|
HC XR FEMUR 2 VIEWS BILATERAL
|
Facility
|
OP
|
$254.90
|
|
|
Service Code
|
CPT 73552
|
| Hospital Charge Code |
32000336
|
|
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 FINGERS BIL MIN 2 VW
|
Facility
|
OP
|
$228.33
|
|
|
Service Code
|
CPT 73140
|
| Hospital Charge Code |
32000090
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$40.25 |
| Max. Negotiated Rate |
$205.50 |
| Rate for Payer: Aetna Commercial |
$194.08
|
| Rate for Payer: Aetna Medicare |
$59.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71.35
|
| Rate for Payer: BCBS Complete |
$42.26
|
| Rate for Payer: BCBS MAPPO |
$57.08
|
| Rate for Payer: BCBS Trust/PPO |
$187.71
|
| Rate for Payer: BCN Commercial |
$187.71
|
| Rate for Payer: BCN Medicare Advantage |
$57.08
|
| Rate for Payer: Cash Price |
$182.66
|
| Rate for Payer: Cofinity Commercial |
$196.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.08
|
| Rate for Payer: Healthscope Commercial |
$205.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.25
|
| Rate for Payer: Mclaren Medicaid |
$40.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.94
|
| Rate for Payer: Meridian Medicaid |
$42.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$62.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.08
|
| Rate for Payer: Nomi Health Commercial |
$187.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$171.25
|
| Rate for Payer: PACE Senior Care Partners |
$54.23
|
| Rate for Payer: PACE SWMI |
$57.08
|
| Rate for Payer: PHP Commercial |
$194.08
|
| Rate for Payer: PHP Medicare Advantage |
$57.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$198.65
|
| Rate for Payer: Priority Health Medicare |
$57.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.92
|
| Rate for Payer: Railroad Medicare Medicare |
$57.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$200.93
|
| Rate for Payer: UHC Core |
$190.66
|
| Rate for Payer: UHC Exchange |
$57.08
|
| Rate for Payer: UHC Medicaid |
$40.25
|
| Rate for Payer: UHC Medicare Advantage |
$57.08
|
| Rate for Payer: UHCCP Medicaid |
$40.25
|
| Rate for Payer: VA VA |
$57.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.25
|
|
|
HC XR FINGERS BIL MIN 2 VW
|
Facility
|
IP
|
$228.33
|
|
|
Service Code
|
CPT 73140
|
| Hospital Charge Code |
32000090
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$158.92 |
| Max. Negotiated Rate |
$205.50 |
| Rate for Payer: Aetna Commercial |
$194.08
|
| Rate for Payer: BCBS Trust/PPO |
$188.58
|
| Rate for Payer: BCN Commercial |
$188.58
|
| Rate for Payer: Cash Price |
$182.66
|
| Rate for Payer: Cofinity Commercial |
$196.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.66
|
| Rate for Payer: Healthscope Commercial |
$205.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.08
|
| Rate for Payer: Nomi Health Commercial |
$187.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$171.25
|
| Rate for Payer: PHP Commercial |
$194.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$198.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$200.93
|
| Rate for Payer: UHC Core |
$190.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.25
|
|
|
HC XR FINGERS MIN 2 VW
|
Facility
|
IP
|
$197.92
|
|
|
Service Code
|
CPT 73140
|
| Hospital Charge Code |
32000089
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$137.75 |
| Max. Negotiated Rate |
$178.13 |
| Rate for Payer: Aetna Commercial |
$168.23
|
| Rate for Payer: BCBS Trust/PPO |
$163.46
|
| Rate for Payer: BCN Commercial |
$163.46
|
| Rate for Payer: Cash Price |
$158.34
|
| Rate for Payer: Cofinity Commercial |
$170.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.34
|
| Rate for Payer: Healthscope Commercial |
$178.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.23
|
| Rate for Payer: Nomi Health Commercial |
$162.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.44
|
| Rate for Payer: PHP Commercial |
$168.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$172.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.17
|
| Rate for Payer: UHC Core |
$165.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.44
|
|
|
HC XR FINGERS MIN 2 VW
|
Facility
|
OP
|
$197.92
|
|
|
Service Code
|
CPT 73140
|
| Hospital Charge Code |
32000089
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$34.89 |
| Max. Negotiated Rate |
$178.13 |
| Rate for Payer: Aetna Commercial |
$168.23
|
| Rate for Payer: Aetna Medicare |
$51.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.85
|
| Rate for Payer: BCBS Complete |
$36.63
|
| Rate for Payer: BCBS MAPPO |
$49.48
|
| Rate for Payer: BCBS Trust/PPO |
$162.71
|
| Rate for Payer: BCN Commercial |
$162.71
|
| Rate for Payer: BCN Medicare Advantage |
$49.48
|
| Rate for Payer: Cash Price |
$158.34
|
| Rate for Payer: Cofinity Commercial |
$170.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.48
|
| Rate for Payer: Healthscope Commercial |
$178.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.44
|
| Rate for Payer: Mclaren Medicaid |
$34.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.95
|
| Rate for Payer: Meridian Medicaid |
$36.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.23
|
| Rate for Payer: Nomi Health Commercial |
$162.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.44
|
| Rate for Payer: PACE Senior Care Partners |
$47.01
|
| Rate for Payer: PACE SWMI |
$49.48
|
| Rate for Payer: PHP Commercial |
$168.23
|
| Rate for Payer: PHP Medicare Advantage |
$49.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$172.19
|
| Rate for Payer: Priority Health Medicare |
$49.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.75
|
| Rate for Payer: Railroad Medicare Medicare |
$49.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.17
|
| Rate for Payer: UHC Core |
$165.26
|
| Rate for Payer: UHC Exchange |
$49.48
|
| Rate for Payer: UHC Medicaid |
$34.89
|
| Rate for Payer: UHC Medicare Advantage |
$49.48
|
| Rate for Payer: UHCCP Medicaid |
$34.89
|
| Rate for Payer: VA VA |
$49.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.44
|
|
|
HC XR FLUOROSCOPIC GUIDANCE
|
Facility
|
IP
|
$333.05
|
|
|
Service Code
|
CPT 77002
|
| Hospital Charge Code |
32000246
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$231.80 |
| Max. Negotiated Rate |
$299.75 |
| Rate for Payer: Aetna Commercial |
$283.09
|
| Rate for Payer: BCBS Trust/PPO |
$275.07
|
| Rate for Payer: BCN Commercial |
$275.07
|
| Rate for Payer: Cash Price |
$266.44
|
| Rate for Payer: Cofinity Commercial |
$286.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.44
|
| Rate for Payer: Healthscope Commercial |
$299.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$249.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.09
|
| Rate for Payer: Nomi Health Commercial |
$273.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$249.79
|
| Rate for Payer: PHP Commercial |
$283.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$289.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$231.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$293.08
|
| Rate for Payer: UHC Core |
$278.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$249.79
|
|
|
HC XR FLUOROSCOPIC GUIDANCE
|
Facility
|
OP
|
$333.05
|
|
|
Service Code
|
CPT 77002
|
| Hospital Charge Code |
32000246
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$58.72 |
| Max. Negotiated Rate |
$299.75 |
| Rate for Payer: Aetna Commercial |
$283.09
|
| Rate for Payer: Aetna Medicare |
$86.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$104.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$104.08
|
| Rate for Payer: BCBS Complete |
$61.65
|
| Rate for Payer: BCBS MAPPO |
$83.26
|
| Rate for Payer: BCBS Trust/PPO |
$273.80
|
| Rate for Payer: BCN Commercial |
$273.80
|
| Rate for Payer: BCN Medicare Advantage |
$83.26
|
| Rate for Payer: Cash Price |
$266.44
|
| Rate for Payer: Cofinity Commercial |
$286.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.26
|
| Rate for Payer: Healthscope Commercial |
$299.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$249.79
|
| Rate for Payer: Mclaren Medicaid |
$58.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.43
|
| Rate for Payer: Meridian Medicaid |
$61.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$91.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.09
|
| Rate for Payer: Nomi Health Commercial |
$273.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$249.79
|
| Rate for Payer: PACE Senior Care Partners |
$79.10
|
| Rate for Payer: PACE SWMI |
$83.26
|
| Rate for Payer: PHP Commercial |
$283.09
|
| Rate for Payer: PHP Medicare Advantage |
$83.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$289.75
|
| Rate for Payer: Priority Health Medicare |
$84.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$231.80
|
| Rate for Payer: Railroad Medicare Medicare |
$83.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$293.08
|
| Rate for Payer: UHC Core |
$278.10
|
| Rate for Payer: UHC Exchange |
$83.26
|
| Rate for Payer: UHC Medicaid |
$58.72
|
| Rate for Payer: UHC Medicare Advantage |
$83.26
|
| Rate for Payer: UHCCP Medicaid |
$58.72
|
| Rate for Payer: VA VA |
$83.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$249.79
|
|
|
HC XR FOOT 1 VW
|
Facility
|
OP
|
$297.68
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000125
|
|
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 FOOT 1 VW
|
Facility
|
IP
|
$297.68
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000125
|
|
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 FOOT 2 VIEWS
|
Facility
|
OP
|
$260.57
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000123
|
|
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 FOOT 2 VIEWS
|
Facility
|
IP
|
$260.57
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000123
|
|
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 FOOT 2 VIEWS BILATERAL
|
Facility
|
IP
|
$254.90
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000340
|
|
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 FOOT 2 VIEWS BILATERAL
|
Facility
|
OP
|
$254.90
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000340
|
|
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 FOOT 3 VIEWS
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 73630
|
| Hospital Charge Code |
32000126
|
|
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 FOOT 3 VIEWS
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 73630
|
| Hospital Charge Code |
32000126
|
|
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 FOOT BIL 2 VIEWS
|
Facility
|
IP
|
$297.68
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000124
|
|
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 FOOT BIL 2 VIEWS
|
Facility
|
OP
|
$297.68
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000124
|
|
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 FOOT BIL 3 VIEWS
|
Facility
|
OP
|
$396.48
|
|
|
Service Code
|
CPT 73630
|
| Hospital Charge Code |
32000127
|
|
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 FOOT BIL 3 VIEWS
|
Facility
|
IP
|
$396.48
|
|
|
Service Code
|
CPT 73630
|
| Hospital Charge Code |
32000127
|
|
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 FOREARM 2 VW
|
Facility
|
OP
|
$312.56
|
|
|
Service Code
|
CPT 73090
|
| Hospital Charge Code |
32000076
|
|
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 FOREARM 2 VW
|
Facility
|
IP
|
$312.56
|
|
|
Service Code
|
CPT 73090
|
| Hospital Charge Code |
32000076
|
|
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 FOREARM BIL 2 VW
|
Facility
|
IP
|
$347.15
|
|
|
Service Code
|
CPT 73090
|
| Hospital Charge Code |
32000077
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$241.62 |
| Max. Negotiated Rate |
$312.44 |
| Rate for Payer: Aetna Commercial |
$295.08
|
| Rate for Payer: BCBS Trust/PPO |
$286.71
|
| Rate for Payer: BCN Commercial |
$286.71
|
| Rate for Payer: Cash Price |
$277.72
|
| Rate for Payer: Cofinity Commercial |
$298.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.72
|
| Rate for Payer: Healthscope Commercial |
$312.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$260.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$295.08
|
| Rate for Payer: Nomi Health Commercial |
$284.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$260.36
|
| Rate for Payer: PHP Commercial |
$295.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$302.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$305.49
|
| Rate for Payer: UHC Core |
$289.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$260.36
|
|
|
HC XR FOREARM BIL 2 VW
|
Facility
|
OP
|
$347.15
|
|
|
Service Code
|
CPT 73090
|
| Hospital Charge Code |
32000077
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$61.20 |
| Max. Negotiated Rate |
$312.44 |
| Rate for Payer: Aetna Commercial |
$295.08
|
| Rate for Payer: Aetna Medicare |
$90.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.48
|
| Rate for Payer: BCBS Complete |
$64.26
|
| Rate for Payer: BCBS MAPPO |
$86.79
|
| Rate for Payer: BCBS Trust/PPO |
$285.39
|
| Rate for Payer: BCN Commercial |
$285.39
|
| Rate for Payer: BCN Medicare Advantage |
$86.79
|
| Rate for Payer: Cash Price |
$277.72
|
| Rate for Payer: Cofinity Commercial |
$298.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.79
|
| Rate for Payer: Healthscope Commercial |
$312.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$260.36
|
| Rate for Payer: Mclaren Medicaid |
$61.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.13
|
| Rate for Payer: Meridian Medicaid |
$64.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$295.08
|
| Rate for Payer: Nomi Health Commercial |
$284.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$260.36
|
| Rate for Payer: PACE Senior Care Partners |
$82.45
|
| Rate for Payer: PACE SWMI |
$86.79
|
| Rate for Payer: PHP Commercial |
$295.08
|
| Rate for Payer: PHP Medicare Advantage |
$86.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$302.02
|
| Rate for Payer: Priority Health Medicare |
$87.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.62
|
| Rate for Payer: Railroad Medicare Medicare |
$86.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$305.49
|
| Rate for Payer: UHC Core |
$289.87
|
| Rate for Payer: UHC Exchange |
$86.79
|
| Rate for Payer: UHC Medicaid |
$61.20
|
| Rate for Payer: UHC Medicare Advantage |
$86.79
|
| Rate for Payer: UHCCP Medicaid |
$61.20
|
| Rate for Payer: VA VA |
$86.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$260.36
|
|
|
HC XR HAND 2 VW
|
Facility
|
IP
|
$312.56
|
|
|
Service Code
|
CPT 73120
|
| Hospital Charge Code |
32000085
|
|
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 HAND 2 VW
|
Facility
|
OP
|
$312.56
|
|
|
Service Code
|
CPT 73120
|
| Hospital Charge Code |
32000085
|
|
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
|
|
