|
HC XR ARTHROGRAM WRIST
|
Facility
|
OP
|
$670.87
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
32000084
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$159.33 |
| Max. Negotiated Rate |
$603.78 |
| Rate for Payer: Aetna Commercial |
$570.24
|
| Rate for Payer: Aetna Medicare |
$174.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$209.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$209.65
|
| Rate for Payer: BCBS Complete |
$271.13
|
| Rate for Payer: BCBS MAPPO |
$167.72
|
| Rate for Payer: BCBS Trust/PPO |
$551.52
|
| Rate for Payer: BCN Commercial |
$521.60
|
| Rate for Payer: BCN Medicare Advantage |
$167.72
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cofinity Commercial |
$576.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$536.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.72
|
| Rate for Payer: Healthscope Commercial |
$603.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.15
|
| Rate for Payer: Mclaren Medicaid |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.10
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$192.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$570.24
|
| Rate for Payer: Nomi Health Commercial |
$550.11
|
| Rate for Payer: PACE Senior Care Partners |
$159.33
|
| Rate for Payer: PACE SWMI |
$167.72
|
| Rate for Payer: PHP Commercial |
$570.24
|
| Rate for Payer: PHP Medicare Advantage |
$167.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$436.07
|
| Rate for Payer: Priority Health HMO/PPO |
$583.66
|
| Rate for Payer: Priority Health Medicare |
$169.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$449.48
|
| Rate for Payer: Railroad Medicare Medicare |
$167.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$590.37
|
| Rate for Payer: UHC Core |
$560.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.72
|
| Rate for Payer: UHC Exchange |
$167.72
|
| Rate for Payer: UHC Medicare Advantage |
$167.72
|
| Rate for Payer: UHCCP Medicaid |
$258.20
|
| Rate for Payer: VA VA |
$167.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.15
|
|
|
HC XR ARTHROGRAM WRIST
|
Facility
|
IP
|
$670.87
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
32000084
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$436.07 |
| Max. Negotiated Rate |
$603.78 |
| Rate for Payer: Aetna Commercial |
$570.24
|
| Rate for Payer: BCBS Trust/PPO |
$547.63
|
| Rate for Payer: BCN Commercial |
$518.45
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cofinity Commercial |
$576.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$536.70
|
| Rate for Payer: Healthscope Commercial |
$603.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$570.24
|
| Rate for Payer: Nomi Health Commercial |
$550.11
|
| Rate for Payer: PHP Commercial |
$570.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$436.07
|
| Rate for Payer: Priority Health HMO/PPO |
$583.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$449.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$590.37
|
| Rate for Payer: UHC Core |
$560.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.15
|
|
|
HC XR BONE AGE STUDY
|
Facility
|
IP
|
$306.43
|
|
|
Service Code
|
CPT 77072
|
| Hospital Charge Code |
32000253
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$199.18 |
| Max. Negotiated Rate |
$275.79 |
| Rate for Payer: Aetna Commercial |
$260.47
|
| Rate for Payer: BCBS Trust/PPO |
$250.14
|
| Rate for Payer: BCN Commercial |
$236.81
|
| Rate for Payer: Cash Price |
$245.14
|
| Rate for Payer: Cofinity Commercial |
$263.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.14
|
| Rate for Payer: Healthscope Commercial |
$275.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.47
|
| Rate for Payer: Nomi Health Commercial |
$251.27
|
| Rate for Payer: PHP Commercial |
$260.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.18
|
| Rate for Payer: Priority Health HMO/PPO |
$266.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$205.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.66
|
| Rate for Payer: UHC Core |
$255.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.82
|
|
|
HC XR BONE AGE STUDY
|
Facility
|
OP
|
$306.43
|
|
|
Service Code
|
CPT 77072
|
| Hospital Charge Code |
32000253
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.78 |
| Max. Negotiated Rate |
$275.79 |
| Rate for Payer: Aetna Commercial |
$260.47
|
| Rate for Payer: Aetna Medicare |
$79.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95.76
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$76.61
|
| Rate for Payer: BCBS Trust/PPO |
$251.92
|
| Rate for Payer: BCN Commercial |
$238.25
|
| Rate for Payer: BCN Medicare Advantage |
$76.61
|
| Rate for Payer: Cash Price |
$245.14
|
| Rate for Payer: Cash Price |
$245.14
|
| Rate for Payer: Cofinity Commercial |
$263.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.61
|
| Rate for Payer: Healthscope Commercial |
$275.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.82
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.44
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$88.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.47
|
| Rate for Payer: Nomi Health Commercial |
$251.27
|
| Rate for Payer: PACE Senior Care Partners |
$72.78
|
| Rate for Payer: PACE SWMI |
$76.61
|
| Rate for Payer: PHP Commercial |
$260.47
|
| Rate for Payer: PHP Medicare Advantage |
$76.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.18
|
| Rate for Payer: Priority Health HMO/PPO |
$266.59
|
| Rate for Payer: Priority Health Medicare |
$77.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$205.31
|
| Rate for Payer: Railroad Medicare Medicare |
$76.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.66
|
| Rate for Payer: UHC Core |
$255.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.61
|
| Rate for Payer: UHC Exchange |
$76.61
|
| Rate for Payer: UHC Medicare Advantage |
$76.61
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$76.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.82
|
|
|
HC XR BONE LENGTH STUDY
|
Facility
|
IP
|
$291.84
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
32000254
|
|
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 BONE LENGTH STUDY
|
Facility
|
OP
|
$291.84
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
32000254
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$69.31 |
| 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 |
$80.73
|
| 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 |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.61
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| 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 |
$76.88
|
| 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 |
$76.88
|
| Rate for Payer: VA VA |
$72.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.88
|
|
|
HC XR BONE SURVEY ADULT COMP
|
Facility
|
OP
|
$612.56
|
|
|
Service Code
|
CPT 77075
|
| Hospital Charge Code |
32000257
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$551.30 |
| Rate for Payer: Aetna Commercial |
$520.68
|
| Rate for Payer: Aetna Medicare |
$159.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.43
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$153.14
|
| Rate for Payer: BCBS Trust/PPO |
$503.59
|
| Rate for Payer: BCN Commercial |
$476.27
|
| Rate for Payer: BCN Medicare Advantage |
$153.14
|
| Rate for Payer: Cash Price |
$490.05
|
| Rate for Payer: Cash Price |
$490.05
|
| Rate for Payer: Cofinity Commercial |
$526.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$490.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.14
|
| Rate for Payer: Healthscope Commercial |
$551.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.42
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.80
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.68
|
| Rate for Payer: Nomi Health Commercial |
$502.30
|
| Rate for Payer: PACE Senior Care Partners |
$145.48
|
| Rate for Payer: PACE SWMI |
$153.14
|
| Rate for Payer: PHP Commercial |
$520.68
|
| Rate for Payer: PHP Medicare Advantage |
$153.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$398.16
|
| Rate for Payer: Priority Health HMO/PPO |
$532.93
|
| Rate for Payer: Priority Health Medicare |
$154.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$410.42
|
| Rate for Payer: Railroad Medicare Medicare |
$153.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$539.05
|
| Rate for Payer: UHC Core |
$511.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.14
|
| Rate for Payer: UHC Exchange |
$153.14
|
| Rate for Payer: UHC Medicare Advantage |
$153.14
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$153.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.42
|
|
|
HC XR BONE SURVEY ADULT COMP
|
Facility
|
IP
|
$612.56
|
|
|
Service Code
|
CPT 77075
|
| Hospital Charge Code |
32000257
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$398.16 |
| Max. Negotiated Rate |
$551.30 |
| Rate for Payer: Aetna Commercial |
$520.68
|
| Rate for Payer: BCBS Trust/PPO |
$500.03
|
| Rate for Payer: BCN Commercial |
$473.39
|
| Rate for Payer: Cash Price |
$490.05
|
| Rate for Payer: Cofinity Commercial |
$526.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$490.05
|
| Rate for Payer: Healthscope Commercial |
$551.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.68
|
| Rate for Payer: Nomi Health Commercial |
$502.30
|
| Rate for Payer: PHP Commercial |
$520.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$398.16
|
| Rate for Payer: Priority Health HMO/PPO |
$532.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$410.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$539.05
|
| Rate for Payer: UHC Core |
$511.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.42
|
|
|
HC XR BONE SURVEY INFANT
|
Facility
|
IP
|
$387.96
|
|
|
Service Code
|
CPT 77076
|
| Hospital Charge Code |
32000258
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$252.17 |
| Max. Negotiated Rate |
$349.16 |
| Rate for Payer: Aetna Commercial |
$329.77
|
| Rate for Payer: BCBS Trust/PPO |
$316.69
|
| Rate for Payer: BCN Commercial |
$299.82
|
| Rate for Payer: Cash Price |
$310.37
|
| Rate for Payer: Cofinity Commercial |
$333.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.37
|
| Rate for Payer: Healthscope Commercial |
$349.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$290.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.77
|
| Rate for Payer: Nomi Health Commercial |
$318.13
|
| Rate for Payer: PHP Commercial |
$329.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.17
|
| Rate for Payer: Priority Health HMO/PPO |
$337.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$259.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$341.40
|
| Rate for Payer: UHC Core |
$323.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$290.97
|
|
|
HC XR BONE SURVEY INFANT
|
Facility
|
OP
|
$387.96
|
|
|
Service Code
|
CPT 77076
|
| Hospital Charge Code |
32000258
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$349.16 |
| Rate for Payer: Aetna Commercial |
$329.77
|
| Rate for Payer: Aetna Medicare |
$100.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$121.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$121.24
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$96.99
|
| Rate for Payer: BCBS Trust/PPO |
$318.94
|
| Rate for Payer: BCN Commercial |
$301.64
|
| Rate for Payer: BCN Medicare Advantage |
$96.99
|
| Rate for Payer: Cash Price |
$310.37
|
| Rate for Payer: Cash Price |
$310.37
|
| Rate for Payer: Cofinity Commercial |
$333.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.99
|
| Rate for Payer: Healthscope Commercial |
$349.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$290.97
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.84
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.77
|
| Rate for Payer: Nomi Health Commercial |
$318.13
|
| Rate for Payer: PACE Senior Care Partners |
$92.14
|
| Rate for Payer: PACE SWMI |
$96.99
|
| Rate for Payer: PHP Commercial |
$329.77
|
| Rate for Payer: PHP Medicare Advantage |
$96.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.17
|
| Rate for Payer: Priority Health HMO/PPO |
$337.53
|
| Rate for Payer: Priority Health Medicare |
$97.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$259.93
|
| Rate for Payer: Railroad Medicare Medicare |
$96.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$341.40
|
| Rate for Payer: UHC Core |
$323.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.99
|
| Rate for Payer: UHC Exchange |
$96.99
|
| Rate for Payer: UHC Medicare Advantage |
$96.99
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$96.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$290.97
|
|
|
HC XR BONE SURVEY (METS) LTD
|
Facility
|
OP
|
$308.12
|
|
|
Service Code
|
CPT 77074
|
| Hospital Charge Code |
32000298
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$73.18 |
| Max. Negotiated Rate |
$277.31 |
| Rate for Payer: Aetna Commercial |
$261.90
|
| Rate for Payer: Aetna Medicare |
$80.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$96.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$96.29
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$77.03
|
| Rate for Payer: BCBS Trust/PPO |
$253.31
|
| Rate for Payer: BCN Commercial |
$239.56
|
| Rate for Payer: BCN Medicare Advantage |
$77.03
|
| Rate for Payer: Cash Price |
$246.50
|
| Rate for Payer: Cash Price |
$246.50
|
| Rate for Payer: Cofinity Commercial |
$264.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$246.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.03
|
| Rate for Payer: Healthscope Commercial |
$277.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.09
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.88
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$88.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$261.90
|
| Rate for Payer: Nomi Health Commercial |
$252.66
|
| Rate for Payer: PACE Senior Care Partners |
$73.18
|
| Rate for Payer: PACE SWMI |
$77.03
|
| Rate for Payer: PHP Commercial |
$261.90
|
| Rate for Payer: PHP Medicare Advantage |
$77.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.28
|
| Rate for Payer: Priority Health HMO/PPO |
$268.06
|
| Rate for Payer: Priority Health Medicare |
$77.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$206.44
|
| Rate for Payer: Railroad Medicare Medicare |
$77.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$271.15
|
| Rate for Payer: UHC Core |
$257.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$77.03
|
| Rate for Payer: UHC Exchange |
$77.03
|
| Rate for Payer: UHC Medicare Advantage |
$77.03
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$77.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.09
|
|
|
HC XR BONE SURVEY (METS) LTD
|
Facility
|
IP
|
$308.12
|
|
|
Service Code
|
CPT 77074
|
| Hospital Charge Code |
32000298
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$200.28 |
| Max. Negotiated Rate |
$277.31 |
| Rate for Payer: Aetna Commercial |
$261.90
|
| Rate for Payer: BCBS Trust/PPO |
$251.52
|
| Rate for Payer: BCN Commercial |
$238.12
|
| Rate for Payer: Cash Price |
$246.50
|
| Rate for Payer: Cofinity Commercial |
$264.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$246.50
|
| Rate for Payer: Healthscope Commercial |
$277.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$261.90
|
| Rate for Payer: Nomi Health Commercial |
$252.66
|
| Rate for Payer: PHP Commercial |
$261.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.28
|
| Rate for Payer: Priority Health HMO/PPO |
$268.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$206.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$271.15
|
| Rate for Payer: UHC Core |
$257.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.09
|
|
|
HC XR CHEST 2 VIEWS
|
Facility
|
IP
|
$303.69
|
|
|
Service Code
|
CPT 71046
|
| Hospital Charge Code |
32400010
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$197.40 |
| Max. Negotiated Rate |
$273.32 |
| Rate for Payer: Aetna Commercial |
$258.14
|
| Rate for Payer: BCBS Trust/PPO |
$247.90
|
| Rate for Payer: BCN Commercial |
$234.69
|
| Rate for Payer: Cash Price |
$242.95
|
| Rate for Payer: Cofinity Commercial |
$261.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.95
|
| Rate for Payer: Healthscope Commercial |
$273.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.14
|
| Rate for Payer: Nomi Health Commercial |
$249.03
|
| Rate for Payer: PHP Commercial |
$258.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$197.40
|
| Rate for Payer: Priority Health HMO/PPO |
$264.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$203.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$267.25
|
| Rate for Payer: UHC Core |
$253.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.77
|
|
|
HC XR CHEST 2 VIEWS
|
Facility
|
OP
|
$303.69
|
|
|
Service Code
|
CPT 71046
|
| Hospital Charge Code |
32400010
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$63.66 |
| Max. Negotiated Rate |
$273.32 |
| Rate for Payer: Aetna Commercial |
$258.14
|
| Rate for Payer: Aetna Medicare |
$78.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$94.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$94.90
|
| Rate for Payer: BCBS Complete |
$66.85
|
| Rate for Payer: BCBS MAPPO |
$75.92
|
| Rate for Payer: BCBS Trust/PPO |
$249.66
|
| Rate for Payer: BCN Commercial |
$236.12
|
| Rate for Payer: BCN Medicare Advantage |
$75.92
|
| Rate for Payer: Cash Price |
$242.95
|
| Rate for Payer: Cash Price |
$242.95
|
| Rate for Payer: Cofinity Commercial |
$261.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.92
|
| Rate for Payer: Healthscope Commercial |
$273.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.77
|
| Rate for Payer: Mclaren Medicaid |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.72
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.14
|
| Rate for Payer: Nomi Health Commercial |
$249.03
|
| Rate for Payer: PACE Senior Care Partners |
$72.13
|
| Rate for Payer: PACE SWMI |
$75.92
|
| Rate for Payer: PHP Commercial |
$258.14
|
| Rate for Payer: PHP Medicare Advantage |
$75.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$197.40
|
| Rate for Payer: Priority Health HMO/PPO |
$264.21
|
| Rate for Payer: Priority Health Medicare |
$76.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$203.47
|
| Rate for Payer: Railroad Medicare Medicare |
$75.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$267.25
|
| Rate for Payer: UHC Core |
$253.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.92
|
| Rate for Payer: UHC Exchange |
$75.92
|
| Rate for Payer: UHC Medicare Advantage |
$75.92
|
| Rate for Payer: UHCCP Medicaid |
$63.66
|
| Rate for Payer: VA VA |
$75.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.77
|
|
|
HC XR CHEST 3 VIEWS
|
Facility
|
OP
|
$336.47
|
|
|
Service Code
|
CPT 71047
|
| Hospital Charge Code |
32400011
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$63.66 |
| Max. Negotiated Rate |
$302.82 |
| Rate for Payer: Aetna Commercial |
$286.00
|
| Rate for Payer: Aetna Medicare |
$87.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$105.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$105.15
|
| Rate for Payer: BCBS Complete |
$66.85
|
| Rate for Payer: BCBS MAPPO |
$84.12
|
| Rate for Payer: BCBS Trust/PPO |
$276.61
|
| Rate for Payer: BCN Commercial |
$261.61
|
| Rate for Payer: BCN Medicare Advantage |
$84.12
|
| Rate for Payer: Cash Price |
$269.18
|
| Rate for Payer: Cash Price |
$269.18
|
| Rate for Payer: Cofinity Commercial |
$289.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.12
|
| Rate for Payer: Healthscope Commercial |
$302.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$252.35
|
| Rate for Payer: Mclaren Medicaid |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.32
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$96.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.00
|
| Rate for Payer: Nomi Health Commercial |
$275.91
|
| Rate for Payer: PACE Senior Care Partners |
$79.91
|
| Rate for Payer: PACE SWMI |
$84.12
|
| Rate for Payer: PHP Commercial |
$286.00
|
| Rate for Payer: PHP Medicare Advantage |
$84.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.71
|
| Rate for Payer: Priority Health HMO/PPO |
$292.73
|
| Rate for Payer: Priority Health Medicare |
$84.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$225.43
|
| Rate for Payer: Railroad Medicare Medicare |
$84.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$296.09
|
| Rate for Payer: UHC Core |
$280.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$84.12
|
| Rate for Payer: UHC Exchange |
$84.12
|
| Rate for Payer: UHC Medicare Advantage |
$84.12
|
| Rate for Payer: UHCCP Medicaid |
$63.66
|
| Rate for Payer: VA VA |
$84.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$252.35
|
|
|
HC XR CHEST 3 VIEWS
|
Facility
|
IP
|
$336.47
|
|
|
Service Code
|
CPT 71047
|
| Hospital Charge Code |
32400011
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$218.71 |
| Max. Negotiated Rate |
$302.82 |
| Rate for Payer: Aetna Commercial |
$286.00
|
| Rate for Payer: BCBS Trust/PPO |
$274.66
|
| Rate for Payer: BCN Commercial |
$260.02
|
| Rate for Payer: Cash Price |
$269.18
|
| Rate for Payer: Cofinity Commercial |
$289.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.18
|
| Rate for Payer: Healthscope Commercial |
$302.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$252.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.00
|
| Rate for Payer: Nomi Health Commercial |
$275.91
|
| Rate for Payer: PHP Commercial |
$286.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.71
|
| Rate for Payer: Priority Health HMO/PPO |
$292.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$225.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$296.09
|
| Rate for Payer: UHC Core |
$280.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$252.35
|
|
|
HC XR CHEST 4 OR MORE VIEWS
|
Facility
|
OP
|
$369.24
|
|
|
Service Code
|
CPT 71048
|
| Hospital Charge Code |
32400012
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$332.32 |
| Rate for Payer: Aetna Commercial |
$313.85
|
| Rate for Payer: Aetna Medicare |
$96.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$115.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$115.39
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$92.31
|
| Rate for Payer: BCBS Trust/PPO |
$303.55
|
| Rate for Payer: BCN Commercial |
$287.08
|
| Rate for Payer: BCN Medicare Advantage |
$92.31
|
| Rate for Payer: Cash Price |
$295.39
|
| Rate for Payer: Cash Price |
$295.39
|
| Rate for Payer: Cofinity Commercial |
$317.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$295.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.31
|
| Rate for Payer: Healthscope Commercial |
$332.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.93
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.93
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$106.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.85
|
| Rate for Payer: Nomi Health Commercial |
$302.78
|
| Rate for Payer: PACE Senior Care Partners |
$87.69
|
| Rate for Payer: PACE SWMI |
$92.31
|
| Rate for Payer: PHP Commercial |
$313.85
|
| Rate for Payer: PHP Medicare Advantage |
$92.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.01
|
| Rate for Payer: Priority Health HMO/PPO |
$321.24
|
| Rate for Payer: Priority Health Medicare |
$93.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$247.39
|
| Rate for Payer: Railroad Medicare Medicare |
$92.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.93
|
| Rate for Payer: UHC Core |
$308.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.31
|
| Rate for Payer: UHC Exchange |
$92.31
|
| Rate for Payer: UHC Medicare Advantage |
$92.31
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$92.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.93
|
|
|
HC XR CHEST 4 OR MORE VIEWS
|
Facility
|
IP
|
$369.24
|
|
|
Service Code
|
CPT 71048
|
| Hospital Charge Code |
32400012
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$240.01 |
| Max. Negotiated Rate |
$332.32 |
| Rate for Payer: Aetna Commercial |
$313.85
|
| Rate for Payer: BCBS Trust/PPO |
$301.41
|
| Rate for Payer: BCN Commercial |
$285.35
|
| Rate for Payer: Cash Price |
$295.39
|
| Rate for Payer: Cofinity Commercial |
$317.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$295.39
|
| Rate for Payer: Healthscope Commercial |
$332.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.85
|
| Rate for Payer: Nomi Health Commercial |
$302.78
|
| Rate for Payer: PHP Commercial |
$313.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.01
|
| Rate for Payer: Priority Health HMO/PPO |
$321.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$247.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.93
|
| Rate for Payer: UHC Core |
$308.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.93
|
|
|
HC XR CHEST ABD FOREIG BOD CHILD
|
Facility
|
OP
|
$275.97
|
|
|
Service Code
|
CPT 76010
|
| Hospital Charge Code |
32000234
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$63.66 |
| Max. Negotiated Rate |
$248.37 |
| Rate for Payer: Aetna Commercial |
$234.57
|
| Rate for Payer: Aetna Medicare |
$71.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.24
|
| Rate for Payer: BCBS Complete |
$66.85
|
| Rate for Payer: BCBS MAPPO |
$68.99
|
| Rate for Payer: BCBS Trust/PPO |
$226.87
|
| Rate for Payer: BCN Commercial |
$214.57
|
| Rate for Payer: BCN Medicare Advantage |
$68.99
|
| Rate for Payer: Cash Price |
$220.78
|
| Rate for Payer: Cash Price |
$220.78
|
| Rate for Payer: Cofinity Commercial |
$237.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.99
|
| Rate for Payer: Healthscope Commercial |
$248.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.98
|
| Rate for Payer: Mclaren Medicaid |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.44
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.57
|
| Rate for Payer: Nomi Health Commercial |
$226.30
|
| Rate for Payer: PACE Senior Care Partners |
$65.54
|
| Rate for Payer: PACE SWMI |
$68.99
|
| Rate for Payer: PHP Commercial |
$234.57
|
| Rate for Payer: PHP Medicare Advantage |
$68.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.38
|
| Rate for Payer: Priority Health HMO/PPO |
$240.09
|
| Rate for Payer: Priority Health Medicare |
$69.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.90
|
| Rate for Payer: Railroad Medicare Medicare |
$68.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.85
|
| Rate for Payer: UHC Core |
$230.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.99
|
| Rate for Payer: UHC Exchange |
$68.99
|
| Rate for Payer: UHC Medicare Advantage |
$68.99
|
| Rate for Payer: UHCCP Medicaid |
$63.66
|
| Rate for Payer: VA VA |
$68.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.98
|
|
|
HC XR CHEST ABD FOREIG BOD CHILD
|
Facility
|
IP
|
$275.97
|
|
|
Service Code
|
CPT 76010
|
| Hospital Charge Code |
32000234
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$179.38 |
| Max. Negotiated Rate |
$248.37 |
| Rate for Payer: Aetna Commercial |
$234.57
|
| Rate for Payer: BCBS Trust/PPO |
$225.27
|
| Rate for Payer: BCN Commercial |
$213.27
|
| Rate for Payer: Cash Price |
$220.78
|
| Rate for Payer: Cofinity Commercial |
$237.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.78
|
| Rate for Payer: Healthscope Commercial |
$248.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.57
|
| Rate for Payer: Nomi Health Commercial |
$226.30
|
| Rate for Payer: PHP Commercial |
$234.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.38
|
| Rate for Payer: Priority Health HMO/PPO |
$240.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.85
|
| Rate for Payer: UHC Core |
$230.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.98
|
|
|
HC XR CHEST SINGLE VIEW
|
Facility
|
IP
|
$270.92
|
|
|
Service Code
|
CPT 71045
|
| Hospital Charge Code |
32400009
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$176.10 |
| Max. Negotiated Rate |
$243.83 |
| Rate for Payer: Aetna Commercial |
$230.28
|
| Rate for Payer: BCBS Trust/PPO |
$221.15
|
| Rate for Payer: BCN Commercial |
$209.37
|
| Rate for Payer: Cash Price |
$216.74
|
| Rate for Payer: Cofinity Commercial |
$232.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.74
|
| Rate for Payer: Healthscope Commercial |
$243.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.28
|
| Rate for Payer: Nomi Health Commercial |
$222.15
|
| Rate for Payer: PHP Commercial |
$230.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.10
|
| Rate for Payer: Priority Health HMO/PPO |
$235.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.41
|
| Rate for Payer: UHC Core |
$226.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.19
|
|
|
HC XR CHEST SINGLE VIEW
|
Facility
|
OP
|
$270.92
|
|
|
Service Code
|
CPT 71045
|
| Hospital Charge Code |
32400009
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$63.66 |
| Max. Negotiated Rate |
$243.83 |
| Rate for Payer: Aetna Commercial |
$230.28
|
| Rate for Payer: Aetna Medicare |
$70.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$84.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$84.66
|
| Rate for Payer: BCBS Complete |
$66.85
|
| Rate for Payer: BCBS MAPPO |
$67.73
|
| Rate for Payer: BCBS Trust/PPO |
$222.72
|
| Rate for Payer: BCN Commercial |
$210.64
|
| Rate for Payer: BCN Medicare Advantage |
$67.73
|
| Rate for Payer: Cash Price |
$216.74
|
| Rate for Payer: Cash Price |
$216.74
|
| Rate for Payer: Cofinity Commercial |
$232.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.73
|
| Rate for Payer: Healthscope Commercial |
$243.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.19
|
| Rate for Payer: Mclaren Medicaid |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.12
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.28
|
| Rate for Payer: Nomi Health Commercial |
$222.15
|
| Rate for Payer: PACE Senior Care Partners |
$64.34
|
| Rate for Payer: PACE SWMI |
$67.73
|
| Rate for Payer: PHP Commercial |
$230.28
|
| Rate for Payer: PHP Medicare Advantage |
$67.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.10
|
| Rate for Payer: Priority Health HMO/PPO |
$235.70
|
| Rate for Payer: Priority Health Medicare |
$68.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.52
|
| Rate for Payer: Railroad Medicare Medicare |
$67.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.41
|
| Rate for Payer: UHC Core |
$226.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.73
|
| Rate for Payer: UHC Exchange |
$67.73
|
| Rate for Payer: UHC Medicare Advantage |
$67.73
|
| Rate for Payer: UHCCP Medicaid |
$63.66
|
| Rate for Payer: VA VA |
$67.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.19
|
|
|
HC XR CHOLANGIOGRAM IN OR
|
Facility
|
OP
|
$510.39
|
|
|
Service Code
|
CPT 74300
|
| Hospital Charge Code |
32000149
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$121.22 |
| Max. Negotiated Rate |
$459.35 |
| Rate for Payer: Aetna Commercial |
$433.83
|
| Rate for Payer: Aetna Medicare |
$132.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$159.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$159.50
|
| Rate for Payer: BCBS Complete |
$204.16
|
| Rate for Payer: BCBS MAPPO |
$127.60
|
| Rate for Payer: BCBS Trust/PPO |
$419.59
|
| Rate for Payer: BCN Commercial |
$396.83
|
| Rate for Payer: BCN Medicare Advantage |
$127.60
|
| Rate for Payer: Cash Price |
$408.31
|
| Rate for Payer: Cofinity Commercial |
$438.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.60
|
| Rate for Payer: Healthscope Commercial |
$459.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$146.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.83
|
| Rate for Payer: Nomi Health Commercial |
$418.52
|
| Rate for Payer: PACE Senior Care Partners |
$121.22
|
| Rate for Payer: PACE SWMI |
$127.60
|
| Rate for Payer: PHP Commercial |
$433.83
|
| Rate for Payer: PHP Medicare Advantage |
$127.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.75
|
| Rate for Payer: Priority Health HMO/PPO |
$444.04
|
| Rate for Payer: Priority Health Medicare |
$128.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$341.96
|
| Rate for Payer: Railroad Medicare Medicare |
$127.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$449.14
|
| Rate for Payer: UHC Core |
$426.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.60
|
| Rate for Payer: UHC Exchange |
$127.60
|
| Rate for Payer: UHC Medicare Advantage |
$127.60
|
| Rate for Payer: VA VA |
$127.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.79
|
|
|
HC XR CHOLANGIOGRAM IN OR
|
Facility
|
IP
|
$510.39
|
|
|
Service Code
|
CPT 74300
|
| Hospital Charge Code |
32000149
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$331.75 |
| Max. Negotiated Rate |
$459.35 |
| Rate for Payer: Aetna Commercial |
$433.83
|
| Rate for Payer: BCBS Trust/PPO |
$416.63
|
| Rate for Payer: BCN Commercial |
$394.43
|
| Rate for Payer: Cash Price |
$408.31
|
| Rate for Payer: Cofinity Commercial |
$438.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.31
|
| Rate for Payer: Healthscope Commercial |
$459.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.83
|
| Rate for Payer: Nomi Health Commercial |
$418.52
|
| Rate for Payer: PHP Commercial |
$433.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.75
|
| Rate for Payer: Priority Health HMO/PPO |
$444.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$341.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$449.14
|
| Rate for Payer: UHC Core |
$426.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.79
|
|
|
HC XR CLAVICLE
|
Facility
|
IP
|
$316.49
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000060
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$205.72 |
| Max. Negotiated Rate |
$284.84 |
| Rate for Payer: Aetna Commercial |
$269.02
|
| Rate for Payer: BCBS Trust/PPO |
$258.35
|
| Rate for Payer: BCN Commercial |
$244.58
|
| Rate for Payer: Cash Price |
$253.19
|
| Rate for Payer: Cofinity Commercial |
$272.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$253.19
|
| Rate for Payer: Healthscope Commercial |
$284.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$237.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$269.02
|
| Rate for Payer: Nomi Health Commercial |
$259.52
|
| Rate for Payer: PHP Commercial |
$269.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.72
|
| Rate for Payer: Priority Health HMO/PPO |
$275.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$212.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$278.51
|
| Rate for Payer: UHC Core |
$264.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$237.37
|
|
