|
HC XR ELBOW 2 VW
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000071
|
|
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 ELBOW 2 VW
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000071
|
|
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 ELBOW BIL 3 VW
|
Facility
|
OP
|
$396.48
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000074
|
|
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 ELBOW BIL 3 VW
|
Facility
|
IP
|
$396.48
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000074
|
|
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 ELBOW MIN 3 VW
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000073
|
|
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 ELBOW MIN 3 VW
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000073
|
|
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 ENDO RETROGRADE CHOLANGIOGR
|
Facility
|
OP
|
$566.77
|
|
|
Service Code
|
CPT 74328
|
| Hospital Charge Code |
32000154
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$99.92 |
| Max. Negotiated Rate |
$510.09 |
| Rate for Payer: Aetna Commercial |
$481.75
|
| Rate for Payer: Aetna Medicare |
$147.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$177.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$177.12
|
| Rate for Payer: BCBS Complete |
$104.91
|
| Rate for Payer: BCBS MAPPO |
$141.69
|
| Rate for Payer: BCBS Trust/PPO |
$465.94
|
| Rate for Payer: BCN Commercial |
$465.94
|
| Rate for Payer: BCN Medicare Advantage |
$141.69
|
| Rate for Payer: Cash Price |
$453.42
|
| Rate for Payer: Cofinity Commercial |
$487.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$453.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.69
|
| Rate for Payer: Healthscope Commercial |
$510.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$425.08
|
| Rate for Payer: Mclaren Medicaid |
$99.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$148.78
|
| Rate for Payer: Meridian Medicaid |
$104.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$162.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$155.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$481.75
|
| Rate for Payer: Nomi Health Commercial |
$464.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$425.08
|
| Rate for Payer: PACE Senior Care Partners |
$134.61
|
| Rate for Payer: PACE SWMI |
$141.69
|
| Rate for Payer: PHP Commercial |
$481.75
|
| Rate for Payer: PHP Medicare Advantage |
$141.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$493.09
|
| Rate for Payer: Priority Health Medicare |
$143.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$394.47
|
| Rate for Payer: Railroad Medicare Medicare |
$141.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$498.76
|
| Rate for Payer: UHC Core |
$473.25
|
| Rate for Payer: UHC Exchange |
$141.69
|
| Rate for Payer: UHC Medicaid |
$99.92
|
| Rate for Payer: UHC Medicare Advantage |
$141.69
|
| Rate for Payer: UHCCP Medicaid |
$99.92
|
| Rate for Payer: VA VA |
$141.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$425.08
|
|
|
HC XR ENDO RETROGRADE CHOLANGIOGR
|
Facility
|
IP
|
$566.77
|
|
|
Service Code
|
CPT 74328
|
| Hospital Charge Code |
32000154
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$394.47 |
| Max. Negotiated Rate |
$510.09 |
| Rate for Payer: Aetna Commercial |
$481.75
|
| Rate for Payer: BCBS Trust/PPO |
$468.10
|
| Rate for Payer: BCN Commercial |
$468.10
|
| Rate for Payer: Cash Price |
$453.42
|
| Rate for Payer: Cofinity Commercial |
$487.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$453.42
|
| Rate for Payer: Healthscope Commercial |
$510.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$425.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$481.75
|
| Rate for Payer: Nomi Health Commercial |
$464.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$425.08
|
| Rate for Payer: PHP Commercial |
$481.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$493.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$394.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$498.76
|
| Rate for Payer: UHC Core |
$473.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$425.08
|
|
|
HC XR ESOPHAGEAL DILATION
|
Facility
|
OP
|
$268.31
|
|
|
Service Code
|
CPT 74360
|
| Hospital Charge Code |
32000297
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$47.30 |
| Max. Negotiated Rate |
$241.48 |
| Rate for Payer: Aetna Commercial |
$228.06
|
| Rate for Payer: Aetna Medicare |
$69.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$83.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$83.85
|
| Rate for Payer: BCBS Complete |
$49.66
|
| Rate for Payer: BCBS MAPPO |
$67.08
|
| Rate for Payer: BCBS Trust/PPO |
$220.58
|
| Rate for Payer: BCN Commercial |
$220.58
|
| Rate for Payer: BCN Medicare Advantage |
$67.08
|
| Rate for Payer: Cash Price |
$214.65
|
| Rate for Payer: Cofinity Commercial |
$230.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.08
|
| Rate for Payer: Healthscope Commercial |
$241.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.23
|
| Rate for Payer: Mclaren Medicaid |
$47.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.43
|
| Rate for Payer: Meridian Medicaid |
$49.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$73.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.06
|
| Rate for Payer: Nomi Health Commercial |
$220.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.23
|
| Rate for Payer: PACE Senior Care Partners |
$63.72
|
| Rate for Payer: PACE SWMI |
$67.08
|
| Rate for Payer: PHP Commercial |
$228.06
|
| Rate for Payer: PHP Medicare Advantage |
$67.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$233.43
|
| Rate for Payer: Priority Health Medicare |
$67.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.74
|
| Rate for Payer: Railroad Medicare Medicare |
$67.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.11
|
| Rate for Payer: UHC Core |
$224.04
|
| Rate for Payer: UHC Exchange |
$67.08
|
| Rate for Payer: UHC Medicaid |
$47.30
|
| Rate for Payer: UHC Medicare Advantage |
$67.08
|
| Rate for Payer: UHCCP Medicaid |
$47.30
|
| Rate for Payer: VA VA |
$67.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.23
|
|
|
HC XR ESOPHAGEAL DILATION
|
Facility
|
IP
|
$268.31
|
|
|
Service Code
|
CPT 74360
|
| Hospital Charge Code |
32000297
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$186.74 |
| Max. Negotiated Rate |
$241.48 |
| Rate for Payer: Aetna Commercial |
$228.06
|
| Rate for Payer: BCBS Trust/PPO |
$221.60
|
| Rate for Payer: BCN Commercial |
$221.60
|
| Rate for Payer: Cash Price |
$214.65
|
| Rate for Payer: Cofinity Commercial |
$230.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.65
|
| Rate for Payer: Healthscope Commercial |
$241.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.06
|
| Rate for Payer: Nomi Health Commercial |
$220.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.23
|
| Rate for Payer: PHP Commercial |
$228.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$233.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.11
|
| Rate for Payer: UHC Core |
$224.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.23
|
|
|
HC XR ESOPHAGUS
|
Facility
|
OP
|
$655.74
|
|
|
Service Code
|
CPT 74220
|
| Hospital Charge Code |
32000136
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$115.61 |
| Max. Negotiated Rate |
$590.17 |
| Rate for Payer: Aetna Commercial |
$557.38
|
| Rate for Payer: Aetna Medicare |
$170.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.92
|
| Rate for Payer: BCBS Complete |
$121.38
|
| Rate for Payer: BCBS MAPPO |
$163.94
|
| Rate for Payer: BCBS Trust/PPO |
$539.08
|
| Rate for Payer: BCN Commercial |
$539.08
|
| Rate for Payer: BCN Medicare Advantage |
$163.94
|
| Rate for Payer: Cash Price |
$524.59
|
| Rate for Payer: Cofinity Commercial |
$563.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.94
|
| Rate for Payer: Healthscope Commercial |
$590.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$491.81
|
| Rate for Payer: Mclaren Medicaid |
$115.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.13
|
| Rate for Payer: Meridian Medicaid |
$121.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$188.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$180.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557.38
|
| Rate for Payer: Nomi Health Commercial |
$537.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$491.81
|
| Rate for Payer: PACE Senior Care Partners |
$155.74
|
| Rate for Payer: PACE SWMI |
$163.94
|
| Rate for Payer: PHP Commercial |
$557.38
|
| Rate for Payer: PHP Medicare Advantage |
$163.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$570.49
|
| Rate for Payer: Priority Health Medicare |
$165.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$456.40
|
| Rate for Payer: Railroad Medicare Medicare |
$163.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$577.05
|
| Rate for Payer: UHC Core |
$547.54
|
| Rate for Payer: UHC Exchange |
$163.94
|
| Rate for Payer: UHC Medicaid |
$115.61
|
| Rate for Payer: UHC Medicare Advantage |
$163.94
|
| Rate for Payer: UHCCP Medicaid |
$115.61
|
| Rate for Payer: VA VA |
$163.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$491.81
|
|
|
HC XR ESOPHAGUS
|
Facility
|
IP
|
$655.74
|
|
|
Service Code
|
CPT 74220
|
| Hospital Charge Code |
32000136
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$456.40 |
| Max. Negotiated Rate |
$590.17 |
| Rate for Payer: Aetna Commercial |
$557.38
|
| Rate for Payer: BCBS Trust/PPO |
$541.58
|
| Rate for Payer: BCN Commercial |
$541.58
|
| Rate for Payer: Cash Price |
$524.59
|
| Rate for Payer: Cofinity Commercial |
$563.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.59
|
| Rate for Payer: Healthscope Commercial |
$590.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$491.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557.38
|
| Rate for Payer: Nomi Health Commercial |
$537.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$491.81
|
| Rate for Payer: PHP Commercial |
$557.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$570.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$456.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$577.05
|
| Rate for Payer: UHC Core |
$547.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$491.81
|
|
|
HC XR ESOPHAGUS FB
|
Facility
|
IP
|
$500.82
|
|
|
Service Code
|
HCPCS 74235
|
| Hospital Charge Code |
32000296
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$348.57 |
| Max. Negotiated Rate |
$450.74 |
| Rate for Payer: Aetna Commercial |
$425.70
|
| Rate for Payer: BCBS Trust/PPO |
$413.63
|
| Rate for Payer: BCN Commercial |
$413.63
|
| Rate for Payer: Cash Price |
$400.66
|
| Rate for Payer: Cofinity Commercial |
$430.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.66
|
| Rate for Payer: Healthscope Commercial |
$450.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.70
|
| Rate for Payer: Nomi Health Commercial |
$410.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.62
|
| Rate for Payer: PHP Commercial |
$425.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$435.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.72
|
| Rate for Payer: UHC Core |
$418.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.62
|
|
|
HC XR ESOPHAGUS FB
|
Facility
|
OP
|
$500.82
|
|
|
Service Code
|
HCPCS 74235
|
| Hospital Charge Code |
32000296
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$88.29 |
| Max. Negotiated Rate |
$450.74 |
| Rate for Payer: Aetna Commercial |
$425.70
|
| Rate for Payer: Aetna Medicare |
$130.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$156.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$156.51
|
| Rate for Payer: BCBS Complete |
$92.70
|
| Rate for Payer: BCBS MAPPO |
$125.20
|
| Rate for Payer: BCBS Trust/PPO |
$411.72
|
| Rate for Payer: BCN Commercial |
$411.72
|
| Rate for Payer: BCN Medicare Advantage |
$125.20
|
| Rate for Payer: Cash Price |
$400.66
|
| Rate for Payer: Cofinity Commercial |
$430.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.20
|
| Rate for Payer: Healthscope Commercial |
$450.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.62
|
| Rate for Payer: Mclaren Medicaid |
$88.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.47
|
| Rate for Payer: Meridian Medicaid |
$92.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$143.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$137.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.70
|
| Rate for Payer: Nomi Health Commercial |
$410.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.62
|
| Rate for Payer: PACE Senior Care Partners |
$118.94
|
| Rate for Payer: PACE SWMI |
$125.20
|
| Rate for Payer: PHP Commercial |
$425.70
|
| Rate for Payer: PHP Medicare Advantage |
$125.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$435.71
|
| Rate for Payer: Priority Health Medicare |
$126.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.57
|
| Rate for Payer: Railroad Medicare Medicare |
$125.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.72
|
| Rate for Payer: UHC Core |
$418.18
|
| Rate for Payer: UHC Exchange |
$125.20
|
| Rate for Payer: UHC Medicaid |
$88.29
|
| Rate for Payer: UHC Medicare Advantage |
$125.20
|
| Rate for Payer: UHCCP Medicaid |
$88.29
|
| Rate for Payer: VA VA |
$125.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.62
|
|
|
HC XR ESOPHAGUS HIGH DENSITY
|
Facility
|
OP
|
$655.74
|
|
|
Service Code
|
CPT 74221
|
| Hospital Charge Code |
32000330
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$115.61 |
| Max. Negotiated Rate |
$590.17 |
| Rate for Payer: Aetna Commercial |
$557.38
|
| Rate for Payer: Aetna Medicare |
$170.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.92
|
| Rate for Payer: BCBS Complete |
$121.38
|
| Rate for Payer: BCBS MAPPO |
$163.94
|
| Rate for Payer: BCBS Trust/PPO |
$539.08
|
| Rate for Payer: BCN Commercial |
$539.08
|
| Rate for Payer: BCN Medicare Advantage |
$163.94
|
| Rate for Payer: Cash Price |
$524.59
|
| Rate for Payer: Cofinity Commercial |
$563.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.94
|
| Rate for Payer: Healthscope Commercial |
$590.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$491.81
|
| Rate for Payer: Mclaren Medicaid |
$115.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.13
|
| Rate for Payer: Meridian Medicaid |
$121.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$188.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$180.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557.38
|
| Rate for Payer: Nomi Health Commercial |
$537.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$491.81
|
| Rate for Payer: PACE Senior Care Partners |
$155.74
|
| Rate for Payer: PACE SWMI |
$163.94
|
| Rate for Payer: PHP Commercial |
$557.38
|
| Rate for Payer: PHP Medicare Advantage |
$163.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$570.49
|
| Rate for Payer: Priority Health Medicare |
$165.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$456.40
|
| Rate for Payer: Railroad Medicare Medicare |
$163.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$577.05
|
| Rate for Payer: UHC Core |
$547.54
|
| Rate for Payer: UHC Exchange |
$163.94
|
| Rate for Payer: UHC Medicaid |
$115.61
|
| Rate for Payer: UHC Medicare Advantage |
$163.94
|
| Rate for Payer: UHCCP Medicaid |
$115.61
|
| Rate for Payer: VA VA |
$163.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$491.81
|
|
|
HC XR ESOPHAGUS HIGH DENSITY
|
Facility
|
IP
|
$655.74
|
|
|
Service Code
|
CPT 74221
|
| Hospital Charge Code |
32000330
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$456.40 |
| Max. Negotiated Rate |
$590.17 |
| Rate for Payer: Aetna Commercial |
$557.38
|
| Rate for Payer: BCBS Trust/PPO |
$541.58
|
| Rate for Payer: BCN Commercial |
$541.58
|
| Rate for Payer: Cash Price |
$524.59
|
| Rate for Payer: Cofinity Commercial |
$563.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.59
|
| Rate for Payer: Healthscope Commercial |
$590.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$491.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557.38
|
| Rate for Payer: Nomi Health Commercial |
$537.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$491.81
|
| Rate for Payer: PHP Commercial |
$557.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$570.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$456.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$577.05
|
| Rate for Payer: UHC Core |
$547.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$491.81
|
|
|
HC XR EYE FOREIGN BODY PRE MRI
|
Facility
|
OP
|
$468.87
|
|
|
Service Code
|
CPT 70030
|
| Hospital Charge Code |
32000305
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$82.66 |
| Max. Negotiated Rate |
$421.98 |
| Rate for Payer: Aetna Commercial |
$398.54
|
| Rate for Payer: Aetna Medicare |
$121.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$146.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$146.52
|
| Rate for Payer: BCBS Complete |
$86.79
|
| Rate for Payer: BCBS MAPPO |
$117.22
|
| Rate for Payer: BCBS Trust/PPO |
$385.46
|
| Rate for Payer: BCN Commercial |
$385.46
|
| Rate for Payer: BCN Medicare Advantage |
$117.22
|
| Rate for Payer: Cash Price |
$375.10
|
| Rate for Payer: Cofinity Commercial |
$403.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.22
|
| Rate for Payer: Healthscope Commercial |
$421.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.65
|
| Rate for Payer: Mclaren Medicaid |
$82.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.08
|
| Rate for Payer: Meridian Medicaid |
$86.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$134.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$128.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.54
|
| Rate for Payer: Nomi Health Commercial |
$384.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.65
|
| Rate for Payer: PACE Senior Care Partners |
$111.36
|
| Rate for Payer: PACE SWMI |
$117.22
|
| Rate for Payer: PHP Commercial |
$398.54
|
| Rate for Payer: PHP Medicare Advantage |
$117.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$407.92
|
| Rate for Payer: Priority Health Medicare |
$118.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$326.33
|
| Rate for Payer: Railroad Medicare Medicare |
$117.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$412.61
|
| Rate for Payer: UHC Core |
$391.51
|
| Rate for Payer: UHC Exchange |
$117.22
|
| Rate for Payer: UHC Medicaid |
$82.66
|
| Rate for Payer: UHC Medicare Advantage |
$117.22
|
| Rate for Payer: UHCCP Medicaid |
$82.66
|
| Rate for Payer: VA VA |
$117.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.65
|
|
|
HC XR EYE FOREIGN BODY PRE MRI
|
Facility
|
IP
|
$468.87
|
|
|
Service Code
|
CPT 70030
|
| Hospital Charge Code |
32000305
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$326.33 |
| Max. Negotiated Rate |
$421.98 |
| Rate for Payer: Aetna Commercial |
$398.54
|
| Rate for Payer: BCBS Trust/PPO |
$387.24
|
| Rate for Payer: BCN Commercial |
$387.24
|
| Rate for Payer: Cash Price |
$375.10
|
| Rate for Payer: Cofinity Commercial |
$403.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.10
|
| Rate for Payer: Healthscope Commercial |
$421.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.54
|
| Rate for Payer: Nomi Health Commercial |
$384.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.65
|
| Rate for Payer: PHP Commercial |
$398.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$407.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$326.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$412.61
|
| Rate for Payer: UHC Core |
$391.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.65
|
|
|
HC XR EYE FOR FOREIGN BODY
|
Facility
|
OP
|
$468.87
|
|
|
Service Code
|
CPT 70030
|
| Hospital Charge Code |
32000004
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$82.66 |
| Max. Negotiated Rate |
$421.98 |
| Rate for Payer: Aetna Commercial |
$398.54
|
| Rate for Payer: Aetna Medicare |
$121.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$146.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$146.52
|
| Rate for Payer: BCBS Complete |
$86.79
|
| Rate for Payer: BCBS MAPPO |
$117.22
|
| Rate for Payer: BCBS Trust/PPO |
$385.46
|
| Rate for Payer: BCN Commercial |
$385.46
|
| Rate for Payer: BCN Medicare Advantage |
$117.22
|
| Rate for Payer: Cash Price |
$375.10
|
| Rate for Payer: Cofinity Commercial |
$403.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.22
|
| Rate for Payer: Healthscope Commercial |
$421.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.65
|
| Rate for Payer: Mclaren Medicaid |
$82.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.08
|
| Rate for Payer: Meridian Medicaid |
$86.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$134.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$128.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.54
|
| Rate for Payer: Nomi Health Commercial |
$384.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.65
|
| Rate for Payer: PACE Senior Care Partners |
$111.36
|
| Rate for Payer: PACE SWMI |
$117.22
|
| Rate for Payer: PHP Commercial |
$398.54
|
| Rate for Payer: PHP Medicare Advantage |
$117.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$407.92
|
| Rate for Payer: Priority Health Medicare |
$118.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$326.33
|
| Rate for Payer: Railroad Medicare Medicare |
$117.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$412.61
|
| Rate for Payer: UHC Core |
$391.51
|
| Rate for Payer: UHC Exchange |
$117.22
|
| Rate for Payer: UHC Medicaid |
$82.66
|
| Rate for Payer: UHC Medicare Advantage |
$117.22
|
| Rate for Payer: UHCCP Medicaid |
$82.66
|
| Rate for Payer: VA VA |
$117.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.65
|
|
|
HC XR EYE FOR FOREIGN BODY
|
Facility
|
IP
|
$468.87
|
|
|
Service Code
|
CPT 70030
|
| Hospital Charge Code |
32000004
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$326.33 |
| Max. Negotiated Rate |
$421.98 |
| Rate for Payer: Aetna Commercial |
$398.54
|
| Rate for Payer: BCBS Trust/PPO |
$387.24
|
| Rate for Payer: BCN Commercial |
$387.24
|
| Rate for Payer: Cash Price |
$375.10
|
| Rate for Payer: Cofinity Commercial |
$403.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.10
|
| Rate for Payer: Healthscope Commercial |
$421.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.54
|
| Rate for Payer: Nomi Health Commercial |
$384.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.65
|
| Rate for Payer: PHP Commercial |
$398.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$407.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$326.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$412.61
|
| Rate for Payer: UHC Core |
$391.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.65
|
|
|
HC XR FACIAL BONES MIN 3 VW
|
Facility
|
OP
|
$353.86
|
|
|
Service Code
|
CPT 70150
|
| Hospital Charge Code |
32000010
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$62.39 |
| Max. Negotiated Rate |
$318.47 |
| Rate for Payer: Aetna Commercial |
$300.78
|
| Rate for Payer: Aetna Medicare |
$92.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$110.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$110.58
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$88.47
|
| Rate for Payer: BCBS Trust/PPO |
$290.91
|
| Rate for Payer: BCN Commercial |
$290.91
|
| Rate for Payer: BCN Medicare Advantage |
$88.47
|
| Rate for Payer: Cash Price |
$283.09
|
| Rate for Payer: Cofinity Commercial |
$304.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.47
|
| Rate for Payer: Healthscope Commercial |
$318.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.39
|
| Rate for Payer: Mclaren Medicaid |
$62.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.89
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$101.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$97.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$300.78
|
| Rate for Payer: Nomi Health Commercial |
$290.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$265.39
|
| Rate for Payer: PACE Senior Care Partners |
$84.04
|
| Rate for Payer: PACE SWMI |
$88.47
|
| Rate for Payer: PHP Commercial |
$300.78
|
| Rate for Payer: PHP Medicare Advantage |
$88.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$307.86
|
| Rate for Payer: Priority Health Medicare |
$89.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$246.29
|
| Rate for Payer: Railroad Medicare Medicare |
$88.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.40
|
| Rate for Payer: UHC Core |
$295.47
|
| Rate for Payer: UHC Exchange |
$88.47
|
| Rate for Payer: UHC Medicaid |
$62.39
|
| Rate for Payer: UHC Medicare Advantage |
$88.47
|
| Rate for Payer: UHCCP Medicaid |
$62.39
|
| Rate for Payer: VA VA |
$88.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.39
|
|
|
HC XR FACIAL BONES MIN 3 VW
|
Facility
|
IP
|
$353.86
|
|
|
Service Code
|
CPT 70150
|
| Hospital Charge Code |
32000010
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$246.29 |
| Max. Negotiated Rate |
$318.47 |
| Rate for Payer: Aetna Commercial |
$300.78
|
| Rate for Payer: BCBS Trust/PPO |
$292.25
|
| Rate for Payer: BCN Commercial |
$292.25
|
| Rate for Payer: Cash Price |
$283.09
|
| Rate for Payer: Cofinity Commercial |
$304.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.09
|
| Rate for Payer: Healthscope Commercial |
$318.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$300.78
|
| Rate for Payer: Nomi Health Commercial |
$290.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$265.39
|
| Rate for Payer: PHP Commercial |
$300.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$307.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$246.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.40
|
| Rate for Payer: UHC Core |
$295.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.39
|
|
|
HC XR FEMUR 1 VIEW BILATERAL
|
Facility
|
OP
|
$254.90
|
|
|
Service Code
|
CPT 73551
|
| Hospital Charge Code |
32000341
|
|
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 FEMUR 1 VIEW BILATERAL
|
Facility
|
IP
|
$254.90
|
|
|
Service Code
|
CPT 73551
|
| Hospital Charge Code |
32000341
|
|
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 FEMUR 2 VIEWS BILATERAL
|
Facility
|
IP
|
$254.90
|
|
|
Service Code
|
CPT 73552
|
| Hospital Charge Code |
32000336
|
|
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
|
|
