|
HC XEOMIN PER 1 UNIT (INCOBOTULINUMTOXINA)
|
Facility
|
OP
|
$7.08
|
|
|
Service Code
|
HCPCS J0588
|
| Hospital Charge Code |
63600149
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.25 |
| Max. Negotiated Rate |
$6.37 |
| Rate for Payer: Aetna Commercial |
$6.02
|
| Rate for Payer: Aetna Medicare |
$1.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.21
|
| Rate for Payer: BCBS Complete |
$1.31
|
| Rate for Payer: BCBS MAPPO |
$1.77
|
| Rate for Payer: BCBS Trust/PPO |
$5.82
|
| Rate for Payer: BCN Commercial |
$5.82
|
| Rate for Payer: BCN Medicare Advantage |
$1.77
|
| Rate for Payer: Cash Price |
$5.66
|
| Rate for Payer: Cofinity Commercial |
$6.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.77
|
| Rate for Payer: Healthscope Commercial |
$6.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.31
|
| Rate for Payer: Mclaren Medicaid |
$1.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.86
|
| Rate for Payer: Meridian Medicaid |
$1.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.02
|
| Rate for Payer: Nomi Health Commercial |
$5.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.31
|
| Rate for Payer: PACE Senior Care Partners |
$1.68
|
| Rate for Payer: PACE SWMI |
$1.77
|
| Rate for Payer: PHP Commercial |
$6.02
|
| Rate for Payer: PHP Medicare Advantage |
$1.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6.16
|
| Rate for Payer: Priority Health Medicare |
$1.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.93
|
| Rate for Payer: Railroad Medicare Medicare |
$1.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.23
|
| Rate for Payer: UHC Core |
$5.91
|
| Rate for Payer: UHC Exchange |
$1.77
|
| Rate for Payer: UHC Medicaid |
$1.25
|
| Rate for Payer: UHC Medicare Advantage |
$1.77
|
| Rate for Payer: UHCCP Medicaid |
$1.25
|
| Rate for Payer: VA VA |
$1.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.31
|
|
|
HC XPRESS-WAY CATHETER
|
Facility
|
IP
|
$1,440.96
|
|
| Hospital Charge Code |
27200226
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,002.91 |
| Max. Negotiated Rate |
$1,296.86 |
| Rate for Payer: Aetna Commercial |
$1,224.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,190.09
|
| Rate for Payer: BCN Commercial |
$1,190.09
|
| Rate for Payer: Cash Price |
$1,152.77
|
| Rate for Payer: Cofinity Commercial |
$1,239.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,152.77
|
| Rate for Payer: Healthscope Commercial |
$1,296.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,080.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,224.82
|
| Rate for Payer: Nomi Health Commercial |
$1,181.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,080.72
|
| Rate for Payer: PHP Commercial |
$1,224.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,253.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,002.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,268.04
|
| Rate for Payer: UHC Core |
$1,203.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,080.72
|
|
|
HC XPRESS-WAY CATHETER
|
Facility
|
OP
|
$1,440.96
|
|
| Hospital Charge Code |
27200226
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$254.04 |
| Max. Negotiated Rate |
$1,296.86 |
| Rate for Payer: Aetna Commercial |
$1,224.82
|
| Rate for Payer: Aetna Medicare |
$374.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$450.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$450.30
|
| Rate for Payer: BCBS Complete |
$266.72
|
| Rate for Payer: BCBS MAPPO |
$360.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,184.61
|
| Rate for Payer: BCN Commercial |
$1,184.61
|
| Rate for Payer: BCN Medicare Advantage |
$360.24
|
| Rate for Payer: Cash Price |
$1,152.77
|
| Rate for Payer: Cofinity Commercial |
$1,239.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,152.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$360.24
|
| Rate for Payer: Healthscope Commercial |
$1,296.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,080.72
|
| Rate for Payer: Mclaren Medicaid |
$254.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$378.25
|
| Rate for Payer: Meridian Medicaid |
$266.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$414.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$396.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,224.82
|
| Rate for Payer: Nomi Health Commercial |
$1,181.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,080.72
|
| Rate for Payer: PACE Senior Care Partners |
$342.23
|
| Rate for Payer: PACE SWMI |
$360.24
|
| Rate for Payer: PHP Commercial |
$1,224.82
|
| Rate for Payer: PHP Medicare Advantage |
$360.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,253.64
|
| Rate for Payer: Priority Health Medicare |
$363.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,002.91
|
| Rate for Payer: Railroad Medicare Medicare |
$360.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,268.04
|
| Rate for Payer: UHC Core |
$1,203.20
|
| Rate for Payer: UHC Exchange |
$360.24
|
| Rate for Payer: UHC Medicaid |
$254.04
|
| Rate for Payer: UHC Medicare Advantage |
$360.24
|
| Rate for Payer: UHCCP Medicaid |
$254.04
|
| Rate for Payer: VA VA |
$360.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,080.72
|
|
|
HC XR ABDOMEN 1 VIEW
|
Facility
|
OP
|
$312.00
|
|
|
Service Code
|
CPT 74018
|
| Hospital Charge Code |
32000325
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.01 |
| Max. Negotiated Rate |
$280.80 |
| Rate for Payer: Aetna Commercial |
$265.20
|
| Rate for Payer: Aetna Medicare |
$81.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$97.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$97.50
|
| Rate for Payer: BCBS Complete |
$57.75
|
| Rate for Payer: BCBS MAPPO |
$78.00
|
| Rate for Payer: BCBS Trust/PPO |
$256.50
|
| Rate for Payer: BCN Commercial |
$256.50
|
| Rate for Payer: BCN Medicare Advantage |
$78.00
|
| Rate for Payer: Cash Price |
$249.60
|
| Rate for Payer: Cofinity Commercial |
$268.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.00
|
| Rate for Payer: Healthscope Commercial |
$280.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.00
|
| Rate for Payer: Mclaren Medicaid |
$55.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.90
|
| Rate for Payer: Meridian Medicaid |
$57.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$85.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.20
|
| Rate for Payer: Nomi Health Commercial |
$255.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.00
|
| Rate for Payer: PACE Senior Care Partners |
$74.10
|
| Rate for Payer: PACE SWMI |
$78.00
|
| Rate for Payer: PHP Commercial |
$265.20
|
| Rate for Payer: PHP Medicare Advantage |
$78.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$271.44
|
| Rate for Payer: Priority Health Medicare |
$78.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.15
|
| Rate for Payer: Railroad Medicare Medicare |
$78.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$274.56
|
| Rate for Payer: UHC Core |
$260.52
|
| Rate for Payer: UHC Exchange |
$78.00
|
| Rate for Payer: UHC Medicaid |
$55.01
|
| Rate for Payer: UHC Medicare Advantage |
$78.00
|
| Rate for Payer: UHCCP Medicaid |
$55.01
|
| Rate for Payer: VA VA |
$78.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.00
|
|
|
HC XR ABDOMEN 1 VIEW
|
Facility
|
IP
|
$312.00
|
|
|
Service Code
|
CPT 74018
|
| Hospital Charge Code |
32000325
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$217.15 |
| Max. Negotiated Rate |
$280.80 |
| Rate for Payer: Aetna Commercial |
$265.20
|
| Rate for Payer: BCBS Trust/PPO |
$257.68
|
| Rate for Payer: BCN Commercial |
$257.68
|
| Rate for Payer: Cash Price |
$249.60
|
| Rate for Payer: Cofinity Commercial |
$268.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.60
|
| Rate for Payer: Healthscope Commercial |
$280.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.20
|
| Rate for Payer: Nomi Health Commercial |
$255.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.00
|
| Rate for Payer: PHP Commercial |
$265.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$271.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$274.56
|
| Rate for Payer: UHC Core |
$260.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.00
|
|
|
HC XR ABDOMEN 2 VW
|
Facility
|
OP
|
$345.42
|
|
|
Service Code
|
CPT 74019
|
| Hospital Charge Code |
32000326
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$60.90 |
| Max. Negotiated Rate |
$310.88 |
| Rate for Payer: Aetna Commercial |
$293.61
|
| Rate for Payer: Aetna Medicare |
$89.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.94
|
| Rate for Payer: BCBS Complete |
$63.94
|
| Rate for Payer: BCBS MAPPO |
$86.36
|
| Rate for Payer: BCBS Trust/PPO |
$283.97
|
| Rate for Payer: BCN Commercial |
$283.97
|
| Rate for Payer: BCN Medicare Advantage |
$86.36
|
| Rate for Payer: Cash Price |
$276.34
|
| Rate for Payer: Cofinity Commercial |
$297.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.36
|
| Rate for Payer: Healthscope Commercial |
$310.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.06
|
| Rate for Payer: Mclaren Medicaid |
$60.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.67
|
| Rate for Payer: Meridian Medicaid |
$63.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$94.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.61
|
| Rate for Payer: Nomi Health Commercial |
$283.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.06
|
| Rate for Payer: PACE Senior Care Partners |
$82.04
|
| Rate for Payer: PACE SWMI |
$86.36
|
| Rate for Payer: PHP Commercial |
$293.61
|
| Rate for Payer: PHP Medicare Advantage |
$86.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$300.52
|
| Rate for Payer: Priority Health Medicare |
$87.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$240.41
|
| Rate for Payer: Railroad Medicare Medicare |
$86.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.97
|
| Rate for Payer: UHC Core |
$288.43
|
| Rate for Payer: UHC Exchange |
$86.36
|
| Rate for Payer: UHC Medicaid |
$60.90
|
| Rate for Payer: UHC Medicare Advantage |
$86.36
|
| Rate for Payer: UHCCP Medicaid |
$60.90
|
| Rate for Payer: VA VA |
$86.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.06
|
|
|
HC XR ABDOMEN 2 VW
|
Facility
|
IP
|
$345.42
|
|
|
Service Code
|
CPT 74019
|
| Hospital Charge Code |
32000326
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$240.41 |
| Max. Negotiated Rate |
$310.88 |
| Rate for Payer: Aetna Commercial |
$293.61
|
| Rate for Payer: BCBS Trust/PPO |
$285.28
|
| Rate for Payer: BCN Commercial |
$285.28
|
| Rate for Payer: Cash Price |
$276.34
|
| Rate for Payer: Cofinity Commercial |
$297.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.34
|
| Rate for Payer: Healthscope Commercial |
$310.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.61
|
| Rate for Payer: Nomi Health Commercial |
$283.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.06
|
| Rate for Payer: PHP Commercial |
$293.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$300.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$240.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.97
|
| Rate for Payer: UHC Core |
$288.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.06
|
|
|
HC XR ABDOMEN 3 OR MORE VIEWS
|
Facility
|
IP
|
$378.85
|
|
|
Service Code
|
CPT 74021
|
| Hospital Charge Code |
32000327
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$263.68 |
| Max. Negotiated Rate |
$340.96 |
| Rate for Payer: Aetna Commercial |
$322.02
|
| Rate for Payer: BCBS Trust/PPO |
$312.89
|
| Rate for Payer: BCN Commercial |
$312.89
|
| Rate for Payer: Cash Price |
$303.08
|
| Rate for Payer: Cofinity Commercial |
$325.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.08
|
| Rate for Payer: Healthscope Commercial |
$340.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.02
|
| Rate for Payer: Nomi Health Commercial |
$310.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$284.14
|
| Rate for Payer: PHP Commercial |
$322.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$329.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$263.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$333.39
|
| Rate for Payer: UHC Core |
$316.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.14
|
|
|
HC XR ABDOMEN 3 OR MORE VIEWS
|
Facility
|
OP
|
$378.85
|
|
|
Service Code
|
CPT 74021
|
| Hospital Charge Code |
32000327
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$66.79 |
| Max. Negotiated Rate |
$340.96 |
| Rate for Payer: Aetna Commercial |
$322.02
|
| Rate for Payer: Aetna Medicare |
$98.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$118.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$118.39
|
| Rate for Payer: BCBS Complete |
$70.13
|
| Rate for Payer: BCBS MAPPO |
$94.71
|
| Rate for Payer: BCBS Trust/PPO |
$311.45
|
| Rate for Payer: BCN Commercial |
$311.45
|
| Rate for Payer: BCN Medicare Advantage |
$94.71
|
| Rate for Payer: Cash Price |
$303.08
|
| Rate for Payer: Cofinity Commercial |
$325.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.71
|
| Rate for Payer: Healthscope Commercial |
$340.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.14
|
| Rate for Payer: Mclaren Medicaid |
$66.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.45
|
| Rate for Payer: Meridian Medicaid |
$70.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$108.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$104.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.02
|
| Rate for Payer: Nomi Health Commercial |
$310.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$284.14
|
| Rate for Payer: PACE Senior Care Partners |
$89.98
|
| Rate for Payer: PACE SWMI |
$94.71
|
| Rate for Payer: PHP Commercial |
$322.02
|
| Rate for Payer: PHP Medicare Advantage |
$94.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$329.60
|
| Rate for Payer: Priority Health Medicare |
$95.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$263.68
|
| Rate for Payer: Railroad Medicare Medicare |
$94.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$333.39
|
| Rate for Payer: UHC Core |
$316.34
|
| Rate for Payer: UHC Exchange |
$94.71
|
| Rate for Payer: UHC Medicaid |
$66.79
|
| Rate for Payer: UHC Medicare Advantage |
$94.71
|
| Rate for Payer: UHCCP Medicaid |
$66.79
|
| Rate for Payer: VA VA |
$94.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.14
|
|
|
HC XR ABDOMEN ACUTE
|
Facility
|
IP
|
$500.21
|
|
|
Service Code
|
CPT 74022
|
| Hospital Charge Code |
32000135
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$348.15 |
| Max. Negotiated Rate |
$450.19 |
| Rate for Payer: Aetna Commercial |
$425.18
|
| Rate for Payer: BCBS Trust/PPO |
$413.12
|
| Rate for Payer: BCN Commercial |
$413.12
|
| Rate for Payer: Cash Price |
$400.17
|
| Rate for Payer: Cofinity Commercial |
$430.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.17
|
| Rate for Payer: Healthscope Commercial |
$450.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.18
|
| Rate for Payer: Nomi Health Commercial |
$410.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.16
|
| Rate for Payer: PHP Commercial |
$425.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$435.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.18
|
| Rate for Payer: UHC Core |
$417.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.16
|
|
|
HC XR ABDOMEN ACUTE
|
Facility
|
OP
|
$500.21
|
|
|
Service Code
|
CPT 74022
|
| Hospital Charge Code |
32000135
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$88.19 |
| Max. Negotiated Rate |
$450.19 |
| Rate for Payer: Aetna Commercial |
$425.18
|
| Rate for Payer: Aetna Medicare |
$130.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$156.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$156.32
|
| Rate for Payer: BCBS Complete |
$92.59
|
| Rate for Payer: BCBS MAPPO |
$125.05
|
| Rate for Payer: BCBS Trust/PPO |
$411.22
|
| Rate for Payer: BCN Commercial |
$411.22
|
| Rate for Payer: BCN Medicare Advantage |
$125.05
|
| Rate for Payer: Cash Price |
$400.17
|
| Rate for Payer: Cofinity Commercial |
$430.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.05
|
| Rate for Payer: Healthscope Commercial |
$450.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.16
|
| Rate for Payer: Mclaren Medicaid |
$88.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.31
|
| Rate for Payer: Meridian Medicaid |
$92.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$143.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$137.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.18
|
| Rate for Payer: Nomi Health Commercial |
$410.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.16
|
| Rate for Payer: PACE Senior Care Partners |
$118.80
|
| Rate for Payer: PACE SWMI |
$125.05
|
| Rate for Payer: PHP Commercial |
$425.18
|
| Rate for Payer: PHP Medicare Advantage |
$125.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$435.18
|
| Rate for Payer: Priority Health Medicare |
$126.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.15
|
| Rate for Payer: Railroad Medicare Medicare |
$125.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.18
|
| Rate for Payer: UHC Core |
$417.68
|
| Rate for Payer: UHC Exchange |
$125.05
|
| Rate for Payer: UHC Medicaid |
$88.19
|
| Rate for Payer: UHC Medicare Advantage |
$125.05
|
| Rate for Payer: UHCCP Medicaid |
$88.19
|
| Rate for Payer: VA VA |
$125.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.16
|
|
|
HC XR AC JOINTS
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 73050
|
| Hospital Charge Code |
32000068
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$253.71 |
| Max. Negotiated Rate |
$328.08 |
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: BCBS Trust/PPO |
$301.07
|
| Rate for Payer: BCN Commercial |
$301.07
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$298.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$317.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.79
|
| Rate for Payer: UHC Core |
$304.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.40
|
|
|
HC XR AC JOINTS
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 73050
|
| Hospital Charge Code |
32000068
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$64.27 |
| Max. Negotiated Rate |
$328.08 |
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: Aetna Medicare |
$94.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.92
|
| Rate for Payer: BCBS Complete |
$67.47
|
| Rate for Payer: BCBS MAPPO |
$91.13
|
| Rate for Payer: BCBS Trust/PPO |
$299.68
|
| Rate for Payer: BCN Commercial |
$299.68
|
| Rate for Payer: BCN Medicare Advantage |
$91.13
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.13
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.40
|
| Rate for Payer: Mclaren Medicaid |
$64.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.69
|
| Rate for Payer: Meridian Medicaid |
$67.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$298.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PACE Senior Care Partners |
$86.58
|
| Rate for Payer: PACE SWMI |
$91.13
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: PHP Medicare Advantage |
$91.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$317.14
|
| Rate for Payer: Priority Health Medicare |
$92.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.71
|
| Rate for Payer: Railroad Medicare Medicare |
$91.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.79
|
| Rate for Payer: UHC Core |
$304.38
|
| Rate for Payer: UHC Exchange |
$91.13
|
| Rate for Payer: UHC Medicaid |
$64.27
|
| Rate for Payer: UHC Medicare Advantage |
$91.13
|
| Rate for Payer: UHCCP Medicaid |
$64.27
|
| Rate for Payer: VA VA |
$91.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.40
|
|
|
HC XR ANKLE 1 VW
|
Facility
|
OP
|
$248.07
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000118
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$43.73 |
| Max. Negotiated Rate |
$223.26 |
| Rate for Payer: Aetna Commercial |
$210.86
|
| Rate for Payer: Aetna Medicare |
$64.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.52
|
| Rate for Payer: BCBS Complete |
$45.92
|
| Rate for Payer: BCBS MAPPO |
$62.02
|
| Rate for Payer: BCBS Trust/PPO |
$203.94
|
| Rate for Payer: BCN Commercial |
$203.94
|
| Rate for Payer: BCN Medicare Advantage |
$62.02
|
| Rate for Payer: Cash Price |
$198.46
|
| Rate for Payer: Cofinity Commercial |
$213.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.02
|
| Rate for Payer: Healthscope Commercial |
$223.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.05
|
| Rate for Payer: Mclaren Medicaid |
$43.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.12
|
| Rate for Payer: Meridian Medicaid |
$45.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.86
|
| Rate for Payer: Nomi Health Commercial |
$203.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.05
|
| Rate for Payer: PACE Senior Care Partners |
$58.92
|
| Rate for Payer: PACE SWMI |
$62.02
|
| Rate for Payer: PHP Commercial |
$210.86
|
| Rate for Payer: PHP Medicare Advantage |
$62.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$215.82
|
| Rate for Payer: Priority Health Medicare |
$62.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$172.66
|
| Rate for Payer: Railroad Medicare Medicare |
$62.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.30
|
| Rate for Payer: UHC Core |
$207.14
|
| Rate for Payer: UHC Exchange |
$62.02
|
| Rate for Payer: UHC Medicaid |
$43.73
|
| Rate for Payer: UHC Medicare Advantage |
$62.02
|
| Rate for Payer: UHCCP Medicaid |
$43.73
|
| Rate for Payer: VA VA |
$62.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.05
|
|
|
HC XR ANKLE 1 VW
|
Facility
|
IP
|
$248.07
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000118
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$172.66 |
| Max. Negotiated Rate |
$223.26 |
| Rate for Payer: Aetna Commercial |
$210.86
|
| Rate for Payer: BCBS Trust/PPO |
$204.88
|
| Rate for Payer: BCN Commercial |
$204.88
|
| Rate for Payer: Cash Price |
$198.46
|
| Rate for Payer: Cofinity Commercial |
$213.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.46
|
| Rate for Payer: Healthscope Commercial |
$223.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.86
|
| Rate for Payer: Nomi Health Commercial |
$203.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.05
|
| Rate for Payer: PHP Commercial |
$210.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$215.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$172.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.30
|
| Rate for Payer: UHC Core |
$207.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.05
|
|
|
HC XR ANKLE 2 VIEWS
|
Facility
|
OP
|
$260.57
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000117
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.94 |
| Max. Negotiated Rate |
$234.51 |
| Rate for Payer: Aetna Commercial |
$221.48
|
| Rate for Payer: Aetna Medicare |
$67.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.43
|
| Rate for Payer: BCBS Complete |
$48.23
|
| Rate for Payer: BCBS MAPPO |
$65.14
|
| Rate for Payer: BCBS Trust/PPO |
$214.21
|
| Rate for Payer: BCN Commercial |
$214.21
|
| Rate for Payer: BCN Medicare Advantage |
$65.14
|
| Rate for Payer: Cash Price |
$208.46
|
| Rate for Payer: Cofinity Commercial |
$224.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.14
|
| Rate for Payer: Healthscope Commercial |
$234.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.43
|
| Rate for Payer: Mclaren Medicaid |
$45.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.40
|
| Rate for Payer: Meridian Medicaid |
$48.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.48
|
| Rate for Payer: Nomi Health Commercial |
$213.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.43
|
| Rate for Payer: PACE Senior Care Partners |
$61.89
|
| Rate for Payer: PACE SWMI |
$65.14
|
| Rate for Payer: PHP Commercial |
$221.48
|
| Rate for Payer: PHP Medicare Advantage |
$65.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$226.70
|
| Rate for Payer: Priority Health Medicare |
$65.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.36
|
| Rate for Payer: Railroad Medicare Medicare |
$65.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.30
|
| Rate for Payer: UHC Core |
$217.58
|
| Rate for Payer: UHC Exchange |
$65.14
|
| Rate for Payer: UHC Medicaid |
$45.94
|
| Rate for Payer: UHC Medicare Advantage |
$65.14
|
| Rate for Payer: UHCCP Medicaid |
$45.94
|
| Rate for Payer: VA VA |
$65.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.43
|
|
|
HC XR ANKLE 2 VIEWS
|
Facility
|
IP
|
$260.57
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000117
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$181.36 |
| Max. Negotiated Rate |
$234.51 |
| Rate for Payer: Aetna Commercial |
$221.48
|
| Rate for Payer: BCBS Trust/PPO |
$215.20
|
| Rate for Payer: BCN Commercial |
$215.20
|
| Rate for Payer: Cash Price |
$208.46
|
| Rate for Payer: Cofinity Commercial |
$224.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.46
|
| Rate for Payer: Healthscope Commercial |
$234.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.48
|
| Rate for Payer: Nomi Health Commercial |
$213.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.43
|
| Rate for Payer: PHP Commercial |
$221.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$226.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.30
|
| Rate for Payer: UHC Core |
$217.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.43
|
|
|
HC XR ANKLE 2 VIEWS BILATERAL
|
Facility
|
OP
|
$254.90
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000339
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.94 |
| Max. Negotiated Rate |
$229.41 |
| Rate for Payer: Aetna Commercial |
$216.66
|
| Rate for Payer: Aetna Medicare |
$66.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.66
|
| Rate for Payer: BCBS Complete |
$47.18
|
| Rate for Payer: BCBS MAPPO |
$63.73
|
| Rate for Payer: BCBS Trust/PPO |
$209.55
|
| Rate for Payer: BCN Commercial |
$209.55
|
| Rate for Payer: BCN Medicare Advantage |
$63.73
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Commercial |
$219.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.73
|
| Rate for Payer: Healthscope Commercial |
$229.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.18
|
| Rate for Payer: Mclaren Medicaid |
$44.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.91
|
| Rate for Payer: Meridian Medicaid |
$47.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$70.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Nomi Health Commercial |
$209.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.18
|
| Rate for Payer: PACE Senior Care Partners |
$60.54
|
| Rate for Payer: PACE SWMI |
$63.73
|
| Rate for Payer: PHP Commercial |
$216.66
|
| Rate for Payer: PHP Medicare Advantage |
$63.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$221.76
|
| Rate for Payer: Priority Health Medicare |
$64.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$177.41
|
| Rate for Payer: Railroad Medicare Medicare |
$63.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.31
|
| Rate for Payer: UHC Core |
$212.84
|
| Rate for Payer: UHC Exchange |
$63.73
|
| Rate for Payer: UHC Medicaid |
$44.94
|
| Rate for Payer: UHC Medicare Advantage |
$63.73
|
| Rate for Payer: UHCCP Medicaid |
$44.94
|
| Rate for Payer: VA VA |
$63.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.18
|
|
|
HC XR ANKLE 2 VIEWS BILATERAL
|
Facility
|
IP
|
$254.90
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000339
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$177.41 |
| Max. Negotiated Rate |
$229.41 |
| Rate for Payer: Aetna Commercial |
$216.66
|
| Rate for Payer: BCBS Trust/PPO |
$210.52
|
| Rate for Payer: BCN Commercial |
$210.52
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Commercial |
$219.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Healthscope Commercial |
$229.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Nomi Health Commercial |
$209.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.18
|
| Rate for Payer: PHP Commercial |
$216.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$221.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$177.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.31
|
| Rate for Payer: UHC Core |
$212.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.18
|
|
|
HC XR ANKLE BIL 2 VW
|
Facility
|
IP
|
$297.68
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000120
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$207.19 |
| Max. Negotiated Rate |
$267.91 |
| Rate for Payer: Aetna Commercial |
$253.03
|
| Rate for Payer: BCBS Trust/PPO |
$245.85
|
| Rate for Payer: BCN Commercial |
$245.85
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cofinity Commercial |
$256.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.14
|
| Rate for Payer: Healthscope Commercial |
$267.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.03
|
| Rate for Payer: Nomi Health Commercial |
$244.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.26
|
| Rate for Payer: PHP Commercial |
$253.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$258.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.96
|
| Rate for Payer: UHC Core |
$248.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.26
|
|
|
HC XR ANKLE BIL 2 VW
|
Facility
|
OP
|
$297.68
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000120
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$52.48 |
| Max. Negotiated Rate |
$267.91 |
| Rate for Payer: Aetna Commercial |
$253.03
|
| Rate for Payer: Aetna Medicare |
$77.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.03
|
| Rate for Payer: BCBS Complete |
$55.10
|
| Rate for Payer: BCBS MAPPO |
$74.42
|
| Rate for Payer: BCBS Trust/PPO |
$244.72
|
| Rate for Payer: BCN Commercial |
$244.72
|
| Rate for Payer: BCN Medicare Advantage |
$74.42
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cofinity Commercial |
$256.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.42
|
| Rate for Payer: Healthscope Commercial |
$267.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.26
|
| Rate for Payer: Mclaren Medicaid |
$52.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.14
|
| Rate for Payer: Meridian Medicaid |
$55.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$81.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.03
|
| Rate for Payer: Nomi Health Commercial |
$244.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.26
|
| Rate for Payer: PACE Senior Care Partners |
$70.70
|
| Rate for Payer: PACE SWMI |
$74.42
|
| Rate for Payer: PHP Commercial |
$253.03
|
| Rate for Payer: PHP Medicare Advantage |
$74.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$258.98
|
| Rate for Payer: Priority Health Medicare |
$75.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.19
|
| Rate for Payer: Railroad Medicare Medicare |
$74.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.96
|
| Rate for Payer: UHC Core |
$248.56
|
| Rate for Payer: UHC Exchange |
$74.42
|
| Rate for Payer: UHC Medicaid |
$52.48
|
| Rate for Payer: UHC Medicare Advantage |
$74.42
|
| Rate for Payer: UHCCP Medicaid |
$52.48
|
| Rate for Payer: VA VA |
$74.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.26
|
|
|
HC XR ANKLE BIL MIN 3 VW
|
Facility
|
IP
|
$396.48
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
32000122
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$275.95 |
| Max. Negotiated Rate |
$356.83 |
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: BCBS Trust/PPO |
$327.45
|
| Rate for Payer: BCN Commercial |
$327.45
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$325.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$344.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.90
|
| Rate for Payer: UHC Core |
$331.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.36
|
|
|
HC XR ANKLE BIL MIN 3 VW
|
Facility
|
OP
|
$396.48
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
32000122
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$69.90 |
| Max. Negotiated Rate |
$356.83 |
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: Aetna Medicare |
$103.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$123.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$123.90
|
| Rate for Payer: BCBS Complete |
$73.39
|
| Rate for Payer: BCBS MAPPO |
$99.12
|
| Rate for Payer: BCBS Trust/PPO |
$325.95
|
| Rate for Payer: BCN Commercial |
$325.95
|
| Rate for Payer: BCN Medicare Advantage |
$99.12
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.12
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.36
|
| Rate for Payer: Mclaren Medicaid |
$69.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.08
|
| Rate for Payer: Meridian Medicaid |
$73.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$113.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$109.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$325.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PACE Senior Care Partners |
$94.16
|
| Rate for Payer: PACE SWMI |
$99.12
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: PHP Medicare Advantage |
$99.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$344.94
|
| Rate for Payer: Priority Health Medicare |
$100.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.95
|
| Rate for Payer: Railroad Medicare Medicare |
$99.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.90
|
| Rate for Payer: UHC Core |
$331.06
|
| Rate for Payer: UHC Exchange |
$99.12
|
| Rate for Payer: UHC Medicaid |
$69.90
|
| Rate for Payer: UHC Medicare Advantage |
$99.12
|
| Rate for Payer: UHCCP Medicaid |
$69.90
|
| Rate for Payer: VA VA |
$99.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.36
|
|
|
HC XR ANKLE MIN 3 VIEWS
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
32000121
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$64.27 |
| Max. Negotiated Rate |
$328.08 |
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: Aetna Medicare |
$94.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.92
|
| Rate for Payer: BCBS Complete |
$67.47
|
| Rate for Payer: BCBS MAPPO |
$91.13
|
| Rate for Payer: BCBS Trust/PPO |
$299.68
|
| Rate for Payer: BCN Commercial |
$299.68
|
| Rate for Payer: BCN Medicare Advantage |
$91.13
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.13
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.40
|
| Rate for Payer: Mclaren Medicaid |
$64.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.69
|
| Rate for Payer: Meridian Medicaid |
$67.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$298.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PACE Senior Care Partners |
$86.58
|
| Rate for Payer: PACE SWMI |
$91.13
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: PHP Medicare Advantage |
$91.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$317.14
|
| Rate for Payer: Priority Health Medicare |
$92.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.71
|
| Rate for Payer: Railroad Medicare Medicare |
$91.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.79
|
| Rate for Payer: UHC Core |
$304.38
|
| Rate for Payer: UHC Exchange |
$91.13
|
| Rate for Payer: UHC Medicaid |
$64.27
|
| Rate for Payer: UHC Medicare Advantage |
$91.13
|
| Rate for Payer: UHCCP Medicaid |
$64.27
|
| Rate for Payer: VA VA |
$91.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.40
|
|
|
HC XR ANKLE MIN 3 VIEWS
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
32000121
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$253.71 |
| Max. Negotiated Rate |
$328.08 |
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: BCBS Trust/PPO |
$301.07
|
| Rate for Payer: BCN Commercial |
$301.07
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$298.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$317.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.79
|
| Rate for Payer: UHC Core |
$304.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.40
|
|
