|
HC XR ELBOW BIL 3 VW
|
Facility
|
IP
|
$381.09
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000074
|
|
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 MIN 3 VW
|
Facility
|
OP
|
$350.37
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000073
|
|
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 MIN 3 VW
|
Facility
|
IP
|
$350.37
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000073
|
|
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 ENDO RETROGRADE CHOLANGIOGR
|
Facility
|
IP
|
$544.76
|
|
|
Service Code
|
CPT 74328
|
| Hospital Charge Code |
32000154
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$332.25 |
| Max. Negotiated Rate |
$490.28 |
| Rate for Payer: Aetna Commercial |
$463.05
|
| Rate for Payer: BCBS Trust/PPO |
$420.99
|
| Rate for Payer: BCN Commercial |
$420.99
|
| Rate for Payer: Cash Price |
$435.81
|
| Rate for Payer: Cofinity Commercial |
$468.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$435.81
|
| Rate for Payer: Healthscope Commercial |
$490.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$408.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$463.05
|
| Rate for Payer: PHP Commercial |
$463.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$381.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$473.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$332.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$479.39
|
| Rate for Payer: UHC Core |
$454.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$408.57
|
|
|
HC XR ENDO RETROGRADE CHOLANGIOGR
|
Facility
|
OP
|
$544.76
|
|
|
Service Code
|
CPT 74328
|
| Hospital Charge Code |
32000154
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$129.38 |
| Max. Negotiated Rate |
$490.28 |
| Rate for Payer: Aetna Commercial |
$463.05
|
| Rate for Payer: Aetna Medicare |
$141.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$170.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$170.24
|
| Rate for Payer: BCBS Complete |
$217.90
|
| Rate for Payer: BCBS MAPPO |
$136.19
|
| Rate for Payer: BCBS Trust/PPO |
$423.55
|
| Rate for Payer: BCN Commercial |
$423.55
|
| Rate for Payer: BCN Medicare Advantage |
$136.19
|
| Rate for Payer: Cash Price |
$435.81
|
| Rate for Payer: Cofinity Commercial |
$468.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$435.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.19
|
| Rate for Payer: Healthscope Commercial |
$490.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$408.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$143.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$156.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$463.05
|
| Rate for Payer: PACE Senior Care Partners |
$129.38
|
| Rate for Payer: PACE SWMI |
$136.19
|
| Rate for Payer: PHP Commercial |
$463.05
|
| Rate for Payer: PHP Medicare Advantage |
$136.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$381.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$473.94
|
| Rate for Payer: Priority Health Medicare |
$136.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$332.25
|
| Rate for Payer: Railroad Medicare Medicare |
$136.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$479.39
|
| Rate for Payer: UHC Core |
$454.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$136.19
|
| Rate for Payer: UHC Medicare Advantage |
$140.28
|
| Rate for Payer: VA VA |
$136.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$408.57
|
|
|
HC XR ESOPHAGEAL DILATION
|
Facility
|
IP
|
$257.89
|
|
|
Service Code
|
CPT 74360
|
| Hospital Charge Code |
32000297
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$157.29 |
| Max. Negotiated Rate |
$232.10 |
| Rate for Payer: Aetna Commercial |
$219.21
|
| Rate for Payer: BCBS Trust/PPO |
$199.30
|
| Rate for Payer: BCN Commercial |
$199.30
|
| Rate for Payer: Cash Price |
$206.31
|
| Rate for Payer: Cofinity Commercial |
$221.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.31
|
| Rate for Payer: Healthscope Commercial |
$232.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$219.21
|
| Rate for Payer: PHP Commercial |
$219.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$224.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$157.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.94
|
| Rate for Payer: UHC Core |
$215.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.42
|
|
|
HC XR ESOPHAGEAL DILATION
|
Facility
|
OP
|
$257.89
|
|
|
Service Code
|
CPT 74360
|
| Hospital Charge Code |
32000297
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$61.25 |
| Max. Negotiated Rate |
$232.10 |
| Rate for Payer: Aetna Commercial |
$219.21
|
| Rate for Payer: Aetna Medicare |
$67.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.59
|
| Rate for Payer: BCBS Complete |
$103.16
|
| Rate for Payer: BCBS MAPPO |
$64.47
|
| Rate for Payer: BCBS Trust/PPO |
$200.51
|
| Rate for Payer: BCN Commercial |
$200.51
|
| Rate for Payer: BCN Medicare Advantage |
$64.47
|
| Rate for Payer: Cash Price |
$206.31
|
| Rate for Payer: Cofinity Commercial |
$221.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.47
|
| Rate for Payer: Healthscope Commercial |
$232.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$67.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$219.21
|
| Rate for Payer: PACE Senior Care Partners |
$61.25
|
| Rate for Payer: PACE SWMI |
$64.47
|
| Rate for Payer: PHP Commercial |
$219.21
|
| Rate for Payer: PHP Medicare Advantage |
$64.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$224.36
|
| Rate for Payer: Priority Health Medicare |
$64.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$157.29
|
| Rate for Payer: Railroad Medicare Medicare |
$64.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.94
|
| Rate for Payer: UHC Core |
$215.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.47
|
| Rate for Payer: UHC Medicare Advantage |
$66.41
|
| Rate for Payer: VA VA |
$64.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.42
|
|
|
HC XR ESOPHAGUS
|
Facility
|
OP
|
$630.27
|
|
|
Service Code
|
CPT 74220
|
| Hospital Charge Code |
32000136
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$120.53 |
| Max. Negotiated Rate |
$567.24 |
| Rate for Payer: Aetna Commercial |
$535.73
|
| Rate for Payer: Aetna Medicare |
$163.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$196.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$196.96
|
| Rate for Payer: BCBS Complete |
$126.56
|
| Rate for Payer: BCBS MAPPO |
$157.57
|
| Rate for Payer: BCBS Trust/PPO |
$490.03
|
| Rate for Payer: BCN Commercial |
$490.03
|
| Rate for Payer: BCN Medicare Advantage |
$157.57
|
| Rate for Payer: Cash Price |
$504.22
|
| Rate for Payer: Cash Price |
$504.22
|
| Rate for Payer: Cofinity Commercial |
$542.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$504.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.57
|
| Rate for Payer: Healthscope Commercial |
$567.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$472.70
|
| Rate for Payer: Mclaren Medicaid |
$120.53
|
| Rate for Payer: Meridian Medicaid |
$126.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$165.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$181.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$535.73
|
| Rate for Payer: PACE Senior Care Partners |
$149.69
|
| Rate for Payer: PACE SWMI |
$157.57
|
| Rate for Payer: PHP Commercial |
$535.73
|
| Rate for Payer: PHP Medicare Advantage |
$157.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$441.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$548.33
|
| Rate for Payer: Priority Health Medicare |
$157.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$384.40
|
| Rate for Payer: Railroad Medicare Medicare |
$157.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$554.64
|
| Rate for Payer: UHC Core |
$526.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.57
|
| Rate for Payer: UHC Medicare Advantage |
$162.29
|
| Rate for Payer: VA VA |
$157.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$472.70
|
|
|
HC XR ESOPHAGUS
|
Facility
|
IP
|
$630.27
|
|
|
Service Code
|
CPT 74220
|
| Hospital Charge Code |
32000136
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$384.40 |
| Max. Negotiated Rate |
$567.24 |
| Rate for Payer: Aetna Commercial |
$535.73
|
| Rate for Payer: BCBS Trust/PPO |
$487.07
|
| Rate for Payer: BCN Commercial |
$487.07
|
| Rate for Payer: Cash Price |
$504.22
|
| Rate for Payer: Cofinity Commercial |
$542.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$504.22
|
| Rate for Payer: Healthscope Commercial |
$567.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$472.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$535.73
|
| Rate for Payer: PHP Commercial |
$535.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$441.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$548.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$384.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$554.64
|
| Rate for Payer: UHC Core |
$526.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$472.70
|
|
|
HC XR ESOPHAGUS FB
|
Facility
|
IP
|
$481.37
|
|
|
Service Code
|
HCPCS 74235
|
| Hospital Charge Code |
32000296
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$293.59 |
| Max. Negotiated Rate |
$433.23 |
| Rate for Payer: Aetna Commercial |
$409.16
|
| Rate for Payer: BCBS Trust/PPO |
$372.00
|
| Rate for Payer: BCN Commercial |
$372.00
|
| Rate for Payer: Cash Price |
$385.10
|
| Rate for Payer: Cofinity Commercial |
$413.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.10
|
| Rate for Payer: Healthscope Commercial |
$433.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$409.16
|
| Rate for Payer: PHP Commercial |
$409.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$418.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.61
|
| Rate for Payer: UHC Core |
$401.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.03
|
|
|
HC XR ESOPHAGUS FB
|
Facility
|
OP
|
$481.37
|
|
|
Service Code
|
HCPCS 74235
|
| Hospital Charge Code |
32000296
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$114.33 |
| Max. Negotiated Rate |
$433.23 |
| Rate for Payer: Aetna Commercial |
$409.16
|
| Rate for Payer: Aetna Medicare |
$125.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.43
|
| Rate for Payer: BCBS Complete |
$192.55
|
| Rate for Payer: BCBS MAPPO |
$120.34
|
| Rate for Payer: BCBS Trust/PPO |
$374.27
|
| Rate for Payer: BCN Commercial |
$374.27
|
| Rate for Payer: BCN Medicare Advantage |
$120.34
|
| Rate for Payer: Cash Price |
$385.10
|
| Rate for Payer: Cofinity Commercial |
$413.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.34
|
| Rate for Payer: Healthscope Commercial |
$433.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$126.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$409.16
|
| Rate for Payer: PACE Senior Care Partners |
$114.33
|
| Rate for Payer: PACE SWMI |
$120.34
|
| Rate for Payer: PHP Commercial |
$409.16
|
| Rate for Payer: PHP Medicare Advantage |
$120.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$418.79
|
| Rate for Payer: Priority Health Medicare |
$120.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.59
|
| Rate for Payer: Railroad Medicare Medicare |
$120.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.61
|
| Rate for Payer: UHC Core |
$401.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.34
|
| Rate for Payer: UHC Medicare Advantage |
$123.95
|
| Rate for Payer: VA VA |
$120.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.03
|
|
|
HC XR ESOPHAGUS HIGH DENSITY
|
Facility
|
OP
|
$630.27
|
|
|
Service Code
|
CPT 74221
|
| Hospital Charge Code |
32000330
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$120.53 |
| Max. Negotiated Rate |
$567.24 |
| Rate for Payer: Aetna Commercial |
$535.73
|
| Rate for Payer: Aetna Medicare |
$163.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$196.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$196.96
|
| Rate for Payer: BCBS Complete |
$126.56
|
| Rate for Payer: BCBS MAPPO |
$157.57
|
| Rate for Payer: BCBS Trust/PPO |
$490.03
|
| Rate for Payer: BCN Commercial |
$490.03
|
| Rate for Payer: BCN Medicare Advantage |
$157.57
|
| Rate for Payer: Cash Price |
$504.22
|
| Rate for Payer: Cash Price |
$504.22
|
| Rate for Payer: Cofinity Commercial |
$542.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$504.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.57
|
| Rate for Payer: Healthscope Commercial |
$567.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$472.70
|
| Rate for Payer: Mclaren Medicaid |
$120.53
|
| Rate for Payer: Meridian Medicaid |
$126.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$165.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$181.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$535.73
|
| Rate for Payer: PACE Senior Care Partners |
$149.69
|
| Rate for Payer: PACE SWMI |
$157.57
|
| Rate for Payer: PHP Commercial |
$535.73
|
| Rate for Payer: PHP Medicare Advantage |
$157.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$441.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$548.33
|
| Rate for Payer: Priority Health Medicare |
$157.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$384.40
|
| Rate for Payer: Railroad Medicare Medicare |
$157.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$554.64
|
| Rate for Payer: UHC Core |
$526.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.57
|
| Rate for Payer: UHC Medicare Advantage |
$162.29
|
| Rate for Payer: VA VA |
$157.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$472.70
|
|
|
HC XR ESOPHAGUS HIGH DENSITY
|
Facility
|
IP
|
$630.27
|
|
|
Service Code
|
CPT 74221
|
| Hospital Charge Code |
32000330
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$384.40 |
| Max. Negotiated Rate |
$567.24 |
| Rate for Payer: Aetna Commercial |
$535.73
|
| Rate for Payer: BCBS Trust/PPO |
$487.07
|
| Rate for Payer: BCN Commercial |
$487.07
|
| Rate for Payer: Cash Price |
$504.22
|
| Rate for Payer: Cofinity Commercial |
$542.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$504.22
|
| Rate for Payer: Healthscope Commercial |
$567.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$472.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$535.73
|
| Rate for Payer: PHP Commercial |
$535.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$441.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$548.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$384.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$554.64
|
| Rate for Payer: UHC Core |
$526.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$472.70
|
|
|
HC XR EYE FOREIGN BODY PRE MRI
|
Facility
|
OP
|
$450.67
|
|
|
Service Code
|
CPT 70030
|
| Hospital Charge Code |
32000305
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$405.60 |
| Rate for Payer: Aetna Commercial |
$383.07
|
| Rate for Payer: Aetna Medicare |
$117.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$140.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$140.83
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$112.67
|
| Rate for Payer: BCBS Trust/PPO |
$350.40
|
| Rate for Payer: BCN Commercial |
$350.40
|
| Rate for Payer: BCN Medicare Advantage |
$112.67
|
| Rate for Payer: Cash Price |
$360.54
|
| Rate for Payer: Cash Price |
$360.54
|
| Rate for Payer: Cofinity Commercial |
$387.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.67
|
| Rate for Payer: Healthscope Commercial |
$405.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$338.00
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$118.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$129.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$383.07
|
| Rate for Payer: PACE Senior Care Partners |
$107.03
|
| Rate for Payer: PACE SWMI |
$112.67
|
| Rate for Payer: PHP Commercial |
$383.07
|
| Rate for Payer: PHP Medicare Advantage |
$112.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$392.08
|
| Rate for Payer: Priority Health Medicare |
$112.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$274.86
|
| Rate for Payer: Railroad Medicare Medicare |
$112.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.59
|
| Rate for Payer: UHC Core |
$376.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.67
|
| Rate for Payer: UHC Medicare Advantage |
$116.05
|
| Rate for Payer: VA VA |
$112.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$338.00
|
|
|
HC XR EYE FOREIGN BODY PRE MRI
|
Facility
|
IP
|
$450.67
|
|
|
Service Code
|
CPT 70030
|
| Hospital Charge Code |
32000305
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$274.86 |
| Max. Negotiated Rate |
$405.60 |
| Rate for Payer: Aetna Commercial |
$383.07
|
| Rate for Payer: BCBS Trust/PPO |
$348.28
|
| Rate for Payer: BCN Commercial |
$348.28
|
| Rate for Payer: Cash Price |
$360.54
|
| Rate for Payer: Cofinity Commercial |
$387.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.54
|
| Rate for Payer: Healthscope Commercial |
$405.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$338.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$383.07
|
| Rate for Payer: PHP Commercial |
$383.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$392.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$274.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.59
|
| Rate for Payer: UHC Core |
$376.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$338.00
|
|
|
HC XR EYE FOR FOREIGN BODY
|
Facility
|
OP
|
$450.67
|
|
|
Service Code
|
CPT 70030
|
| Hospital Charge Code |
32000004
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$405.60 |
| Rate for Payer: Aetna Commercial |
$383.07
|
| Rate for Payer: Aetna Medicare |
$117.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$140.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$140.83
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$112.67
|
| Rate for Payer: BCBS Trust/PPO |
$350.40
|
| Rate for Payer: BCN Commercial |
$350.40
|
| Rate for Payer: BCN Medicare Advantage |
$112.67
|
| Rate for Payer: Cash Price |
$360.54
|
| Rate for Payer: Cash Price |
$360.54
|
| Rate for Payer: Cofinity Commercial |
$387.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.67
|
| Rate for Payer: Healthscope Commercial |
$405.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$338.00
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$118.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$129.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$383.07
|
| Rate for Payer: PACE Senior Care Partners |
$107.03
|
| Rate for Payer: PACE SWMI |
$112.67
|
| Rate for Payer: PHP Commercial |
$383.07
|
| Rate for Payer: PHP Medicare Advantage |
$112.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$392.08
|
| Rate for Payer: Priority Health Medicare |
$112.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$274.86
|
| Rate for Payer: Railroad Medicare Medicare |
$112.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.59
|
| Rate for Payer: UHC Core |
$376.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.67
|
| Rate for Payer: UHC Medicare Advantage |
$116.05
|
| Rate for Payer: VA VA |
$112.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$338.00
|
|
|
HC XR EYE FOR FOREIGN BODY
|
Facility
|
IP
|
$450.67
|
|
|
Service Code
|
CPT 70030
|
| Hospital Charge Code |
32000004
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$274.86 |
| Max. Negotiated Rate |
$405.60 |
| Rate for Payer: Aetna Commercial |
$383.07
|
| Rate for Payer: BCBS Trust/PPO |
$348.28
|
| Rate for Payer: BCN Commercial |
$348.28
|
| Rate for Payer: Cash Price |
$360.54
|
| Rate for Payer: Cofinity Commercial |
$387.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.54
|
| Rate for Payer: Healthscope Commercial |
$405.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$338.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$383.07
|
| Rate for Payer: PHP Commercial |
$383.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$392.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$274.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.59
|
| Rate for Payer: UHC Core |
$376.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$338.00
|
|
|
HC XR FACIAL BONES MIN 3 VW
|
Facility
|
OP
|
$340.12
|
|
|
Service Code
|
CPT 70150
|
| Hospital Charge Code |
32000010
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$306.11 |
| Rate for Payer: Aetna Commercial |
$289.10
|
| Rate for Payer: Aetna Medicare |
$88.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.29
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$85.03
|
| Rate for Payer: BCBS Trust/PPO |
$264.44
|
| Rate for Payer: BCN Commercial |
$264.44
|
| Rate for Payer: BCN Medicare Advantage |
$85.03
|
| Rate for Payer: Cash Price |
$272.10
|
| Rate for Payer: Cash Price |
$272.10
|
| Rate for Payer: Cofinity Commercial |
$292.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.03
|
| Rate for Payer: Healthscope Commercial |
$306.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.09
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$89.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$289.10
|
| Rate for Payer: PACE Senior Care Partners |
$80.78
|
| Rate for Payer: PACE SWMI |
$85.03
|
| Rate for Payer: PHP Commercial |
$289.10
|
| Rate for Payer: PHP Medicare Advantage |
$85.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$295.90
|
| Rate for Payer: Priority Health Medicare |
$85.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.44
|
| Rate for Payer: Railroad Medicare Medicare |
$85.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$299.31
|
| Rate for Payer: UHC Core |
$284.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.03
|
| Rate for Payer: UHC Medicare Advantage |
$87.58
|
| Rate for Payer: VA VA |
$85.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.09
|
|
|
HC XR FACIAL BONES MIN 3 VW
|
Facility
|
IP
|
$340.12
|
|
|
Service Code
|
CPT 70150
|
| Hospital Charge Code |
32000010
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$207.44 |
| Max. Negotiated Rate |
$306.11 |
| Rate for Payer: Aetna Commercial |
$289.10
|
| Rate for Payer: BCBS Trust/PPO |
$262.84
|
| Rate for Payer: BCN Commercial |
$262.84
|
| Rate for Payer: Cash Price |
$272.10
|
| Rate for Payer: Cofinity Commercial |
$292.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.10
|
| Rate for Payer: Healthscope Commercial |
$306.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$289.10
|
| Rate for Payer: PHP Commercial |
$289.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$295.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$299.31
|
| Rate for Payer: UHC Core |
$284.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.09
|
|
|
HC XR FEMUR 1 VIEW BILATERAL
|
Facility
|
IP
|
$245.00
|
|
|
Service Code
|
CPT 73551
|
| Hospital Charge Code |
32000341
|
|
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 FEMUR 1 VIEW BILATERAL
|
Facility
|
OP
|
$245.00
|
|
|
Service Code
|
CPT 73551
|
| Hospital Charge Code |
32000341
|
|
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 FEMUR 2 VIEWS BILATERAL
|
Facility
|
IP
|
$245.00
|
|
|
Service Code
|
CPT 73552
|
| Hospital Charge Code |
32000336
|
|
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 FEMUR 2 VIEWS BILATERAL
|
Facility
|
OP
|
$245.00
|
|
|
Service Code
|
CPT 73552
|
| Hospital Charge Code |
32000336
|
|
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 FINGERS BIL MIN 2 VW
|
Facility
|
IP
|
$219.46
|
|
|
Service Code
|
CPT 73140
|
| Hospital Charge Code |
32000090
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$133.85 |
| Max. Negotiated Rate |
$197.51 |
| Rate for Payer: Aetna Commercial |
$186.54
|
| Rate for Payer: BCBS Trust/PPO |
$169.60
|
| Rate for Payer: BCN Commercial |
$169.60
|
| Rate for Payer: Cash Price |
$175.57
|
| Rate for Payer: Cofinity Commercial |
$188.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.57
|
| Rate for Payer: Healthscope Commercial |
$197.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$186.54
|
| Rate for Payer: PHP Commercial |
$186.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$190.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.12
|
| Rate for Payer: UHC Core |
$183.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.60
|
|
|
HC XR FINGERS BIL MIN 2 VW
|
Facility
|
OP
|
$219.46
|
|
|
Service Code
|
CPT 73140
|
| Hospital Charge Code |
32000090
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$52.12 |
| Max. Negotiated Rate |
$197.51 |
| Rate for Payer: Aetna Commercial |
$186.54
|
| Rate for Payer: Aetna Medicare |
$57.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$68.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$68.58
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$54.86
|
| Rate for Payer: BCBS Trust/PPO |
$170.63
|
| Rate for Payer: BCN Commercial |
$170.63
|
| Rate for Payer: BCN Medicare Advantage |
$54.86
|
| Rate for Payer: Cash Price |
$175.57
|
| Rate for Payer: Cash Price |
$175.57
|
| Rate for Payer: Cofinity Commercial |
$188.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.86
|
| Rate for Payer: Healthscope Commercial |
$197.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.60
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$186.54
|
| Rate for Payer: PACE Senior Care Partners |
$52.12
|
| Rate for Payer: PACE SWMI |
$54.86
|
| Rate for Payer: PHP Commercial |
$186.54
|
| Rate for Payer: PHP Medicare Advantage |
$54.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$190.93
|
| Rate for Payer: Priority Health Medicare |
$54.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.85
|
| Rate for Payer: Railroad Medicare Medicare |
$54.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.12
|
| Rate for Payer: UHC Core |
$183.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.86
|
| Rate for Payer: UHC Medicare Advantage |
$56.51
|
| Rate for Payer: VA VA |
$54.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.60
|
|
