|
HC XR EYE FOREIGN BODY PRE MRI
|
Facility
|
OP
|
$459.68
|
|
|
Service Code
|
CPT 70030
|
| Hospital Charge Code |
32000305
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$413.71 |
| Rate for Payer: Aetna Commercial |
$390.73
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$298.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$367.74
|
| Rate for Payer: Cash Price |
$367.74
|
| Rate for Payer: Cofinity Commercial |
$395.32
|
| Rate for Payer: Cofinity Commercial |
$321.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$321.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$413.71
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.73
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$390.73
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.79
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$289.60
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$340.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$340.16
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$48.34
|
| Rate for Payer: VA VA |
$85.87
|
|
|
HC XR EYE FOR FOREIGN BODY
|
Facility
|
IP
|
$459.68
|
|
|
Service Code
|
CPT 70030
|
| Hospital Charge Code |
32000004
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$289.60 |
| Max. Negotiated Rate |
$413.71 |
| Rate for Payer: Aetna Commercial |
$390.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$298.79
|
| Rate for Payer: Cash Price |
$367.74
|
| Rate for Payer: Cofinity Commercial |
$321.78
|
| Rate for Payer: Cofinity Commercial |
$395.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$321.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.74
|
| Rate for Payer: Healthscope Commercial |
$413.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.73
|
| Rate for Payer: PHP Commercial |
$390.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.79
|
| Rate for Payer: Priority Health SBD |
$289.60
|
|
|
HC XR EYE FOR FOREIGN BODY
|
Facility
|
OP
|
$459.68
|
|
|
Service Code
|
CPT 70030
|
| Hospital Charge Code |
32000004
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$413.71 |
| Rate for Payer: Aetna Commercial |
$390.73
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$298.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$367.74
|
| Rate for Payer: Cash Price |
$367.74
|
| Rate for Payer: Cofinity Commercial |
$395.32
|
| Rate for Payer: Cofinity Commercial |
$321.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$321.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$413.71
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.73
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$390.73
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.79
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$289.60
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$340.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$340.16
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$48.34
|
| Rate for Payer: VA VA |
$85.87
|
|
|
HC XR FACIAL BONES MIN 3 VW
|
Facility
|
OP
|
$346.92
|
|
|
Service Code
|
CPT 70150
|
| Hospital Charge Code |
32000010
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$312.23 |
| Rate for Payer: Aetna Commercial |
$294.88
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$277.54
|
| Rate for Payer: Cash Price |
$277.54
|
| Rate for Payer: Cofinity Commercial |
$298.35
|
| Rate for Payer: Cofinity Commercial |
$242.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$242.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$312.23
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.88
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$294.88
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.50
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$218.56
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$256.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$256.72
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$58.39
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC XR FACIAL BONES MIN 3 VW
|
Facility
|
IP
|
$346.92
|
|
|
Service Code
|
CPT 70150
|
| Hospital Charge Code |
32000010
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$218.56 |
| Max. Negotiated Rate |
$312.23 |
| Rate for Payer: Aetna Commercial |
$294.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.50
|
| Rate for Payer: Cash Price |
$277.54
|
| Rate for Payer: Cofinity Commercial |
$242.84
|
| Rate for Payer: Cofinity Commercial |
$298.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$242.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.54
|
| Rate for Payer: Healthscope Commercial |
$312.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.88
|
| Rate for Payer: PHP Commercial |
$294.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.50
|
| Rate for Payer: Priority Health SBD |
$218.56
|
|
|
HC XR FEMUR 1 VIEW BILATERAL
|
Facility
|
OP
|
$249.90
|
|
|
Service Code
|
CPT 73551
|
| Hospital Charge Code |
32000341
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$241.72 |
| Rate for Payer: Aetna Commercial |
$212.41
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Cofinity Commercial |
$174.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.41
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$212.41
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.44
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$157.44
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$184.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$184.93
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$48.34
|
| Rate for Payer: VA VA |
$85.87
|
|
|
HC XR FEMUR 1 VIEW BILATERAL
|
Facility
|
IP
|
$249.90
|
|
|
Service Code
|
CPT 73551
|
| Hospital Charge Code |
32000341
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$157.44 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Aetna Commercial |
$212.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.44
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$174.93
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.41
|
| Rate for Payer: PHP Commercial |
$212.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.44
|
| Rate for Payer: Priority Health SBD |
$157.44
|
|
|
HC XR FEMUR 2 VIEWS BILATERAL
|
Facility
|
IP
|
$249.90
|
|
|
Service Code
|
CPT 73552
|
| Hospital Charge Code |
32000336
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$157.44 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Aetna Commercial |
$212.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.44
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$174.93
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.41
|
| Rate for Payer: PHP Commercial |
$212.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.44
|
| Rate for Payer: Priority Health SBD |
$157.44
|
|
|
HC XR FEMUR 2 VIEWS BILATERAL
|
Facility
|
OP
|
$249.90
|
|
|
Service Code
|
CPT 73552
|
| Hospital Charge Code |
32000336
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$241.72 |
| Rate for Payer: Aetna Commercial |
$212.41
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Cofinity Commercial |
$174.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.41
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$212.41
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.44
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$157.44
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$184.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$184.93
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$48.34
|
| Rate for Payer: VA VA |
$85.87
|
|
|
HC XR FINGERS BIL MIN 2 VW
|
Facility
|
IP
|
$223.85
|
|
|
Service Code
|
CPT 73140
|
| Hospital Charge Code |
32000090
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$141.03 |
| Max. Negotiated Rate |
$201.47 |
| Rate for Payer: Aetna Commercial |
$190.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.50
|
| Rate for Payer: Cash Price |
$179.08
|
| Rate for Payer: Cofinity Commercial |
$156.69
|
| Rate for Payer: Cofinity Commercial |
$192.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$156.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.08
|
| Rate for Payer: Healthscope Commercial |
$201.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.27
|
| Rate for Payer: PHP Commercial |
$190.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.50
|
| Rate for Payer: Priority Health SBD |
$141.03
|
|
|
HC XR FINGERS BIL MIN 2 VW
|
Facility
|
OP
|
$223.85
|
|
|
Service Code
|
CPT 73140
|
| Hospital Charge Code |
32000090
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$241.72 |
| Rate for Payer: Aetna Commercial |
$190.27
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$179.08
|
| Rate for Payer: Cash Price |
$179.08
|
| Rate for Payer: Cofinity Commercial |
$192.51
|
| Rate for Payer: Cofinity Commercial |
$156.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$156.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$201.47
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.27
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$190.27
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.50
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$141.03
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$165.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$165.65
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$48.34
|
| Rate for Payer: VA VA |
$85.87
|
|
|
HC XR FINGERS MIN 2 VW
|
Facility
|
IP
|
$194.04
|
|
|
Service Code
|
CPT 73140
|
| Hospital Charge Code |
32000089
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$122.25 |
| Max. Negotiated Rate |
$174.64 |
| Rate for Payer: Aetna Commercial |
$164.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.13
|
| Rate for Payer: Cash Price |
$155.23
|
| Rate for Payer: Cofinity Commercial |
$135.83
|
| Rate for Payer: Cofinity Commercial |
$166.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$135.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.23
|
| Rate for Payer: Healthscope Commercial |
$174.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.93
|
| Rate for Payer: PHP Commercial |
$164.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.13
|
| Rate for Payer: Priority Health SBD |
$122.25
|
|
|
HC XR FINGERS MIN 2 VW
|
Facility
|
OP
|
$194.04
|
|
|
Service Code
|
CPT 73140
|
| Hospital Charge Code |
32000089
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$241.72 |
| Rate for Payer: Aetna Commercial |
$164.93
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$155.23
|
| Rate for Payer: Cash Price |
$155.23
|
| Rate for Payer: Cofinity Commercial |
$166.87
|
| Rate for Payer: Cofinity Commercial |
$135.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$135.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$174.64
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.93
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$164.93
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.13
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$122.25
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$143.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$143.59
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$48.34
|
| Rate for Payer: VA VA |
$85.87
|
|
|
HC XR FLUOROSCOPIC GUIDANCE
|
Facility
|
IP
|
$313.20
|
|
|
Service Code
|
CPT 77002
|
| Hospital Charge Code |
32000246
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$197.32 |
| Max. Negotiated Rate |
$281.88 |
| Rate for Payer: Aetna Commercial |
$266.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.58
|
| Rate for Payer: Cash Price |
$250.56
|
| Rate for Payer: Cofinity Commercial |
$219.24
|
| Rate for Payer: Cofinity Commercial |
$269.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$219.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$250.56
|
| Rate for Payer: Healthscope Commercial |
$281.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$266.22
|
| Rate for Payer: PHP Commercial |
$266.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.58
|
| Rate for Payer: Priority Health SBD |
$197.32
|
|
|
HC XR FLUOROSCOPIC GUIDANCE
|
Facility
|
OP
|
$313.20
|
|
|
Service Code
|
CPT 77002
|
| Hospital Charge Code |
32000246
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$125.28 |
| Max. Negotiated Rate |
$281.88 |
| Rate for Payer: Aetna Commercial |
$266.22
|
| Rate for Payer: Aetna Medicare |
$156.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.58
|
| Rate for Payer: BCBS Complete |
$125.28
|
| Rate for Payer: Cash Price |
$250.56
|
| Rate for Payer: Cofinity Commercial |
$219.24
|
| Rate for Payer: Cofinity Commercial |
$269.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$219.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$250.56
|
| Rate for Payer: Healthscope Commercial |
$281.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$266.22
|
| Rate for Payer: PHP Commercial |
$266.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.58
|
| Rate for Payer: Priority Health SBD |
$197.32
|
| Rate for Payer: UHC Core |
$231.77
|
| Rate for Payer: UHC Exchange |
$231.77
|
|
|
HC XR FOOT 1 VW
|
Facility
|
OP
|
$291.84
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000125
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$262.66 |
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$250.98
|
| Rate for Payer: Cofinity Commercial |
$204.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$204.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$262.66
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$183.86
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$215.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$215.96
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$48.34
|
| Rate for Payer: VA VA |
$85.87
|
|
|
HC XR FOOT 1 VW
|
Facility
|
IP
|
$291.84
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000125
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$183.86 |
| Max. Negotiated Rate |
$262.66 |
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.70
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$204.29
|
| Rate for Payer: Cofinity Commercial |
$250.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$204.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Healthscope Commercial |
$262.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: Priority Health SBD |
$183.86
|
|
|
HC XR FOOT 2 VIEWS
|
Facility
|
OP
|
$255.46
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000123
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$241.72 |
| Rate for Payer: Aetna Commercial |
$217.14
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$204.37
|
| Rate for Payer: Cash Price |
$204.37
|
| Rate for Payer: Cofinity Commercial |
$219.70
|
| Rate for Payer: Cofinity Commercial |
$178.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$178.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$229.91
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.14
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$217.14
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.05
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$160.94
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$189.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$189.04
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$48.34
|
| Rate for Payer: VA VA |
$85.87
|
|
|
HC XR FOOT 2 VIEWS
|
Facility
|
IP
|
$255.46
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000123
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$160.94 |
| Max. Negotiated Rate |
$229.91 |
| Rate for Payer: Aetna Commercial |
$217.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.05
|
| Rate for Payer: Cash Price |
$204.37
|
| Rate for Payer: Cofinity Commercial |
$178.82
|
| Rate for Payer: Cofinity Commercial |
$219.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$178.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.37
|
| Rate for Payer: Healthscope Commercial |
$229.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.14
|
| Rate for Payer: PHP Commercial |
$217.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.05
|
| Rate for Payer: Priority Health SBD |
$160.94
|
|
|
HC XR FOOT 2 VIEWS BILATERAL
|
Facility
|
IP
|
$249.90
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000340
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$157.44 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Aetna Commercial |
$212.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.44
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$174.93
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.41
|
| Rate for Payer: PHP Commercial |
$212.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.44
|
| Rate for Payer: Priority Health SBD |
$157.44
|
|
|
HC XR FOOT 2 VIEWS BILATERAL
|
Facility
|
OP
|
$249.90
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000340
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$241.72 |
| Rate for Payer: Aetna Commercial |
$212.41
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Cofinity Commercial |
$174.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.41
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$212.41
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.44
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$157.44
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$184.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$184.93
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$48.34
|
| Rate for Payer: VA VA |
$85.87
|
|
|
HC XR FOOT 3 VIEWS
|
Facility
|
OP
|
$357.38
|
|
|
Service Code
|
CPT 73630
|
| Hospital Charge Code |
32000126
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$321.64 |
| Rate for Payer: Aetna Commercial |
$303.77
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$307.35
|
| Rate for Payer: Cofinity Commercial |
$250.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$250.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$321.64
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$303.77
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$225.15
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$264.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$264.46
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$48.34
|
| Rate for Payer: VA VA |
$85.87
|
|
|
HC XR FOOT 3 VIEWS
|
Facility
|
IP
|
$357.38
|
|
|
Service Code
|
CPT 73630
|
| Hospital Charge Code |
32000126
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$225.15 |
| Max. Negotiated Rate |
$321.64 |
| Rate for Payer: Aetna Commercial |
$303.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.30
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$250.17
|
| Rate for Payer: Cofinity Commercial |
$307.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$250.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Healthscope Commercial |
$321.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: PHP Commercial |
$303.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health SBD |
$225.15
|
|
|
HC XR FOOT BIL 2 VIEWS
|
Facility
|
OP
|
$291.84
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000124
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$262.66 |
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$250.98
|
| Rate for Payer: Cofinity Commercial |
$204.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$204.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$262.66
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$183.86
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$215.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$215.96
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$48.34
|
| Rate for Payer: VA VA |
$85.87
|
|
|
HC XR FOOT BIL 2 VIEWS
|
Facility
|
IP
|
$291.84
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000124
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$183.86 |
| Max. Negotiated Rate |
$262.66 |
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.70
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$204.29
|
| Rate for Payer: Cofinity Commercial |
$250.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$204.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Healthscope Commercial |
$262.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: Priority Health SBD |
$183.86
|
|
