|
HC XR CHEST ABD FOREIG BOD CHILD
|
Facility
|
IP
|
$281.49
|
|
|
Service Code
|
CPT 76010
|
| Hospital Charge Code |
32000234
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$177.34 |
| Max. Negotiated Rate |
$253.34 |
| Rate for Payer: Aetna Commercial |
$239.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.97
|
| Rate for Payer: Cash Price |
$225.19
|
| Rate for Payer: Cofinity Advantage |
$197.04
|
| Rate for Payer: Cofinity Commercial |
$242.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.19
|
| Rate for Payer: Healthscope Commercial |
$253.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$211.12
|
| Rate for Payer: PHP Commercial |
$239.27
|
| Rate for Payer: Priority Health SBD |
$177.34
|
|
|
HC XR CHEST ABD FOREIG BOD CHILD
|
Facility
|
OP
|
$281.49
|
|
|
Service Code
|
CPT 76010
|
| Hospital Charge Code |
32000234
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$280.42 |
| Rate for Payer: Aetna Commercial |
$239.27
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$46.94
|
| Rate for Payer: BCN Commercial |
$46.94
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$225.19
|
| Rate for Payer: Cash Price |
$225.19
|
| Rate for Payer: Cofinity Advantage |
$197.04
|
| Rate for Payer: Cofinity Commercial |
$242.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$253.34
|
| Rate for Payer: Mclaren Medicaid |
$45.35
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.27
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$211.12
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$239.27
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$177.34
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.97
|
| Rate for Payer: UHC Core |
$146.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$110.63
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XR CHEST SINGLE VIEW
|
Facility
|
IP
|
$276.34
|
|
|
Service Code
|
CPT 71045
|
| Hospital Charge Code |
32400009
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$174.09 |
| Max. Negotiated Rate |
$248.71 |
| Rate for Payer: Aetna Commercial |
$234.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.62
|
| Rate for Payer: Cash Price |
$221.07
|
| Rate for Payer: Cofinity Advantage |
$193.44
|
| Rate for Payer: Cofinity Commercial |
$237.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.07
|
| Rate for Payer: Healthscope Commercial |
$248.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$207.25
|
| Rate for Payer: PHP Commercial |
$234.89
|
| Rate for Payer: Priority Health SBD |
$174.09
|
|
|
HC XR CHEST SINGLE VIEW
|
Facility
|
OP
|
$276.34
|
|
|
Service Code
|
CPT 71045
|
| Hospital Charge Code |
32400009
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$39.38 |
| Max. Negotiated Rate |
$280.42 |
| Rate for Payer: Aetna Commercial |
$234.89
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$39.38
|
| Rate for Payer: BCN Commercial |
$39.38
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$221.07
|
| Rate for Payer: Cash Price |
$221.07
|
| Rate for Payer: Cofinity Advantage |
$193.44
|
| Rate for Payer: Cofinity Commercial |
$237.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$248.71
|
| Rate for Payer: Mclaren Medicaid |
$45.35
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.89
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$207.25
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$234.89
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$174.09
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.62
|
| Rate for Payer: UHC Core |
$143.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$108.60
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XR CHOLANGIOGRAM IN OR
|
Facility
|
IP
|
$520.60
|
|
|
Service Code
|
CPT 74300
|
| Hospital Charge Code |
32000149
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$327.98 |
| Max. Negotiated Rate |
$468.54 |
| Rate for Payer: Aetna Commercial |
$442.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.39
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cofinity Advantage |
$364.42
|
| Rate for Payer: Cofinity Commercial |
$447.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.48
|
| Rate for Payer: Healthscope Commercial |
$468.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.45
|
| Rate for Payer: PHP Commercial |
$442.51
|
| Rate for Payer: Priority Health SBD |
$327.98
|
|
|
HC XR CHOLANGIOGRAM IN OR
|
Facility
|
OP
|
$520.60
|
|
|
Service Code
|
CPT 74300
|
| Hospital Charge Code |
32000149
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$93.13 |
| Max. Negotiated Rate |
$468.54 |
| Rate for Payer: Aetna Commercial |
$442.51
|
| Rate for Payer: Aetna Medicare |
$260.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.39
|
| Rate for Payer: BCBS Complete |
$208.24
|
| Rate for Payer: BCBS Trust/PPO |
$93.13
|
| Rate for Payer: BCN Commercial |
$93.13
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cofinity Advantage |
$364.42
|
| Rate for Payer: Cofinity Commercial |
$447.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.48
|
| Rate for Payer: Healthscope Commercial |
$468.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$416.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.45
|
| Rate for Payer: PHP Commercial |
$442.51
|
| Rate for Payer: Priority Health SBD |
$327.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$338.39
|
| Rate for Payer: UHC Core |
$271.23
|
| Rate for Payer: UHC Exchange |
$204.60
|
|
|
HC XR CLAVICLE
|
Facility
|
IP
|
$322.82
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000060
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$203.38 |
| Max. Negotiated Rate |
$290.54 |
| Rate for Payer: Aetna Commercial |
$274.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.83
|
| Rate for Payer: Cash Price |
$258.26
|
| Rate for Payer: Cofinity Advantage |
$225.97
|
| Rate for Payer: Cofinity Commercial |
$277.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.26
|
| Rate for Payer: Healthscope Commercial |
$290.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$242.12
|
| Rate for Payer: PHP Commercial |
$274.40
|
| Rate for Payer: Priority Health SBD |
$203.38
|
|
|
HC XR CLAVICLE
|
Facility
|
OP
|
$322.82
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000060
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$290.54 |
| Rate for Payer: Aetna Commercial |
$274.40
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$56.03
|
| Rate for Payer: BCN Commercial |
$56.03
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$258.26
|
| Rate for Payer: Cash Price |
$258.26
|
| Rate for Payer: Cofinity Advantage |
$225.97
|
| Rate for Payer: Cofinity Commercial |
$277.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$290.54
|
| Rate for Payer: Mclaren Medicaid |
$45.35
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274.40
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$242.12
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$274.40
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$203.38
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.83
|
| Rate for Payer: UHC Core |
$168.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$126.87
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XR CLAVICLE BIL
|
Facility
|
IP
|
$347.15
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000061
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$218.70 |
| Max. Negotiated Rate |
$312.44 |
| Rate for Payer: Aetna Commercial |
$295.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.65
|
| Rate for Payer: Cash Price |
$277.72
|
| Rate for Payer: Cofinity Advantage |
$243.00
|
| Rate for Payer: Cofinity Commercial |
$298.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.72
|
| Rate for Payer: Healthscope Commercial |
$312.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$295.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$260.36
|
| Rate for Payer: PHP Commercial |
$295.08
|
| Rate for Payer: Priority Health SBD |
$218.70
|
|
|
HC XR CLAVICLE BIL
|
Facility
|
OP
|
$347.15
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000061
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$312.44 |
| Rate for Payer: Aetna Commercial |
$295.08
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$56.03
|
| Rate for Payer: BCN Commercial |
$56.03
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$277.72
|
| Rate for Payer: Cash Price |
$277.72
|
| Rate for Payer: Cofinity Advantage |
$243.00
|
| Rate for Payer: Cofinity Commercial |
$298.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$312.44
|
| Rate for Payer: Mclaren Medicaid |
$45.35
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$295.08
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$260.36
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$295.08
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$218.70
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.65
|
| Rate for Payer: UHC Core |
$180.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$136.43
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XR COLON
|
Facility
|
IP
|
$874.59
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
32000273
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$550.99 |
| Max. Negotiated Rate |
$787.13 |
| Rate for Payer: Aetna Commercial |
$743.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$568.48
|
| Rate for Payer: Cash Price |
$699.67
|
| Rate for Payer: Cofinity Advantage |
$612.21
|
| Rate for Payer: Cofinity Commercial |
$752.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$699.67
|
| Rate for Payer: Healthscope Commercial |
$787.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$743.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$655.94
|
| Rate for Payer: PHP Commercial |
$743.40
|
| Rate for Payer: Priority Health SBD |
$550.99
|
|
|
HC XR COLON
|
Facility
|
OP
|
$874.59
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
32000273
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$787.13 |
| Rate for Payer: Aetna Commercial |
$743.40
|
| Rate for Payer: Aetna Medicare |
$181.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$568.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$232.45
|
| Rate for Payer: BCN Commercial |
$232.45
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$699.67
|
| Rate for Payer: Cash Price |
$699.67
|
| Rate for Payer: Cofinity Advantage |
$612.21
|
| Rate for Payer: Cofinity Commercial |
$752.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$699.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$787.13
|
| Rate for Payer: Mclaren Medicaid |
$91.40
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$743.40
|
| Rate for Payer: Nomi Health Commercial |
$524.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$655.94
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$743.40
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$565.19
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health SBD |
$550.99
|
| Rate for Payer: Priority Health Tiered Network |
$452.15
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$568.48
|
| Rate for Payer: UHC Core |
$455.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$343.71
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
|
HC XR COLON HIGH DENSITY
|
Facility
|
OP
|
$1,249.37
|
|
|
Service Code
|
CPT 74280
|
| Hospital Charge Code |
32000146
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$1,124.43 |
| Rate for Payer: Aetna Commercial |
$1,061.96
|
| Rate for Payer: Aetna Medicare |
$181.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$812.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$354.35
|
| Rate for Payer: BCN Commercial |
$354.35
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$999.50
|
| Rate for Payer: Cash Price |
$999.50
|
| Rate for Payer: Cofinity Advantage |
$874.56
|
| Rate for Payer: Cofinity Commercial |
$1,074.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$999.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$1,124.43
|
| Rate for Payer: Mclaren Medicaid |
$91.40
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,061.96
|
| Rate for Payer: Nomi Health Commercial |
$524.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$937.03
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$1,061.96
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$565.19
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health SBD |
$787.10
|
| Rate for Payer: Priority Health Tiered Network |
$452.15
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$812.09
|
| Rate for Payer: UHC Core |
$650.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$491.00
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
|
HC XR COLON HIGH DENSITY
|
Facility
|
IP
|
$1,249.37
|
|
|
Service Code
|
CPT 74280
|
| Hospital Charge Code |
32000146
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$787.10 |
| Max. Negotiated Rate |
$1,124.43 |
| Rate for Payer: Aetna Commercial |
$1,061.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$812.09
|
| Rate for Payer: Cash Price |
$999.50
|
| Rate for Payer: Cofinity Advantage |
$874.56
|
| Rate for Payer: Cofinity Commercial |
$1,074.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$999.50
|
| Rate for Payer: Healthscope Commercial |
$1,124.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,061.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$937.03
|
| Rate for Payer: PHP Commercial |
$1,061.96
|
| Rate for Payer: Priority Health SBD |
$787.10
|
|
|
HC XR COLON THERAPEUTIC FOR INTUS
|
Facility
|
OP
|
$608.92
|
|
|
Service Code
|
CPT 74283
|
| Hospital Charge Code |
32000147
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$565.19 |
| Rate for Payer: Aetna Commercial |
$517.58
|
| Rate for Payer: Aetna Medicare |
$181.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$395.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$362.68
|
| Rate for Payer: BCN Commercial |
$362.68
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$487.14
|
| Rate for Payer: Cash Price |
$487.14
|
| Rate for Payer: Cofinity Advantage |
$426.24
|
| Rate for Payer: Cofinity Commercial |
$523.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$487.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$548.03
|
| Rate for Payer: Mclaren Medicaid |
$91.40
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$517.58
|
| Rate for Payer: Nomi Health Commercial |
$524.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$456.69
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$517.58
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$565.19
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health SBD |
$383.62
|
| Rate for Payer: Priority Health Tiered Network |
$452.15
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$395.80
|
| Rate for Payer: UHC Core |
$317.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$239.31
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
|
HC XR COLON THERAPEUTIC FOR INTUS
|
Facility
|
IP
|
$608.92
|
|
|
Service Code
|
CPT 74283
|
| Hospital Charge Code |
32000147
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$383.62 |
| Max. Negotiated Rate |
$548.03 |
| Rate for Payer: Aetna Commercial |
$517.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$395.80
|
| Rate for Payer: Cash Price |
$487.14
|
| Rate for Payer: Cofinity Advantage |
$426.24
|
| Rate for Payer: Cofinity Commercial |
$523.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$487.14
|
| Rate for Payer: Healthscope Commercial |
$548.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$517.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$456.69
|
| Rate for Payer: PHP Commercial |
$517.58
|
| Rate for Payer: Priority Health SBD |
$383.62
|
|
|
HC XR CYSTOGRAM MIN 3 VW
|
Facility
|
OP
|
$447.83
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000163
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.82 |
| Max. Negotiated Rate |
$1,124.16 |
| Rate for Payer: Aetna Commercial |
$380.66
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$291.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$59.82
|
| Rate for Payer: BCN Commercial |
$59.82
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$358.26
|
| Rate for Payer: Cash Price |
$358.26
|
| Rate for Payer: Cofinity Advantage |
$313.48
|
| Rate for Payer: Cofinity Commercial |
$385.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$403.05
|
| Rate for Payer: Mclaren Medicaid |
$181.81
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.66
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.87
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$380.66
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$282.13
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.09
|
| Rate for Payer: UHC Core |
$233.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$176.00
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC XR CYSTOGRAM MIN 3 VW
|
Facility
|
IP
|
$447.83
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000163
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$282.13 |
| Max. Negotiated Rate |
$403.05 |
| Rate for Payer: Aetna Commercial |
$380.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$291.09
|
| Rate for Payer: Cash Price |
$358.26
|
| Rate for Payer: Cofinity Advantage |
$313.48
|
| Rate for Payer: Cofinity Commercial |
$385.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.26
|
| Rate for Payer: Healthscope Commercial |
$403.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.87
|
| Rate for Payer: PHP Commercial |
$380.66
|
| Rate for Payer: Priority Health SBD |
$282.13
|
|
|
HC XR CYSTOGRAM VOIDING
|
Facility
|
IP
|
$520.60
|
|
|
Service Code
|
CPT 74455
|
| Hospital Charge Code |
32000166
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$327.98 |
| Max. Negotiated Rate |
$468.54 |
| Rate for Payer: Aetna Commercial |
$442.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.39
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cofinity Advantage |
$364.42
|
| Rate for Payer: Cofinity Commercial |
$447.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.48
|
| Rate for Payer: Healthscope Commercial |
$468.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.45
|
| Rate for Payer: PHP Commercial |
$442.51
|
| Rate for Payer: Priority Health SBD |
$327.98
|
|
|
HC XR CYSTOGRAM VOIDING
|
Facility
|
OP
|
$520.60
|
|
|
Service Code
|
CPT 74455
|
| Hospital Charge Code |
32000166
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$768.83 |
| Rate for Payer: Aetna Commercial |
$442.51
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$195.34
|
| Rate for Payer: BCN Commercial |
$195.34
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cofinity Advantage |
$364.42
|
| Rate for Payer: Cofinity Commercial |
$447.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$468.54
|
| Rate for Payer: Mclaren Medicaid |
$124.34
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.51
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.45
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$442.51
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$327.98
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$338.39
|
| Rate for Payer: UHC Core |
$271.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$204.60
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC XR DEFECOGRAPHY 4 WAY
|
Facility
|
OP
|
$832.87
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000164
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.82 |
| Max. Negotiated Rate |
$1,124.16 |
| Rate for Payer: Aetna Commercial |
$707.94
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$541.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$59.82
|
| Rate for Payer: BCN Commercial |
$59.82
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Advantage |
$583.01
|
| Rate for Payer: Cofinity Commercial |
$716.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$749.58
|
| Rate for Payer: Mclaren Medicaid |
$181.81
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$707.94
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$524.71
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$541.37
|
| Rate for Payer: UHC Core |
$433.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$327.32
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC XR DEFECOGRAPHY 4 WAY
|
Facility
|
IP
|
$832.87
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000164
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$524.71 |
| Max. Negotiated Rate |
$749.58 |
| Rate for Payer: Aetna Commercial |
$707.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$541.37
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Advantage |
$583.01
|
| Rate for Payer: Cofinity Commercial |
$716.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Healthscope Commercial |
$749.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: PHP Commercial |
$707.94
|
| Rate for Payer: Priority Health SBD |
$524.71
|
|
|
HC XR ELBOW 2 BIL VW
|
Facility
|
OP
|
$396.48
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000072
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$356.83 |
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$48.46
|
| Rate for Payer: BCN Commercial |
$48.46
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Advantage |
$277.54
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Mclaren Medicaid |
$45.35
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$249.78
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.71
|
| Rate for Payer: UHC Core |
$206.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$155.82
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XR ELBOW 2 BIL VW
|
Facility
|
IP
|
$396.48
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000072
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$249.78 |
| Max. Negotiated Rate |
$356.83 |
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.71
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Advantage |
$277.54
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: Priority Health SBD |
$249.78
|
|
|
HC XR ELBOW 2 VW
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000071
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$328.08 |
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$48.46
|
| Rate for Payer: BCN Commercial |
$48.46
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Advantage |
$255.17
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Mclaren Medicaid |
$45.35
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$229.65
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.94
|
| Rate for Payer: UHC Core |
$189.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$143.26
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
