
$359.23
|
| Rate for Payer: Mclaren Commercial |
$333.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$314.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$325.90
|
|
