|
HC XR CHEST SINGLE VIEW
|
Facility
|
OP
|
$265.61
|
|
|
Service Code
|
CPT 71045
|
| Hospital Charge Code |
32400009
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$239.05 |
| Rate for Payer: Aetna Commercial |
$225.77
|
| Rate for Payer: Aetna Medicare |
$69.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$83.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$83.00
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$66.40
|
| Rate for Payer: BCBS Trust/PPO |
$206.51
|
| Rate for Payer: BCN Commercial |
$206.51
|
| Rate for Payer: BCN Medicare Advantage |
$66.40
|
| Rate for Payer: Cash Price |
$212.49
|
| Rate for Payer: Cash Price |
$212.49
|
| Rate for Payer: Cofinity Commercial |
$228.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.40
|
| Rate for Payer: Healthscope Commercial |
$239.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.21
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$69.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$225.77
|
| Rate for Payer: PACE Senior Care Partners |
$63.08
|
| Rate for Payer: PACE SWMI |
$66.40
|
| Rate for Payer: PHP Commercial |
$225.77
|
| Rate for Payer: PHP Medicare Advantage |
$66.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$231.08
|
| Rate for Payer: Priority Health Medicare |
$66.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.00
|
| Rate for Payer: Railroad Medicare Medicare |
$66.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.74
|
| Rate for Payer: UHC Core |
$221.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.40
|
| Rate for Payer: UHC Medicare Advantage |
$68.39
|
| Rate for Payer: VA VA |
$66.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.21
|
|
|
HC XR CHEST SINGLE VIEW
|
Facility
|
IP
|
$265.61
|
|
|
Service Code
|
CPT 71045
|
| Hospital Charge Code |
32400009
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$162.00 |
| Max. Negotiated Rate |
$239.05 |
| Rate for Payer: Aetna Commercial |
$225.77
|
| Rate for Payer: BCBS Trust/PPO |
$205.26
|
| Rate for Payer: BCN Commercial |
$205.26
|
| Rate for Payer: Cash Price |
$212.49
|
| Rate for Payer: Cofinity Commercial |
$228.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.49
|
| Rate for Payer: Healthscope Commercial |
$239.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$225.77
|
| Rate for Payer: PHP Commercial |
$225.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$231.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.74
|
| Rate for Payer: UHC Core |
$221.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.21
|
|
|
HC XR CHOLANGIOGRAM IN OR
|
Facility
|
IP
|
$500.38
|
|
|
Service Code
|
CPT 74300
|
| Hospital Charge Code |
32000149
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$305.18 |
| Max. Negotiated Rate |
$450.34 |
| Rate for Payer: Aetna Commercial |
$425.32
|
| Rate for Payer: BCBS Trust/PPO |
$386.69
|
| Rate for Payer: BCN Commercial |
$386.69
|
| Rate for Payer: Cash Price |
$400.30
|
| Rate for Payer: Cofinity Commercial |
$430.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.30
|
| Rate for Payer: Healthscope Commercial |
$450.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$425.32
|
| Rate for Payer: PHP Commercial |
$425.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$435.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$305.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.33
|
| Rate for Payer: UHC Core |
$417.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.28
|
|
|
HC XR CHOLANGIOGRAM IN OR
|
Facility
|
OP
|
$500.38
|
|
|
Service Code
|
CPT 74300
|
| Hospital Charge Code |
32000149
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$118.84 |
| Max. Negotiated Rate |
$450.34 |
| Rate for Payer: Aetna Commercial |
$425.32
|
| Rate for Payer: Aetna Medicare |
$130.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$156.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$156.37
|
| Rate for Payer: BCBS Complete |
$200.15
|
| Rate for Payer: BCBS MAPPO |
$125.10
|
| Rate for Payer: BCBS Trust/PPO |
$389.05
|
| Rate for Payer: BCN Commercial |
$389.05
|
| Rate for Payer: BCN Medicare Advantage |
$125.10
|
| Rate for Payer: Cash Price |
$400.30
|
| Rate for Payer: Cofinity Commercial |
$430.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.10
|
| Rate for Payer: Healthscope Commercial |
$450.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$131.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$143.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$425.32
|
| Rate for Payer: PACE Senior Care Partners |
$118.84
|
| Rate for Payer: PACE SWMI |
$125.10
|
| Rate for Payer: PHP Commercial |
$425.32
|
| Rate for Payer: PHP Medicare Advantage |
$125.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$435.33
|
| Rate for Payer: Priority Health Medicare |
$125.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$305.18
|
| Rate for Payer: Railroad Medicare Medicare |
$125.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.33
|
| Rate for Payer: UHC Core |
$417.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.10
|
| Rate for Payer: UHC Medicare Advantage |
$128.85
|
| Rate for Payer: VA VA |
$125.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.28
|
|
|
HC XR CLAVICLE
|
Facility
|
OP
|
$310.28
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000060
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$279.25 |
| Rate for Payer: Aetna Commercial |
$263.74
|
| Rate for Payer: Aetna Medicare |
$80.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$96.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$96.96
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$77.57
|
| Rate for Payer: BCBS Trust/PPO |
$241.24
|
| Rate for Payer: BCN Commercial |
$241.24
|
| Rate for Payer: BCN Medicare Advantage |
$77.57
|
| Rate for Payer: Cash Price |
$248.22
|
| Rate for Payer: Cash Price |
$248.22
|
| Rate for Payer: Cofinity Commercial |
$266.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.57
|
| Rate for Payer: Healthscope Commercial |
$279.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.71
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$81.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$263.74
|
| Rate for Payer: PACE Senior Care Partners |
$73.69
|
| Rate for Payer: PACE SWMI |
$77.57
|
| Rate for Payer: PHP Commercial |
$263.74
|
| Rate for Payer: PHP Medicare Advantage |
$77.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$269.94
|
| Rate for Payer: Priority Health Medicare |
$77.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$189.24
|
| Rate for Payer: Railroad Medicare Medicare |
$77.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.05
|
| Rate for Payer: UHC Core |
$259.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$77.57
|
| Rate for Payer: UHC Medicare Advantage |
$79.90
|
| Rate for Payer: VA VA |
$77.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.71
|
|
|
HC XR CLAVICLE
|
Facility
|
IP
|
$310.28
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000060
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$189.24 |
| Max. Negotiated Rate |
$279.25 |
| Rate for Payer: Aetna Commercial |
$263.74
|
| Rate for Payer: BCBS Trust/PPO |
$239.78
|
| Rate for Payer: BCN Commercial |
$239.78
|
| Rate for Payer: Cash Price |
$248.22
|
| Rate for Payer: Cofinity Commercial |
$266.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.22
|
| Rate for Payer: Healthscope Commercial |
$279.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$263.74
|
| Rate for Payer: PHP Commercial |
$263.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$269.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$189.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.05
|
| Rate for Payer: UHC Core |
$259.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.71
|
|
|
HC XR CLAVICLE BIL
|
Facility
|
IP
|
$333.67
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000061
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$203.51 |
| Max. Negotiated Rate |
$300.30 |
| Rate for Payer: Aetna Commercial |
$283.62
|
| Rate for Payer: BCBS Trust/PPO |
$257.86
|
| Rate for Payer: BCN Commercial |
$257.86
|
| Rate for Payer: Cash Price |
$266.94
|
| Rate for Payer: Cofinity Commercial |
$286.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.94
|
| Rate for Payer: Healthscope Commercial |
$300.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$283.62
|
| Rate for Payer: PHP Commercial |
$283.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$290.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$203.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$293.63
|
| Rate for Payer: UHC Core |
$278.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.25
|
|
|
HC XR CLAVICLE BIL
|
Facility
|
OP
|
$333.67
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000061
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$300.30 |
| Rate for Payer: Aetna Commercial |
$283.62
|
| Rate for Payer: Aetna Medicare |
$86.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$104.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$104.27
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$83.42
|
| Rate for Payer: BCBS Trust/PPO |
$259.43
|
| Rate for Payer: BCN Commercial |
$259.43
|
| Rate for Payer: BCN Medicare Advantage |
$83.42
|
| Rate for Payer: Cash Price |
$266.94
|
| Rate for Payer: Cash Price |
$266.94
|
| Rate for Payer: Cofinity Commercial |
$286.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.42
|
| Rate for Payer: Healthscope Commercial |
$300.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.25
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$87.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$283.62
|
| Rate for Payer: PACE Senior Care Partners |
$79.25
|
| Rate for Payer: PACE SWMI |
$83.42
|
| Rate for Payer: PHP Commercial |
$283.62
|
| Rate for Payer: PHP Medicare Advantage |
$83.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$290.29
|
| Rate for Payer: Priority Health Medicare |
$83.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$203.51
|
| Rate for Payer: Railroad Medicare Medicare |
$83.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$293.63
|
| Rate for Payer: UHC Core |
$278.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.42
|
| Rate for Payer: UHC Medicare Advantage |
$85.92
|
| Rate for Payer: VA VA |
$83.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.25
|
|
|
HC XR COLON
|
Facility
|
IP
|
$840.63
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
32000273
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$512.70 |
| Max. Negotiated Rate |
$756.57 |
| Rate for Payer: Aetna Commercial |
$714.54
|
| Rate for Payer: BCBS Trust/PPO |
$649.64
|
| Rate for Payer: BCN Commercial |
$649.64
|
| Rate for Payer: Cash Price |
$672.50
|
| Rate for Payer: Cofinity Commercial |
$722.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$672.50
|
| Rate for Payer: Healthscope Commercial |
$756.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$630.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$714.54
|
| Rate for Payer: PHP Commercial |
$714.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$588.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$731.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$512.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$739.75
|
| Rate for Payer: UHC Core |
$701.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$630.47
|
|
|
HC XR COLON
|
Facility
|
OP
|
$840.63
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
32000273
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$120.53 |
| Max. Negotiated Rate |
$756.57 |
| Rate for Payer: Aetna Commercial |
$714.54
|
| Rate for Payer: Aetna Medicare |
$218.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.70
|
| Rate for Payer: BCBS Complete |
$126.56
|
| Rate for Payer: BCBS MAPPO |
$210.16
|
| Rate for Payer: BCBS Trust/PPO |
$653.59
|
| Rate for Payer: BCN Commercial |
$653.59
|
| Rate for Payer: BCN Medicare Advantage |
$210.16
|
| Rate for Payer: Cash Price |
$672.50
|
| Rate for Payer: Cash Price |
$672.50
|
| Rate for Payer: Cofinity Commercial |
$722.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$672.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.16
|
| Rate for Payer: Healthscope Commercial |
$756.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$630.47
|
| Rate for Payer: Mclaren Medicaid |
$120.53
|
| Rate for Payer: Meridian Medicaid |
$126.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$714.54
|
| Rate for Payer: PACE Senior Care Partners |
$199.65
|
| Rate for Payer: PACE SWMI |
$210.16
|
| Rate for Payer: PHP Commercial |
$714.54
|
| Rate for Payer: PHP Medicare Advantage |
$210.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$588.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$731.35
|
| Rate for Payer: Priority Health Medicare |
$210.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$512.70
|
| Rate for Payer: Railroad Medicare Medicare |
$210.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$739.75
|
| Rate for Payer: UHC Core |
$701.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$210.16
|
| Rate for Payer: UHC Medicare Advantage |
$216.46
|
| Rate for Payer: VA VA |
$210.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$630.47
|
|
|
HC XR COLON HIGH DENSITY
|
Facility
|
OP
|
$1,200.85
|
|
|
Service Code
|
CPT 74280
|
| Hospital Charge Code |
32000146
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$120.53 |
| Max. Negotiated Rate |
$1,080.76 |
| Rate for Payer: Aetna Commercial |
$1,020.72
|
| Rate for Payer: Aetna Medicare |
$312.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$375.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$375.27
|
| Rate for Payer: BCBS Complete |
$126.56
|
| Rate for Payer: BCBS MAPPO |
$300.21
|
| Rate for Payer: BCBS Trust/PPO |
$933.66
|
| Rate for Payer: BCN Commercial |
$933.66
|
| Rate for Payer: BCN Medicare Advantage |
$300.21
|
| Rate for Payer: Cash Price |
$960.68
|
| Rate for Payer: Cash Price |
$960.68
|
| Rate for Payer: Cofinity Commercial |
$1,032.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$960.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.21
|
| Rate for Payer: Healthscope Commercial |
$1,080.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$900.64
|
| Rate for Payer: Mclaren Medicaid |
$120.53
|
| Rate for Payer: Meridian Medicaid |
$126.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$315.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$345.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,020.72
|
| Rate for Payer: PACE Senior Care Partners |
$285.20
|
| Rate for Payer: PACE SWMI |
$300.21
|
| Rate for Payer: PHP Commercial |
$1,020.72
|
| Rate for Payer: PHP Medicare Advantage |
$300.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$840.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,044.74
|
| Rate for Payer: Priority Health Medicare |
$300.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$732.40
|
| Rate for Payer: Railroad Medicare Medicare |
$300.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,056.75
|
| Rate for Payer: UHC Core |
$1,002.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$300.21
|
| Rate for Payer: UHC Medicare Advantage |
$309.22
|
| Rate for Payer: VA VA |
$300.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$900.64
|
|
|
HC XR COLON HIGH DENSITY
|
Facility
|
IP
|
$1,200.85
|
|
|
Service Code
|
CPT 74280
|
| Hospital Charge Code |
32000146
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$732.40 |
| Max. Negotiated Rate |
$1,080.76 |
| Rate for Payer: Aetna Commercial |
$1,020.72
|
| Rate for Payer: BCBS Trust/PPO |
$928.02
|
| Rate for Payer: BCN Commercial |
$928.02
|
| Rate for Payer: Cash Price |
$960.68
|
| Rate for Payer: Cofinity Commercial |
$1,032.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$960.68
|
| Rate for Payer: Healthscope Commercial |
$1,080.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$900.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,020.72
|
| Rate for Payer: PHP Commercial |
$1,020.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$840.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,044.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$732.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,056.75
|
| Rate for Payer: UHC Core |
$1,002.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$900.64
|
|
|
HC XR COLON THERAPEUTIC FOR INTUS
|
Facility
|
OP
|
$571.84
|
|
|
Service Code
|
CPT 74283
|
| Hospital Charge Code |
32000147
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$120.53 |
| Max. Negotiated Rate |
$514.66 |
| Rate for Payer: Aetna Commercial |
$486.06
|
| Rate for Payer: Aetna Medicare |
$148.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$178.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$178.70
|
| Rate for Payer: BCBS Complete |
$126.56
|
| Rate for Payer: BCBS MAPPO |
$142.96
|
| Rate for Payer: BCBS Trust/PPO |
$444.61
|
| Rate for Payer: BCN Commercial |
$444.61
|
| Rate for Payer: BCN Medicare Advantage |
$142.96
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cofinity Commercial |
$491.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.96
|
| Rate for Payer: Healthscope Commercial |
$514.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$428.88
|
| Rate for Payer: Mclaren Medicaid |
$120.53
|
| Rate for Payer: Meridian Medicaid |
$126.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$150.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.06
|
| Rate for Payer: PACE Senior Care Partners |
$135.81
|
| Rate for Payer: PACE SWMI |
$142.96
|
| Rate for Payer: PHP Commercial |
$486.06
|
| Rate for Payer: PHP Medicare Advantage |
$142.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$497.50
|
| Rate for Payer: Priority Health Medicare |
$142.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.77
|
| Rate for Payer: Railroad Medicare Medicare |
$142.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$503.22
|
| Rate for Payer: UHC Core |
$477.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.96
|
| Rate for Payer: UHC Medicare Advantage |
$147.25
|
| Rate for Payer: VA VA |
$142.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$428.88
|
|
|
HC XR COLON THERAPEUTIC FOR INTUS
|
Facility
|
IP
|
$571.84
|
|
|
Service Code
|
CPT 74283
|
| Hospital Charge Code |
32000147
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$348.77 |
| Max. Negotiated Rate |
$514.66 |
| Rate for Payer: Aetna Commercial |
$486.06
|
| Rate for Payer: BCBS Trust/PPO |
$441.92
|
| Rate for Payer: BCN Commercial |
$441.92
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cofinity Commercial |
$491.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.47
|
| Rate for Payer: Healthscope Commercial |
$514.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$428.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.06
|
| Rate for Payer: PHP Commercial |
$486.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$497.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$503.22
|
| Rate for Payer: UHC Core |
$477.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$428.88
|
|
|
HC XR CYSTOGRAM MIN 3 VW
|
Facility
|
IP
|
$430.44
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000163
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.53 |
| Max. Negotiated Rate |
$387.40 |
| Rate for Payer: Aetna Commercial |
$365.87
|
| Rate for Payer: BCBS Trust/PPO |
$332.64
|
| Rate for Payer: BCN Commercial |
$332.64
|
| Rate for Payer: Cash Price |
$344.35
|
| Rate for Payer: Cofinity Commercial |
$370.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.35
|
| Rate for Payer: Healthscope Commercial |
$387.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.87
|
| Rate for Payer: PHP Commercial |
$365.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$374.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$378.79
|
| Rate for Payer: UHC Core |
$359.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.83
|
|
|
HC XR CYSTOGRAM MIN 3 VW
|
Facility
|
OP
|
$430.44
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000163
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$102.23 |
| Max. Negotiated Rate |
$387.40 |
| Rate for Payer: Aetna Commercial |
$365.87
|
| Rate for Payer: Aetna Medicare |
$111.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$134.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$134.51
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$107.61
|
| Rate for Payer: BCBS Trust/PPO |
$334.67
|
| Rate for Payer: BCN Commercial |
$334.67
|
| Rate for Payer: BCN Medicare Advantage |
$107.61
|
| Rate for Payer: Cash Price |
$344.35
|
| Rate for Payer: Cash Price |
$344.35
|
| Rate for Payer: Cofinity Commercial |
$370.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.61
|
| Rate for Payer: Healthscope Commercial |
$387.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.83
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.87
|
| Rate for Payer: PACE Senior Care Partners |
$102.23
|
| Rate for Payer: PACE SWMI |
$107.61
|
| Rate for Payer: PHP Commercial |
$365.87
|
| Rate for Payer: PHP Medicare Advantage |
$107.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$374.48
|
| Rate for Payer: Priority Health Medicare |
$107.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.53
|
| Rate for Payer: Railroad Medicare Medicare |
$107.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$378.79
|
| Rate for Payer: UHC Core |
$359.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.61
|
| Rate for Payer: UHC Medicare Advantage |
$110.84
|
| Rate for Payer: VA VA |
$107.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.83
|
|
|
HC XR CYSTOGRAM VOIDING
|
Facility
|
OP
|
$500.38
|
|
|
Service Code
|
CPT 74455
|
| Hospital Charge Code |
32000166
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$118.84 |
| Max. Negotiated Rate |
$450.34 |
| Rate for Payer: Aetna Commercial |
$425.32
|
| Rate for Payer: Aetna Medicare |
$130.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$156.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$156.37
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$125.10
|
| Rate for Payer: BCBS Trust/PPO |
$389.05
|
| Rate for Payer: BCN Commercial |
$389.05
|
| Rate for Payer: BCN Medicare Advantage |
$125.10
|
| Rate for Payer: Cash Price |
$400.30
|
| Rate for Payer: Cash Price |
$400.30
|
| Rate for Payer: Cofinity Commercial |
$430.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.10
|
| Rate for Payer: Healthscope Commercial |
$450.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.28
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$131.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$143.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$425.32
|
| Rate for Payer: PACE Senior Care Partners |
$118.84
|
| Rate for Payer: PACE SWMI |
$125.10
|
| Rate for Payer: PHP Commercial |
$425.32
|
| Rate for Payer: PHP Medicare Advantage |
$125.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$435.33
|
| Rate for Payer: Priority Health Medicare |
$125.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$305.18
|
| Rate for Payer: Railroad Medicare Medicare |
$125.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.33
|
| Rate for Payer: UHC Core |
$417.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.10
|
| Rate for Payer: UHC Medicare Advantage |
$128.85
|
| Rate for Payer: VA VA |
$125.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.28
|
|
|
HC XR CYSTOGRAM VOIDING
|
Facility
|
IP
|
$500.38
|
|
|
Service Code
|
CPT 74455
|
| Hospital Charge Code |
32000166
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$305.18 |
| Max. Negotiated Rate |
$450.34 |
| Rate for Payer: Aetna Commercial |
$425.32
|
| Rate for Payer: BCBS Trust/PPO |
$386.69
|
| Rate for Payer: BCN Commercial |
$386.69
|
| Rate for Payer: Cash Price |
$400.30
|
| Rate for Payer: Cofinity Commercial |
$430.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.30
|
| Rate for Payer: Healthscope Commercial |
$450.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$425.32
|
| Rate for Payer: PHP Commercial |
$425.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$435.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$305.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.33
|
| Rate for Payer: UHC Core |
$417.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.28
|
|
|
HC XR DEFECOGRAPHY 4 WAY
|
Facility
|
IP
|
$800.53
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000164
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$488.24 |
| Max. Negotiated Rate |
$720.48 |
| Rate for Payer: Aetna Commercial |
$680.45
|
| Rate for Payer: BCBS Trust/PPO |
$618.65
|
| Rate for Payer: BCN Commercial |
$618.65
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$688.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Healthscope Commercial |
$720.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: PHP Commercial |
$680.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$696.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$704.47
|
| Rate for Payer: UHC Core |
$668.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.40
|
|
|
HC XR DEFECOGRAPHY 4 WAY
|
Facility
|
OP
|
$800.53
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000164
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$190.13 |
| Max. Negotiated Rate |
$720.48 |
| Rate for Payer: Aetna Commercial |
$680.45
|
| Rate for Payer: Aetna Medicare |
$208.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$250.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$250.17
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$200.13
|
| Rate for Payer: BCBS Trust/PPO |
$622.41
|
| Rate for Payer: BCN Commercial |
$622.41
|
| Rate for Payer: BCN Medicare Advantage |
$200.13
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$688.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.13
|
| Rate for Payer: Healthscope Commercial |
$720.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.40
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$210.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$230.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: PACE Senior Care Partners |
$190.13
|
| Rate for Payer: PACE SWMI |
$200.13
|
| Rate for Payer: PHP Commercial |
$680.45
|
| Rate for Payer: PHP Medicare Advantage |
$200.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$696.46
|
| Rate for Payer: Priority Health Medicare |
$200.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.24
|
| Rate for Payer: Railroad Medicare Medicare |
$200.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$704.47
|
| Rate for Payer: UHC Core |
$668.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$200.13
|
| Rate for Payer: UHC Medicare Advantage |
$206.14
|
| Rate for Payer: VA VA |
$200.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.40
|
|
|
HC XR ELBOW 2 BIL VW
|
Facility
|
OP
|
$381.09
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000072
|
|
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 ELBOW 2 BIL VW
|
Facility
|
IP
|
$381.09
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000072
|
|
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 ELBOW 2 VW
|
Facility
|
OP
|
$350.37
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000071
|
|
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 ELBOW 2 VW
|
Facility
|
IP
|
$350.37
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000071
|
|
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 ELBOW BIL 3 VW
|
Facility
|
OP
|
$381.09
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000074
|
|
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
|
|
