|
HC XR ARTHROGRAM HIP
|
Facility
|
OP
|
$600.30
|
|
|
Service Code
|
CPT 73525
|
| Hospital Charge Code |
32000097
|
|
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 KNEE
|
Facility
|
OP
|
$600.30
|
|
|
Service Code
|
CPT 73580
|
| Hospital Charge Code |
32000111
|
|
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 KNEE
|
Facility
|
IP
|
$600.30
|
|
|
Service Code
|
CPT 73580
|
| Hospital Charge Code |
32000111
|
|
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 SHOULDER
|
Facility
|
OP
|
$600.30
|
|
|
Service Code
|
CPT 73040
|
| Hospital Charge Code |
32000067
|
|
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 SHOULDER
|
Facility
|
IP
|
$600.30
|
|
|
Service Code
|
CPT 73040
|
| Hospital Charge Code |
32000067
|
|
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 WRIST
|
Facility
|
IP
|
$657.72
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
32000084
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$401.14 |
| Max. Negotiated Rate |
$591.95 |
| Rate for Payer: Aetna Commercial |
$559.06
|
| Rate for Payer: BCBS Trust/PPO |
$508.29
|
| Rate for Payer: BCN Commercial |
$508.29
|
| Rate for Payer: Cash Price |
$526.18
|
| Rate for Payer: Cofinity Commercial |
$565.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$526.18
|
| Rate for Payer: Healthscope Commercial |
$591.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$493.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$559.06
|
| Rate for Payer: PHP Commercial |
$559.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$460.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$572.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$401.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$578.79
|
| Rate for Payer: UHC Core |
$549.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$493.29
|
|
|
HC XR ARTHROGRAM WRIST
|
Facility
|
OP
|
$657.72
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
32000084
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$156.21 |
| Max. Negotiated Rate |
$591.95 |
| Rate for Payer: Aetna Commercial |
$559.06
|
| Rate for Payer: Aetna Medicare |
$171.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$205.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$205.54
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$164.43
|
| Rate for Payer: BCBS Trust/PPO |
$511.38
|
| Rate for Payer: BCN Commercial |
$511.38
|
| Rate for Payer: BCN Medicare Advantage |
$164.43
|
| Rate for Payer: Cash Price |
$526.18
|
| Rate for Payer: Cash Price |
$526.18
|
| Rate for Payer: Cofinity Commercial |
$565.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$526.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.43
|
| Rate for Payer: Healthscope Commercial |
$591.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$493.29
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$172.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$189.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$559.06
|
| Rate for Payer: PACE Senior Care Partners |
$156.21
|
| Rate for Payer: PACE SWMI |
$164.43
|
| Rate for Payer: PHP Commercial |
$559.06
|
| Rate for Payer: PHP Medicare Advantage |
$164.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$460.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$572.22
|
| Rate for Payer: Priority Health Medicare |
$164.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$401.14
|
| Rate for Payer: Railroad Medicare Medicare |
$164.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$578.79
|
| Rate for Payer: UHC Core |
$549.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$164.43
|
| Rate for Payer: UHC Medicare Advantage |
$169.36
|
| Rate for Payer: VA VA |
$164.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$493.29
|
|
|
HC XR BONE AGE STUDY
|
Facility
|
IP
|
$300.42
|
|
|
Service Code
|
CPT 77072
|
| Hospital Charge Code |
32000253
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$183.23 |
| Max. Negotiated Rate |
$270.38 |
| Rate for Payer: Aetna Commercial |
$255.36
|
| Rate for Payer: BCBS Trust/PPO |
$232.16
|
| Rate for Payer: BCN Commercial |
$232.16
|
| Rate for Payer: Cash Price |
$240.34
|
| Rate for Payer: Cofinity Commercial |
$258.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.34
|
| Rate for Payer: Healthscope Commercial |
$270.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$255.36
|
| Rate for Payer: PHP Commercial |
$255.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$261.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$183.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.37
|
| Rate for Payer: UHC Core |
$250.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.32
|
|
|
HC XR BONE AGE STUDY
|
Facility
|
OP
|
$300.42
|
|
|
Service Code
|
CPT 77072
|
| Hospital Charge Code |
32000253
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$71.35 |
| Max. Negotiated Rate |
$270.38 |
| Rate for Payer: Aetna Commercial |
$255.36
|
| Rate for Payer: Aetna Medicare |
$78.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.88
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$75.10
|
| Rate for Payer: BCBS Trust/PPO |
$233.58
|
| Rate for Payer: BCN Commercial |
$233.58
|
| Rate for Payer: BCN Medicare Advantage |
$75.10
|
| Rate for Payer: Cash Price |
$240.34
|
| Rate for Payer: Cash Price |
$240.34
|
| Rate for Payer: Cofinity Commercial |
$258.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.10
|
| Rate for Payer: Healthscope Commercial |
$270.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.32
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$255.36
|
| Rate for Payer: PACE Senior Care Partners |
$71.35
|
| Rate for Payer: PACE SWMI |
$75.10
|
| Rate for Payer: PHP Commercial |
$255.36
|
| Rate for Payer: PHP Medicare Advantage |
$75.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$261.37
|
| Rate for Payer: Priority Health Medicare |
$75.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$183.23
|
| Rate for Payer: Railroad Medicare Medicare |
$75.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.37
|
| Rate for Payer: UHC Core |
$250.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.10
|
| Rate for Payer: UHC Medicare Advantage |
$77.36
|
| Rate for Payer: VA VA |
$75.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.32
|
|
|
HC XR BONE LENGTH STUDY
|
Facility
|
OP
|
$286.12
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
32000254
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$67.95 |
| 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 |
$75.72
|
| 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 |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| 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 |
$72.12
|
| 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 BONE LENGTH STUDY
|
Facility
|
IP
|
$286.12
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
32000254
|
|
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 BONE SURVEY ADULT COMP
|
Facility
|
IP
|
$600.55
|
|
|
Service Code
|
CPT 77075
|
| Hospital Charge Code |
32000257
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$366.28 |
| Max. Negotiated Rate |
$540.50 |
| Rate for Payer: Aetna Commercial |
$510.47
|
| Rate for Payer: BCBS Trust/PPO |
$464.11
|
| Rate for Payer: BCN Commercial |
$464.11
|
| Rate for Payer: Cash Price |
$480.44
|
| Rate for Payer: Cofinity Commercial |
$516.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.44
|
| Rate for Payer: Healthscope Commercial |
$540.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.47
|
| Rate for Payer: PHP Commercial |
$510.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$522.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$366.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.48
|
| Rate for Payer: UHC Core |
$501.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.41
|
|
|
HC XR BONE SURVEY ADULT COMP
|
Facility
|
OP
|
$600.55
|
|
|
Service Code
|
CPT 77075
|
| Hospital Charge Code |
32000257
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$540.50 |
| Rate for Payer: Aetna Commercial |
$510.47
|
| Rate for Payer: Aetna Medicare |
$156.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$187.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$187.67
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$150.14
|
| Rate for Payer: BCBS Trust/PPO |
$466.93
|
| Rate for Payer: BCN Commercial |
$466.93
|
| Rate for Payer: BCN Medicare Advantage |
$150.14
|
| Rate for Payer: Cash Price |
$480.44
|
| Rate for Payer: Cash Price |
$480.44
|
| Rate for Payer: Cofinity Commercial |
$516.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.14
|
| Rate for Payer: Healthscope Commercial |
$540.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.41
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$157.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$172.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.47
|
| Rate for Payer: PACE Senior Care Partners |
$142.63
|
| Rate for Payer: PACE SWMI |
$150.14
|
| Rate for Payer: PHP Commercial |
$510.47
|
| Rate for Payer: PHP Medicare Advantage |
$150.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$522.48
|
| Rate for Payer: Priority Health Medicare |
$150.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$366.28
|
| Rate for Payer: Railroad Medicare Medicare |
$150.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.48
|
| Rate for Payer: UHC Core |
$501.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.14
|
| Rate for Payer: UHC Medicare Advantage |
$154.64
|
| Rate for Payer: VA VA |
$150.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.41
|
|
|
HC XR BONE SURVEY INFANT
|
Facility
|
OP
|
$380.35
|
|
|
Service Code
|
CPT 77076
|
| Hospital Charge Code |
32000258
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$342.32 |
| Rate for Payer: Aetna Commercial |
$323.30
|
| Rate for Payer: Aetna Medicare |
$98.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$118.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$118.86
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$95.09
|
| Rate for Payer: BCBS Trust/PPO |
$295.72
|
| Rate for Payer: BCN Commercial |
$295.72
|
| Rate for Payer: BCN Medicare Advantage |
$95.09
|
| Rate for Payer: Cash Price |
$304.28
|
| Rate for Payer: Cash Price |
$304.28
|
| Rate for Payer: Cofinity Commercial |
$327.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.09
|
| Rate for Payer: Healthscope Commercial |
$342.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.26
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$99.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.30
|
| Rate for Payer: PACE Senior Care Partners |
$90.33
|
| Rate for Payer: PACE SWMI |
$95.09
|
| Rate for Payer: PHP Commercial |
$323.30
|
| Rate for Payer: PHP Medicare Advantage |
$95.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$330.90
|
| Rate for Payer: Priority Health Medicare |
$95.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$231.98
|
| Rate for Payer: Railroad Medicare Medicare |
$95.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$334.71
|
| Rate for Payer: UHC Core |
$317.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.09
|
| Rate for Payer: UHC Medicare Advantage |
$97.94
|
| Rate for Payer: VA VA |
$95.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.26
|
|
|
HC XR BONE SURVEY INFANT
|
Facility
|
IP
|
$380.35
|
|
|
Service Code
|
CPT 77076
|
| Hospital Charge Code |
32000258
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$231.98 |
| Max. Negotiated Rate |
$342.32 |
| Rate for Payer: Aetna Commercial |
$323.30
|
| Rate for Payer: BCBS Trust/PPO |
$293.93
|
| Rate for Payer: BCN Commercial |
$293.93
|
| Rate for Payer: Cash Price |
$304.28
|
| Rate for Payer: Cofinity Commercial |
$327.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.28
|
| Rate for Payer: Healthscope Commercial |
$342.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.30
|
| Rate for Payer: PHP Commercial |
$323.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$330.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$231.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$334.71
|
| Rate for Payer: UHC Core |
$317.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.26
|
|
|
HC XR BONE SURVEY (METS) LTD
|
Facility
|
OP
|
$302.08
|
|
|
Service Code
|
CPT 77074
|
| Hospital Charge Code |
32000298
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$71.74 |
| Max. Negotiated Rate |
$271.87 |
| Rate for Payer: Aetna Commercial |
$256.77
|
| Rate for Payer: Aetna Medicare |
$78.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$94.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$94.40
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$75.52
|
| Rate for Payer: BCBS Trust/PPO |
$234.87
|
| Rate for Payer: BCN Commercial |
$234.87
|
| Rate for Payer: BCN Medicare Advantage |
$75.52
|
| Rate for Payer: Cash Price |
$241.66
|
| Rate for Payer: Cash Price |
$241.66
|
| Rate for Payer: Cofinity Commercial |
$259.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$241.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.52
|
| Rate for Payer: Healthscope Commercial |
$271.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$226.56
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$79.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$256.77
|
| Rate for Payer: PACE Senior Care Partners |
$71.74
|
| Rate for Payer: PACE SWMI |
$75.52
|
| Rate for Payer: PHP Commercial |
$256.77
|
| Rate for Payer: PHP Medicare Advantage |
$75.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$262.81
|
| Rate for Payer: Priority Health Medicare |
$75.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.24
|
| Rate for Payer: Railroad Medicare Medicare |
$75.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$265.83
|
| Rate for Payer: UHC Core |
$252.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.52
|
| Rate for Payer: UHC Medicare Advantage |
$77.79
|
| Rate for Payer: VA VA |
$75.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$226.56
|
|
|
HC XR BONE SURVEY (METS) LTD
|
Facility
|
IP
|
$302.08
|
|
|
Service Code
|
CPT 77074
|
| Hospital Charge Code |
32000298
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$184.24 |
| Max. Negotiated Rate |
$271.87 |
| Rate for Payer: Aetna Commercial |
$256.77
|
| Rate for Payer: BCBS Trust/PPO |
$233.45
|
| Rate for Payer: BCN Commercial |
$233.45
|
| Rate for Payer: Cash Price |
$241.66
|
| Rate for Payer: Cofinity Commercial |
$259.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$241.66
|
| Rate for Payer: Healthscope Commercial |
$271.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$226.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$256.77
|
| Rate for Payer: PHP Commercial |
$256.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$262.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$265.83
|
| Rate for Payer: UHC Core |
$252.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$226.56
|
|
|
HC XR CHEST 2 VIEWS
|
Facility
|
OP
|
$297.74
|
|
|
Service Code
|
CPT 71046
|
| Hospital Charge Code |
32400010
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$267.97 |
| Rate for Payer: Aetna Commercial |
$253.08
|
| Rate for Payer: Aetna Medicare |
$77.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.04
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$74.44
|
| Rate for Payer: BCBS Trust/PPO |
$231.49
|
| Rate for Payer: BCN Commercial |
$231.49
|
| Rate for Payer: BCN Medicare Advantage |
$74.44
|
| Rate for Payer: Cash Price |
$238.19
|
| Rate for Payer: Cash Price |
$238.19
|
| Rate for Payer: Cofinity Commercial |
$256.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.44
|
| Rate for Payer: Healthscope Commercial |
$267.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.30
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$253.08
|
| Rate for Payer: PACE Senior Care Partners |
$70.71
|
| Rate for Payer: PACE SWMI |
$74.44
|
| Rate for Payer: PHP Commercial |
$253.08
|
| Rate for Payer: PHP Medicare Advantage |
$74.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$259.03
|
| Rate for Payer: Priority Health Medicare |
$74.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.59
|
| Rate for Payer: Railroad Medicare Medicare |
$74.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$262.01
|
| Rate for Payer: UHC Core |
$248.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.44
|
| Rate for Payer: UHC Medicare Advantage |
$76.67
|
| Rate for Payer: VA VA |
$74.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.30
|
|
|
HC XR CHEST 2 VIEWS
|
Facility
|
IP
|
$297.74
|
|
|
Service Code
|
CPT 71046
|
| Hospital Charge Code |
32400010
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$181.59 |
| Max. Negotiated Rate |
$267.97 |
| Rate for Payer: Aetna Commercial |
$253.08
|
| Rate for Payer: BCBS Trust/PPO |
$230.09
|
| Rate for Payer: BCN Commercial |
$230.09
|
| Rate for Payer: Cash Price |
$238.19
|
| Rate for Payer: Cofinity Commercial |
$256.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.19
|
| Rate for Payer: Healthscope Commercial |
$267.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$253.08
|
| Rate for Payer: PHP Commercial |
$253.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$259.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$262.01
|
| Rate for Payer: UHC Core |
$248.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.30
|
|
|
HC XR CHEST 3 VIEWS
|
Facility
|
IP
|
$329.87
|
|
|
Service Code
|
CPT 71047
|
| Hospital Charge Code |
32400011
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$201.19 |
| Max. Negotiated Rate |
$296.88 |
| Rate for Payer: Aetna Commercial |
$280.39
|
| Rate for Payer: BCBS Trust/PPO |
$254.92
|
| Rate for Payer: BCN Commercial |
$254.92
|
| Rate for Payer: Cash Price |
$263.90
|
| Rate for Payer: Cofinity Commercial |
$283.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.90
|
| Rate for Payer: Healthscope Commercial |
$296.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.39
|
| Rate for Payer: PHP Commercial |
$280.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$286.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.29
|
| Rate for Payer: UHC Core |
$275.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.40
|
|
|
HC XR CHEST 3 VIEWS
|
Facility
|
OP
|
$329.87
|
|
|
Service Code
|
CPT 71047
|
| Hospital Charge Code |
32400011
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$296.88 |
| Rate for Payer: Aetna Commercial |
$280.39
|
| Rate for Payer: Aetna Medicare |
$85.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.08
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$82.47
|
| Rate for Payer: BCBS Trust/PPO |
$256.47
|
| Rate for Payer: BCN Commercial |
$256.47
|
| Rate for Payer: BCN Medicare Advantage |
$82.47
|
| Rate for Payer: Cash Price |
$263.90
|
| Rate for Payer: Cash Price |
$263.90
|
| Rate for Payer: Cofinity Commercial |
$283.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.47
|
| Rate for Payer: Healthscope Commercial |
$296.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.40
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$86.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.39
|
| Rate for Payer: PACE Senior Care Partners |
$78.34
|
| Rate for Payer: PACE SWMI |
$82.47
|
| Rate for Payer: PHP Commercial |
$280.39
|
| Rate for Payer: PHP Medicare Advantage |
$82.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$286.99
|
| Rate for Payer: Priority Health Medicare |
$82.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.19
|
| Rate for Payer: Railroad Medicare Medicare |
$82.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.29
|
| Rate for Payer: UHC Core |
$275.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.47
|
| Rate for Payer: UHC Medicare Advantage |
$84.94
|
| Rate for Payer: VA VA |
$82.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.40
|
|
|
HC XR CHEST 4 OR MORE VIEWS
|
Facility
|
IP
|
$362.00
|
|
|
Service Code
|
CPT 71048
|
| Hospital Charge Code |
32400012
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$220.78 |
| Max. Negotiated Rate |
$325.80 |
| Rate for Payer: Aetna Commercial |
$307.70
|
| Rate for Payer: BCBS Trust/PPO |
$279.75
|
| Rate for Payer: BCN Commercial |
$279.75
|
| Rate for Payer: Cash Price |
$289.60
|
| Rate for Payer: Cofinity Commercial |
$311.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.60
|
| Rate for Payer: Healthscope Commercial |
$325.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$271.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$307.70
|
| Rate for Payer: PHP Commercial |
$307.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$314.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$220.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$318.56
|
| Rate for Payer: UHC Core |
$302.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$271.50
|
|
|
HC XR CHEST 4 OR MORE VIEWS
|
Facility
|
OP
|
$362.00
|
|
|
Service Code
|
CPT 71048
|
| Hospital Charge Code |
32400012
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$325.80 |
| Rate for Payer: Aetna Commercial |
$307.70
|
| Rate for Payer: Aetna Medicare |
$94.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.12
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$90.50
|
| Rate for Payer: BCBS Trust/PPO |
$281.46
|
| Rate for Payer: BCN Commercial |
$281.46
|
| Rate for Payer: BCN Medicare Advantage |
$90.50
|
| Rate for Payer: Cash Price |
$289.60
|
| Rate for Payer: Cash Price |
$289.60
|
| Rate for Payer: Cofinity Commercial |
$311.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.50
|
| Rate for Payer: Healthscope Commercial |
$325.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$271.50
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$95.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$307.70
|
| Rate for Payer: PACE Senior Care Partners |
$85.98
|
| Rate for Payer: PACE SWMI |
$90.50
|
| Rate for Payer: PHP Commercial |
$307.70
|
| Rate for Payer: PHP Medicare Advantage |
$90.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$314.94
|
| Rate for Payer: Priority Health Medicare |
$90.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$220.78
|
| Rate for Payer: Railroad Medicare Medicare |
$90.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$318.56
|
| Rate for Payer: UHC Core |
$302.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.50
|
| Rate for Payer: UHC Medicare Advantage |
$93.22
|
| Rate for Payer: VA VA |
$90.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$271.50
|
|
|
HC XR CHEST ABD FOREIG BOD CHILD
|
Facility
|
IP
|
$270.56
|
|
|
Service Code
|
CPT 76010
|
| Hospital Charge Code |
32000234
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$165.01 |
| Max. Negotiated Rate |
$243.50 |
| Rate for Payer: Aetna Commercial |
$229.98
|
| Rate for Payer: BCBS Trust/PPO |
$209.09
|
| Rate for Payer: BCN Commercial |
$209.09
|
| Rate for Payer: Cash Price |
$216.45
|
| Rate for Payer: Cofinity Commercial |
$232.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.45
|
| Rate for Payer: Healthscope Commercial |
$243.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.98
|
| Rate for Payer: PHP Commercial |
$229.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$235.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.09
|
| Rate for Payer: UHC Core |
$225.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.92
|
|
|
HC XR CHEST ABD FOREIG BOD CHILD
|
Facility
|
OP
|
$270.56
|
|
|
Service Code
|
CPT 76010
|
| Hospital Charge Code |
32000234
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$243.50 |
| Rate for Payer: Aetna Commercial |
$229.98
|
| Rate for Payer: Aetna Medicare |
$70.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$84.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$84.55
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$67.64
|
| Rate for Payer: BCBS Trust/PPO |
$210.36
|
| Rate for Payer: BCN Commercial |
$210.36
|
| Rate for Payer: BCN Medicare Advantage |
$67.64
|
| Rate for Payer: Cash Price |
$216.45
|
| Rate for Payer: Cash Price |
$216.45
|
| Rate for Payer: Cofinity Commercial |
$232.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.64
|
| Rate for Payer: Healthscope Commercial |
$243.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.92
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$71.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.98
|
| Rate for Payer: PACE Senior Care Partners |
$64.26
|
| Rate for Payer: PACE SWMI |
$67.64
|
| Rate for Payer: PHP Commercial |
$229.98
|
| Rate for Payer: PHP Medicare Advantage |
$67.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$235.39
|
| Rate for Payer: Priority Health Medicare |
$67.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.01
|
| Rate for Payer: Railroad Medicare Medicare |
$67.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.09
|
| Rate for Payer: UHC Core |
$225.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.64
|
| Rate for Payer: UHC Medicare Advantage |
$69.67
|
| Rate for Payer: VA VA |
$67.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.92
|
|
