|
HC HH POUCH CLOSURE CLAMP
|
Facility
|
OP
|
$16.83
|
|
| Hospital Charge Code |
27000138
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$15.15 |
| Rate for Payer: Aetna Commercial |
$14.31
|
| Rate for Payer: Aetna Medicare |
$4.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.26
|
| Rate for Payer: BCBS Complete |
$6.73
|
| Rate for Payer: BCBS MAPPO |
$4.21
|
| Rate for Payer: BCBS Trust/PPO |
$13.84
|
| Rate for Payer: BCN Commercial |
$13.09
|
| Rate for Payer: BCN Medicare Advantage |
$4.21
|
| Rate for Payer: Cash Price |
$13.46
|
| Rate for Payer: Cofinity Commercial |
$14.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.21
|
| Rate for Payer: Healthscope Commercial |
$15.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.31
|
| Rate for Payer: Nomi Health Commercial |
$13.80
|
| Rate for Payer: PACE Senior Care Partners |
$4.00
|
| Rate for Payer: PACE SWMI |
$4.21
|
| Rate for Payer: PHP Commercial |
$14.31
|
| Rate for Payer: PHP Medicare Advantage |
$4.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.94
|
| Rate for Payer: Priority Health HMO/PPO |
$14.64
|
| Rate for Payer: Priority Health Medicare |
$4.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.28
|
| Rate for Payer: Railroad Medicare Medicare |
$4.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.81
|
| Rate for Payer: UHC Core |
$14.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.21
|
| Rate for Payer: UHC Exchange |
$4.21
|
| Rate for Payer: UHC Medicare Advantage |
$4.21
|
| Rate for Payer: VA VA |
$4.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.62
|
|
|
HC HH POUCH CLOSURE CLAMP
|
Facility
|
IP
|
$16.83
|
|
| Hospital Charge Code |
27000138
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.94 |
| Max. Negotiated Rate |
$15.15 |
| Rate for Payer: Aetna Commercial |
$14.31
|
| Rate for Payer: BCBS Trust/PPO |
$13.74
|
| Rate for Payer: BCN Commercial |
$13.01
|
| Rate for Payer: Cash Price |
$13.46
|
| Rate for Payer: Cofinity Commercial |
$14.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.46
|
| Rate for Payer: Healthscope Commercial |
$15.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.31
|
| Rate for Payer: Nomi Health Commercial |
$13.80
|
| Rate for Payer: PHP Commercial |
$14.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.94
|
| Rate for Payer: Priority Health HMO/PPO |
$14.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.81
|
| Rate for Payer: UHC Core |
$14.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.62
|
|
|
HC HH WET ONES
|
Facility
|
OP
|
$16.05
|
|
| Hospital Charge Code |
27000170
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.81 |
| Max. Negotiated Rate |
$14.45 |
| Rate for Payer: Aetna Commercial |
$13.64
|
| Rate for Payer: Aetna Medicare |
$4.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.02
|
| Rate for Payer: BCBS Complete |
$6.42
|
| Rate for Payer: BCBS MAPPO |
$4.01
|
| Rate for Payer: BCBS Trust/PPO |
$13.19
|
| Rate for Payer: BCN Commercial |
$12.48
|
| Rate for Payer: BCN Medicare Advantage |
$4.01
|
| Rate for Payer: Cash Price |
$12.84
|
| Rate for Payer: Cofinity Commercial |
$13.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.01
|
| Rate for Payer: Healthscope Commercial |
$14.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.64
|
| Rate for Payer: Nomi Health Commercial |
$13.16
|
| Rate for Payer: PACE Senior Care Partners |
$3.81
|
| Rate for Payer: PACE SWMI |
$4.01
|
| Rate for Payer: PHP Commercial |
$13.64
|
| Rate for Payer: PHP Medicare Advantage |
$4.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.43
|
| Rate for Payer: Priority Health HMO/PPO |
$13.96
|
| Rate for Payer: Priority Health Medicare |
$4.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.75
|
| Rate for Payer: Railroad Medicare Medicare |
$4.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.12
|
| Rate for Payer: UHC Core |
$13.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.01
|
| Rate for Payer: UHC Exchange |
$4.01
|
| Rate for Payer: UHC Medicare Advantage |
$4.01
|
| Rate for Payer: VA VA |
$4.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.04
|
|
|
HC HH WET ONES
|
Facility
|
IP
|
$16.05
|
|
| Hospital Charge Code |
27000170
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.43 |
| Max. Negotiated Rate |
$14.45 |
| Rate for Payer: Aetna Commercial |
$13.64
|
| Rate for Payer: BCBS Trust/PPO |
$13.10
|
| Rate for Payer: BCN Commercial |
$12.40
|
| Rate for Payer: Cash Price |
$12.84
|
| Rate for Payer: Cofinity Commercial |
$13.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.84
|
| Rate for Payer: Healthscope Commercial |
$14.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.64
|
| Rate for Payer: Nomi Health Commercial |
$13.16
|
| Rate for Payer: PHP Commercial |
$13.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.43
|
| Rate for Payer: Priority Health HMO/PPO |
$13.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.12
|
| Rate for Payer: UHC Core |
$13.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.04
|
|
|
HC HIAA SEROTONIN URINE
|
Facility
|
OP
|
$44.74
|
|
|
Service Code
|
CPT 83497
|
| Hospital Charge Code |
30100248
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.33 |
| Max. Negotiated Rate |
$40.27 |
| Rate for Payer: Aetna Commercial |
$38.03
|
| Rate for Payer: Aetna Medicare |
$11.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.98
|
| Rate for Payer: BCBS Complete |
$9.79
|
| Rate for Payer: BCBS MAPPO |
$11.19
|
| Rate for Payer: BCBS Trust/PPO |
$36.78
|
| Rate for Payer: BCN Commercial |
$34.79
|
| Rate for Payer: BCN Medicare Advantage |
$11.19
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$38.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.19
|
| Rate for Payer: Healthscope Commercial |
$40.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.55
|
| Rate for Payer: Mclaren Medicaid |
$9.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.74
|
| Rate for Payer: Meridian Medicaid |
$9.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: Nomi Health Commercial |
$36.69
|
| Rate for Payer: PACE Senior Care Partners |
$10.63
|
| Rate for Payer: PACE SWMI |
$11.19
|
| Rate for Payer: PHP Commercial |
$38.03
|
| Rate for Payer: PHP Medicare Advantage |
$11.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.08
|
| Rate for Payer: Priority Health HMO/PPO |
$38.92
|
| Rate for Payer: Priority Health Medicare |
$11.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.98
|
| Rate for Payer: Railroad Medicare Medicare |
$11.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.37
|
| Rate for Payer: UHC Core |
$37.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.19
|
| Rate for Payer: UHC Exchange |
$11.19
|
| Rate for Payer: UHC Medicare Advantage |
$11.19
|
| Rate for Payer: UHCCP Medicaid |
$9.33
|
| Rate for Payer: VA VA |
$11.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.55
|
|
|
HC HIAA SEROTONIN URINE
|
Facility
|
IP
|
$44.74
|
|
|
Service Code
|
CPT 83497
|
| Hospital Charge Code |
30100248
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.08 |
| Max. Negotiated Rate |
$40.27 |
| Rate for Payer: Aetna Commercial |
$38.03
|
| Rate for Payer: BCBS Trust/PPO |
$36.52
|
| Rate for Payer: BCN Commercial |
$34.58
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$38.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Healthscope Commercial |
$40.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: Nomi Health Commercial |
$36.69
|
| Rate for Payer: PHP Commercial |
$38.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.08
|
| Rate for Payer: Priority Health HMO/PPO |
$38.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.37
|
| Rate for Payer: UHC Core |
$37.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.55
|
|
|
HC HIB PRP-OMP VACC 3 DOSE IM
|
Facility
|
IP
|
$42.17
|
|
|
Service Code
|
CPT 90647
|
| Hospital Charge Code |
63600180
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$27.41 |
| Max. Negotiated Rate |
$37.95 |
| Rate for Payer: Aetna Commercial |
$35.84
|
| Rate for Payer: BCBS Trust/PPO |
$34.42
|
| Rate for Payer: BCN Commercial |
$32.59
|
| Rate for Payer: Cash Price |
$33.74
|
| Rate for Payer: Cofinity Commercial |
$36.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.74
|
| Rate for Payer: Healthscope Commercial |
$37.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.84
|
| Rate for Payer: Nomi Health Commercial |
$34.58
|
| Rate for Payer: PHP Commercial |
$35.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.41
|
| Rate for Payer: Priority Health HMO/PPO |
$36.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.11
|
| Rate for Payer: UHC Core |
$35.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.63
|
|
|
HC HIB PRP-OMP VACC 3 DOSE IM
|
Facility
|
OP
|
$42.17
|
|
|
Service Code
|
CPT 90647
|
| Hospital Charge Code |
63600180
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.02 |
| Max. Negotiated Rate |
$37.95 |
| Rate for Payer: Aetna Commercial |
$35.84
|
| Rate for Payer: Aetna Medicare |
$10.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.18
|
| Rate for Payer: BCBS Complete |
$16.87
|
| Rate for Payer: BCBS MAPPO |
$10.54
|
| Rate for Payer: BCBS Trust/PPO |
$34.67
|
| Rate for Payer: BCN Commercial |
$32.79
|
| Rate for Payer: BCN Medicare Advantage |
$10.54
|
| Rate for Payer: Cash Price |
$33.74
|
| Rate for Payer: Cofinity Commercial |
$36.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.54
|
| Rate for Payer: Healthscope Commercial |
$37.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.84
|
| Rate for Payer: Nomi Health Commercial |
$34.58
|
| Rate for Payer: PACE Senior Care Partners |
$10.02
|
| Rate for Payer: PACE SWMI |
$10.54
|
| Rate for Payer: PHP Commercial |
$35.84
|
| Rate for Payer: PHP Medicare Advantage |
$10.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.41
|
| Rate for Payer: Priority Health HMO/PPO |
$36.69
|
| Rate for Payer: Priority Health Medicare |
$10.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.25
|
| Rate for Payer: Railroad Medicare Medicare |
$10.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.11
|
| Rate for Payer: UHC Core |
$35.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.54
|
| Rate for Payer: UHC Exchange |
$10.54
|
| Rate for Payer: UHC Medicare Advantage |
$10.54
|
| Rate for Payer: VA VA |
$10.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.63
|
|
|
HC HIGH FLOW JET VENT
|
Facility
|
OP
|
$1,043.46
|
|
| Hospital Charge Code |
27000699
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$247.82 |
| Max. Negotiated Rate |
$939.11 |
| Rate for Payer: Aetna Commercial |
$886.94
|
| Rate for Payer: Aetna Medicare |
$271.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$326.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$326.08
|
| Rate for Payer: BCBS Complete |
$417.38
|
| Rate for Payer: BCBS MAPPO |
$260.87
|
| Rate for Payer: BCBS Trust/PPO |
$857.83
|
| Rate for Payer: BCN Commercial |
$811.29
|
| Rate for Payer: BCN Medicare Advantage |
$260.87
|
| Rate for Payer: Cash Price |
$834.77
|
| Rate for Payer: Cofinity Commercial |
$897.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$834.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.87
|
| Rate for Payer: Healthscope Commercial |
$939.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$782.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$886.94
|
| Rate for Payer: Nomi Health Commercial |
$855.64
|
| Rate for Payer: PACE Senior Care Partners |
$247.82
|
| Rate for Payer: PACE SWMI |
$260.87
|
| Rate for Payer: PHP Commercial |
$886.94
|
| Rate for Payer: PHP Medicare Advantage |
$260.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$678.25
|
| Rate for Payer: Priority Health HMO/PPO |
$907.81
|
| Rate for Payer: Priority Health Medicare |
$263.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$699.12
|
| Rate for Payer: Railroad Medicare Medicare |
$260.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$918.24
|
| Rate for Payer: UHC Core |
$871.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.87
|
| Rate for Payer: UHC Exchange |
$260.87
|
| Rate for Payer: UHC Medicare Advantage |
$260.87
|
| Rate for Payer: VA VA |
$260.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$782.60
|
|
|
HC HIGH FLOW JET VENT
|
Facility
|
IP
|
$1,043.46
|
|
| Hospital Charge Code |
27000699
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$678.25 |
| Max. Negotiated Rate |
$939.11 |
| Rate for Payer: Aetna Commercial |
$886.94
|
| Rate for Payer: BCBS Trust/PPO |
$851.78
|
| Rate for Payer: BCN Commercial |
$806.39
|
| Rate for Payer: Cash Price |
$834.77
|
| Rate for Payer: Cofinity Commercial |
$897.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$834.77
|
| Rate for Payer: Healthscope Commercial |
$939.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$782.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$886.94
|
| Rate for Payer: Nomi Health Commercial |
$855.64
|
| Rate for Payer: PHP Commercial |
$886.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$678.25
|
| Rate for Payer: Priority Health HMO/PPO |
$907.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$699.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$918.24
|
| Rate for Payer: UHC Core |
$871.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$782.60
|
|
|
HC HIGH FLOW OXYGEN THERAPY
|
Facility
|
IP
|
$217.39
|
|
| Hospital Charge Code |
27000632
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$141.30 |
| Max. Negotiated Rate |
$195.65 |
| Rate for Payer: Aetna Commercial |
$184.78
|
| Rate for Payer: BCBS Trust/PPO |
$177.46
|
| Rate for Payer: BCN Commercial |
$168.00
|
| Rate for Payer: Cash Price |
$173.91
|
| Rate for Payer: Cofinity Commercial |
$186.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.91
|
| Rate for Payer: Healthscope Commercial |
$195.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.78
|
| Rate for Payer: Nomi Health Commercial |
$178.26
|
| Rate for Payer: PHP Commercial |
$184.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.30
|
| Rate for Payer: Priority Health HMO/PPO |
$189.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.30
|
| Rate for Payer: UHC Core |
$181.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.04
|
|
|
HC HIGH FLOW OXYGEN THERAPY
|
Facility
|
OP
|
$217.39
|
|
| Hospital Charge Code |
27000632
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$51.63 |
| Max. Negotiated Rate |
$195.65 |
| Rate for Payer: Aetna Commercial |
$184.78
|
| Rate for Payer: Aetna Medicare |
$56.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.93
|
| Rate for Payer: BCBS Complete |
$86.96
|
| Rate for Payer: BCBS MAPPO |
$54.35
|
| Rate for Payer: BCBS Trust/PPO |
$178.72
|
| Rate for Payer: BCN Commercial |
$169.02
|
| Rate for Payer: BCN Medicare Advantage |
$54.35
|
| Rate for Payer: Cash Price |
$173.91
|
| Rate for Payer: Cofinity Commercial |
$186.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.35
|
| Rate for Payer: Healthscope Commercial |
$195.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.78
|
| Rate for Payer: Nomi Health Commercial |
$178.26
|
| Rate for Payer: PACE Senior Care Partners |
$51.63
|
| Rate for Payer: PACE SWMI |
$54.35
|
| Rate for Payer: PHP Commercial |
$184.78
|
| Rate for Payer: PHP Medicare Advantage |
$54.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.30
|
| Rate for Payer: Priority Health HMO/PPO |
$189.13
|
| Rate for Payer: Priority Health Medicare |
$54.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.65
|
| Rate for Payer: Railroad Medicare Medicare |
$54.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.30
|
| Rate for Payer: UHC Core |
$181.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.35
|
| Rate for Payer: UHC Exchange |
$54.35
|
| Rate for Payer: UHC Medicare Advantage |
$54.35
|
| Rate for Payer: VA VA |
$54.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.04
|
|
|
HC HINGE EXTENSION/FLEX WRIST/F
|
Facility
|
OP
|
$1,541.87
|
|
|
Service Code
|
HCPCS L3900
|
| Hospital Charge Code |
27400048
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$366.19 |
| Max. Negotiated Rate |
$1,387.68 |
| Rate for Payer: Aetna Commercial |
$1,310.59
|
| Rate for Payer: Aetna Medicare |
$400.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$481.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$481.83
|
| Rate for Payer: BCBS Complete |
$616.75
|
| Rate for Payer: BCBS MAPPO |
$385.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,267.57
|
| Rate for Payer: BCN Commercial |
$1,198.80
|
| Rate for Payer: BCN Medicare Advantage |
$385.47
|
| Rate for Payer: Cash Price |
$1,233.50
|
| Rate for Payer: Cofinity Commercial |
$1,326.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,233.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$385.47
|
| Rate for Payer: Healthscope Commercial |
$1,387.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,156.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$404.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$443.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,310.59
|
| Rate for Payer: Nomi Health Commercial |
$1,264.33
|
| Rate for Payer: PACE Senior Care Partners |
$366.19
|
| Rate for Payer: PACE SWMI |
$385.47
|
| Rate for Payer: PHP Commercial |
$1,310.59
|
| Rate for Payer: PHP Medicare Advantage |
$385.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,002.22
|
| Rate for Payer: Priority Health HMO/PPO |
$1,341.43
|
| Rate for Payer: Priority Health Medicare |
$389.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,033.05
|
| Rate for Payer: Railroad Medicare Medicare |
$385.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,356.85
|
| Rate for Payer: UHC Core |
$1,287.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$385.47
|
| Rate for Payer: UHC Exchange |
$385.47
|
| Rate for Payer: UHC Medicare Advantage |
$385.47
|
| Rate for Payer: VA VA |
$385.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,156.40
|
|
|
HC HINGE EXTENSION/FLEX WRIST/F
|
Facility
|
IP
|
$1,541.87
|
|
|
Service Code
|
HCPCS L3900
|
| Hospital Charge Code |
27400048
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,002.22 |
| Max. Negotiated Rate |
$1,387.68 |
| Rate for Payer: Aetna Commercial |
$1,310.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,258.63
|
| Rate for Payer: BCN Commercial |
$1,191.56
|
| Rate for Payer: Cash Price |
$1,233.50
|
| Rate for Payer: Cofinity Commercial |
$1,326.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,233.50
|
| Rate for Payer: Healthscope Commercial |
$1,387.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,156.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,310.59
|
| Rate for Payer: Nomi Health Commercial |
$1,264.33
|
| Rate for Payer: PHP Commercial |
$1,310.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,002.22
|
| Rate for Payer: Priority Health HMO/PPO |
$1,341.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,033.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,356.85
|
| Rate for Payer: UHC Core |
$1,287.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,156.40
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED 2 VIEWS
|
Facility
|
IP
|
$391.43
|
|
|
Service Code
|
CPT 73521
|
| Hospital Charge Code |
32000312
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$254.43 |
| Max. Negotiated Rate |
$352.29 |
| Rate for Payer: Aetna Commercial |
$332.72
|
| Rate for Payer: BCBS Trust/PPO |
$319.52
|
| Rate for Payer: BCN Commercial |
$302.50
|
| Rate for Payer: Cash Price |
$313.14
|
| Rate for Payer: Cofinity Commercial |
$336.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.14
|
| Rate for Payer: Healthscope Commercial |
$352.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$293.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$332.72
|
| Rate for Payer: Nomi Health Commercial |
$320.97
|
| Rate for Payer: PHP Commercial |
$332.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.43
|
| Rate for Payer: Priority Health HMO/PPO |
$340.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$344.46
|
| Rate for Payer: UHC Core |
$326.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$293.57
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED 2 VIEWS
|
Facility
|
OP
|
$391.43
|
|
|
Service Code
|
CPT 73521
|
| Hospital Charge Code |
32000312
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$352.29 |
| Rate for Payer: Aetna Commercial |
$332.72
|
| Rate for Payer: Aetna Medicare |
$101.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.32
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$97.86
|
| Rate for Payer: BCBS Trust/PPO |
$321.79
|
| Rate for Payer: BCN Commercial |
$304.34
|
| Rate for Payer: BCN Medicare Advantage |
$97.86
|
| Rate for Payer: Cash Price |
$313.14
|
| Rate for Payer: Cash Price |
$313.14
|
| Rate for Payer: Cofinity Commercial |
$336.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.86
|
| Rate for Payer: Healthscope Commercial |
$352.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$293.57
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.75
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$332.72
|
| Rate for Payer: Nomi Health Commercial |
$320.97
|
| Rate for Payer: PACE Senior Care Partners |
$92.96
|
| Rate for Payer: PACE SWMI |
$97.86
|
| Rate for Payer: PHP Commercial |
$332.72
|
| Rate for Payer: PHP Medicare Advantage |
$97.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.43
|
| Rate for Payer: Priority Health HMO/PPO |
$340.54
|
| Rate for Payer: Priority Health Medicare |
$98.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.26
|
| Rate for Payer: Railroad Medicare Medicare |
$97.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$344.46
|
| Rate for Payer: UHC Core |
$326.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.86
|
| Rate for Payer: UHC Exchange |
$97.86
|
| Rate for Payer: UHC Medicare Advantage |
$97.86
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$97.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$293.57
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED 3 TO 4 VIEWS
|
Facility
|
OP
|
$481.76
|
|
|
Service Code
|
CPT 73522
|
| Hospital Charge Code |
32000313
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$433.58 |
| Rate for Payer: Aetna Commercial |
$409.50
|
| Rate for Payer: Aetna Medicare |
$125.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.55
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$120.44
|
| Rate for Payer: BCBS Trust/PPO |
$396.05
|
| Rate for Payer: BCN Commercial |
$374.57
|
| Rate for Payer: BCN Medicare Advantage |
$120.44
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cofinity Commercial |
$414.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.44
|
| Rate for Payer: Healthscope Commercial |
$433.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.32
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.46
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.50
|
| Rate for Payer: Nomi Health Commercial |
$395.04
|
| Rate for Payer: PACE Senior Care Partners |
$114.42
|
| Rate for Payer: PACE SWMI |
$120.44
|
| Rate for Payer: PHP Commercial |
$409.50
|
| Rate for Payer: PHP Medicare Advantage |
$120.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.14
|
| Rate for Payer: Priority Health HMO/PPO |
$419.13
|
| Rate for Payer: Priority Health Medicare |
$121.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$322.78
|
| Rate for Payer: Railroad Medicare Medicare |
$120.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.95
|
| Rate for Payer: UHC Core |
$402.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.44
|
| Rate for Payer: UHC Exchange |
$120.44
|
| Rate for Payer: UHC Medicare Advantage |
$120.44
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$120.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.32
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED 3 TO 4 VIEWS
|
Facility
|
IP
|
$481.76
|
|
|
Service Code
|
CPT 73522
|
| Hospital Charge Code |
32000313
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$313.14 |
| Max. Negotiated Rate |
$433.58 |
| Rate for Payer: Aetna Commercial |
$409.50
|
| Rate for Payer: BCBS Trust/PPO |
$393.26
|
| Rate for Payer: BCN Commercial |
$372.30
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cofinity Commercial |
$414.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.41
|
| Rate for Payer: Healthscope Commercial |
$433.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.50
|
| Rate for Payer: Nomi Health Commercial |
$395.04
|
| Rate for Payer: PHP Commercial |
$409.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.14
|
| Rate for Payer: Priority Health HMO/PPO |
$419.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$322.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.95
|
| Rate for Payer: UHC Core |
$402.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.32
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED MIN 5 VIEWS
|
Facility
|
OP
|
$541.99
|
|
|
Service Code
|
CPT 73523
|
| Hospital Charge Code |
32000314
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$487.79 |
| Rate for Payer: Aetna Commercial |
$460.69
|
| Rate for Payer: Aetna Medicare |
$140.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$169.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$169.37
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$135.50
|
| Rate for Payer: BCBS Trust/PPO |
$445.57
|
| Rate for Payer: BCN Commercial |
$421.40
|
| Rate for Payer: BCN Medicare Advantage |
$135.50
|
| Rate for Payer: Cash Price |
$433.59
|
| Rate for Payer: Cash Price |
$433.59
|
| Rate for Payer: Cofinity Commercial |
$466.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.50
|
| Rate for Payer: Healthscope Commercial |
$487.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.49
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$142.27
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$155.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$460.69
|
| Rate for Payer: Nomi Health Commercial |
$444.43
|
| Rate for Payer: PACE Senior Care Partners |
$128.72
|
| Rate for Payer: PACE SWMI |
$135.50
|
| Rate for Payer: PHP Commercial |
$460.69
|
| Rate for Payer: PHP Medicare Advantage |
$135.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.29
|
| Rate for Payer: Priority Health HMO/PPO |
$471.53
|
| Rate for Payer: Priority Health Medicare |
$136.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$363.13
|
| Rate for Payer: Railroad Medicare Medicare |
$135.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$476.95
|
| Rate for Payer: UHC Core |
$452.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$135.50
|
| Rate for Payer: UHC Exchange |
$135.50
|
| Rate for Payer: UHC Medicare Advantage |
$135.50
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$135.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.49
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED MIN 5 VIEWS
|
Facility
|
IP
|
$541.99
|
|
|
Service Code
|
CPT 73523
|
| Hospital Charge Code |
32000314
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$352.29 |
| Max. Negotiated Rate |
$487.79 |
| Rate for Payer: Aetna Commercial |
$460.69
|
| Rate for Payer: BCBS Trust/PPO |
$442.43
|
| Rate for Payer: BCN Commercial |
$418.85
|
| Rate for Payer: Cash Price |
$433.59
|
| Rate for Payer: Cofinity Commercial |
$466.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.59
|
| Rate for Payer: Healthscope Commercial |
$487.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$460.69
|
| Rate for Payer: Nomi Health Commercial |
$444.43
|
| Rate for Payer: PHP Commercial |
$460.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.29
|
| Rate for Payer: Priority Health HMO/PPO |
$471.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$363.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$476.95
|
| Rate for Payer: UHC Core |
$452.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.49
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 1 VIEW
|
Facility
|
IP
|
$150.54
|
|
|
Service Code
|
CPT 73501
|
| Hospital Charge Code |
32000309
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$97.85 |
| Max. Negotiated Rate |
$135.49 |
| Rate for Payer: Aetna Commercial |
$127.96
|
| Rate for Payer: BCBS Trust/PPO |
$122.89
|
| Rate for Payer: BCN Commercial |
$116.34
|
| Rate for Payer: Cash Price |
$120.43
|
| Rate for Payer: Cofinity Commercial |
$129.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.43
|
| Rate for Payer: Healthscope Commercial |
$135.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.96
|
| Rate for Payer: Nomi Health Commercial |
$123.44
|
| Rate for Payer: PHP Commercial |
$127.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.85
|
| Rate for Payer: Priority Health HMO/PPO |
$130.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.48
|
| Rate for Payer: UHC Core |
$125.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.91
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 1 VIEW
|
Facility
|
OP
|
$150.54
|
|
|
Service Code
|
CPT 73501
|
| Hospital Charge Code |
32000309
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$35.75 |
| Max. Negotiated Rate |
$135.49 |
| Rate for Payer: Aetna Commercial |
$127.96
|
| Rate for Payer: Aetna Medicare |
$39.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.04
|
| Rate for Payer: BCBS Complete |
$66.85
|
| Rate for Payer: BCBS MAPPO |
$37.63
|
| Rate for Payer: BCBS Trust/PPO |
$123.76
|
| Rate for Payer: BCN Commercial |
$117.04
|
| Rate for Payer: BCN Medicare Advantage |
$37.63
|
| Rate for Payer: Cash Price |
$120.43
|
| Rate for Payer: Cash Price |
$120.43
|
| Rate for Payer: Cofinity Commercial |
$129.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.63
|
| Rate for Payer: Healthscope Commercial |
$135.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.91
|
| Rate for Payer: Mclaren Medicaid |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.52
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.96
|
| Rate for Payer: Nomi Health Commercial |
$123.44
|
| Rate for Payer: PACE Senior Care Partners |
$35.75
|
| Rate for Payer: PACE SWMI |
$37.63
|
| Rate for Payer: PHP Commercial |
$127.96
|
| Rate for Payer: PHP Medicare Advantage |
$37.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.85
|
| Rate for Payer: Priority Health HMO/PPO |
$130.97
|
| Rate for Payer: Priority Health Medicare |
$38.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.86
|
| Rate for Payer: Railroad Medicare Medicare |
$37.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.48
|
| Rate for Payer: UHC Core |
$125.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.63
|
| Rate for Payer: UHC Exchange |
$37.63
|
| Rate for Payer: UHC Medicare Advantage |
$37.63
|
| Rate for Payer: UHCCP Medicaid |
$63.66
|
| Rate for Payer: VA VA |
$37.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.91
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 2 OR 3 VIEWS
|
Facility
|
OP
|
$301.10
|
|
|
Service Code
|
CPT 73502
|
| Hospital Charge Code |
32000310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$63.66 |
| Max. Negotiated Rate |
$270.99 |
| Rate for Payer: Aetna Commercial |
$255.94
|
| Rate for Payer: Aetna Medicare |
$78.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$94.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$94.09
|
| Rate for Payer: BCBS Complete |
$66.85
|
| Rate for Payer: BCBS MAPPO |
$75.28
|
| Rate for Payer: BCBS Trust/PPO |
$247.53
|
| Rate for Payer: BCN Commercial |
$234.11
|
| Rate for Payer: BCN Medicare Advantage |
$75.28
|
| Rate for Payer: Cash Price |
$240.88
|
| Rate for Payer: Cash Price |
$240.88
|
| Rate for Payer: Cofinity Commercial |
$258.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.28
|
| Rate for Payer: Healthscope Commercial |
$270.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.82
|
| Rate for Payer: Mclaren Medicaid |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.04
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.94
|
| Rate for Payer: Nomi Health Commercial |
$246.90
|
| Rate for Payer: PACE Senior Care Partners |
$71.51
|
| Rate for Payer: PACE SWMI |
$75.28
|
| Rate for Payer: PHP Commercial |
$255.94
|
| Rate for Payer: PHP Medicare Advantage |
$75.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.72
|
| Rate for Payer: Priority Health HMO/PPO |
$261.96
|
| Rate for Payer: Priority Health Medicare |
$76.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.74
|
| Rate for Payer: Railroad Medicare Medicare |
$75.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.97
|
| Rate for Payer: UHC Core |
$251.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.28
|
| Rate for Payer: UHC Exchange |
$75.28
|
| Rate for Payer: UHC Medicare Advantage |
$75.28
|
| Rate for Payer: UHCCP Medicaid |
$63.66
|
| Rate for Payer: VA VA |
$75.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.82
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 2 OR 3 VIEWS
|
Facility
|
IP
|
$301.10
|
|
|
Service Code
|
CPT 73502
|
| Hospital Charge Code |
32000310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$195.72 |
| Max. Negotiated Rate |
$270.99 |
| Rate for Payer: Aetna Commercial |
$255.94
|
| Rate for Payer: BCBS Trust/PPO |
$245.79
|
| Rate for Payer: BCN Commercial |
$232.69
|
| Rate for Payer: Cash Price |
$240.88
|
| Rate for Payer: Cofinity Commercial |
$258.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.88
|
| Rate for Payer: Healthscope Commercial |
$270.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.94
|
| Rate for Payer: Nomi Health Commercial |
$246.90
|
| Rate for Payer: PHP Commercial |
$255.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.72
|
| Rate for Payer: Priority Health HMO/PPO |
$261.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.97
|
| Rate for Payer: UHC Core |
$251.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.82
|
|
|
HC HIP UNI W PELVIS IF PERFORMED MIN 4 VIEWS
|
Facility
|
IP
|
$391.43
|
|
|
Service Code
|
CPT 73503
|
| Hospital Charge Code |
32000311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$254.43 |
| Max. Negotiated Rate |
$352.29 |
| Rate for Payer: Aetna Commercial |
$332.72
|
| Rate for Payer: BCBS Trust/PPO |
$319.52
|
| Rate for Payer: BCN Commercial |
$302.50
|
| Rate for Payer: Cash Price |
$313.14
|
| Rate for Payer: Cofinity Commercial |
$336.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.14
|
| Rate for Payer: Healthscope Commercial |
$352.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$293.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$332.72
|
| Rate for Payer: Nomi Health Commercial |
$320.97
|
| Rate for Payer: PHP Commercial |
$332.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.43
|
| Rate for Payer: Priority Health HMO/PPO |
$340.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$344.46
|
| Rate for Payer: UHC Core |
$326.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$293.57
|
|
