|
HC XR FINGERS MIN 2 VW
|
Facility
|
IP
|
$190.24
|
|
|
Service Code
|
CPT 73140
|
| Hospital Charge Code |
32000089
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$116.03 |
| Max. Negotiated Rate |
$171.22 |
| Rate for Payer: Aetna Commercial |
$161.70
|
| Rate for Payer: BCBS Trust/PPO |
$147.02
|
| Rate for Payer: BCN Commercial |
$147.02
|
| Rate for Payer: Cash Price |
$152.19
|
| Rate for Payer: Cofinity Commercial |
$163.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.19
|
| Rate for Payer: Healthscope Commercial |
$171.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$161.70
|
| Rate for Payer: PHP Commercial |
$161.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.41
|
| Rate for Payer: UHC Core |
$158.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.68
|
|
|
HC XR FINGERS MIN 2 VW
|
Facility
|
OP
|
$190.24
|
|
|
Service Code
|
CPT 73140
|
| Hospital Charge Code |
32000089
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.18 |
| Max. Negotiated Rate |
$171.22 |
| Rate for Payer: Aetna Commercial |
$161.70
|
| Rate for Payer: Aetna Medicare |
$49.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.45
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$47.56
|
| Rate for Payer: BCBS Trust/PPO |
$147.91
|
| Rate for Payer: BCN Commercial |
$147.91
|
| Rate for Payer: BCN Medicare Advantage |
$47.56
|
| Rate for Payer: Cash Price |
$152.19
|
| Rate for Payer: Cash Price |
$152.19
|
| Rate for Payer: Cofinity Commercial |
$163.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.56
|
| Rate for Payer: Healthscope Commercial |
$171.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.68
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$49.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$161.70
|
| Rate for Payer: PACE Senior Care Partners |
$45.18
|
| Rate for Payer: PACE SWMI |
$47.56
|
| Rate for Payer: PHP Commercial |
$161.70
|
| Rate for Payer: PHP Medicare Advantage |
$47.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.51
|
| Rate for Payer: Priority Health Medicare |
$47.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.03
|
| Rate for Payer: Railroad Medicare Medicare |
$47.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.41
|
| Rate for Payer: UHC Core |
$158.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.56
|
| Rate for Payer: UHC Medicare Advantage |
$48.99
|
| Rate for Payer: VA VA |
$47.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.68
|
|
|
HC XR FLUOROSCOPIC GUIDANCE
|
Facility
|
OP
|
$290.00
|
|
|
Service Code
|
CPT 77002
|
| Hospital Charge Code |
32000246
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$68.88 |
| Max. Negotiated Rate |
$261.00 |
| Rate for Payer: Aetna Commercial |
$246.50
|
| Rate for Payer: Aetna Medicare |
$75.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$90.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$90.62
|
| Rate for Payer: BCBS Complete |
$116.00
|
| Rate for Payer: BCBS MAPPO |
$72.50
|
| Rate for Payer: BCBS Trust/PPO |
$225.48
|
| Rate for Payer: BCN Commercial |
$225.48
|
| Rate for Payer: BCN Medicare Advantage |
$72.50
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cofinity Commercial |
$249.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.50
|
| Rate for Payer: Healthscope Commercial |
$261.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$217.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$76.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$246.50
|
| Rate for Payer: PACE Senior Care Partners |
$68.88
|
| Rate for Payer: PACE SWMI |
$72.50
|
| Rate for Payer: PHP Commercial |
$246.50
|
| Rate for Payer: PHP Medicare Advantage |
$72.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$252.30
|
| Rate for Payer: Priority Health Medicare |
$72.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.87
|
| Rate for Payer: Railroad Medicare Medicare |
$72.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.20
|
| Rate for Payer: UHC Core |
$242.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.50
|
| Rate for Payer: UHC Medicare Advantage |
$74.68
|
| Rate for Payer: VA VA |
$72.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$217.50
|
|
|
HC XR FLUOROSCOPIC GUIDANCE
|
Facility
|
IP
|
$290.00
|
|
|
Service Code
|
CPT 77002
|
| Hospital Charge Code |
32000246
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$176.87 |
| Max. Negotiated Rate |
$261.00 |
| Rate for Payer: Aetna Commercial |
$246.50
|
| Rate for Payer: BCBS Trust/PPO |
$224.11
|
| Rate for Payer: BCN Commercial |
$224.11
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cofinity Commercial |
$249.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.00
|
| Rate for Payer: Healthscope Commercial |
$261.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$217.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$246.50
|
| Rate for Payer: PHP Commercial |
$246.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$252.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.20
|
| Rate for Payer: UHC Core |
$242.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$217.50
|
|
|
HC XR FOOT 1 VW
|
Facility
|
OP
|
$286.12
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000125
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$257.51 |
| Rate for Payer: Aetna Commercial |
$243.20
|
| Rate for Payer: Aetna Medicare |
$74.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.41
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$71.53
|
| Rate for Payer: BCBS Trust/PPO |
$222.46
|
| Rate for Payer: BCN Commercial |
$222.46
|
| Rate for Payer: BCN Medicare Advantage |
$71.53
|
| Rate for Payer: Cash Price |
$228.90
|
| Rate for Payer: Cash Price |
$228.90
|
| Rate for Payer: Cofinity Commercial |
$246.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.53
|
| Rate for Payer: Healthscope Commercial |
$257.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.59
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$75.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$243.20
|
| Rate for Payer: PACE Senior Care Partners |
$67.95
|
| Rate for Payer: PACE SWMI |
$71.53
|
| Rate for Payer: PHP Commercial |
$243.20
|
| Rate for Payer: PHP Medicare Advantage |
$71.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.92
|
| Rate for Payer: Priority Health Medicare |
$71.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.50
|
| Rate for Payer: Railroad Medicare Medicare |
$71.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.79
|
| Rate for Payer: UHC Core |
$238.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.53
|
| Rate for Payer: UHC Medicare Advantage |
$73.68
|
| Rate for Payer: VA VA |
$71.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.59
|
|
|
HC XR FOOT 1 VW
|
Facility
|
IP
|
$286.12
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000125
|
|
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 FOOT 2 VIEWS
|
Facility
|
OP
|
$250.45
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000123
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.48 |
| Max. Negotiated Rate |
$225.40 |
| Rate for Payer: Aetna Commercial |
$212.88
|
| Rate for Payer: Aetna Medicare |
$65.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$78.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$78.27
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$62.61
|
| Rate for Payer: BCBS Trust/PPO |
$194.72
|
| Rate for Payer: BCN Commercial |
$194.72
|
| Rate for Payer: BCN Medicare Advantage |
$62.61
|
| Rate for Payer: Cash Price |
$200.36
|
| Rate for Payer: Cash Price |
$200.36
|
| Rate for Payer: Cofinity Commercial |
$215.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.61
|
| Rate for Payer: Healthscope Commercial |
$225.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.84
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$212.88
|
| Rate for Payer: PACE Senior Care Partners |
$59.48
|
| Rate for Payer: PACE SWMI |
$62.61
|
| Rate for Payer: PHP Commercial |
$212.88
|
| Rate for Payer: PHP Medicare Advantage |
$62.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.89
|
| Rate for Payer: Priority Health Medicare |
$62.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$152.75
|
| Rate for Payer: Railroad Medicare Medicare |
$62.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$220.40
|
| Rate for Payer: UHC Core |
$209.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.61
|
| Rate for Payer: UHC Medicare Advantage |
$64.49
|
| Rate for Payer: VA VA |
$62.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.84
|
|
|
HC XR FOOT 2 VIEWS
|
Facility
|
IP
|
$250.45
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000123
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$152.75 |
| Max. Negotiated Rate |
$225.40 |
| Rate for Payer: Aetna Commercial |
$212.88
|
| Rate for Payer: BCBS Trust/PPO |
$193.55
|
| Rate for Payer: BCN Commercial |
$193.55
|
| Rate for Payer: Cash Price |
$200.36
|
| Rate for Payer: Cofinity Commercial |
$215.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.36
|
| Rate for Payer: Healthscope Commercial |
$225.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$212.88
|
| Rate for Payer: PHP Commercial |
$212.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$152.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$220.40
|
| Rate for Payer: UHC Core |
$209.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.84
|
|
|
HC XR FOOT 2 VIEWS BILATERAL
|
Facility
|
OP
|
$245.00
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000340
|
|
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 FOOT 2 VIEWS BILATERAL
|
Facility
|
IP
|
$245.00
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000340
|
|
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 FOOT 3 VIEWS
|
Facility
|
IP
|
$350.37
|
|
|
Service Code
|
CPT 73630
|
| Hospital Charge Code |
32000126
|
|
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 FOOT 3 VIEWS
|
Facility
|
OP
|
$350.37
|
|
|
Service Code
|
CPT 73630
|
| Hospital Charge Code |
32000126
|
|
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 FOOT BIL 2 VIEWS
|
Facility
|
OP
|
$286.12
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000124
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$257.51 |
| Rate for Payer: Aetna Commercial |
$243.20
|
| Rate for Payer: Aetna Medicare |
$74.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.41
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$71.53
|
| Rate for Payer: BCBS Trust/PPO |
$222.46
|
| Rate for Payer: BCN Commercial |
$222.46
|
| Rate for Payer: BCN Medicare Advantage |
$71.53
|
| Rate for Payer: Cash Price |
$228.90
|
| Rate for Payer: Cash Price |
$228.90
|
| Rate for Payer: Cofinity Commercial |
$246.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.53
|
| Rate for Payer: Healthscope Commercial |
$257.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.59
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$75.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$243.20
|
| Rate for Payer: PACE Senior Care Partners |
$67.95
|
| Rate for Payer: PACE SWMI |
$71.53
|
| Rate for Payer: PHP Commercial |
$243.20
|
| Rate for Payer: PHP Medicare Advantage |
$71.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.92
|
| Rate for Payer: Priority Health Medicare |
$71.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.50
|
| Rate for Payer: Railroad Medicare Medicare |
$71.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.79
|
| Rate for Payer: UHC Core |
$238.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.53
|
| Rate for Payer: UHC Medicare Advantage |
$73.68
|
| Rate for Payer: VA VA |
$71.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.59
|
|
|
HC XR FOOT BIL 2 VIEWS
|
Facility
|
IP
|
$286.12
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000124
|
|
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 FOOT BIL 3 VIEWS
|
Facility
|
IP
|
$381.09
|
|
|
Service Code
|
CPT 73630
|
| Hospital Charge Code |
32000127
|
|
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 FOOT BIL 3 VIEWS
|
Facility
|
OP
|
$381.09
|
|
|
Service Code
|
CPT 73630
|
| Hospital Charge Code |
32000127
|
|
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 FOREARM 2 VW
|
Facility
|
OP
|
$300.42
|
|
|
Service Code
|
CPT 73090
|
| Hospital Charge Code |
32000076
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.61 |
| 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 |
$62.59
|
| 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 |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| 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 |
$59.61
|
| 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 FOREARM 2 VW
|
Facility
|
IP
|
$300.42
|
|
|
Service Code
|
CPT 73090
|
| Hospital Charge Code |
32000076
|
|
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 FOREARM BIL 2 VW
|
Facility
|
OP
|
$333.67
|
|
|
Service Code
|
CPT 73090
|
| Hospital Charge Code |
32000077
|
|
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 FOREARM BIL 2 VW
|
Facility
|
IP
|
$333.67
|
|
|
Service Code
|
CPT 73090
|
| Hospital Charge Code |
32000077
|
|
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 HAND 2 VW
|
Facility
|
OP
|
$300.42
|
|
|
Service Code
|
CPT 73120
|
| Hospital Charge Code |
32000085
|
|
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 HAND 2 VW
|
Facility
|
IP
|
$300.42
|
|
|
Service Code
|
CPT 73120
|
| Hospital Charge Code |
32000085
|
|
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 HAND 3 VW
|
Facility
|
IP
|
$400.20
|
|
|
Service Code
|
CPT 73130
|
| Hospital Charge Code |
32000087
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$244.08 |
| Max. Negotiated Rate |
$360.18 |
| Rate for Payer: Aetna Commercial |
$340.17
|
| Rate for Payer: BCBS Trust/PPO |
$309.27
|
| Rate for Payer: BCN Commercial |
$309.27
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cofinity Commercial |
$344.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.16
|
| Rate for Payer: Healthscope Commercial |
$360.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.17
|
| Rate for Payer: PHP Commercial |
$340.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$348.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.18
|
| Rate for Payer: UHC Core |
$334.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.15
|
|
|
HC XR HAND 3 VW
|
Facility
|
OP
|
$400.20
|
|
|
Service Code
|
CPT 73130
|
| Hospital Charge Code |
32000087
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$360.18 |
| Rate for Payer: Aetna Commercial |
$340.17
|
| Rate for Payer: Aetna Medicare |
$104.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$125.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$125.06
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$100.05
|
| Rate for Payer: BCBS Trust/PPO |
$311.16
|
| Rate for Payer: BCN Commercial |
$311.16
|
| Rate for Payer: BCN Medicare Advantage |
$100.05
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cofinity Commercial |
$344.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.05
|
| Rate for Payer: Healthscope Commercial |
$360.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.15
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$105.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$115.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.17
|
| Rate for Payer: PACE Senior Care Partners |
$95.05
|
| Rate for Payer: PACE SWMI |
$100.05
|
| Rate for Payer: PHP Commercial |
$340.17
|
| Rate for Payer: PHP Medicare Advantage |
$100.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$348.17
|
| Rate for Payer: Priority Health Medicare |
$100.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.08
|
| Rate for Payer: Railroad Medicare Medicare |
$100.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.18
|
| Rate for Payer: UHC Core |
$334.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.05
|
| Rate for Payer: UHC Medicare Advantage |
$103.05
|
| Rate for Payer: VA VA |
$100.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.15
|
|
|
HC XR HANDS BIL 2 VW
|
Facility
|
OP
|
$333.67
|
|
|
Service Code
|
CPT 73120
|
| Hospital Charge Code |
32000086
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.12 |
| 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 |
$75.72
|
| 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 |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| 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 |
$72.12
|
| 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
|
|
