|
HC XR KNEE 3 VIEWS
|
Facility
|
IP
|
$374.92
|
|
|
Service Code
|
CPT 73562
|
| Hospital Charge Code |
32000106
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$260.94 |
| Max. Negotiated Rate |
$337.43 |
| Rate for Payer: Aetna Commercial |
$318.68
|
| Rate for Payer: BCBS Trust/PPO |
$309.65
|
| Rate for Payer: BCN Commercial |
$309.65
|
| 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: Healthscope Commercial |
$337.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.19
|
| 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: PHP Commercial |
$318.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$326.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$329.93
|
| Rate for Payer: UHC Core |
$313.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.19
|
|
|
HC XR KNEE 3 VIEWS BIL
|
Facility
|
IP
|
$495.72
|
|
|
Service Code
|
CPT 73562
|
| Hospital Charge Code |
32000107
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$345.02 |
| Max. Negotiated Rate |
$446.15 |
| Rate for Payer: Aetna Commercial |
$421.36
|
| Rate for Payer: BCBS Trust/PPO |
$409.42
|
| Rate for Payer: BCN Commercial |
$409.42
|
| Rate for Payer: Cash Price |
$396.58
|
| Rate for Payer: Cofinity Commercial |
$426.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.58
|
| Rate for Payer: Healthscope Commercial |
$446.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$421.36
|
| Rate for Payer: Nomi Health Commercial |
$406.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$371.79
|
| Rate for Payer: PHP Commercial |
$421.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$431.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$345.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$436.23
|
| Rate for Payer: UHC Core |
$413.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.79
|
|
|
HC XR KNEE 3 VIEWS BIL
|
Facility
|
OP
|
$495.72
|
|
|
Service Code
|
CPT 73562
|
| Hospital Charge Code |
32000107
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$87.40 |
| Max. Negotiated Rate |
$446.15 |
| Rate for Payer: Aetna Commercial |
$421.36
|
| Rate for Payer: Aetna Medicare |
$128.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$154.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$154.91
|
| Rate for Payer: BCBS Complete |
$91.76
|
| Rate for Payer: BCBS MAPPO |
$123.93
|
| Rate for Payer: BCBS Trust/PPO |
$407.53
|
| Rate for Payer: BCN Commercial |
$407.53
|
| Rate for Payer: BCN Medicare Advantage |
$123.93
|
| Rate for Payer: Cash Price |
$396.58
|
| Rate for Payer: Cofinity Commercial |
$426.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.93
|
| Rate for Payer: Healthscope Commercial |
$446.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.79
|
| Rate for Payer: Mclaren Medicaid |
$87.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.13
|
| Rate for Payer: Meridian Medicaid |
$91.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$142.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$421.36
|
| Rate for Payer: Nomi Health Commercial |
$406.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$371.79
|
| Rate for Payer: PACE Senior Care Partners |
$117.73
|
| Rate for Payer: PACE SWMI |
$123.93
|
| Rate for Payer: PHP Commercial |
$421.36
|
| Rate for Payer: PHP Medicare Advantage |
$123.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$431.28
|
| Rate for Payer: Priority Health Medicare |
$125.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$345.02
|
| Rate for Payer: Railroad Medicare Medicare |
$123.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$436.23
|
| Rate for Payer: UHC Core |
$413.93
|
| Rate for Payer: UHC Exchange |
$123.93
|
| Rate for Payer: UHC Medicaid |
$87.40
|
| Rate for Payer: UHC Medicare Advantage |
$123.93
|
| Rate for Payer: UHCCP Medicaid |
$87.40
|
| Rate for Payer: VA VA |
$123.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.79
|
|
|
HC XR KNEE 4 VIEWS
|
Facility
|
IP
|
$416.36
|
|
|
Service Code
|
CPT 73564
|
| Hospital Charge Code |
32000108
|
|
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 KNEE 4 VIEWS
|
Facility
|
OP
|
$416.36
|
|
|
Service Code
|
CPT 73564
|
| Hospital Charge Code |
32000108
|
|
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 KNEE BIL 1 OR 2 VW
|
Facility
|
OP
|
$347.15
|
|
|
Service Code
|
CPT 73560
|
| Hospital Charge Code |
32000105
|
|
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 KNEE BIL 1 OR 2 VW
|
Facility
|
IP
|
$347.15
|
|
|
Service Code
|
CPT 73560
|
| Hospital Charge Code |
32000105
|
|
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 KNEE BIL 4 VW
|
Facility
|
OP
|
$446.38
|
|
|
Service Code
|
CPT 73564
|
| Hospital Charge Code |
32000109
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$78.70 |
| Max. Negotiated Rate |
$401.74 |
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: Aetna Medicare |
$116.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$139.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$139.49
|
| Rate for Payer: BCBS Complete |
$82.62
|
| Rate for Payer: BCBS MAPPO |
$111.59
|
| Rate for Payer: BCBS Trust/PPO |
$366.97
|
| Rate for Payer: BCN Commercial |
$366.97
|
| Rate for Payer: BCN Medicare Advantage |
$111.59
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.59
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: Mclaren Medicaid |
$78.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.17
|
| Rate for Payer: Meridian Medicaid |
$82.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$122.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$366.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PACE Senior Care Partners |
$106.02
|
| Rate for Payer: PACE SWMI |
$111.59
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: PHP Medicare Advantage |
$111.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$388.35
|
| Rate for Payer: Priority Health Medicare |
$112.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.68
|
| Rate for Payer: Railroad Medicare Medicare |
$111.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.81
|
| Rate for Payer: UHC Core |
$372.73
|
| Rate for Payer: UHC Exchange |
$111.59
|
| Rate for Payer: UHC Medicaid |
$78.70
|
| Rate for Payer: UHC Medicare Advantage |
$111.59
|
| Rate for Payer: UHCCP Medicaid |
$78.70
|
| Rate for Payer: VA VA |
$111.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC XR KNEE BIL 4 VW
|
Facility
|
IP
|
$446.38
|
|
|
Service Code
|
CPT 73564
|
| Hospital Charge Code |
32000109
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$310.68 |
| Max. Negotiated Rate |
$401.74 |
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: BCBS Trust/PPO |
$368.67
|
| Rate for Payer: BCN Commercial |
$368.67
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$366.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$388.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.81
|
| Rate for Payer: UHC Core |
$372.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC XR KNEES STANDING AP
|
Facility
|
IP
|
$416.36
|
|
|
Service Code
|
CPT 73565
|
| Hospital Charge Code |
32000110
|
|
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 KNEES STANDING AP
|
Facility
|
OP
|
$416.36
|
|
|
Service Code
|
CPT 73565
|
| Hospital Charge Code |
32000110
|
|
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 MANDIBLE LESS THAN 4 VW
|
Facility
|
IP
|
$249.89
|
|
|
Service Code
|
CPT 70100
|
| Hospital Charge Code |
32000005
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$173.92 |
| Max. Negotiated Rate |
$224.90 |
| Rate for Payer: Aetna Commercial |
$212.41
|
| Rate for Payer: BCBS Trust/PPO |
$206.38
|
| Rate for Payer: BCN Commercial |
$206.38
|
| Rate for Payer: Cash Price |
$199.91
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$224.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.41
|
| Rate for Payer: Nomi Health Commercial |
$204.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.42
|
| Rate for Payer: PHP Commercial |
$212.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$217.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.90
|
| Rate for Payer: UHC Core |
$208.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.42
|
|
|
HC XR MANDIBLE LESS THAN 4 VW
|
Facility
|
OP
|
$249.89
|
|
|
Service Code
|
CPT 70100
|
| Hospital Charge Code |
32000005
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.06 |
| Max. Negotiated Rate |
$224.90 |
| Rate for Payer: Aetna Commercial |
$212.41
|
| Rate for Payer: Aetna Medicare |
$64.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$78.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$78.09
|
| Rate for Payer: BCBS Complete |
$46.25
|
| Rate for Payer: BCBS MAPPO |
$62.47
|
| Rate for Payer: BCBS Trust/PPO |
$205.43
|
| Rate for Payer: BCN Commercial |
$205.43
|
| Rate for Payer: BCN Medicare Advantage |
$62.47
|
| Rate for Payer: Cash Price |
$199.91
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.47
|
| Rate for Payer: Healthscope Commercial |
$224.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.42
|
| Rate for Payer: Mclaren Medicaid |
$44.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.60
|
| Rate for Payer: Meridian Medicaid |
$46.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.41
|
| Rate for Payer: Nomi Health Commercial |
$204.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.42
|
| Rate for Payer: PACE Senior Care Partners |
$59.35
|
| Rate for Payer: PACE SWMI |
$62.47
|
| Rate for Payer: PHP Commercial |
$212.41
|
| Rate for Payer: PHP Medicare Advantage |
$62.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$217.40
|
| Rate for Payer: Priority Health Medicare |
$63.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.92
|
| Rate for Payer: Railroad Medicare Medicare |
$62.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.90
|
| Rate for Payer: UHC Core |
$208.66
|
| Rate for Payer: UHC Exchange |
$62.47
|
| Rate for Payer: UHC Medicaid |
$44.06
|
| Rate for Payer: UHC Medicare Advantage |
$62.47
|
| Rate for Payer: UHCCP Medicaid |
$44.06
|
| Rate for Payer: VA VA |
$62.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.42
|
|
|
HC XR MANDIBLE MIN 4 VW
|
Facility
|
IP
|
$468.74
|
|
|
Service Code
|
CPT 70110
|
| Hospital Charge Code |
32000006
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$326.24 |
| Max. Negotiated Rate |
$421.87 |
| Rate for Payer: Aetna Commercial |
$398.43
|
| Rate for Payer: BCBS Trust/PPO |
$387.13
|
| Rate for Payer: BCN Commercial |
$387.13
|
| Rate for Payer: Cash Price |
$374.99
|
| Rate for Payer: Cofinity Commercial |
$403.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.99
|
| Rate for Payer: Healthscope Commercial |
$421.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.43
|
| Rate for Payer: Nomi Health Commercial |
$384.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.56
|
| Rate for Payer: PHP Commercial |
$398.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$407.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$326.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$412.49
|
| Rate for Payer: UHC Core |
$391.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.56
|
|
|
HC XR MANDIBLE MIN 4 VW
|
Facility
|
OP
|
$468.74
|
|
|
Service Code
|
CPT 70110
|
| Hospital Charge Code |
32000006
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$82.64 |
| Max. Negotiated Rate |
$421.87 |
| Rate for Payer: Aetna Commercial |
$398.43
|
| Rate for Payer: Aetna Medicare |
$121.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$146.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$146.48
|
| Rate for Payer: BCBS Complete |
$86.76
|
| Rate for Payer: BCBS MAPPO |
$117.19
|
| Rate for Payer: BCBS Trust/PPO |
$385.35
|
| Rate for Payer: BCN Commercial |
$385.35
|
| Rate for Payer: BCN Medicare Advantage |
$117.19
|
| Rate for Payer: Cash Price |
$374.99
|
| Rate for Payer: Cofinity Commercial |
$403.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.19
|
| Rate for Payer: Healthscope Commercial |
$421.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.56
|
| Rate for Payer: Mclaren Medicaid |
$82.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.04
|
| Rate for Payer: Meridian Medicaid |
$86.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$134.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$128.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.43
|
| Rate for Payer: Nomi Health Commercial |
$384.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.56
|
| Rate for Payer: PACE Senior Care Partners |
$111.33
|
| Rate for Payer: PACE SWMI |
$117.19
|
| Rate for Payer: PHP Commercial |
$398.43
|
| Rate for Payer: PHP Medicare Advantage |
$117.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$407.80
|
| Rate for Payer: Priority Health Medicare |
$118.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$326.24
|
| Rate for Payer: Railroad Medicare Medicare |
$117.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$412.49
|
| Rate for Payer: UHC Core |
$391.40
|
| Rate for Payer: UHC Exchange |
$117.19
|
| Rate for Payer: UHC Medicaid |
$82.64
|
| Rate for Payer: UHC Medicare Advantage |
$117.19
|
| Rate for Payer: UHCCP Medicaid |
$82.64
|
| Rate for Payer: VA VA |
$117.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.56
|
|
|
HC XR MASTOIDS 3 VW PER SIDE
|
Facility
|
OP
|
$141.58
|
|
|
Service Code
|
CPT 70130
|
| Hospital Charge Code |
32000008
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$24.96 |
| Max. Negotiated Rate |
$127.42 |
| Rate for Payer: Aetna Commercial |
$120.34
|
| Rate for Payer: Aetna Medicare |
$36.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.24
|
| Rate for Payer: BCBS Complete |
$26.21
|
| Rate for Payer: BCBS MAPPO |
$35.40
|
| Rate for Payer: BCBS Trust/PPO |
$116.39
|
| Rate for Payer: BCN Commercial |
$116.39
|
| Rate for Payer: BCN Medicare Advantage |
$35.40
|
| Rate for Payer: Cash Price |
$113.26
|
| Rate for Payer: Cofinity Commercial |
$121.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.40
|
| Rate for Payer: Healthscope Commercial |
$127.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.19
|
| Rate for Payer: Mclaren Medicaid |
$24.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.16
|
| Rate for Payer: Meridian Medicaid |
$26.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.34
|
| Rate for Payer: Nomi Health Commercial |
$116.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$106.19
|
| Rate for Payer: PACE Senior Care Partners |
$33.63
|
| Rate for Payer: PACE SWMI |
$35.40
|
| Rate for Payer: PHP Commercial |
$120.34
|
| Rate for Payer: PHP Medicare Advantage |
$35.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$123.17
|
| Rate for Payer: Priority Health Medicare |
$35.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$98.54
|
| Rate for Payer: Railroad Medicare Medicare |
$35.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.59
|
| Rate for Payer: UHC Core |
$118.22
|
| Rate for Payer: UHC Exchange |
$35.40
|
| Rate for Payer: UHC Medicaid |
$24.96
|
| Rate for Payer: UHC Medicare Advantage |
$35.40
|
| Rate for Payer: UHCCP Medicaid |
$24.96
|
| Rate for Payer: VA VA |
$35.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.19
|
|
|
HC XR MASTOIDS 3 VW PER SIDE
|
Facility
|
IP
|
$141.58
|
|
|
Service Code
|
CPT 70130
|
| Hospital Charge Code |
32000008
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$98.54 |
| Max. Negotiated Rate |
$127.42 |
| Rate for Payer: Aetna Commercial |
$120.34
|
| Rate for Payer: BCBS Trust/PPO |
$116.93
|
| Rate for Payer: BCN Commercial |
$116.93
|
| Rate for Payer: Cash Price |
$113.26
|
| Rate for Payer: Cofinity Commercial |
$121.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.26
|
| Rate for Payer: Healthscope Commercial |
$127.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.34
|
| Rate for Payer: Nomi Health Commercial |
$116.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$106.19
|
| Rate for Payer: PHP Commercial |
$120.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$123.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$98.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.59
|
| Rate for Payer: UHC Core |
$118.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.19
|
|
|
HC XR MASTOIDS LESS THAN 3 VW
|
Facility
|
IP
|
$113.83
|
|
|
Service Code
|
CPT 70120
|
| Hospital Charge Code |
32000007
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$79.23 |
| Max. Negotiated Rate |
$102.45 |
| Rate for Payer: Aetna Commercial |
$96.76
|
| Rate for Payer: BCBS Trust/PPO |
$94.01
|
| Rate for Payer: BCN Commercial |
$94.01
|
| Rate for Payer: Cash Price |
$91.06
|
| Rate for Payer: Cofinity Commercial |
$97.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.06
|
| Rate for Payer: Healthscope Commercial |
$102.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.76
|
| Rate for Payer: Nomi Health Commercial |
$93.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.37
|
| Rate for Payer: PHP Commercial |
$96.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$99.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.17
|
| Rate for Payer: UHC Core |
$95.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.37
|
|
|
HC XR MASTOIDS LESS THAN 3 VW
|
Facility
|
OP
|
$113.83
|
|
|
Service Code
|
CPT 70120
|
| Hospital Charge Code |
32000007
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$20.07 |
| Max. Negotiated Rate |
$102.45 |
| Rate for Payer: Aetna Commercial |
$96.76
|
| Rate for Payer: Aetna Medicare |
$29.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.57
|
| Rate for Payer: BCBS Complete |
$21.07
|
| Rate for Payer: BCBS MAPPO |
$28.46
|
| Rate for Payer: BCBS Trust/PPO |
$93.58
|
| Rate for Payer: BCN Commercial |
$93.58
|
| Rate for Payer: BCN Medicare Advantage |
$28.46
|
| Rate for Payer: Cash Price |
$91.06
|
| Rate for Payer: Cofinity Commercial |
$97.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.46
|
| Rate for Payer: Healthscope Commercial |
$102.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.37
|
| Rate for Payer: Mclaren Medicaid |
$20.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.88
|
| Rate for Payer: Meridian Medicaid |
$21.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.76
|
| Rate for Payer: Nomi Health Commercial |
$93.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.37
|
| Rate for Payer: PACE Senior Care Partners |
$27.03
|
| Rate for Payer: PACE SWMI |
$28.46
|
| Rate for Payer: PHP Commercial |
$96.76
|
| Rate for Payer: PHP Medicare Advantage |
$28.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$99.03
|
| Rate for Payer: Priority Health Medicare |
$28.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.23
|
| Rate for Payer: Railroad Medicare Medicare |
$28.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.17
|
| Rate for Payer: UHC Core |
$95.05
|
| Rate for Payer: UHC Exchange |
$28.46
|
| Rate for Payer: UHC Medicaid |
$20.07
|
| Rate for Payer: UHC Medicare Advantage |
$28.46
|
| Rate for Payer: UHCCP Medicaid |
$20.07
|
| Rate for Payer: VA VA |
$28.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.37
|
|
|
HC XR MED EXAM REVIEW
|
Facility
|
IP
|
$606.79
|
|
| Hospital Charge Code |
32000265
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$422.33 |
| Max. Negotiated Rate |
$546.11 |
| Rate for Payer: Aetna Commercial |
$515.77
|
| Rate for Payer: BCBS Trust/PPO |
$501.15
|
| Rate for Payer: BCN Commercial |
$501.15
|
| Rate for Payer: Cash Price |
$485.43
|
| Rate for Payer: Cofinity Commercial |
$521.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$485.43
|
| Rate for Payer: Healthscope Commercial |
$546.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$455.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$515.77
|
| Rate for Payer: Nomi Health Commercial |
$497.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$455.09
|
| Rate for Payer: PHP Commercial |
$515.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$527.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$422.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$533.98
|
| Rate for Payer: UHC Core |
$506.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$455.09
|
|
|
HC XR MED EXAM REVIEW
|
Facility
|
OP
|
$606.79
|
|
| Hospital Charge Code |
32000265
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$106.98 |
| Max. Negotiated Rate |
$546.11 |
| Rate for Payer: Aetna Commercial |
$515.77
|
| Rate for Payer: Aetna Medicare |
$157.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$189.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$189.62
|
| Rate for Payer: BCBS Complete |
$112.32
|
| Rate for Payer: BCBS MAPPO |
$151.70
|
| Rate for Payer: BCBS Trust/PPO |
$498.84
|
| Rate for Payer: BCN Commercial |
$498.84
|
| Rate for Payer: BCN Medicare Advantage |
$151.70
|
| Rate for Payer: Cash Price |
$485.43
|
| Rate for Payer: Cofinity Commercial |
$521.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$485.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.70
|
| Rate for Payer: Healthscope Commercial |
$546.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$455.09
|
| Rate for Payer: Mclaren Medicaid |
$106.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$159.28
|
| Rate for Payer: Meridian Medicaid |
$112.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$166.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$515.77
|
| Rate for Payer: Nomi Health Commercial |
$497.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$455.09
|
| Rate for Payer: PACE Senior Care Partners |
$144.11
|
| Rate for Payer: PACE SWMI |
$151.70
|
| Rate for Payer: PHP Commercial |
$515.77
|
| Rate for Payer: PHP Medicare Advantage |
$151.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$527.91
|
| Rate for Payer: Priority Health Medicare |
$153.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$422.33
|
| Rate for Payer: Railroad Medicare Medicare |
$151.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$533.98
|
| Rate for Payer: UHC Core |
$506.67
|
| Rate for Payer: UHC Exchange |
$151.70
|
| Rate for Payer: UHC Medicaid |
$106.98
|
| Rate for Payer: UHC Medicare Advantage |
$151.70
|
| Rate for Payer: UHCCP Medicaid |
$106.98
|
| Rate for Payer: VA VA |
$151.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$455.09
|
|
|
HC XR MYELOGRAM CERVICAL
|
Facility
|
IP
|
$1,031.84
|
|
|
Service Code
|
CPT 72240
|
| Hospital Charge Code |
32000053
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$718.16 |
| Max. Negotiated Rate |
$928.66 |
| Rate for Payer: Aetna Commercial |
$877.06
|
| Rate for Payer: BCBS Trust/PPO |
$852.20
|
| Rate for Payer: BCN Commercial |
$852.20
|
| Rate for Payer: Cash Price |
$825.47
|
| Rate for Payer: Cofinity Commercial |
$887.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.47
|
| Rate for Payer: Healthscope Commercial |
$928.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$773.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$877.06
|
| Rate for Payer: Nomi Health Commercial |
$846.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$773.88
|
| Rate for Payer: PHP Commercial |
$877.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$897.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$718.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$908.02
|
| Rate for Payer: UHC Core |
$861.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$773.88
|
|
|
HC XR MYELOGRAM CERVICAL
|
Facility
|
OP
|
$1,031.84
|
|
|
Service Code
|
CPT 72240
|
| Hospital Charge Code |
32000053
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$181.91 |
| Max. Negotiated Rate |
$928.66 |
| Rate for Payer: Aetna Commercial |
$877.06
|
| Rate for Payer: Aetna Medicare |
$268.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$322.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$322.45
|
| Rate for Payer: BCBS Complete |
$190.99
|
| Rate for Payer: BCBS MAPPO |
$257.96
|
| Rate for Payer: BCBS Trust/PPO |
$848.28
|
| Rate for Payer: BCN Commercial |
$848.28
|
| Rate for Payer: BCN Medicare Advantage |
$257.96
|
| Rate for Payer: Cash Price |
$825.47
|
| Rate for Payer: Cofinity Commercial |
$887.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.96
|
| Rate for Payer: Healthscope Commercial |
$928.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$773.88
|
| Rate for Payer: Mclaren Medicaid |
$181.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.86
|
| Rate for Payer: Meridian Medicaid |
$190.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$296.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$283.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$877.06
|
| Rate for Payer: Nomi Health Commercial |
$846.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$773.88
|
| Rate for Payer: PACE Senior Care Partners |
$245.06
|
| Rate for Payer: PACE SWMI |
$257.96
|
| Rate for Payer: PHP Commercial |
$877.06
|
| Rate for Payer: PHP Medicare Advantage |
$257.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$897.70
|
| Rate for Payer: Priority Health Medicare |
$260.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$718.16
|
| Rate for Payer: Railroad Medicare Medicare |
$257.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$908.02
|
| Rate for Payer: UHC Core |
$861.59
|
| Rate for Payer: UHC Exchange |
$257.96
|
| Rate for Payer: UHC Medicaid |
$181.91
|
| Rate for Payer: UHC Medicare Advantage |
$257.96
|
| Rate for Payer: UHCCP Medicaid |
$181.91
|
| Rate for Payer: VA VA |
$257.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$773.88
|
|
|
HC XR NASAL FACIAL BONES LESS THAN 3 VW
|
Facility
|
OP
|
$138.70
|
|
|
Service Code
|
CPT 70140
|
| Hospital Charge Code |
32000009
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$24.45 |
| Max. Negotiated Rate |
$124.83 |
| Rate for Payer: Aetna Commercial |
$117.89
|
| Rate for Payer: Aetna Medicare |
$36.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.34
|
| Rate for Payer: BCBS Complete |
$25.67
|
| Rate for Payer: BCBS MAPPO |
$34.67
|
| Rate for Payer: BCBS Trust/PPO |
$114.03
|
| Rate for Payer: BCN Commercial |
$114.03
|
| Rate for Payer: BCN Medicare Advantage |
$34.67
|
| Rate for Payer: Cash Price |
$110.96
|
| Rate for Payer: Cofinity Commercial |
$119.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.67
|
| Rate for Payer: Healthscope Commercial |
$124.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$104.03
|
| Rate for Payer: Mclaren Medicaid |
$24.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.41
|
| Rate for Payer: Meridian Medicaid |
$25.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.89
|
| Rate for Payer: Nomi Health Commercial |
$113.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.03
|
| Rate for Payer: PACE Senior Care Partners |
$32.94
|
| Rate for Payer: PACE SWMI |
$34.67
|
| Rate for Payer: PHP Commercial |
$117.89
|
| Rate for Payer: PHP Medicare Advantage |
$34.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$120.67
|
| Rate for Payer: Priority Health Medicare |
$35.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.54
|
| Rate for Payer: Railroad Medicare Medicare |
$34.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.06
|
| Rate for Payer: UHC Core |
$115.81
|
| Rate for Payer: UHC Exchange |
$34.67
|
| Rate for Payer: UHC Medicaid |
$24.45
|
| Rate for Payer: UHC Medicare Advantage |
$34.67
|
| Rate for Payer: UHCCP Medicaid |
$24.45
|
| Rate for Payer: VA VA |
$34.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$104.03
|
|
|
HC XR NASAL FACIAL BONES LESS THAN 3 VW
|
Facility
|
IP
|
$138.70
|
|
|
Service Code
|
CPT 70140
|
| Hospital Charge Code |
32000009
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$96.54 |
| Max. Negotiated Rate |
$124.83 |
| Rate for Payer: Aetna Commercial |
$117.89
|
| Rate for Payer: BCBS Trust/PPO |
$114.55
|
| Rate for Payer: BCN Commercial |
$114.55
|
| Rate for Payer: Cash Price |
$110.96
|
| Rate for Payer: Cofinity Commercial |
$119.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.96
|
| Rate for Payer: Healthscope Commercial |
$124.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$104.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.89
|
| Rate for Payer: Nomi Health Commercial |
$113.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.03
|
| Rate for Payer: PHP Commercial |
$117.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$120.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.06
|
| Rate for Payer: UHC Core |
$115.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$104.03
|
|
