|
HC XR ARTHROGRAM ELBOW
|
Facility
|
OP
|
$624.56
|
|
|
Service Code
|
CPT 73085
|
| Hospital Charge Code |
32000075
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$110.11 |
| Max. Negotiated Rate |
$562.10 |
| Rate for Payer: Aetna Commercial |
$530.88
|
| Rate for Payer: Aetna Medicare |
$162.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$195.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$195.18
|
| Rate for Payer: BCBS Complete |
$115.61
|
| Rate for Payer: BCBS MAPPO |
$156.14
|
| Rate for Payer: BCBS Trust/PPO |
$513.45
|
| Rate for Payer: BCN Commercial |
$513.45
|
| Rate for Payer: BCN Medicare Advantage |
$156.14
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Commercial |
$537.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.14
|
| Rate for Payer: Healthscope Commercial |
$562.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.42
|
| Rate for Payer: Mclaren Medicaid |
$110.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.95
|
| Rate for Payer: Meridian Medicaid |
$115.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$179.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$171.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Nomi Health Commercial |
$512.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: PACE Senior Care Partners |
$148.33
|
| Rate for Payer: PACE SWMI |
$156.14
|
| Rate for Payer: PHP Commercial |
$530.88
|
| Rate for Payer: PHP Medicare Advantage |
$156.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$543.37
|
| Rate for Payer: Priority Health Medicare |
$157.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.69
|
| Rate for Payer: Railroad Medicare Medicare |
$156.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.61
|
| Rate for Payer: UHC Core |
$521.51
|
| Rate for Payer: UHC Exchange |
$156.14
|
| Rate for Payer: UHC Medicaid |
$110.11
|
| Rate for Payer: UHC Medicare Advantage |
$156.14
|
| Rate for Payer: UHCCP Medicaid |
$110.11
|
| Rate for Payer: VA VA |
$156.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.42
|
|
|
HC XR ARTHROGRAM ELBOW
|
Facility
|
IP
|
$624.56
|
|
|
Service Code
|
CPT 73085
|
| Hospital Charge Code |
32000075
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$434.69 |
| Max. Negotiated Rate |
$562.10 |
| Rate for Payer: Aetna Commercial |
$530.88
|
| Rate for Payer: BCBS Trust/PPO |
$515.82
|
| Rate for Payer: BCN Commercial |
$515.82
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Commercial |
$537.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Healthscope Commercial |
$562.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Nomi Health Commercial |
$512.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: PHP Commercial |
$530.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$543.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.61
|
| Rate for Payer: UHC Core |
$521.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.42
|
|
|
HC XR ARTHROGRAM HIP
|
Facility
|
OP
|
$624.56
|
|
|
Service Code
|
CPT 73525
|
| Hospital Charge Code |
32000097
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$110.11 |
| Max. Negotiated Rate |
$562.10 |
| Rate for Payer: Aetna Commercial |
$530.88
|
| Rate for Payer: Aetna Medicare |
$162.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$195.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$195.18
|
| Rate for Payer: BCBS Complete |
$115.61
|
| Rate for Payer: BCBS MAPPO |
$156.14
|
| Rate for Payer: BCBS Trust/PPO |
$513.45
|
| Rate for Payer: BCN Commercial |
$513.45
|
| Rate for Payer: BCN Medicare Advantage |
$156.14
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Commercial |
$537.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.14
|
| Rate for Payer: Healthscope Commercial |
$562.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.42
|
| Rate for Payer: Mclaren Medicaid |
$110.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.95
|
| Rate for Payer: Meridian Medicaid |
$115.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$179.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$171.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Nomi Health Commercial |
$512.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: PACE Senior Care Partners |
$148.33
|
| Rate for Payer: PACE SWMI |
$156.14
|
| Rate for Payer: PHP Commercial |
$530.88
|
| Rate for Payer: PHP Medicare Advantage |
$156.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$543.37
|
| Rate for Payer: Priority Health Medicare |
$157.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.69
|
| Rate for Payer: Railroad Medicare Medicare |
$156.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.61
|
| Rate for Payer: UHC Core |
$521.51
|
| Rate for Payer: UHC Exchange |
$156.14
|
| Rate for Payer: UHC Medicaid |
$110.11
|
| Rate for Payer: UHC Medicare Advantage |
$156.14
|
| Rate for Payer: UHCCP Medicaid |
$110.11
|
| Rate for Payer: VA VA |
$156.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.42
|
|
|
HC XR ARTHROGRAM HIP
|
Facility
|
IP
|
$624.56
|
|
|
Service Code
|
CPT 73525
|
| Hospital Charge Code |
32000097
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$434.69 |
| Max. Negotiated Rate |
$562.10 |
| Rate for Payer: Aetna Commercial |
$530.88
|
| Rate for Payer: BCBS Trust/PPO |
$515.82
|
| Rate for Payer: BCN Commercial |
$515.82
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Commercial |
$537.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Healthscope Commercial |
$562.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Nomi Health Commercial |
$512.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: PHP Commercial |
$530.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$543.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.61
|
| Rate for Payer: UHC Core |
$521.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.42
|
|
|
HC XR ARTHROGRAM KNEE
|
Facility
|
OP
|
$624.56
|
|
|
Service Code
|
CPT 73580
|
| Hospital Charge Code |
32000111
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$110.11 |
| Max. Negotiated Rate |
$562.10 |
| Rate for Payer: Aetna Commercial |
$530.88
|
| Rate for Payer: Aetna Medicare |
$162.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$195.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$195.18
|
| Rate for Payer: BCBS Complete |
$115.61
|
| Rate for Payer: BCBS MAPPO |
$156.14
|
| Rate for Payer: BCBS Trust/PPO |
$513.45
|
| Rate for Payer: BCN Commercial |
$513.45
|
| Rate for Payer: BCN Medicare Advantage |
$156.14
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Commercial |
$537.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.14
|
| Rate for Payer: Healthscope Commercial |
$562.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.42
|
| Rate for Payer: Mclaren Medicaid |
$110.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.95
|
| Rate for Payer: Meridian Medicaid |
$115.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$179.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$171.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Nomi Health Commercial |
$512.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: PACE Senior Care Partners |
$148.33
|
| Rate for Payer: PACE SWMI |
$156.14
|
| Rate for Payer: PHP Commercial |
$530.88
|
| Rate for Payer: PHP Medicare Advantage |
$156.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$543.37
|
| Rate for Payer: Priority Health Medicare |
$157.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.69
|
| Rate for Payer: Railroad Medicare Medicare |
$156.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.61
|
| Rate for Payer: UHC Core |
$521.51
|
| Rate for Payer: UHC Exchange |
$156.14
|
| Rate for Payer: UHC Medicaid |
$110.11
|
| Rate for Payer: UHC Medicare Advantage |
$156.14
|
| Rate for Payer: UHCCP Medicaid |
$110.11
|
| Rate for Payer: VA VA |
$156.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.42
|
|
|
HC XR ARTHROGRAM KNEE
|
Facility
|
IP
|
$624.56
|
|
|
Service Code
|
CPT 73580
|
| Hospital Charge Code |
32000111
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$434.69 |
| Max. Negotiated Rate |
$562.10 |
| Rate for Payer: Aetna Commercial |
$530.88
|
| Rate for Payer: BCBS Trust/PPO |
$515.82
|
| Rate for Payer: BCN Commercial |
$515.82
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Commercial |
$537.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Healthscope Commercial |
$562.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Nomi Health Commercial |
$512.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: PHP Commercial |
$530.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$543.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.61
|
| Rate for Payer: UHC Core |
$521.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.42
|
|
|
HC XR ARTHROGRAM SHOULDER
|
Facility
|
IP
|
$624.56
|
|
|
Service Code
|
CPT 73040
|
| Hospital Charge Code |
32000067
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$434.69 |
| Max. Negotiated Rate |
$562.10 |
| Rate for Payer: Aetna Commercial |
$530.88
|
| Rate for Payer: BCBS Trust/PPO |
$515.82
|
| Rate for Payer: BCN Commercial |
$515.82
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Commercial |
$537.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Healthscope Commercial |
$562.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Nomi Health Commercial |
$512.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: PHP Commercial |
$530.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$543.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.61
|
| Rate for Payer: UHC Core |
$521.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.42
|
|
|
HC XR ARTHROGRAM SHOULDER
|
Facility
|
OP
|
$624.56
|
|
|
Service Code
|
CPT 73040
|
| Hospital Charge Code |
32000067
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$110.11 |
| Max. Negotiated Rate |
$562.10 |
| Rate for Payer: Aetna Commercial |
$530.88
|
| Rate for Payer: Aetna Medicare |
$162.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$195.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$195.18
|
| Rate for Payer: BCBS Complete |
$115.61
|
| Rate for Payer: BCBS MAPPO |
$156.14
|
| Rate for Payer: BCBS Trust/PPO |
$513.45
|
| Rate for Payer: BCN Commercial |
$513.45
|
| Rate for Payer: BCN Medicare Advantage |
$156.14
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Commercial |
$537.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.14
|
| Rate for Payer: Healthscope Commercial |
$562.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.42
|
| Rate for Payer: Mclaren Medicaid |
$110.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.95
|
| Rate for Payer: Meridian Medicaid |
$115.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$179.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$171.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Nomi Health Commercial |
$512.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: PACE Senior Care Partners |
$148.33
|
| Rate for Payer: PACE SWMI |
$156.14
|
| Rate for Payer: PHP Commercial |
$530.88
|
| Rate for Payer: PHP Medicare Advantage |
$156.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$543.37
|
| Rate for Payer: Priority Health Medicare |
$157.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.69
|
| Rate for Payer: Railroad Medicare Medicare |
$156.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.61
|
| Rate for Payer: UHC Core |
$521.51
|
| Rate for Payer: UHC Exchange |
$156.14
|
| Rate for Payer: UHC Medicaid |
$110.11
|
| Rate for Payer: UHC Medicare Advantage |
$156.14
|
| Rate for Payer: UHCCP Medicaid |
$110.11
|
| Rate for Payer: VA VA |
$156.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.42
|
|
|
HC XR ARTHROGRAM WRIST
|
Facility
|
IP
|
$684.29
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
32000084
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$476.27 |
| Max. Negotiated Rate |
$615.86 |
| Rate for Payer: Aetna Commercial |
$581.65
|
| Rate for Payer: BCBS Trust/PPO |
$565.16
|
| Rate for Payer: BCN Commercial |
$565.16
|
| Rate for Payer: Cash Price |
$547.43
|
| Rate for Payer: Cofinity Commercial |
$588.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$547.43
|
| Rate for Payer: Healthscope Commercial |
$615.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$513.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$581.65
|
| Rate for Payer: Nomi Health Commercial |
$561.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$513.22
|
| Rate for Payer: PHP Commercial |
$581.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$595.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$476.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$602.18
|
| Rate for Payer: UHC Core |
$571.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$513.22
|
|
|
HC XR ARTHROGRAM WRIST
|
Facility
|
OP
|
$684.29
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
32000084
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$120.64 |
| Max. Negotiated Rate |
$615.86 |
| Rate for Payer: Aetna Commercial |
$581.65
|
| Rate for Payer: Aetna Medicare |
$177.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$213.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$213.84
|
| Rate for Payer: BCBS Complete |
$126.66
|
| Rate for Payer: BCBS MAPPO |
$171.07
|
| Rate for Payer: BCBS Trust/PPO |
$562.55
|
| Rate for Payer: BCN Commercial |
$562.55
|
| Rate for Payer: BCN Medicare Advantage |
$171.07
|
| Rate for Payer: Cash Price |
$547.43
|
| Rate for Payer: Cofinity Commercial |
$588.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$547.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.07
|
| Rate for Payer: Healthscope Commercial |
$615.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$513.22
|
| Rate for Payer: Mclaren Medicaid |
$120.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.63
|
| Rate for Payer: Meridian Medicaid |
$126.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$196.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$188.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$581.65
|
| Rate for Payer: Nomi Health Commercial |
$561.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$513.22
|
| Rate for Payer: PACE Senior Care Partners |
$162.52
|
| Rate for Payer: PACE SWMI |
$171.07
|
| Rate for Payer: PHP Commercial |
$581.65
|
| Rate for Payer: PHP Medicare Advantage |
$171.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$595.33
|
| Rate for Payer: Priority Health Medicare |
$172.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$476.27
|
| Rate for Payer: Railroad Medicare Medicare |
$171.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$602.18
|
| Rate for Payer: UHC Core |
$571.38
|
| Rate for Payer: UHC Exchange |
$171.07
|
| Rate for Payer: UHC Medicaid |
$120.64
|
| Rate for Payer: UHC Medicare Advantage |
$171.07
|
| Rate for Payer: UHCCP Medicaid |
$120.64
|
| Rate for Payer: VA VA |
$171.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$513.22
|
|
|
HC XR BONE AGE STUDY
|
Facility
|
OP
|
$312.56
|
|
|
Service Code
|
CPT 77072
|
| Hospital Charge Code |
32000253
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.10 |
| Max. Negotiated Rate |
$281.30 |
| Rate for Payer: Aetna Commercial |
$265.68
|
| Rate for Payer: Aetna Medicare |
$81.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$97.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$97.67
|
| Rate for Payer: BCBS Complete |
$57.85
|
| Rate for Payer: BCBS MAPPO |
$78.14
|
| Rate for Payer: BCBS Trust/PPO |
$256.96
|
| Rate for Payer: BCN Commercial |
$256.96
|
| Rate for Payer: BCN Medicare Advantage |
$78.14
|
| Rate for Payer: Cash Price |
$250.05
|
| Rate for Payer: Cofinity Commercial |
$268.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$250.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.14
|
| Rate for Payer: Healthscope Commercial |
$281.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.42
|
| Rate for Payer: Mclaren Medicaid |
$55.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.05
|
| Rate for Payer: Meridian Medicaid |
$57.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$85.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.68
|
| Rate for Payer: Nomi Health Commercial |
$256.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.42
|
| Rate for Payer: PACE Senior Care Partners |
$74.23
|
| Rate for Payer: PACE SWMI |
$78.14
|
| Rate for Payer: PHP Commercial |
$265.68
|
| Rate for Payer: PHP Medicare Advantage |
$78.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$271.93
|
| Rate for Payer: Priority Health Medicare |
$78.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.54
|
| Rate for Payer: Railroad Medicare Medicare |
$78.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$275.05
|
| Rate for Payer: UHC Core |
$260.99
|
| Rate for Payer: UHC Exchange |
$78.14
|
| Rate for Payer: UHC Medicaid |
$55.10
|
| Rate for Payer: UHC Medicare Advantage |
$78.14
|
| Rate for Payer: UHCCP Medicaid |
$55.10
|
| Rate for Payer: VA VA |
$78.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.42
|
|
|
HC XR BONE AGE STUDY
|
Facility
|
IP
|
$312.56
|
|
|
Service Code
|
CPT 77072
|
| Hospital Charge Code |
32000253
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$217.54 |
| Max. Negotiated Rate |
$281.30 |
| Rate for Payer: Aetna Commercial |
$265.68
|
| Rate for Payer: BCBS Trust/PPO |
$258.14
|
| Rate for Payer: BCN Commercial |
$258.14
|
| Rate for Payer: Cash Price |
$250.05
|
| Rate for Payer: Cofinity Commercial |
$268.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$250.05
|
| Rate for Payer: Healthscope Commercial |
$281.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.68
|
| Rate for Payer: Nomi Health Commercial |
$256.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.42
|
| Rate for Payer: PHP Commercial |
$265.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$271.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$275.05
|
| Rate for Payer: UHC Core |
$260.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.42
|
|
|
HC XR BONE LENGTH STUDY
|
Facility
|
OP
|
$297.68
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
32000254
|
|
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 BONE LENGTH STUDY
|
Facility
|
IP
|
$297.68
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
32000254
|
|
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 BONE SURVEY ADULT COMP
|
Facility
|
IP
|
$624.81
|
|
|
Service Code
|
CPT 77075
|
| Hospital Charge Code |
32000257
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$434.87 |
| Max. Negotiated Rate |
$562.33 |
| Rate for Payer: Aetna Commercial |
$531.09
|
| Rate for Payer: BCBS Trust/PPO |
$516.03
|
| Rate for Payer: BCN Commercial |
$516.03
|
| Rate for Payer: Cash Price |
$499.85
|
| Rate for Payer: Cofinity Commercial |
$537.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.85
|
| Rate for Payer: Healthscope Commercial |
$562.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$531.09
|
| Rate for Payer: Nomi Health Commercial |
$512.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.61
|
| Rate for Payer: PHP Commercial |
$531.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$543.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.83
|
| Rate for Payer: UHC Core |
$521.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.61
|
|
|
HC XR BONE SURVEY ADULT COMP
|
Facility
|
OP
|
$624.81
|
|
|
Service Code
|
CPT 77075
|
| Hospital Charge Code |
32000257
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$110.15 |
| Max. Negotiated Rate |
$562.33 |
| Rate for Payer: Aetna Commercial |
$531.09
|
| Rate for Payer: Aetna Medicare |
$162.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$195.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$195.25
|
| Rate for Payer: BCBS Complete |
$115.65
|
| Rate for Payer: BCBS MAPPO |
$156.20
|
| Rate for Payer: BCBS Trust/PPO |
$513.66
|
| Rate for Payer: BCN Commercial |
$513.66
|
| Rate for Payer: BCN Medicare Advantage |
$156.20
|
| Rate for Payer: Cash Price |
$499.85
|
| Rate for Payer: Cofinity Commercial |
$537.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.20
|
| Rate for Payer: Healthscope Commercial |
$562.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.61
|
| Rate for Payer: Mclaren Medicaid |
$110.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.01
|
| Rate for Payer: Meridian Medicaid |
$115.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$179.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$171.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$531.09
|
| Rate for Payer: Nomi Health Commercial |
$512.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.61
|
| Rate for Payer: PACE Senior Care Partners |
$148.39
|
| Rate for Payer: PACE SWMI |
$156.20
|
| Rate for Payer: PHP Commercial |
$531.09
|
| Rate for Payer: PHP Medicare Advantage |
$156.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$543.58
|
| Rate for Payer: Priority Health Medicare |
$157.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.87
|
| Rate for Payer: Railroad Medicare Medicare |
$156.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.83
|
| Rate for Payer: UHC Core |
$521.72
|
| Rate for Payer: UHC Exchange |
$156.20
|
| Rate for Payer: UHC Medicaid |
$110.15
|
| Rate for Payer: UHC Medicare Advantage |
$156.20
|
| Rate for Payer: UHCCP Medicaid |
$110.15
|
| Rate for Payer: VA VA |
$156.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.61
|
|
|
HC XR BONE SURVEY INFANT
|
Facility
|
OP
|
$395.72
|
|
|
Service Code
|
CPT 77076
|
| Hospital Charge Code |
32000258
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$69.77 |
| Max. Negotiated Rate |
$356.15 |
| Rate for Payer: Aetna Commercial |
$336.36
|
| Rate for Payer: Aetna Medicare |
$102.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$123.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$123.66
|
| Rate for Payer: BCBS Complete |
$73.25
|
| Rate for Payer: BCBS MAPPO |
$98.93
|
| Rate for Payer: BCBS Trust/PPO |
$325.32
|
| Rate for Payer: BCN Commercial |
$325.32
|
| Rate for Payer: BCN Medicare Advantage |
$98.93
|
| Rate for Payer: Cash Price |
$316.58
|
| Rate for Payer: Cofinity Commercial |
$340.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.93
|
| Rate for Payer: Healthscope Commercial |
$356.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$296.79
|
| Rate for Payer: Mclaren Medicaid |
$69.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.88
|
| Rate for Payer: Meridian Medicaid |
$73.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$113.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$336.36
|
| Rate for Payer: Nomi Health Commercial |
$324.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$296.79
|
| Rate for Payer: PACE Senior Care Partners |
$93.98
|
| Rate for Payer: PACE SWMI |
$98.93
|
| Rate for Payer: PHP Commercial |
$336.36
|
| Rate for Payer: PHP Medicare Advantage |
$98.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$344.28
|
| Rate for Payer: Priority Health Medicare |
$99.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.42
|
| Rate for Payer: Railroad Medicare Medicare |
$98.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.23
|
| Rate for Payer: UHC Core |
$330.43
|
| Rate for Payer: UHC Exchange |
$98.93
|
| Rate for Payer: UHC Medicaid |
$69.77
|
| Rate for Payer: UHC Medicare Advantage |
$98.93
|
| Rate for Payer: UHCCP Medicaid |
$69.77
|
| Rate for Payer: VA VA |
$98.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$296.79
|
|
|
HC XR BONE SURVEY INFANT
|
Facility
|
IP
|
$395.72
|
|
|
Service Code
|
CPT 77076
|
| Hospital Charge Code |
32000258
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$275.42 |
| Max. Negotiated Rate |
$356.15 |
| Rate for Payer: Aetna Commercial |
$336.36
|
| Rate for Payer: BCBS Trust/PPO |
$326.83
|
| Rate for Payer: BCN Commercial |
$326.83
|
| Rate for Payer: Cash Price |
$316.58
|
| Rate for Payer: Cofinity Commercial |
$340.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.58
|
| Rate for Payer: Healthscope Commercial |
$356.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$296.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$336.36
|
| Rate for Payer: Nomi Health Commercial |
$324.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$296.79
|
| Rate for Payer: PHP Commercial |
$336.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$344.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.23
|
| Rate for Payer: UHC Core |
$330.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$296.79
|
|
|
HC XR BONE SURVEY (METS) LTD
|
Facility
|
OP
|
$314.28
|
|
|
Service Code
|
CPT 77074
|
| Hospital Charge Code |
32000298
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.41 |
| Max. Negotiated Rate |
$282.85 |
| Rate for Payer: Aetna Commercial |
$267.14
|
| Rate for Payer: Aetna Medicare |
$81.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.21
|
| Rate for Payer: BCBS Complete |
$58.17
|
| Rate for Payer: BCBS MAPPO |
$78.57
|
| Rate for Payer: BCBS Trust/PPO |
$258.37
|
| Rate for Payer: BCN Commercial |
$258.37
|
| Rate for Payer: BCN Medicare Advantage |
$78.57
|
| Rate for Payer: Cash Price |
$251.42
|
| Rate for Payer: Cofinity Commercial |
$270.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$251.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.57
|
| Rate for Payer: Healthscope Commercial |
$282.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$235.71
|
| Rate for Payer: Mclaren Medicaid |
$55.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.50
|
| Rate for Payer: Meridian Medicaid |
$58.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$86.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$267.14
|
| Rate for Payer: Nomi Health Commercial |
$257.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$235.71
|
| Rate for Payer: PACE Senior Care Partners |
$74.64
|
| Rate for Payer: PACE SWMI |
$78.57
|
| Rate for Payer: PHP Commercial |
$267.14
|
| Rate for Payer: PHP Medicare Advantage |
$78.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$273.42
|
| Rate for Payer: Priority Health Medicare |
$79.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$218.74
|
| Rate for Payer: Railroad Medicare Medicare |
$78.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$276.57
|
| Rate for Payer: UHC Core |
$262.42
|
| Rate for Payer: UHC Exchange |
$78.57
|
| Rate for Payer: UHC Medicaid |
$55.41
|
| Rate for Payer: UHC Medicare Advantage |
$78.57
|
| Rate for Payer: UHCCP Medicaid |
$55.41
|
| Rate for Payer: VA VA |
$78.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$235.71
|
|
|
HC XR BONE SURVEY (METS) LTD
|
Facility
|
IP
|
$314.28
|
|
|
Service Code
|
CPT 77074
|
| Hospital Charge Code |
32000298
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$218.74 |
| Max. Negotiated Rate |
$282.85 |
| Rate for Payer: Aetna Commercial |
$267.14
|
| Rate for Payer: BCBS Trust/PPO |
$259.56
|
| Rate for Payer: BCN Commercial |
$259.56
|
| Rate for Payer: Cash Price |
$251.42
|
| Rate for Payer: Cofinity Commercial |
$270.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$251.42
|
| Rate for Payer: Healthscope Commercial |
$282.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$235.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$267.14
|
| Rate for Payer: Nomi Health Commercial |
$257.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$235.71
|
| Rate for Payer: PHP Commercial |
$267.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$273.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$218.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$276.57
|
| Rate for Payer: UHC Core |
$262.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$235.71
|
|
|
HC XR CHEST 2 VIEWS
|
Facility
|
OP
|
$309.76
|
|
|
Service Code
|
CPT 71046
|
| Hospital Charge Code |
32400010
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$54.61 |
| Max. Negotiated Rate |
$278.78 |
| Rate for Payer: Aetna Commercial |
$263.30
|
| Rate for Payer: Aetna Medicare |
$80.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$96.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$96.80
|
| Rate for Payer: BCBS Complete |
$57.34
|
| Rate for Payer: BCBS MAPPO |
$77.44
|
| Rate for Payer: BCBS Trust/PPO |
$254.65
|
| Rate for Payer: BCN Commercial |
$254.65
|
| Rate for Payer: BCN Medicare Advantage |
$77.44
|
| Rate for Payer: Cash Price |
$247.81
|
| Rate for Payer: Cofinity Commercial |
$266.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.44
|
| Rate for Payer: Healthscope Commercial |
$278.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.32
|
| Rate for Payer: Mclaren Medicaid |
$54.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.31
|
| Rate for Payer: Meridian Medicaid |
$57.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$85.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.30
|
| Rate for Payer: Nomi Health Commercial |
$254.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$232.32
|
| Rate for Payer: PACE Senior Care Partners |
$73.57
|
| Rate for Payer: PACE SWMI |
$77.44
|
| Rate for Payer: PHP Commercial |
$263.30
|
| Rate for Payer: PHP Medicare Advantage |
$77.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$269.49
|
| Rate for Payer: Priority Health Medicare |
$78.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$215.59
|
| Rate for Payer: Railroad Medicare Medicare |
$77.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.59
|
| Rate for Payer: UHC Core |
$258.65
|
| Rate for Payer: UHC Exchange |
$77.44
|
| Rate for Payer: UHC Medicaid |
$54.61
|
| Rate for Payer: UHC Medicare Advantage |
$77.44
|
| Rate for Payer: UHCCP Medicaid |
$54.61
|
| Rate for Payer: VA VA |
$77.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.32
|
|
|
HC XR CHEST 2 VIEWS
|
Facility
|
IP
|
$309.76
|
|
|
Service Code
|
CPT 71046
|
| Hospital Charge Code |
32400010
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$215.59 |
| Max. Negotiated Rate |
$278.78 |
| Rate for Payer: Aetna Commercial |
$263.30
|
| Rate for Payer: BCBS Trust/PPO |
$255.83
|
| Rate for Payer: BCN Commercial |
$255.83
|
| Rate for Payer: Cash Price |
$247.81
|
| Rate for Payer: Cofinity Commercial |
$266.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.81
|
| Rate for Payer: Healthscope Commercial |
$278.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.30
|
| Rate for Payer: Nomi Health Commercial |
$254.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$232.32
|
| Rate for Payer: PHP Commercial |
$263.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$269.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$215.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.59
|
| Rate for Payer: UHC Core |
$258.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.32
|
|
|
HC XR CHEST 3 VIEWS
|
Facility
|
IP
|
$343.20
|
|
|
Service Code
|
CPT 71047
|
| Hospital Charge Code |
32400011
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$238.87 |
| Max. Negotiated Rate |
$308.88 |
| Rate for Payer: Aetna Commercial |
$291.72
|
| Rate for Payer: BCBS Trust/PPO |
$283.45
|
| Rate for Payer: BCN Commercial |
$283.45
|
| Rate for Payer: Cash Price |
$274.56
|
| Rate for Payer: Cofinity Commercial |
$295.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.56
|
| Rate for Payer: Healthscope Commercial |
$308.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.72
|
| Rate for Payer: Nomi Health Commercial |
$281.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.40
|
| Rate for Payer: PHP Commercial |
$291.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$298.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.02
|
| Rate for Payer: UHC Core |
$286.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.40
|
|
|
HC XR CHEST 3 VIEWS
|
Facility
|
OP
|
$343.20
|
|
|
Service Code
|
CPT 71047
|
| Hospital Charge Code |
32400011
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$60.51 |
| Max. Negotiated Rate |
$308.88 |
| Rate for Payer: Aetna Commercial |
$291.72
|
| Rate for Payer: Aetna Medicare |
$89.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.25
|
| Rate for Payer: BCBS Complete |
$63.53
|
| Rate for Payer: BCBS MAPPO |
$85.80
|
| Rate for Payer: BCBS Trust/PPO |
$282.14
|
| Rate for Payer: BCN Commercial |
$282.14
|
| Rate for Payer: BCN Medicare Advantage |
$85.80
|
| Rate for Payer: Cash Price |
$274.56
|
| Rate for Payer: Cofinity Commercial |
$295.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.80
|
| Rate for Payer: Healthscope Commercial |
$308.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.40
|
| Rate for Payer: Mclaren Medicaid |
$60.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.09
|
| Rate for Payer: Meridian Medicaid |
$63.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$94.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.72
|
| Rate for Payer: Nomi Health Commercial |
$281.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.40
|
| Rate for Payer: PACE Senior Care Partners |
$81.51
|
| Rate for Payer: PACE SWMI |
$85.80
|
| Rate for Payer: PHP Commercial |
$291.72
|
| Rate for Payer: PHP Medicare Advantage |
$85.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$298.58
|
| Rate for Payer: Priority Health Medicare |
$86.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.87
|
| Rate for Payer: Railroad Medicare Medicare |
$85.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.02
|
| Rate for Payer: UHC Core |
$286.57
|
| Rate for Payer: UHC Exchange |
$85.80
|
| Rate for Payer: UHC Medicaid |
$60.51
|
| Rate for Payer: UHC Medicare Advantage |
$85.80
|
| Rate for Payer: UHCCP Medicaid |
$60.51
|
| Rate for Payer: VA VA |
$85.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.40
|
|
|
HC XR CHEST 4 OR MORE VIEWS
|
Facility
|
IP
|
$376.62
|
|
|
Service Code
|
CPT 71048
|
| Hospital Charge Code |
32400012
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$262.13 |
| Max. Negotiated Rate |
$338.96 |
| Rate for Payer: Aetna Commercial |
$320.13
|
| Rate for Payer: BCBS Trust/PPO |
$311.05
|
| Rate for Payer: BCN Commercial |
$311.05
|
| Rate for Payer: Cash Price |
$301.30
|
| Rate for Payer: Cofinity Commercial |
$323.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$301.30
|
| Rate for Payer: Healthscope Commercial |
$338.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$282.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$320.13
|
| Rate for Payer: Nomi Health Commercial |
$308.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.46
|
| Rate for Payer: PHP Commercial |
$320.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$327.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$331.43
|
| Rate for Payer: UHC Core |
$314.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$282.46
|
|
