|
HC XR TEETH PARTIAL FULL MOUTH
|
Facility
|
OP
|
$172.67
|
|
|
Service Code
|
CPT 70310
|
| Hospital Charge Code |
32000019
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$30.44 |
| Max. Negotiated Rate |
$155.40 |
| Rate for Payer: Aetna Commercial |
$146.77
|
| Rate for Payer: Aetna Medicare |
$44.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.96
|
| Rate for Payer: BCBS Complete |
$31.96
|
| Rate for Payer: BCBS MAPPO |
$43.17
|
| Rate for Payer: BCBS Trust/PPO |
$141.95
|
| Rate for Payer: BCN Commercial |
$141.95
|
| Rate for Payer: BCN Medicare Advantage |
$43.17
|
| Rate for Payer: Cash Price |
$138.14
|
| Rate for Payer: Cofinity Commercial |
$148.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.17
|
| Rate for Payer: Healthscope Commercial |
$155.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.50
|
| Rate for Payer: Mclaren Medicaid |
$30.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.33
|
| Rate for Payer: Meridian Medicaid |
$31.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146.77
|
| Rate for Payer: Nomi Health Commercial |
$141.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.50
|
| Rate for Payer: PACE Senior Care Partners |
$41.01
|
| Rate for Payer: PACE SWMI |
$43.17
|
| Rate for Payer: PHP Commercial |
$146.77
|
| Rate for Payer: PHP Medicare Advantage |
$43.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$150.22
|
| Rate for Payer: Priority Health Medicare |
$43.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$120.18
|
| Rate for Payer: Railroad Medicare Medicare |
$43.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.95
|
| Rate for Payer: UHC Core |
$144.18
|
| Rate for Payer: UHC Exchange |
$43.17
|
| Rate for Payer: UHC Medicaid |
$30.44
|
| Rate for Payer: UHC Medicare Advantage |
$43.17
|
| Rate for Payer: UHCCP Medicaid |
$30.44
|
| Rate for Payer: VA VA |
$43.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.50
|
|
|
HC XR TEETH PARTIAL FULL MOUTH
|
Facility
|
IP
|
$172.67
|
|
|
Service Code
|
CPT 70310
|
| Hospital Charge Code |
32000019
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$120.18 |
| Max. Negotiated Rate |
$155.40 |
| Rate for Payer: Aetna Commercial |
$146.77
|
| Rate for Payer: BCBS Trust/PPO |
$142.61
|
| Rate for Payer: BCN Commercial |
$142.61
|
| Rate for Payer: Cash Price |
$138.14
|
| Rate for Payer: Cofinity Commercial |
$148.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.14
|
| Rate for Payer: Healthscope Commercial |
$155.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146.77
|
| Rate for Payer: Nomi Health Commercial |
$141.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.50
|
| Rate for Payer: PHP Commercial |
$146.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$150.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$120.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.95
|
| Rate for Payer: UHC Core |
$144.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.50
|
|
|
HC XR TIB FIB 2 VIEWS
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 73590
|
| Hospital Charge Code |
32000112
|
|
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 TIB FIB 2 VIEWS
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 73590
|
| Hospital Charge Code |
32000112
|
|
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 TIB FIB BIL 2 VW
|
Facility
|
OP
|
$396.48
|
|
|
Service Code
|
CPT 73590
|
| Hospital Charge Code |
32000113
|
|
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 TIB FIB BIL 2 VW
|
Facility
|
IP
|
$396.48
|
|
|
Service Code
|
CPT 73590
|
| Hospital Charge Code |
32000113
|
|
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 TMJ COMPLETE BIL
|
Facility
|
IP
|
$416.36
|
|
|
Service Code
|
CPT 70330
|
| Hospital Charge Code |
32000022
|
|
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 TMJ COMPLETE BIL
|
Facility
|
OP
|
$416.36
|
|
|
Service Code
|
CPT 70330
|
| Hospital Charge Code |
32000022
|
|
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 TMJ LTD
|
Facility
|
IP
|
$113.83
|
|
|
Service Code
|
CPT 70328
|
| Hospital Charge Code |
32000021
|
|
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 TMJ LTD
|
Facility
|
OP
|
$113.83
|
|
|
Service Code
|
CPT 70328
|
| Hospital Charge Code |
32000021
|
|
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 TOES BIL MIN 2 VIEWS
|
Facility
|
IP
|
$228.33
|
|
|
Service Code
|
CPT 73660
|
| Hospital Charge Code |
32000131
|
|
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 TOES BIL MIN 2 VIEWS
|
Facility
|
OP
|
$228.33
|
|
|
Service Code
|
CPT 73660
|
| Hospital Charge Code |
32000131
|
|
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 TOES MIN 2 VIEWS
|
Facility
|
OP
|
$197.92
|
|
|
Service Code
|
CPT 73660
|
| Hospital Charge Code |
32000130
|
|
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 TOES MIN 2 VIEWS
|
Facility
|
IP
|
$197.92
|
|
|
Service Code
|
CPT 73660
|
| Hospital Charge Code |
32000130
|
|
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 UGI GASTRO THIN BARM
|
Facility
|
OP
|
$315.25
|
|
|
Service Code
|
CPT 74240
|
| Hospital Charge Code |
32000138
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.58 |
| Max. Negotiated Rate |
$283.73 |
| Rate for Payer: Aetna Commercial |
$267.96
|
| Rate for Payer: Aetna Medicare |
$81.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.52
|
| Rate for Payer: BCBS Complete |
$58.35
|
| Rate for Payer: BCBS MAPPO |
$78.81
|
| Rate for Payer: BCBS Trust/PPO |
$259.17
|
| Rate for Payer: BCN Commercial |
$259.17
|
| Rate for Payer: BCN Medicare Advantage |
$78.81
|
| Rate for Payer: Cash Price |
$252.20
|
| Rate for Payer: Cofinity Commercial |
$271.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.81
|
| Rate for Payer: Healthscope Commercial |
$283.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.44
|
| Rate for Payer: Mclaren Medicaid |
$55.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.75
|
| Rate for Payer: Meridian Medicaid |
$58.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$86.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$267.96
|
| Rate for Payer: Nomi Health Commercial |
$258.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.44
|
| Rate for Payer: PACE Senior Care Partners |
$74.87
|
| Rate for Payer: PACE SWMI |
$78.81
|
| Rate for Payer: PHP Commercial |
$267.96
|
| Rate for Payer: PHP Medicare Advantage |
$78.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$274.27
|
| Rate for Payer: Priority Health Medicare |
$79.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.41
|
| Rate for Payer: Railroad Medicare Medicare |
$78.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$277.42
|
| Rate for Payer: UHC Core |
$263.23
|
| Rate for Payer: UHC Exchange |
$78.81
|
| Rate for Payer: UHC Medicaid |
$55.58
|
| Rate for Payer: UHC Medicare Advantage |
$78.81
|
| Rate for Payer: UHCCP Medicaid |
$55.58
|
| Rate for Payer: VA VA |
$78.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.44
|
|
|
HC XR UGI GASTRO THIN BARM
|
Facility
|
IP
|
$315.25
|
|
|
Service Code
|
CPT 74240
|
| Hospital Charge Code |
32000138
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$219.41 |
| Max. Negotiated Rate |
$283.73 |
| Rate for Payer: Aetna Commercial |
$267.96
|
| Rate for Payer: BCBS Trust/PPO |
$260.36
|
| Rate for Payer: BCN Commercial |
$260.36
|
| Rate for Payer: Cash Price |
$252.20
|
| Rate for Payer: Cofinity Commercial |
$271.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.20
|
| Rate for Payer: Healthscope Commercial |
$283.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$267.96
|
| Rate for Payer: Nomi Health Commercial |
$258.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.44
|
| Rate for Payer: PHP Commercial |
$267.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$274.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$277.42
|
| Rate for Payer: UHC Core |
$263.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.44
|
|
|
HC XR UPPER GI
|
Facility
|
OP
|
$595.21
|
|
|
Service Code
|
CPT 74246
|
| Hospital Charge Code |
32000141
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$104.94 |
| Max. Negotiated Rate |
$535.69 |
| Rate for Payer: Aetna Commercial |
$505.93
|
| Rate for Payer: Aetna Medicare |
$154.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$186.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$186.00
|
| Rate for Payer: BCBS Complete |
$110.17
|
| Rate for Payer: BCBS MAPPO |
$148.80
|
| Rate for Payer: BCBS Trust/PPO |
$489.32
|
| Rate for Payer: BCN Commercial |
$489.32
|
| Rate for Payer: BCN Medicare Advantage |
$148.80
|
| Rate for Payer: Cash Price |
$476.17
|
| Rate for Payer: Cofinity Commercial |
$511.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.80
|
| Rate for Payer: Healthscope Commercial |
$535.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.41
|
| Rate for Payer: Mclaren Medicaid |
$104.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.24
|
| Rate for Payer: Meridian Medicaid |
$110.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$171.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$163.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.93
|
| Rate for Payer: Nomi Health Commercial |
$488.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.41
|
| Rate for Payer: PACE Senior Care Partners |
$141.36
|
| Rate for Payer: PACE SWMI |
$148.80
|
| Rate for Payer: PHP Commercial |
$505.93
|
| Rate for Payer: PHP Medicare Advantage |
$148.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$517.83
|
| Rate for Payer: Priority Health Medicare |
$150.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$414.27
|
| Rate for Payer: Railroad Medicare Medicare |
$148.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$523.78
|
| Rate for Payer: UHC Core |
$497.00
|
| Rate for Payer: UHC Exchange |
$148.80
|
| Rate for Payer: UHC Medicaid |
$104.94
|
| Rate for Payer: UHC Medicare Advantage |
$148.80
|
| Rate for Payer: UHCCP Medicaid |
$104.94
|
| Rate for Payer: VA VA |
$148.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.41
|
|
|
HC XR UPPER GI
|
Facility
|
IP
|
$595.21
|
|
|
Service Code
|
CPT 74246
|
| Hospital Charge Code |
32000141
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$414.27 |
| Max. Negotiated Rate |
$535.69 |
| Rate for Payer: Aetna Commercial |
$505.93
|
| Rate for Payer: BCBS Trust/PPO |
$491.58
|
| Rate for Payer: BCN Commercial |
$491.58
|
| Rate for Payer: Cash Price |
$476.17
|
| Rate for Payer: Cofinity Commercial |
$511.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.17
|
| Rate for Payer: Healthscope Commercial |
$535.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.93
|
| Rate for Payer: Nomi Health Commercial |
$488.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.41
|
| Rate for Payer: PHP Commercial |
$505.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$517.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$414.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$523.78
|
| Rate for Payer: UHC Core |
$497.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.41
|
|
|
HC XR URETHROGRAM RETROGRADE
|
Facility
|
IP
|
$576.94
|
|
|
Service Code
|
CPT 74450
|
| Hospital Charge Code |
32000165
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$401.55 |
| Max. Negotiated Rate |
$519.25 |
| Rate for Payer: Aetna Commercial |
$490.40
|
| Rate for Payer: BCBS Trust/PPO |
$476.49
|
| Rate for Payer: BCN Commercial |
$476.49
|
| Rate for Payer: Cash Price |
$461.55
|
| Rate for Payer: Cofinity Commercial |
$496.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.55
|
| Rate for Payer: Healthscope Commercial |
$519.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$432.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.40
|
| Rate for Payer: Nomi Health Commercial |
$473.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$432.70
|
| Rate for Payer: PHP Commercial |
$490.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$501.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$401.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$507.71
|
| Rate for Payer: UHC Core |
$481.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$432.70
|
|
|
HC XR URETHROGRAM RETROGRADE
|
Facility
|
OP
|
$576.94
|
|
|
Service Code
|
CPT 74450
|
| Hospital Charge Code |
32000165
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$101.71 |
| Max. Negotiated Rate |
$519.25 |
| Rate for Payer: Aetna Commercial |
$490.40
|
| Rate for Payer: Aetna Medicare |
$150.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$180.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$180.29
|
| Rate for Payer: BCBS Complete |
$106.79
|
| Rate for Payer: BCBS MAPPO |
$144.24
|
| Rate for Payer: BCBS Trust/PPO |
$474.30
|
| Rate for Payer: BCN Commercial |
$474.30
|
| Rate for Payer: BCN Medicare Advantage |
$144.24
|
| Rate for Payer: Cash Price |
$461.55
|
| Rate for Payer: Cofinity Commercial |
$496.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.24
|
| Rate for Payer: Healthscope Commercial |
$519.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$432.70
|
| Rate for Payer: Mclaren Medicaid |
$101.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.45
|
| Rate for Payer: Meridian Medicaid |
$106.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$165.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$158.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.40
|
| Rate for Payer: Nomi Health Commercial |
$473.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$432.70
|
| Rate for Payer: PACE Senior Care Partners |
$137.02
|
| Rate for Payer: PACE SWMI |
$144.24
|
| Rate for Payer: PHP Commercial |
$490.40
|
| Rate for Payer: PHP Medicare Advantage |
$144.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$501.94
|
| Rate for Payer: Priority Health Medicare |
$145.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$401.55
|
| Rate for Payer: Railroad Medicare Medicare |
$144.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$507.71
|
| Rate for Payer: UHC Core |
$481.74
|
| Rate for Payer: UHC Exchange |
$144.24
|
| Rate for Payer: UHC Medicaid |
$101.71
|
| Rate for Payer: UHC Medicare Advantage |
$144.24
|
| Rate for Payer: UHCCP Medicaid |
$101.71
|
| Rate for Payer: VA VA |
$144.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$432.70
|
|
|
HC XR UROGRAPHY INF
|
Facility
|
OP
|
$808.74
|
|
|
Service Code
|
CPT 74410
|
| Hospital Charge Code |
32000293
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$142.58 |
| Max. Negotiated Rate |
$727.87 |
| Rate for Payer: Aetna Commercial |
$687.43
|
| Rate for Payer: Aetna Medicare |
$210.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$252.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$252.73
|
| Rate for Payer: BCBS Complete |
$149.70
|
| Rate for Payer: BCBS MAPPO |
$202.19
|
| Rate for Payer: BCBS Trust/PPO |
$664.87
|
| Rate for Payer: BCN Commercial |
$664.87
|
| Rate for Payer: BCN Medicare Advantage |
$202.19
|
| Rate for Payer: Cash Price |
$646.99
|
| Rate for Payer: Cofinity Commercial |
$695.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$646.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$202.19
|
| Rate for Payer: Healthscope Commercial |
$727.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$606.55
|
| Rate for Payer: Mclaren Medicaid |
$142.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$212.29
|
| Rate for Payer: Meridian Medicaid |
$149.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$232.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$222.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$687.43
|
| Rate for Payer: Nomi Health Commercial |
$663.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$606.55
|
| Rate for Payer: PACE Senior Care Partners |
$192.08
|
| Rate for Payer: PACE SWMI |
$202.19
|
| Rate for Payer: PHP Commercial |
$687.43
|
| Rate for Payer: PHP Medicare Advantage |
$202.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$142.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$703.60
|
| Rate for Payer: Priority Health Medicare |
$204.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$562.88
|
| Rate for Payer: Railroad Medicare Medicare |
$202.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$711.69
|
| Rate for Payer: UHC Core |
$675.30
|
| Rate for Payer: UHC Exchange |
$202.19
|
| Rate for Payer: UHC Medicaid |
$142.58
|
| Rate for Payer: UHC Medicare Advantage |
$202.19
|
| Rate for Payer: UHCCP Medicaid |
$142.58
|
| Rate for Payer: VA VA |
$202.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$606.55
|
|
|
HC XR UROGRAPHY INF
|
Facility
|
IP
|
$808.74
|
|
|
Service Code
|
CPT 74410
|
| Hospital Charge Code |
32000293
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$562.88 |
| Max. Negotiated Rate |
$727.87 |
| Rate for Payer: Aetna Commercial |
$687.43
|
| Rate for Payer: BCBS Trust/PPO |
$667.94
|
| Rate for Payer: BCN Commercial |
$667.94
|
| Rate for Payer: Cash Price |
$646.99
|
| Rate for Payer: Cofinity Commercial |
$695.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$646.99
|
| Rate for Payer: Healthscope Commercial |
$727.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$606.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$687.43
|
| Rate for Payer: Nomi Health Commercial |
$663.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$606.55
|
| Rate for Payer: PHP Commercial |
$687.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$703.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$562.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$711.69
|
| Rate for Payer: UHC Core |
$675.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$606.55
|
|
|
HC XR WRIST 2 VW
|
Facility
|
IP
|
$260.57
|
|
|
Service Code
|
CPT 73100
|
| Hospital Charge Code |
32000080
|
|
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 WRIST 2 VW
|
Facility
|
OP
|
$260.57
|
|
|
Service Code
|
CPT 73100
|
| Hospital Charge Code |
32000080
|
|
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 WRIST BIL 2 VW
|
Facility
|
OP
|
$297.68
|
|
|
Service Code
|
CPT 73100
|
| Hospital Charge Code |
32000081
|
|
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
|
|
