|
HC XEOMIN PER 1 UNIT (INCOBOTULINUMTOXINA)
|
Facility
|
IP
|
$6.94
|
|
|
Service Code
|
HCPCS J0588
|
| Hospital Charge Code |
63600149
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.51 |
| Max. Negotiated Rate |
$6.25 |
| Rate for Payer: Aetna Commercial |
$5.90
|
| Rate for Payer: BCBS Trust/PPO |
$5.67
|
| Rate for Payer: BCN Commercial |
$5.36
|
| Rate for Payer: Cash Price |
$5.55
|
| Rate for Payer: Cofinity Commercial |
$5.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.55
|
| Rate for Payer: Healthscope Commercial |
$6.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.90
|
| Rate for Payer: Nomi Health Commercial |
$5.69
|
| Rate for Payer: PHP Commercial |
$5.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.51
|
| Rate for Payer: Priority Health HMO/PPO |
$6.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.11
|
| Rate for Payer: UHC Core |
$5.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.20
|
|
|
HC XEOMIN PER 1 UNIT (INCOBOTULINUMTOXINA)
|
Facility
|
OP
|
$6.94
|
|
|
Service Code
|
HCPCS J0588
|
| Hospital Charge Code |
63600149
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.65 |
| Max. Negotiated Rate |
$6.25 |
| Rate for Payer: Aetna Commercial |
$5.90
|
| Rate for Payer: Aetna Medicare |
$1.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.17
|
| Rate for Payer: BCBS Complete |
$4.03
|
| Rate for Payer: BCBS MAPPO |
$1.74
|
| Rate for Payer: BCBS Trust/PPO |
$5.71
|
| Rate for Payer: BCN Commercial |
$5.40
|
| Rate for Payer: BCN Medicare Advantage |
$1.74
|
| Rate for Payer: Cash Price |
$5.55
|
| Rate for Payer: Cash Price |
$5.55
|
| Rate for Payer: Cofinity Commercial |
$5.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.74
|
| Rate for Payer: Healthscope Commercial |
$6.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.20
|
| Rate for Payer: Mclaren Medicaid |
$3.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.82
|
| Rate for Payer: Meridian Medicaid |
$4.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.90
|
| Rate for Payer: Nomi Health Commercial |
$5.69
|
| Rate for Payer: PACE Senior Care Partners |
$1.65
|
| Rate for Payer: PACE SWMI |
$1.74
|
| Rate for Payer: PHP Commercial |
$5.90
|
| Rate for Payer: PHP Medicare Advantage |
$1.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.51
|
| Rate for Payer: Priority Health HMO/PPO |
$6.04
|
| Rate for Payer: Priority Health Medicare |
$1.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.11
|
| Rate for Payer: UHC Core |
$5.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.74
|
| Rate for Payer: UHC Exchange |
$1.74
|
| Rate for Payer: UHC Medicare Advantage |
$1.74
|
| Rate for Payer: UHCCP Medicaid |
$3.84
|
| Rate for Payer: VA VA |
$1.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.20
|
|
|
HC XPRESS-WAY CATHETER
|
Facility
|
IP
|
$1,412.71
|
|
| Hospital Charge Code |
27200226
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$918.26 |
| Max. Negotiated Rate |
$1,271.44 |
| Rate for Payer: Aetna Commercial |
$1,200.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,153.20
|
| Rate for Payer: BCN Commercial |
$1,091.74
|
| Rate for Payer: Cash Price |
$1,130.17
|
| Rate for Payer: Cofinity Commercial |
$1,214.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.17
|
| Rate for Payer: Healthscope Commercial |
$1,271.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,059.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,200.80
|
| Rate for Payer: Nomi Health Commercial |
$1,158.42
|
| Rate for Payer: PHP Commercial |
$1,200.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$918.26
|
| Rate for Payer: Priority Health HMO/PPO |
$1,229.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$946.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,243.18
|
| Rate for Payer: UHC Core |
$1,179.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,059.53
|
|
|
HC XPRESS-WAY CATHETER
|
Facility
|
OP
|
$1,412.71
|
|
| Hospital Charge Code |
27200226
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$335.52 |
| Max. Negotiated Rate |
$1,271.44 |
| Rate for Payer: Aetna Commercial |
$1,200.80
|
| Rate for Payer: Aetna Medicare |
$367.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$441.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$441.47
|
| Rate for Payer: BCBS Complete |
$565.08
|
| Rate for Payer: BCBS MAPPO |
$353.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,161.39
|
| Rate for Payer: BCN Commercial |
$1,098.38
|
| Rate for Payer: BCN Medicare Advantage |
$353.18
|
| Rate for Payer: Cash Price |
$1,130.17
|
| Rate for Payer: Cofinity Commercial |
$1,214.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$353.18
|
| Rate for Payer: Healthscope Commercial |
$1,271.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,059.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$406.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,200.80
|
| Rate for Payer: Nomi Health Commercial |
$1,158.42
|
| Rate for Payer: PACE Senior Care Partners |
$335.52
|
| Rate for Payer: PACE SWMI |
$353.18
|
| Rate for Payer: PHP Commercial |
$1,200.80
|
| Rate for Payer: PHP Medicare Advantage |
$353.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$918.26
|
| Rate for Payer: Priority Health HMO/PPO |
$1,229.06
|
| Rate for Payer: Priority Health Medicare |
$356.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$946.52
|
| Rate for Payer: Railroad Medicare Medicare |
$353.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,243.18
|
| Rate for Payer: UHC Core |
$1,179.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$353.18
|
| Rate for Payer: UHC Exchange |
$353.18
|
| Rate for Payer: UHC Medicare Advantage |
$353.18
|
| Rate for Payer: VA VA |
$353.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,059.53
|
|
|
HC XR ABDOMEN 1 VIEW
|
Facility
|
IP
|
$305.88
|
|
|
Service Code
|
CPT 74018
|
| Hospital Charge Code |
32000325
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$198.82 |
| Max. Negotiated Rate |
$275.29 |
| Rate for Payer: Aetna Commercial |
$260.00
|
| Rate for Payer: BCBS Trust/PPO |
$249.69
|
| Rate for Payer: BCN Commercial |
$236.38
|
| Rate for Payer: Cash Price |
$244.70
|
| Rate for Payer: Cofinity Commercial |
$263.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.70
|
| Rate for Payer: Healthscope Commercial |
$275.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.00
|
| Rate for Payer: Nomi Health Commercial |
$250.82
|
| Rate for Payer: PHP Commercial |
$260.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.82
|
| Rate for Payer: Priority Health HMO/PPO |
$266.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.17
|
| Rate for Payer: UHC Core |
$255.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.41
|
|
|
HC XR ABDOMEN 1 VIEW
|
Facility
|
OP
|
$305.88
|
|
|
Service Code
|
CPT 74018
|
| Hospital Charge Code |
32000325
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$62.37 |
| Max. Negotiated Rate |
$275.29 |
| Rate for Payer: Aetna Commercial |
$260.00
|
| Rate for Payer: Aetna Medicare |
$79.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95.59
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$76.47
|
| Rate for Payer: BCBS Trust/PPO |
$251.46
|
| Rate for Payer: BCN Commercial |
$237.82
|
| Rate for Payer: BCN Medicare Advantage |
$76.47
|
| Rate for Payer: Cash Price |
$244.70
|
| Rate for Payer: Cash Price |
$244.70
|
| Rate for Payer: Cofinity Commercial |
$263.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.47
|
| Rate for Payer: Healthscope Commercial |
$275.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.41
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.29
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.00
|
| Rate for Payer: Nomi Health Commercial |
$250.82
|
| Rate for Payer: PACE Senior Care Partners |
$72.65
|
| Rate for Payer: PACE SWMI |
$76.47
|
| Rate for Payer: PHP Commercial |
$260.00
|
| Rate for Payer: PHP Medicare Advantage |
$76.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.82
|
| Rate for Payer: Priority Health HMO/PPO |
$266.12
|
| Rate for Payer: Priority Health Medicare |
$77.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.94
|
| Rate for Payer: Railroad Medicare Medicare |
$76.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.17
|
| Rate for Payer: UHC Core |
$255.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.47
|
| Rate for Payer: UHC Exchange |
$76.47
|
| Rate for Payer: UHC Medicare Advantage |
$76.47
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$76.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.41
|
|
|
HC XR ABDOMEN 2 VW
|
Facility
|
IP
|
$338.65
|
|
|
Service Code
|
CPT 74019
|
| Hospital Charge Code |
32000326
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$220.12 |
| Max. Negotiated Rate |
$304.78 |
| Rate for Payer: Aetna Commercial |
$287.85
|
| Rate for Payer: BCBS Trust/PPO |
$276.44
|
| Rate for Payer: BCN Commercial |
$261.71
|
| Rate for Payer: Cash Price |
$270.92
|
| Rate for Payer: Cofinity Commercial |
$291.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.92
|
| Rate for Payer: Healthscope Commercial |
$304.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.85
|
| Rate for Payer: Nomi Health Commercial |
$277.69
|
| Rate for Payer: PHP Commercial |
$287.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.12
|
| Rate for Payer: Priority Health HMO/PPO |
$294.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$226.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$298.01
|
| Rate for Payer: UHC Core |
$282.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.99
|
|
|
HC XR ABDOMEN 2 VW
|
Facility
|
OP
|
$338.65
|
|
|
Service Code
|
CPT 74019
|
| Hospital Charge Code |
32000326
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$304.78 |
| Rate for Payer: Aetna Commercial |
$287.85
|
| Rate for Payer: Aetna Medicare |
$88.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$105.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$105.83
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$84.66
|
| Rate for Payer: BCBS Trust/PPO |
$278.40
|
| Rate for Payer: BCN Commercial |
$263.30
|
| Rate for Payer: BCN Medicare Advantage |
$84.66
|
| Rate for Payer: Cash Price |
$270.92
|
| Rate for Payer: Cash Price |
$270.92
|
| Rate for Payer: Cofinity Commercial |
$291.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.66
|
| Rate for Payer: Healthscope Commercial |
$304.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.99
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.90
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.85
|
| Rate for Payer: Nomi Health Commercial |
$277.69
|
| Rate for Payer: PACE Senior Care Partners |
$80.43
|
| Rate for Payer: PACE SWMI |
$84.66
|
| Rate for Payer: PHP Commercial |
$287.85
|
| Rate for Payer: PHP Medicare Advantage |
$84.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.12
|
| Rate for Payer: Priority Health HMO/PPO |
$294.63
|
| Rate for Payer: Priority Health Medicare |
$85.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$226.90
|
| Rate for Payer: Railroad Medicare Medicare |
$84.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$298.01
|
| Rate for Payer: UHC Core |
$282.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$84.66
|
| Rate for Payer: UHC Exchange |
$84.66
|
| Rate for Payer: UHC Medicare Advantage |
$84.66
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$84.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.99
|
|
|
HC XR ABDOMEN 3 OR MORE VIEWS
|
Facility
|
OP
|
$371.42
|
|
|
Service Code
|
CPT 74021
|
| Hospital Charge Code |
32000327
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$334.28 |
| Rate for Payer: Aetna Commercial |
$315.71
|
| Rate for Payer: Aetna Medicare |
$96.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$116.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$116.07
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$92.86
|
| Rate for Payer: BCBS Trust/PPO |
$305.34
|
| Rate for Payer: BCN Commercial |
$288.78
|
| Rate for Payer: BCN Medicare Advantage |
$92.86
|
| Rate for Payer: Cash Price |
$297.14
|
| Rate for Payer: Cash Price |
$297.14
|
| Rate for Payer: Cofinity Commercial |
$319.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.86
|
| Rate for Payer: Healthscope Commercial |
$334.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$278.56
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.50
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$106.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$315.71
|
| Rate for Payer: Nomi Health Commercial |
$304.56
|
| Rate for Payer: PACE Senior Care Partners |
$88.21
|
| Rate for Payer: PACE SWMI |
$92.86
|
| Rate for Payer: PHP Commercial |
$315.71
|
| Rate for Payer: PHP Medicare Advantage |
$92.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.42
|
| Rate for Payer: Priority Health HMO/PPO |
$323.14
|
| Rate for Payer: Priority Health Medicare |
$93.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$248.85
|
| Rate for Payer: Railroad Medicare Medicare |
$92.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.85
|
| Rate for Payer: UHC Core |
$310.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.86
|
| Rate for Payer: UHC Exchange |
$92.86
|
| Rate for Payer: UHC Medicare Advantage |
$92.86
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$92.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$278.56
|
|
|
HC XR ABDOMEN 3 OR MORE VIEWS
|
Facility
|
IP
|
$371.42
|
|
|
Service Code
|
CPT 74021
|
| Hospital Charge Code |
32000327
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$241.42 |
| Max. Negotiated Rate |
$334.28 |
| Rate for Payer: Aetna Commercial |
$315.71
|
| Rate for Payer: BCBS Trust/PPO |
$303.19
|
| Rate for Payer: BCN Commercial |
$287.03
|
| Rate for Payer: Cash Price |
$297.14
|
| Rate for Payer: Cofinity Commercial |
$319.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.14
|
| Rate for Payer: Healthscope Commercial |
$334.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$278.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$315.71
|
| Rate for Payer: Nomi Health Commercial |
$304.56
|
| Rate for Payer: PHP Commercial |
$315.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.42
|
| Rate for Payer: Priority Health HMO/PPO |
$323.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$248.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.85
|
| Rate for Payer: UHC Core |
$310.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$278.56
|
|
|
HC XR ABDOMEN ACUTE
|
Facility
|
OP
|
$490.40
|
|
|
Service Code
|
CPT 74022
|
| Hospital Charge Code |
32000135
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$441.36 |
| Rate for Payer: Aetna Commercial |
$416.84
|
| Rate for Payer: Aetna Medicare |
$127.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$153.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$153.25
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$122.60
|
| Rate for Payer: BCBS Trust/PPO |
$403.16
|
| Rate for Payer: BCN Commercial |
$381.29
|
| Rate for Payer: BCN Medicare Advantage |
$122.60
|
| Rate for Payer: Cash Price |
$392.32
|
| Rate for Payer: Cash Price |
$392.32
|
| Rate for Payer: Cofinity Commercial |
$421.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.60
|
| Rate for Payer: Healthscope Commercial |
$441.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.80
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.73
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$140.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.84
|
| Rate for Payer: Nomi Health Commercial |
$402.13
|
| Rate for Payer: PACE Senior Care Partners |
$116.47
|
| Rate for Payer: PACE SWMI |
$122.60
|
| Rate for Payer: PHP Commercial |
$416.84
|
| Rate for Payer: PHP Medicare Advantage |
$122.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.76
|
| Rate for Payer: Priority Health HMO/PPO |
$426.65
|
| Rate for Payer: Priority Health Medicare |
$123.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$328.57
|
| Rate for Payer: Railroad Medicare Medicare |
$122.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.55
|
| Rate for Payer: UHC Core |
$409.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.60
|
| Rate for Payer: UHC Exchange |
$122.60
|
| Rate for Payer: UHC Medicare Advantage |
$122.60
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$122.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.80
|
|
|
HC XR ABDOMEN ACUTE
|
Facility
|
IP
|
$490.40
|
|
|
Service Code
|
CPT 74022
|
| Hospital Charge Code |
32000135
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$318.76 |
| Max. Negotiated Rate |
$441.36 |
| Rate for Payer: Aetna Commercial |
$416.84
|
| Rate for Payer: BCBS Trust/PPO |
$400.31
|
| Rate for Payer: BCN Commercial |
$378.98
|
| Rate for Payer: Cash Price |
$392.32
|
| Rate for Payer: Cofinity Commercial |
$421.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.32
|
| Rate for Payer: Healthscope Commercial |
$441.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.84
|
| Rate for Payer: Nomi Health Commercial |
$402.13
|
| Rate for Payer: PHP Commercial |
$416.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.76
|
| Rate for Payer: Priority Health HMO/PPO |
$426.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$328.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.55
|
| Rate for Payer: UHC Core |
$409.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.80
|
|
|
HC XR AC JOINTS
|
Facility
|
OP
|
$357.38
|
|
|
Service Code
|
CPT 73050
|
| Hospital Charge Code |
32000068
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$62.37 |
| Max. Negotiated Rate |
$321.64 |
| Rate for Payer: Aetna Commercial |
$303.77
|
| Rate for Payer: Aetna Medicare |
$92.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.68
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$89.34
|
| Rate for Payer: BCBS Trust/PPO |
$293.80
|
| Rate for Payer: BCN Commercial |
$277.86
|
| Rate for Payer: BCN Medicare Advantage |
$89.34
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$307.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.34
|
| Rate for Payer: Healthscope Commercial |
$321.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.04
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.81
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: Nomi Health Commercial |
$293.05
|
| Rate for Payer: PACE Senior Care Partners |
$84.88
|
| Rate for Payer: PACE SWMI |
$89.34
|
| Rate for Payer: PHP Commercial |
$303.77
|
| Rate for Payer: PHP Medicare Advantage |
$89.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health HMO/PPO |
$310.92
|
| Rate for Payer: Priority Health Medicare |
$90.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$239.44
|
| Rate for Payer: Railroad Medicare Medicare |
$89.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.49
|
| Rate for Payer: UHC Core |
$298.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.34
|
| Rate for Payer: UHC Exchange |
$89.34
|
| Rate for Payer: UHC Medicare Advantage |
$89.34
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$89.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
|
HC XR AC JOINTS
|
Facility
|
IP
|
$357.38
|
|
|
Service Code
|
CPT 73050
|
| Hospital Charge Code |
32000068
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$232.30 |
| Max. Negotiated Rate |
$321.64 |
| Rate for Payer: Aetna Commercial |
$303.77
|
| Rate for Payer: BCBS Trust/PPO |
$291.73
|
| Rate for Payer: BCN Commercial |
$276.18
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$307.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Healthscope Commercial |
$321.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: Nomi Health Commercial |
$293.05
|
| Rate for Payer: PHP Commercial |
$303.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health HMO/PPO |
$310.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$239.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.49
|
| Rate for Payer: UHC Core |
$298.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
|
HC XR ANKLE 1 VW
|
Facility
|
OP
|
$243.21
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000118
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$57.76 |
| Max. Negotiated Rate |
$218.89 |
| Rate for Payer: Aetna Commercial |
$206.73
|
| Rate for Payer: Aetna Medicare |
$63.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.00
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$60.80
|
| Rate for Payer: BCBS Trust/PPO |
$199.94
|
| Rate for Payer: BCN Commercial |
$189.10
|
| Rate for Payer: BCN Medicare Advantage |
$60.80
|
| Rate for Payer: Cash Price |
$194.57
|
| Rate for Payer: Cash Price |
$194.57
|
| Rate for Payer: Cofinity Commercial |
$209.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.80
|
| Rate for Payer: Healthscope Commercial |
$218.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.41
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.84
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.73
|
| Rate for Payer: Nomi Health Commercial |
$199.43
|
| Rate for Payer: PACE Senior Care Partners |
$57.76
|
| Rate for Payer: PACE SWMI |
$60.80
|
| Rate for Payer: PHP Commercial |
$206.73
|
| Rate for Payer: PHP Medicare Advantage |
$60.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.09
|
| Rate for Payer: Priority Health HMO/PPO |
$211.59
|
| Rate for Payer: Priority Health Medicare |
$61.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.95
|
| Rate for Payer: Railroad Medicare Medicare |
$60.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.02
|
| Rate for Payer: UHC Core |
$203.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.80
|
| Rate for Payer: UHC Exchange |
$60.80
|
| Rate for Payer: UHC Medicare Advantage |
$60.80
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$60.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.41
|
|
|
HC XR ANKLE 1 VW
|
Facility
|
IP
|
$243.21
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000118
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$158.09 |
| Max. Negotiated Rate |
$218.89 |
| Rate for Payer: Aetna Commercial |
$206.73
|
| Rate for Payer: BCBS Trust/PPO |
$198.53
|
| Rate for Payer: BCN Commercial |
$187.95
|
| Rate for Payer: Cash Price |
$194.57
|
| Rate for Payer: Cofinity Commercial |
$209.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.57
|
| Rate for Payer: Healthscope Commercial |
$218.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.73
|
| Rate for Payer: Nomi Health Commercial |
$199.43
|
| Rate for Payer: PHP Commercial |
$206.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.09
|
| Rate for Payer: Priority Health HMO/PPO |
$211.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.02
|
| Rate for Payer: UHC Core |
$203.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.41
|
|
|
HC XR ANKLE 2 VIEWS
|
Facility
|
IP
|
$255.46
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000117
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$166.05 |
| Max. Negotiated Rate |
$229.91 |
| Rate for Payer: Aetna Commercial |
$217.14
|
| Rate for Payer: BCBS Trust/PPO |
$208.53
|
| Rate for Payer: BCN Commercial |
$197.42
|
| Rate for Payer: Cash Price |
$204.37
|
| Rate for Payer: Cofinity Commercial |
$219.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.37
|
| Rate for Payer: Healthscope Commercial |
$229.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.14
|
| Rate for Payer: Nomi Health Commercial |
$209.48
|
| Rate for Payer: PHP Commercial |
$217.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.05
|
| Rate for Payer: Priority Health HMO/PPO |
$222.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$171.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.80
|
| Rate for Payer: UHC Core |
$213.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.60
|
|
|
HC XR ANKLE 2 VIEWS
|
Facility
|
OP
|
$255.46
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000117
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$60.67 |
| Max. Negotiated Rate |
$229.91 |
| Rate for Payer: Aetna Commercial |
$217.14
|
| Rate for Payer: Aetna Medicare |
$66.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.83
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$63.86
|
| Rate for Payer: BCBS Trust/PPO |
$210.01
|
| Rate for Payer: BCN Commercial |
$198.62
|
| Rate for Payer: BCN Medicare Advantage |
$63.86
|
| Rate for Payer: Cash Price |
$204.37
|
| Rate for Payer: Cash Price |
$204.37
|
| Rate for Payer: Cofinity Commercial |
$219.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.86
|
| Rate for Payer: Healthscope Commercial |
$229.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.60
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.06
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.14
|
| Rate for Payer: Nomi Health Commercial |
$209.48
|
| Rate for Payer: PACE Senior Care Partners |
$60.67
|
| Rate for Payer: PACE SWMI |
$63.86
|
| Rate for Payer: PHP Commercial |
$217.14
|
| Rate for Payer: PHP Medicare Advantage |
$63.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.05
|
| Rate for Payer: Priority Health HMO/PPO |
$222.25
|
| Rate for Payer: Priority Health Medicare |
$64.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$171.16
|
| Rate for Payer: Railroad Medicare Medicare |
$63.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.80
|
| Rate for Payer: UHC Core |
$213.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.86
|
| Rate for Payer: UHC Exchange |
$63.86
|
| Rate for Payer: UHC Medicare Advantage |
$63.86
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$63.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.60
|
|
|
HC XR ANKLE 2 VIEWS BILATERAL
|
Facility
|
IP
|
$249.90
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000339
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$162.44 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Aetna Commercial |
$212.42
|
| Rate for Payer: BCBS Trust/PPO |
$203.99
|
| Rate for Payer: BCN Commercial |
$193.12
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.42
|
| Rate for Payer: Nomi Health Commercial |
$204.92
|
| Rate for Payer: PHP Commercial |
$212.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.44
|
| Rate for Payer: Priority Health HMO/PPO |
$217.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$167.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.91
|
| Rate for Payer: UHC Core |
$208.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.42
|
|
|
HC XR ANKLE 2 VIEWS BILATERAL
|
Facility
|
OP
|
$249.90
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000339
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.35 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Aetna Commercial |
$212.42
|
| 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 |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$62.48
|
| Rate for Payer: BCBS Trust/PPO |
$205.44
|
| Rate for Payer: BCN Commercial |
$194.30
|
| Rate for Payer: BCN Medicare Advantage |
$62.48
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.48
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.42
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.60
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.42
|
| Rate for Payer: Nomi Health Commercial |
$204.92
|
| Rate for Payer: PACE Senior Care Partners |
$59.35
|
| Rate for Payer: PACE SWMI |
$62.48
|
| Rate for Payer: PHP Commercial |
$212.42
|
| Rate for Payer: PHP Medicare Advantage |
$62.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.44
|
| Rate for Payer: Priority Health HMO/PPO |
$217.41
|
| Rate for Payer: Priority Health Medicare |
$63.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$167.43
|
| Rate for Payer: Railroad Medicare Medicare |
$62.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.91
|
| Rate for Payer: UHC Core |
$208.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.48
|
| Rate for Payer: UHC Exchange |
$62.48
|
| Rate for Payer: UHC Medicare Advantage |
$62.48
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$62.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.42
|
|
|
HC XR ANKLE BIL 2 VW
|
Facility
|
IP
|
$291.84
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000120
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$189.70 |
| Max. Negotiated Rate |
$262.66 |
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: BCBS Trust/PPO |
$238.23
|
| Rate for Payer: BCN Commercial |
$225.53
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$250.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Healthscope Commercial |
$262.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$239.31
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: Priority Health HMO/PPO |
$253.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.82
|
| Rate for Payer: UHC Core |
$243.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.88
|
|
|
HC XR ANKLE BIL 2 VW
|
Facility
|
OP
|
$291.84
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000120
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$62.37 |
| Max. Negotiated Rate |
$262.66 |
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: Aetna Medicare |
$75.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$91.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$91.20
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$72.96
|
| Rate for Payer: BCBS Trust/PPO |
$239.92
|
| Rate for Payer: BCN Commercial |
$226.91
|
| Rate for Payer: BCN Medicare Advantage |
$72.96
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$250.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.96
|
| Rate for Payer: Healthscope Commercial |
$262.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.88
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.61
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$239.31
|
| Rate for Payer: PACE Senior Care Partners |
$69.31
|
| Rate for Payer: PACE SWMI |
$72.96
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: PHP Medicare Advantage |
$72.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: Priority Health HMO/PPO |
$253.90
|
| Rate for Payer: Priority Health Medicare |
$73.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.53
|
| Rate for Payer: Railroad Medicare Medicare |
$72.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.82
|
| Rate for Payer: UHC Core |
$243.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.96
|
| Rate for Payer: UHC Exchange |
$72.96
|
| Rate for Payer: UHC Medicare Advantage |
$72.96
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$72.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.88
|
|
|
HC XR ANKLE BIL MIN 3 VW
|
Facility
|
IP
|
$388.71
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
32000122
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$252.66 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: BCBS Trust/PPO |
$317.30
|
| Rate for Payer: BCN Commercial |
$300.40
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: Nomi Health Commercial |
$318.74
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health HMO/PPO |
$338.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.06
|
| Rate for Payer: UHC Core |
$324.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC XR ANKLE BIL MIN 3 VW
|
Facility
|
OP
|
$388.71
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
32000122
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$62.37 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: Aetna Medicare |
$101.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$121.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$121.47
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$97.18
|
| Rate for Payer: BCBS Trust/PPO |
$319.56
|
| Rate for Payer: BCN Commercial |
$302.22
|
| Rate for Payer: BCN Medicare Advantage |
$97.18
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.18
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.04
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: Nomi Health Commercial |
$318.74
|
| Rate for Payer: PACE Senior Care Partners |
$92.32
|
| Rate for Payer: PACE SWMI |
$97.18
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: PHP Medicare Advantage |
$97.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health HMO/PPO |
$338.18
|
| Rate for Payer: Priority Health Medicare |
$98.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.44
|
| Rate for Payer: Railroad Medicare Medicare |
$97.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.06
|
| Rate for Payer: UHC Core |
$324.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.18
|
| Rate for Payer: UHC Exchange |
$97.18
|
| Rate for Payer: UHC Medicare Advantage |
$97.18
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$97.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC XR ANKLE MIN 3 VIEWS
|
Facility
|
OP
|
$357.38
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
32000121
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$62.37 |
| Max. Negotiated Rate |
$321.64 |
| Rate for Payer: Aetna Commercial |
$303.77
|
| Rate for Payer: Aetna Medicare |
$92.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.68
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$89.34
|
| Rate for Payer: BCBS Trust/PPO |
$293.80
|
| Rate for Payer: BCN Commercial |
$277.86
|
| Rate for Payer: BCN Medicare Advantage |
$89.34
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$307.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.34
|
| Rate for Payer: Healthscope Commercial |
$321.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.04
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.81
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: Nomi Health Commercial |
$293.05
|
| Rate for Payer: PACE Senior Care Partners |
$84.88
|
| Rate for Payer: PACE SWMI |
$89.34
|
| Rate for Payer: PHP Commercial |
$303.77
|
| Rate for Payer: PHP Medicare Advantage |
$89.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health HMO/PPO |
$310.92
|
| Rate for Payer: Priority Health Medicare |
$90.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$239.44
|
| Rate for Payer: Railroad Medicare Medicare |
$89.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.49
|
| Rate for Payer: UHC Core |
$298.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.34
|
| Rate for Payer: UHC Exchange |
$89.34
|
| Rate for Payer: UHC Medicare Advantage |
$89.34
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$89.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
