|
HC XR HAND 3 VW
|
Facility
|
IP
|
$416.36
|
|
|
Service Code
|
CPT 73130
|
| Hospital Charge Code |
32000087
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$289.79 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: BCBS Trust/PPO |
$343.87
|
| Rate for Payer: BCN Commercial |
$343.87
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Nomi Health Commercial |
$341.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.40
|
| Rate for Payer: UHC Core |
$347.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.27
|
|
|
HC XR HAND 3 VW
|
Facility
|
OP
|
$416.36
|
|
|
Service Code
|
CPT 73130
|
| Hospital Charge Code |
32000087
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$73.40 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: Aetna Medicare |
$108.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.11
|
| Rate for Payer: BCBS Complete |
$77.07
|
| Rate for Payer: BCBS MAPPO |
$104.09
|
| Rate for Payer: BCBS Trust/PPO |
$342.29
|
| Rate for Payer: BCN Commercial |
$342.29
|
| Rate for Payer: BCN Medicare Advantage |
$104.09
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.09
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.27
|
| Rate for Payer: Mclaren Medicaid |
$73.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.29
|
| Rate for Payer: Meridian Medicaid |
$77.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Nomi Health Commercial |
$341.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PACE Senior Care Partners |
$98.89
|
| Rate for Payer: PACE SWMI |
$104.09
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: PHP Medicare Advantage |
$104.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.23
|
| Rate for Payer: Priority Health Medicare |
$105.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.79
|
| Rate for Payer: Railroad Medicare Medicare |
$104.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.40
|
| Rate for Payer: UHC Core |
$347.66
|
| Rate for Payer: UHC Exchange |
$104.09
|
| Rate for Payer: UHC Medicaid |
$73.40
|
| Rate for Payer: UHC Medicare Advantage |
$104.09
|
| Rate for Payer: UHCCP Medicaid |
$73.40
|
| Rate for Payer: VA VA |
$104.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.27
|
|
|
HC XR HANDS BIL 2 VW
|
Facility
|
IP
|
$347.15
|
|
|
Service Code
|
CPT 73120
|
| Hospital Charge Code |
32000086
|
|
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 HANDS BIL 2 VW
|
Facility
|
OP
|
$347.15
|
|
|
Service Code
|
CPT 73120
|
| Hospital Charge Code |
32000086
|
|
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 HANDS BIL 3 VW
|
Facility
|
OP
|
$460.68
|
|
|
Service Code
|
CPT 73130
|
| Hospital Charge Code |
32000088
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$81.22 |
| Max. Negotiated Rate |
$414.61 |
| Rate for Payer: Aetna Commercial |
$391.58
|
| Rate for Payer: Aetna Medicare |
$119.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$143.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$143.96
|
| Rate for Payer: BCBS Complete |
$85.27
|
| Rate for Payer: BCBS MAPPO |
$115.17
|
| Rate for Payer: BCBS Trust/PPO |
$378.73
|
| Rate for Payer: BCN Commercial |
$378.73
|
| Rate for Payer: BCN Medicare Advantage |
$115.17
|
| Rate for Payer: Cash Price |
$368.54
|
| Rate for Payer: Cofinity Commercial |
$396.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.17
|
| Rate for Payer: Healthscope Commercial |
$414.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$345.51
|
| Rate for Payer: Mclaren Medicaid |
$81.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.93
|
| Rate for Payer: Meridian Medicaid |
$85.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$132.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$126.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391.58
|
| Rate for Payer: Nomi Health Commercial |
$377.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.51
|
| Rate for Payer: PACE Senior Care Partners |
$109.41
|
| Rate for Payer: PACE SWMI |
$115.17
|
| Rate for Payer: PHP Commercial |
$391.58
|
| Rate for Payer: PHP Medicare Advantage |
$115.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$400.79
|
| Rate for Payer: Priority Health Medicare |
$116.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$320.63
|
| Rate for Payer: Railroad Medicare Medicare |
$115.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$405.40
|
| Rate for Payer: UHC Core |
$384.67
|
| Rate for Payer: UHC Exchange |
$115.17
|
| Rate for Payer: UHC Medicaid |
$81.22
|
| Rate for Payer: UHC Medicare Advantage |
$115.17
|
| Rate for Payer: UHCCP Medicaid |
$81.22
|
| Rate for Payer: VA VA |
$115.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$345.51
|
|
|
HC XR HANDS BIL 3 VW
|
Facility
|
IP
|
$460.68
|
|
|
Service Code
|
CPT 73130
|
| Hospital Charge Code |
32000088
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$320.63 |
| Max. Negotiated Rate |
$414.61 |
| Rate for Payer: Aetna Commercial |
$391.58
|
| Rate for Payer: BCBS Trust/PPO |
$380.48
|
| Rate for Payer: BCN Commercial |
$380.48
|
| Rate for Payer: Cash Price |
$368.54
|
| Rate for Payer: Cofinity Commercial |
$396.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.54
|
| Rate for Payer: Healthscope Commercial |
$414.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$345.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391.58
|
| Rate for Payer: Nomi Health Commercial |
$377.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.51
|
| Rate for Payer: PHP Commercial |
$391.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$400.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$320.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$405.40
|
| Rate for Payer: UHC Core |
$384.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$345.51
|
|
|
HC XR HUMERUS 2 VW
|
Facility
|
IP
|
$312.56
|
|
|
Service Code
|
CPT 73060
|
| Hospital Charge Code |
32000069
|
|
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 HUMERUS 2 VW
|
Facility
|
OP
|
$312.56
|
|
|
Service Code
|
CPT 73060
|
| Hospital Charge Code |
32000069
|
|
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 HUMERUS BIL 2 VW
|
Facility
|
OP
|
$347.15
|
|
|
Service Code
|
CPT 73060
|
| Hospital Charge Code |
32000070
|
|
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 HUMERUS BIL 2 VW
|
Facility
|
IP
|
$347.15
|
|
|
Service Code
|
CPT 73060
|
| Hospital Charge Code |
32000070
|
|
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 HYSTEROSALPINGOGRAM
|
Facility
|
OP
|
$728.91
|
|
|
Service Code
|
CPT 74740
|
| Hospital Charge Code |
32000174
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$128.51 |
| Max. Negotiated Rate |
$656.02 |
| Rate for Payer: Aetna Commercial |
$619.57
|
| Rate for Payer: Aetna Medicare |
$189.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$227.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$227.78
|
| Rate for Payer: BCBS Complete |
$134.92
|
| Rate for Payer: BCBS MAPPO |
$182.23
|
| Rate for Payer: BCBS Trust/PPO |
$599.24
|
| Rate for Payer: BCN Commercial |
$599.24
|
| Rate for Payer: BCN Medicare Advantage |
$182.23
|
| Rate for Payer: Cash Price |
$583.13
|
| Rate for Payer: Cofinity Commercial |
$626.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$583.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.23
|
| Rate for Payer: Healthscope Commercial |
$656.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.68
|
| Rate for Payer: Mclaren Medicaid |
$128.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.34
|
| Rate for Payer: Meridian Medicaid |
$134.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$209.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$200.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.57
|
| Rate for Payer: Nomi Health Commercial |
$597.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.68
|
| Rate for Payer: PACE Senior Care Partners |
$173.12
|
| Rate for Payer: PACE SWMI |
$182.23
|
| Rate for Payer: PHP Commercial |
$619.57
|
| Rate for Payer: PHP Medicare Advantage |
$182.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$634.15
|
| Rate for Payer: Priority Health Medicare |
$184.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$507.32
|
| Rate for Payer: Railroad Medicare Medicare |
$182.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$641.44
|
| Rate for Payer: UHC Core |
$608.64
|
| Rate for Payer: UHC Exchange |
$182.23
|
| Rate for Payer: UHC Medicaid |
$128.51
|
| Rate for Payer: UHC Medicare Advantage |
$182.23
|
| Rate for Payer: UHCCP Medicaid |
$128.51
|
| Rate for Payer: VA VA |
$182.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.68
|
|
|
HC XR HYSTEROSALPINGOGRAM
|
Facility
|
IP
|
$728.91
|
|
|
Service Code
|
CPT 74740
|
| Hospital Charge Code |
32000174
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$507.32 |
| Max. Negotiated Rate |
$656.02 |
| Rate for Payer: Aetna Commercial |
$619.57
|
| Rate for Payer: BCBS Trust/PPO |
$602.01
|
| Rate for Payer: BCN Commercial |
$602.01
|
| Rate for Payer: Cash Price |
$583.13
|
| Rate for Payer: Cofinity Commercial |
$626.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$583.13
|
| Rate for Payer: Healthscope Commercial |
$656.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.57
|
| Rate for Payer: Nomi Health Commercial |
$597.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.68
|
| Rate for Payer: PHP Commercial |
$619.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$634.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$507.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$641.44
|
| Rate for Payer: UHC Core |
$608.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.68
|
|
|
HC XR INFANT LOWER EXT BIL MIN 2 VW
|
Facility
|
IP
|
$347.15
|
|
|
Service Code
|
CPT 73592
|
| Hospital Charge Code |
32000116
|
|
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 INFANT LOWER EXT BIL MIN 2 VW
|
Facility
|
OP
|
$347.15
|
|
|
Service Code
|
CPT 73592
|
| Hospital Charge Code |
32000116
|
|
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 INFANT LOWER EXT MIN 2 VW
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 73592
|
| Hospital Charge Code |
32000115
|
|
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 INFANT LOWER EXT MIN 2 VW
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 73592
|
| Hospital Charge Code |
32000115
|
|
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 INFANT UPPER EXT
|
Facility
|
IP
|
$312.56
|
|
|
Service Code
|
CPT 73092
|
| Hospital Charge Code |
32000078
|
|
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 INFANT UPPER EXT
|
Facility
|
OP
|
$312.56
|
|
|
Service Code
|
CPT 73092
|
| Hospital Charge Code |
32000078
|
|
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 INFANT UPPER EXT BIL
|
Facility
|
OP
|
$347.15
|
|
|
Service Code
|
CPT 73092
|
| Hospital Charge Code |
32000079
|
|
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 INFANT UPPER EXT BIL
|
Facility
|
IP
|
$347.15
|
|
|
Service Code
|
CPT 73092
|
| Hospital Charge Code |
32000079
|
|
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 JOINT SURVEY 1 VW
|
Facility
|
OP
|
$320.06
|
|
|
Service Code
|
CPT 77077
|
| Hospital Charge Code |
32000259
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$56.43 |
| Max. Negotiated Rate |
$288.05 |
| Rate for Payer: Aetna Commercial |
$272.05
|
| Rate for Payer: Aetna Medicare |
$83.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.02
|
| Rate for Payer: BCBS Complete |
$59.24
|
| Rate for Payer: BCBS MAPPO |
$80.02
|
| Rate for Payer: BCBS Trust/PPO |
$263.12
|
| Rate for Payer: BCN Commercial |
$263.12
|
| Rate for Payer: BCN Medicare Advantage |
$80.02
|
| Rate for Payer: Cash Price |
$256.05
|
| Rate for Payer: Cofinity Commercial |
$275.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.02
|
| Rate for Payer: Healthscope Commercial |
$288.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.04
|
| Rate for Payer: Mclaren Medicaid |
$56.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.02
|
| Rate for Payer: Meridian Medicaid |
$59.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.05
|
| Rate for Payer: Nomi Health Commercial |
$262.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.04
|
| Rate for Payer: PACE Senior Care Partners |
$76.01
|
| Rate for Payer: PACE SWMI |
$80.02
|
| Rate for Payer: PHP Commercial |
$272.05
|
| Rate for Payer: PHP Medicare Advantage |
$80.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$278.45
|
| Rate for Payer: Priority Health Medicare |
$80.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$222.76
|
| Rate for Payer: Railroad Medicare Medicare |
$80.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$281.65
|
| Rate for Payer: UHC Core |
$267.25
|
| Rate for Payer: UHC Exchange |
$80.02
|
| Rate for Payer: UHC Medicaid |
$56.43
|
| Rate for Payer: UHC Medicare Advantage |
$80.02
|
| Rate for Payer: UHCCP Medicaid |
$56.43
|
| Rate for Payer: VA VA |
$80.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.04
|
|
|
HC XR JOINT SURVEY 1 VW
|
Facility
|
IP
|
$320.06
|
|
|
Service Code
|
CPT 77077
|
| Hospital Charge Code |
32000259
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$222.76 |
| Max. Negotiated Rate |
$288.05 |
| Rate for Payer: Aetna Commercial |
$272.05
|
| Rate for Payer: BCBS Trust/PPO |
$264.34
|
| Rate for Payer: BCN Commercial |
$264.34
|
| Rate for Payer: Cash Price |
$256.05
|
| Rate for Payer: Cofinity Commercial |
$275.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.05
|
| Rate for Payer: Healthscope Commercial |
$288.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.05
|
| Rate for Payer: Nomi Health Commercial |
$262.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.04
|
| Rate for Payer: PHP Commercial |
$272.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$278.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$222.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$281.65
|
| Rate for Payer: UHC Core |
$267.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.04
|
|
|
HC XR KNEE 1 OR 2 VW
|
Facility
|
IP
|
$312.56
|
|
|
Service Code
|
CPT 73560
|
| Hospital Charge Code |
32000104
|
|
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 KNEE 1 OR 2 VW
|
Facility
|
OP
|
$312.56
|
|
|
Service Code
|
CPT 73560
|
| Hospital Charge Code |
32000104
|
|
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 KNEE 3 VIEWS
|
Facility
|
OP
|
$374.92
|
|
|
Service Code
|
CPT 73562
|
| Hospital Charge Code |
32000106
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$66.10 |
| Max. Negotiated Rate |
$337.43 |
| Rate for Payer: Aetna Commercial |
$318.68
|
| Rate for Payer: Aetna Medicare |
$97.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$117.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$117.16
|
| Rate for Payer: BCBS Complete |
$69.40
|
| Rate for Payer: BCBS MAPPO |
$93.73
|
| Rate for Payer: BCBS Trust/PPO |
$308.22
|
| Rate for Payer: BCN Commercial |
$308.22
|
| Rate for Payer: BCN Medicare Advantage |
$93.73
|
| Rate for Payer: Cash Price |
$299.94
|
| Rate for Payer: Cofinity Commercial |
$322.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.73
|
| Rate for Payer: Healthscope Commercial |
$337.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.19
|
| Rate for Payer: Mclaren Medicaid |
$66.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.42
|
| Rate for Payer: Meridian Medicaid |
$69.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$103.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.68
|
| Rate for Payer: Nomi Health Commercial |
$307.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$281.19
|
| Rate for Payer: PACE Senior Care Partners |
$89.04
|
| Rate for Payer: PACE SWMI |
$93.73
|
| Rate for Payer: PHP Commercial |
$318.68
|
| Rate for Payer: PHP Medicare Advantage |
$93.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$326.18
|
| Rate for Payer: Priority Health Medicare |
$94.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.94
|
| Rate for Payer: Railroad Medicare Medicare |
$93.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$329.93
|
| Rate for Payer: UHC Core |
$313.06
|
| Rate for Payer: UHC Exchange |
$93.73
|
| Rate for Payer: UHC Medicaid |
$66.10
|
| Rate for Payer: UHC Medicare Advantage |
$93.73
|
| Rate for Payer: UHCCP Medicaid |
$66.10
|
| Rate for Payer: VA VA |
$93.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.19
|
|
