|
HC XR ABDOMEN 1 VIEW
|
Facility
|
IP
|
$299.88
|
|
|
Service Code
|
CPT 74018
|
| Hospital Charge Code |
32000325
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$182.90 |
| Max. Negotiated Rate |
$269.89 |
| Rate for Payer: Aetna Commercial |
$254.90
|
| Rate for Payer: BCBS Trust/PPO |
$231.75
|
| Rate for Payer: BCN Commercial |
$231.75
|
| Rate for Payer: Cash Price |
$239.90
|
| Rate for Payer: Cofinity Commercial |
$257.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.90
|
| Rate for Payer: Healthscope Commercial |
$269.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$254.90
|
| Rate for Payer: PHP Commercial |
$254.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.89
|
| Rate for Payer: UHC Core |
$250.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.91
|
|
|
HC XR ABDOMEN 1 VIEW
|
Facility
|
OP
|
$299.88
|
|
|
Service Code
|
CPT 74018
|
| Hospital Charge Code |
32000325
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$269.89 |
| Rate for Payer: Aetna Commercial |
$254.90
|
| Rate for Payer: Aetna Medicare |
$77.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.71
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$74.97
|
| Rate for Payer: BCBS Trust/PPO |
$233.16
|
| Rate for Payer: BCN Commercial |
$233.16
|
| Rate for Payer: BCN Medicare Advantage |
$74.97
|
| Rate for Payer: Cash Price |
$239.90
|
| Rate for Payer: Cash Price |
$239.90
|
| Rate for Payer: Cofinity Commercial |
$257.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.97
|
| Rate for Payer: Healthscope Commercial |
$269.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.91
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$254.90
|
| Rate for Payer: PACE Senior Care Partners |
$71.22
|
| Rate for Payer: PACE SWMI |
$74.97
|
| Rate for Payer: PHP Commercial |
$254.90
|
| Rate for Payer: PHP Medicare Advantage |
$74.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.90
|
| Rate for Payer: Priority Health Medicare |
$74.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.90
|
| Rate for Payer: Railroad Medicare Medicare |
$74.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.89
|
| Rate for Payer: UHC Core |
$250.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.97
|
| Rate for Payer: UHC Medicare Advantage |
$77.22
|
| Rate for Payer: VA VA |
$74.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.91
|
|
|
HC XR ABDOMEN 2 VW
|
Facility
|
OP
|
$332.01
|
|
|
Service Code
|
CPT 74019
|
| Hospital Charge Code |
32000326
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$298.81 |
| Rate for Payer: Aetna Commercial |
$282.21
|
| Rate for Payer: Aetna Medicare |
$86.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.75
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$83.00
|
| Rate for Payer: BCBS Trust/PPO |
$258.14
|
| Rate for Payer: BCN Commercial |
$258.14
|
| Rate for Payer: BCN Medicare Advantage |
$83.00
|
| Rate for Payer: Cash Price |
$265.61
|
| Rate for Payer: Cash Price |
$265.61
|
| Rate for Payer: Cofinity Commercial |
$285.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.00
|
| Rate for Payer: Healthscope Commercial |
$298.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$249.01
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$87.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$282.21
|
| Rate for Payer: PACE Senior Care Partners |
$78.85
|
| Rate for Payer: PACE SWMI |
$83.00
|
| Rate for Payer: PHP Commercial |
$282.21
|
| Rate for Payer: PHP Medicare Advantage |
$83.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$288.85
|
| Rate for Payer: Priority Health Medicare |
$83.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$202.49
|
| Rate for Payer: Railroad Medicare Medicare |
$83.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$292.17
|
| Rate for Payer: UHC Core |
$277.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.00
|
| Rate for Payer: UHC Medicare Advantage |
$85.49
|
| Rate for Payer: VA VA |
$83.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$249.01
|
|
|
HC XR ABDOMEN 2 VW
|
Facility
|
IP
|
$332.01
|
|
|
Service Code
|
CPT 74019
|
| Hospital Charge Code |
32000326
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$202.49 |
| Max. Negotiated Rate |
$298.81 |
| Rate for Payer: Aetna Commercial |
$282.21
|
| Rate for Payer: BCBS Trust/PPO |
$256.58
|
| Rate for Payer: BCN Commercial |
$256.58
|
| Rate for Payer: Cash Price |
$265.61
|
| Rate for Payer: Cofinity Commercial |
$285.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.61
|
| Rate for Payer: Healthscope Commercial |
$298.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$249.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$282.21
|
| Rate for Payer: PHP Commercial |
$282.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$288.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$202.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$292.17
|
| Rate for Payer: UHC Core |
$277.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$249.01
|
|
|
HC XR ABDOMEN 3 OR MORE VIEWS
|
Facility
|
OP
|
$364.14
|
|
|
Service Code
|
CPT 74021
|
| Hospital Charge Code |
32000327
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$327.73 |
| Rate for Payer: Aetna Commercial |
$309.52
|
| Rate for Payer: Aetna Medicare |
$94.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.79
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$91.04
|
| Rate for Payer: BCBS Trust/PPO |
$283.12
|
| Rate for Payer: BCN Commercial |
$283.12
|
| Rate for Payer: BCN Medicare Advantage |
$91.04
|
| Rate for Payer: Cash Price |
$291.31
|
| Rate for Payer: Cash Price |
$291.31
|
| Rate for Payer: Cofinity Commercial |
$313.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.04
|
| Rate for Payer: Healthscope Commercial |
$327.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.10
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$95.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$309.52
|
| Rate for Payer: PACE Senior Care Partners |
$86.48
|
| Rate for Payer: PACE SWMI |
$91.04
|
| Rate for Payer: PHP Commercial |
$309.52
|
| Rate for Payer: PHP Medicare Advantage |
$91.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$316.80
|
| Rate for Payer: Priority Health Medicare |
$91.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$222.09
|
| Rate for Payer: Railroad Medicare Medicare |
$91.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.44
|
| Rate for Payer: UHC Core |
$304.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.04
|
| Rate for Payer: UHC Medicare Advantage |
$93.77
|
| Rate for Payer: VA VA |
$91.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.10
|
|
|
HC XR ABDOMEN 3 OR MORE VIEWS
|
Facility
|
IP
|
$364.14
|
|
|
Service Code
|
CPT 74021
|
| Hospital Charge Code |
32000327
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$222.09 |
| Max. Negotiated Rate |
$327.73 |
| Rate for Payer: Aetna Commercial |
$309.52
|
| Rate for Payer: BCBS Trust/PPO |
$281.41
|
| Rate for Payer: BCN Commercial |
$281.41
|
| Rate for Payer: Cash Price |
$291.31
|
| Rate for Payer: Cofinity Commercial |
$313.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.31
|
| Rate for Payer: Healthscope Commercial |
$327.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$309.52
|
| Rate for Payer: PHP Commercial |
$309.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$316.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$222.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.44
|
| Rate for Payer: UHC Core |
$304.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.10
|
|
|
HC XR ABDOMEN ACUTE
|
Facility
|
IP
|
$480.78
|
|
|
Service Code
|
CPT 74022
|
| Hospital Charge Code |
32000135
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$293.23 |
| Max. Negotiated Rate |
$432.70 |
| Rate for Payer: Aetna Commercial |
$408.66
|
| Rate for Payer: BCBS Trust/PPO |
$371.55
|
| Rate for Payer: BCN Commercial |
$371.55
|
| Rate for Payer: Cash Price |
$384.62
|
| Rate for Payer: Cofinity Commercial |
$413.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.62
|
| Rate for Payer: Healthscope Commercial |
$432.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$408.66
|
| Rate for Payer: PHP Commercial |
$408.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$418.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.09
|
| Rate for Payer: UHC Core |
$401.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.58
|
|
|
HC XR ABDOMEN ACUTE
|
Facility
|
OP
|
$480.78
|
|
|
Service Code
|
CPT 74022
|
| Hospital Charge Code |
32000135
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$432.70 |
| Rate for Payer: Aetna Commercial |
$408.66
|
| Rate for Payer: Aetna Medicare |
$125.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.24
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$120.20
|
| Rate for Payer: BCBS Trust/PPO |
$373.81
|
| Rate for Payer: BCN Commercial |
$373.81
|
| Rate for Payer: BCN Medicare Advantage |
$120.20
|
| Rate for Payer: Cash Price |
$384.62
|
| Rate for Payer: Cash Price |
$384.62
|
| Rate for Payer: Cofinity Commercial |
$413.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.20
|
| Rate for Payer: Healthscope Commercial |
$432.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.58
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$126.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$408.66
|
| Rate for Payer: PACE Senior Care Partners |
$114.19
|
| Rate for Payer: PACE SWMI |
$120.20
|
| Rate for Payer: PHP Commercial |
$408.66
|
| Rate for Payer: PHP Medicare Advantage |
$120.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$418.28
|
| Rate for Payer: Priority Health Medicare |
$120.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.23
|
| Rate for Payer: Railroad Medicare Medicare |
$120.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.09
|
| Rate for Payer: UHC Core |
$401.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.20
|
| Rate for Payer: UHC Medicare Advantage |
$123.80
|
| Rate for Payer: VA VA |
$120.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.58
|
|
|
HC XR AC JOINTS
|
Facility
|
IP
|
$350.37
|
|
|
Service Code
|
CPT 73050
|
| Hospital Charge Code |
32000068
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$213.69 |
| Max. Negotiated Rate |
$315.33 |
| Rate for Payer: Aetna Commercial |
$297.81
|
| Rate for Payer: BCBS Trust/PPO |
$270.77
|
| Rate for Payer: BCN Commercial |
$270.77
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cofinity Commercial |
$301.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.30
|
| Rate for Payer: Healthscope Commercial |
$315.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.81
|
| Rate for Payer: PHP Commercial |
$297.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.33
|
| Rate for Payer: UHC Core |
$292.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.78
|
|
|
HC XR AC JOINTS
|
Facility
|
OP
|
$350.37
|
|
|
Service Code
|
CPT 73050
|
| Hospital Charge Code |
32000068
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$315.33 |
| Rate for Payer: Aetna Commercial |
$297.81
|
| Rate for Payer: Aetna Medicare |
$91.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.49
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$87.59
|
| Rate for Payer: BCBS Trust/PPO |
$272.41
|
| Rate for Payer: BCN Commercial |
$272.41
|
| Rate for Payer: BCN Medicare Advantage |
$87.59
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cofinity Commercial |
$301.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.59
|
| Rate for Payer: Healthscope Commercial |
$315.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.78
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$91.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.81
|
| Rate for Payer: PACE Senior Care Partners |
$83.21
|
| Rate for Payer: PACE SWMI |
$87.59
|
| Rate for Payer: PHP Commercial |
$297.81
|
| Rate for Payer: PHP Medicare Advantage |
$87.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.82
|
| Rate for Payer: Priority Health Medicare |
$87.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.69
|
| Rate for Payer: Railroad Medicare Medicare |
$87.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.33
|
| Rate for Payer: UHC Core |
$292.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.59
|
| Rate for Payer: UHC Medicare Advantage |
$90.22
|
| Rate for Payer: VA VA |
$87.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.78
|
|
|
HC XR ANKLE 1 VW
|
Facility
|
OP
|
$238.44
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000118
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$56.63 |
| Max. Negotiated Rate |
$214.60 |
| Rate for Payer: Aetna Commercial |
$202.67
|
| Rate for Payer: Aetna Medicare |
$61.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$74.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$74.51
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$59.61
|
| Rate for Payer: BCBS Trust/PPO |
$185.39
|
| Rate for Payer: BCN Commercial |
$185.39
|
| Rate for Payer: BCN Medicare Advantage |
$59.61
|
| Rate for Payer: Cash Price |
$190.75
|
| Rate for Payer: Cash Price |
$190.75
|
| Rate for Payer: Cofinity Commercial |
$205.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.61
|
| Rate for Payer: Healthscope Commercial |
$214.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.83
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$62.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$202.67
|
| Rate for Payer: PACE Senior Care Partners |
$56.63
|
| Rate for Payer: PACE SWMI |
$59.61
|
| Rate for Payer: PHP Commercial |
$202.67
|
| Rate for Payer: PHP Medicare Advantage |
$59.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.44
|
| Rate for Payer: Priority Health Medicare |
$59.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.42
|
| Rate for Payer: Railroad Medicare Medicare |
$59.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.83
|
| Rate for Payer: UHC Core |
$199.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.61
|
| Rate for Payer: UHC Medicare Advantage |
$61.40
|
| Rate for Payer: VA VA |
$59.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.83
|
|
|
HC XR ANKLE 1 VW
|
Facility
|
IP
|
$238.44
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000118
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$145.42 |
| Max. Negotiated Rate |
$214.60 |
| Rate for Payer: Aetna Commercial |
$202.67
|
| Rate for Payer: BCBS Trust/PPO |
$184.27
|
| Rate for Payer: BCN Commercial |
$184.27
|
| Rate for Payer: Cash Price |
$190.75
|
| Rate for Payer: Cofinity Commercial |
$205.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.75
|
| Rate for Payer: Healthscope Commercial |
$214.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$202.67
|
| Rate for Payer: PHP Commercial |
$202.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.83
|
| Rate for Payer: UHC Core |
$199.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.83
|
|
|
HC XR ANKLE 2 VIEWS
|
Facility
|
IP
|
$250.45
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000117
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$152.75 |
| Max. Negotiated Rate |
$225.40 |
| Rate for Payer: Aetna Commercial |
$212.88
|
| Rate for Payer: BCBS Trust/PPO |
$193.55
|
| Rate for Payer: BCN Commercial |
$193.55
|
| Rate for Payer: Cash Price |
$200.36
|
| Rate for Payer: Cofinity Commercial |
$215.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.36
|
| Rate for Payer: Healthscope Commercial |
$225.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$212.88
|
| Rate for Payer: PHP Commercial |
$212.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$152.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$220.40
|
| Rate for Payer: UHC Core |
$209.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.84
|
|
|
HC XR ANKLE 2 VIEWS
|
Facility
|
OP
|
$250.45
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000117
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.48 |
| Max. Negotiated Rate |
$225.40 |
| Rate for Payer: Aetna Commercial |
$212.88
|
| Rate for Payer: Aetna Medicare |
$65.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$78.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$78.27
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$62.61
|
| Rate for Payer: BCBS Trust/PPO |
$194.72
|
| Rate for Payer: BCN Commercial |
$194.72
|
| Rate for Payer: BCN Medicare Advantage |
$62.61
|
| Rate for Payer: Cash Price |
$200.36
|
| Rate for Payer: Cash Price |
$200.36
|
| Rate for Payer: Cofinity Commercial |
$215.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.61
|
| Rate for Payer: Healthscope Commercial |
$225.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.84
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$212.88
|
| Rate for Payer: PACE Senior Care Partners |
$59.48
|
| Rate for Payer: PACE SWMI |
$62.61
|
| Rate for Payer: PHP Commercial |
$212.88
|
| Rate for Payer: PHP Medicare Advantage |
$62.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.89
|
| Rate for Payer: Priority Health Medicare |
$62.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$152.75
|
| Rate for Payer: Railroad Medicare Medicare |
$62.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$220.40
|
| Rate for Payer: UHC Core |
$209.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.61
|
| Rate for Payer: UHC Medicare Advantage |
$64.49
|
| Rate for Payer: VA VA |
$62.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.84
|
|
|
HC XR ANKLE 2 VIEWS BILATERAL
|
Facility
|
IP
|
$245.00
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000339
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$149.43 |
| Max. Negotiated Rate |
$220.50 |
| Rate for Payer: Aetna Commercial |
$208.25
|
| Rate for Payer: BCBS Trust/PPO |
$189.34
|
| Rate for Payer: BCN Commercial |
$189.34
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cofinity Commercial |
$210.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.00
|
| Rate for Payer: Healthscope Commercial |
$220.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$208.25
|
| Rate for Payer: PHP Commercial |
$208.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$213.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.60
|
| Rate for Payer: UHC Core |
$204.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.75
|
|
|
HC XR ANKLE 2 VIEWS BILATERAL
|
Facility
|
OP
|
$245.00
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000339
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$58.19 |
| Max. Negotiated Rate |
$220.50 |
| Rate for Payer: Aetna Commercial |
$208.25
|
| Rate for Payer: Aetna Medicare |
$63.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.56
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$61.25
|
| Rate for Payer: BCBS Trust/PPO |
$190.49
|
| Rate for Payer: BCN Commercial |
$190.49
|
| Rate for Payer: BCN Medicare Advantage |
$61.25
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cofinity Commercial |
$210.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.25
|
| Rate for Payer: Healthscope Commercial |
$220.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.75
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$64.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$208.25
|
| Rate for Payer: PACE Senior Care Partners |
$58.19
|
| Rate for Payer: PACE SWMI |
$61.25
|
| Rate for Payer: PHP Commercial |
$208.25
|
| Rate for Payer: PHP Medicare Advantage |
$61.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$213.15
|
| Rate for Payer: Priority Health Medicare |
$61.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.43
|
| Rate for Payer: Railroad Medicare Medicare |
$61.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.60
|
| Rate for Payer: UHC Core |
$204.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.25
|
| Rate for Payer: UHC Medicare Advantage |
$63.09
|
| Rate for Payer: VA VA |
$61.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.75
|
|
|
HC XR ANKLE BIL 2 VW
|
Facility
|
OP
|
$286.12
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000120
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$257.51 |
| Rate for Payer: Aetna Commercial |
$243.20
|
| Rate for Payer: Aetna Medicare |
$74.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.41
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$71.53
|
| Rate for Payer: BCBS Trust/PPO |
$222.46
|
| Rate for Payer: BCN Commercial |
$222.46
|
| Rate for Payer: BCN Medicare Advantage |
$71.53
|
| Rate for Payer: Cash Price |
$228.90
|
| Rate for Payer: Cash Price |
$228.90
|
| Rate for Payer: Cofinity Commercial |
$246.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.53
|
| Rate for Payer: Healthscope Commercial |
$257.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.59
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$75.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$243.20
|
| Rate for Payer: PACE Senior Care Partners |
$67.95
|
| Rate for Payer: PACE SWMI |
$71.53
|
| Rate for Payer: PHP Commercial |
$243.20
|
| Rate for Payer: PHP Medicare Advantage |
$71.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.92
|
| Rate for Payer: Priority Health Medicare |
$71.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.50
|
| Rate for Payer: Railroad Medicare Medicare |
$71.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.79
|
| Rate for Payer: UHC Core |
$238.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.53
|
| Rate for Payer: UHC Medicare Advantage |
$73.68
|
| Rate for Payer: VA VA |
$71.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.59
|
|
|
HC XR ANKLE BIL 2 VW
|
Facility
|
IP
|
$286.12
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000120
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$174.50 |
| Max. Negotiated Rate |
$257.51 |
| Rate for Payer: Aetna Commercial |
$243.20
|
| Rate for Payer: BCBS Trust/PPO |
$221.11
|
| Rate for Payer: BCN Commercial |
$221.11
|
| Rate for Payer: Cash Price |
$228.90
|
| Rate for Payer: Cofinity Commercial |
$246.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.90
|
| Rate for Payer: Healthscope Commercial |
$257.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$243.20
|
| Rate for Payer: PHP Commercial |
$243.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.79
|
| Rate for Payer: UHC Core |
$238.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.59
|
|
|
HC XR ANKLE BIL MIN 3 VW
|
Facility
|
OP
|
$381.09
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
32000122
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$342.98 |
| Rate for Payer: Aetna Commercial |
$323.93
|
| Rate for Payer: Aetna Medicare |
$99.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$119.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$119.09
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$95.27
|
| Rate for Payer: BCBS Trust/PPO |
$296.30
|
| Rate for Payer: BCN Commercial |
$296.30
|
| Rate for Payer: BCN Medicare Advantage |
$95.27
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$327.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.27
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$100.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: PACE Senior Care Partners |
$90.51
|
| Rate for Payer: PACE SWMI |
$95.27
|
| Rate for Payer: PHP Commercial |
$323.93
|
| Rate for Payer: PHP Medicare Advantage |
$95.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$331.55
|
| Rate for Payer: Priority Health Medicare |
$95.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$232.43
|
| Rate for Payer: Railroad Medicare Medicare |
$95.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.36
|
| Rate for Payer: UHC Core |
$318.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.27
|
| Rate for Payer: UHC Medicare Advantage |
$98.13
|
| Rate for Payer: VA VA |
$95.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
|
HC XR ANKLE BIL MIN 3 VW
|
Facility
|
IP
|
$381.09
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
32000122
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$232.43 |
| Max. Negotiated Rate |
$342.98 |
| Rate for Payer: Aetna Commercial |
$323.93
|
| Rate for Payer: BCBS Trust/PPO |
$294.51
|
| Rate for Payer: BCN Commercial |
$294.51
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$327.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: PHP Commercial |
$323.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$331.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$232.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.36
|
| Rate for Payer: UHC Core |
$318.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
|
HC XR ANKLE MIN 3 VIEWS
|
Facility
|
OP
|
$350.37
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
32000121
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$315.33 |
| Rate for Payer: Aetna Commercial |
$297.81
|
| Rate for Payer: Aetna Medicare |
$91.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.49
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$87.59
|
| Rate for Payer: BCBS Trust/PPO |
$272.41
|
| Rate for Payer: BCN Commercial |
$272.41
|
| Rate for Payer: BCN Medicare Advantage |
$87.59
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cofinity Commercial |
$301.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.59
|
| Rate for Payer: Healthscope Commercial |
$315.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.78
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$91.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.81
|
| Rate for Payer: PACE Senior Care Partners |
$83.21
|
| Rate for Payer: PACE SWMI |
$87.59
|
| Rate for Payer: PHP Commercial |
$297.81
|
| Rate for Payer: PHP Medicare Advantage |
$87.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.82
|
| Rate for Payer: Priority Health Medicare |
$87.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.69
|
| Rate for Payer: Railroad Medicare Medicare |
$87.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.33
|
| Rate for Payer: UHC Core |
$292.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.59
|
| Rate for Payer: UHC Medicare Advantage |
$90.22
|
| Rate for Payer: VA VA |
$87.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.78
|
|
|
HC XR ANKLE MIN 3 VIEWS
|
Facility
|
IP
|
$350.37
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
32000121
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$213.69 |
| Max. Negotiated Rate |
$315.33 |
| Rate for Payer: Aetna Commercial |
$297.81
|
| Rate for Payer: BCBS Trust/PPO |
$270.77
|
| Rate for Payer: BCN Commercial |
$270.77
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cofinity Commercial |
$301.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.30
|
| Rate for Payer: Healthscope Commercial |
$315.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.81
|
| Rate for Payer: PHP Commercial |
$297.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.33
|
| Rate for Payer: UHC Core |
$292.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.78
|
|
|
HC XR ARTHROGRAM ELBOW
|
Facility
|
OP
|
$600.30
|
|
|
Service Code
|
CPT 73085
|
| Hospital Charge Code |
32000075
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$142.57 |
| Max. Negotiated Rate |
$540.27 |
| Rate for Payer: Aetna Commercial |
$510.26
|
| Rate for Payer: Aetna Medicare |
$156.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$187.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$187.59
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$150.08
|
| Rate for Payer: BCBS Trust/PPO |
$466.73
|
| Rate for Payer: BCN Commercial |
$466.73
|
| Rate for Payer: BCN Medicare Advantage |
$150.08
|
| Rate for Payer: Cash Price |
$480.24
|
| Rate for Payer: Cash Price |
$480.24
|
| Rate for Payer: Cofinity Commercial |
$516.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.08
|
| Rate for Payer: Healthscope Commercial |
$540.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.22
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$157.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$172.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.26
|
| Rate for Payer: PACE Senior Care Partners |
$142.57
|
| Rate for Payer: PACE SWMI |
$150.08
|
| Rate for Payer: PHP Commercial |
$510.26
|
| Rate for Payer: PHP Medicare Advantage |
$150.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$522.26
|
| Rate for Payer: Priority Health Medicare |
$150.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$366.12
|
| Rate for Payer: Railroad Medicare Medicare |
$150.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.26
|
| Rate for Payer: UHC Core |
$501.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.08
|
| Rate for Payer: UHC Medicare Advantage |
$154.58
|
| Rate for Payer: VA VA |
$150.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.22
|
|
|
HC XR ARTHROGRAM ELBOW
|
Facility
|
IP
|
$600.30
|
|
|
Service Code
|
CPT 73085
|
| Hospital Charge Code |
32000075
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$366.12 |
| Max. Negotiated Rate |
$540.27 |
| Rate for Payer: Aetna Commercial |
$510.26
|
| Rate for Payer: BCBS Trust/PPO |
$463.91
|
| Rate for Payer: BCN Commercial |
$463.91
|
| Rate for Payer: Cash Price |
$480.24
|
| Rate for Payer: Cofinity Commercial |
$516.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.24
|
| Rate for Payer: Healthscope Commercial |
$540.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.26
|
| Rate for Payer: PHP Commercial |
$510.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$522.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$366.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.26
|
| Rate for Payer: UHC Core |
$501.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.22
|
|
|
HC XR ARTHROGRAM HIP
|
Facility
|
IP
|
$600.30
|
|
|
Service Code
|
CPT 73525
|
| Hospital Charge Code |
32000097
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$366.12 |
| Max. Negotiated Rate |
$540.27 |
| Rate for Payer: Aetna Commercial |
$510.26
|
| Rate for Payer: BCBS Trust/PPO |
$463.91
|
| Rate for Payer: BCN Commercial |
$463.91
|
| Rate for Payer: Cash Price |
$480.24
|
| Rate for Payer: Cofinity Commercial |
$516.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.24
|
| Rate for Payer: Healthscope Commercial |
$540.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.26
|
| Rate for Payer: PHP Commercial |
$510.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$522.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$366.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.26
|
| Rate for Payer: UHC Core |
$501.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.22
|
|
