|
HC XR CLAVICLE
|
Facility
|
OP
|
$316.49
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000060
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$63.66 |
| Max. Negotiated Rate |
$284.84 |
| Rate for Payer: Aetna Commercial |
$269.02
|
| Rate for Payer: Aetna Medicare |
$82.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.90
|
| Rate for Payer: BCBS Complete |
$66.85
|
| Rate for Payer: BCBS MAPPO |
$79.12
|
| Rate for Payer: BCBS Trust/PPO |
$260.19
|
| Rate for Payer: BCN Commercial |
$246.07
|
| Rate for Payer: BCN Medicare Advantage |
$79.12
|
| Rate for Payer: Cash Price |
$253.19
|
| 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: Health Alliance Plan Medicare Advantage |
$79.12
|
| Rate for Payer: Healthscope Commercial |
$284.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$237.37
|
| Rate for Payer: Mclaren Medicaid |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.08
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$269.02
|
| Rate for Payer: Nomi Health Commercial |
$259.52
|
| Rate for Payer: PACE Senior Care Partners |
$75.17
|
| Rate for Payer: PACE SWMI |
$79.12
|
| Rate for Payer: PHP Commercial |
$269.02
|
| Rate for Payer: PHP Medicare Advantage |
$79.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.72
|
| Rate for Payer: Priority Health HMO/PPO |
$275.35
|
| Rate for Payer: Priority Health Medicare |
$79.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$212.05
|
| Rate for Payer: Railroad Medicare Medicare |
$79.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$278.51
|
| Rate for Payer: UHC Core |
$264.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.12
|
| Rate for Payer: UHC Exchange |
$79.12
|
| Rate for Payer: UHC Medicare Advantage |
$79.12
|
| Rate for Payer: UHCCP Medicaid |
$63.66
|
| Rate for Payer: VA VA |
$79.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$237.37
|
|
|
HC XR CLAVICLE BIL
|
Facility
|
OP
|
$340.34
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000061
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$63.66 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Aetna Commercial |
$289.29
|
| Rate for Payer: Aetna Medicare |
$88.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.36
|
| Rate for Payer: BCBS Complete |
$66.85
|
| Rate for Payer: BCBS MAPPO |
$85.08
|
| Rate for Payer: BCBS Trust/PPO |
$279.79
|
| Rate for Payer: BCN Commercial |
$264.61
|
| Rate for Payer: BCN Medicare Advantage |
$85.08
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$292.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.08
|
| Rate for Payer: Healthscope Commercial |
$306.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.25
|
| Rate for Payer: Mclaren Medicaid |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.34
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.29
|
| Rate for Payer: Nomi Health Commercial |
$279.08
|
| Rate for Payer: PACE Senior Care Partners |
$80.83
|
| Rate for Payer: PACE SWMI |
$85.08
|
| Rate for Payer: PHP Commercial |
$289.29
|
| Rate for Payer: PHP Medicare Advantage |
$85.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.22
|
| Rate for Payer: Priority Health HMO/PPO |
$296.10
|
| Rate for Payer: Priority Health Medicare |
$85.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.03
|
| Rate for Payer: Railroad Medicare Medicare |
$85.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$299.50
|
| Rate for Payer: UHC Core |
$284.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.08
|
| Rate for Payer: UHC Exchange |
$85.08
|
| Rate for Payer: UHC Medicare Advantage |
$85.08
|
| Rate for Payer: UHCCP Medicaid |
$63.66
|
| Rate for Payer: VA VA |
$85.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.25
|
|
|
HC XR CLAVICLE BIL
|
Facility
|
IP
|
$340.34
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000061
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$221.22 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Aetna Commercial |
$289.29
|
| Rate for Payer: BCBS Trust/PPO |
$277.82
|
| Rate for Payer: BCN Commercial |
$263.01
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$292.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Healthscope Commercial |
$306.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.29
|
| Rate for Payer: Nomi Health Commercial |
$279.08
|
| Rate for Payer: PHP Commercial |
$289.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.22
|
| Rate for Payer: Priority Health HMO/PPO |
$296.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$299.50
|
| Rate for Payer: UHC Core |
$284.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.25
|
|
|
HC XR COLON
|
Facility
|
IP
|
$857.44
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
32000273
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$557.34 |
| Max. Negotiated Rate |
$771.70 |
| Rate for Payer: Aetna Commercial |
$728.82
|
| Rate for Payer: BCBS Trust/PPO |
$699.93
|
| Rate for Payer: BCN Commercial |
$662.63
|
| Rate for Payer: Cash Price |
$685.95
|
| Rate for Payer: Cofinity Commercial |
$737.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$685.95
|
| Rate for Payer: Healthscope Commercial |
$771.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$643.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$728.82
|
| Rate for Payer: Nomi Health Commercial |
$703.10
|
| Rate for Payer: PHP Commercial |
$728.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$557.34
|
| Rate for Payer: Priority Health HMO/PPO |
$745.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$574.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$754.55
|
| Rate for Payer: UHC Core |
$715.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$643.08
|
|
|
HC XR COLON
|
Facility
|
OP
|
$857.44
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
32000273
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$128.71 |
| Max. Negotiated Rate |
$771.70 |
| Rate for Payer: Aetna Commercial |
$728.82
|
| Rate for Payer: Aetna Medicare |
$222.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$267.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$267.95
|
| Rate for Payer: BCBS Complete |
$135.15
|
| Rate for Payer: BCBS MAPPO |
$214.36
|
| Rate for Payer: BCBS Trust/PPO |
$704.90
|
| Rate for Payer: BCN Commercial |
$666.66
|
| Rate for Payer: BCN Medicare Advantage |
$214.36
|
| Rate for Payer: Cash Price |
$685.95
|
| Rate for Payer: Cash Price |
$685.95
|
| Rate for Payer: Cofinity Commercial |
$737.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$685.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$214.36
|
| Rate for Payer: Healthscope Commercial |
$771.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$643.08
|
| Rate for Payer: Mclaren Medicaid |
$128.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.08
|
| Rate for Payer: Meridian Medicaid |
$135.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$246.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$728.82
|
| Rate for Payer: Nomi Health Commercial |
$703.10
|
| Rate for Payer: PACE Senior Care Partners |
$203.64
|
| Rate for Payer: PACE SWMI |
$214.36
|
| Rate for Payer: PHP Commercial |
$728.82
|
| Rate for Payer: PHP Medicare Advantage |
$214.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$557.34
|
| Rate for Payer: Priority Health HMO/PPO |
$745.97
|
| Rate for Payer: Priority Health Medicare |
$216.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$574.48
|
| Rate for Payer: Railroad Medicare Medicare |
$214.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$754.55
|
| Rate for Payer: UHC Core |
$715.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$214.36
|
| Rate for Payer: UHC Exchange |
$214.36
|
| Rate for Payer: UHC Medicare Advantage |
$214.36
|
| Rate for Payer: UHCCP Medicaid |
$128.71
|
| Rate for Payer: VA VA |
$214.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$643.08
|
|
|
HC XR COLON HIGH DENSITY
|
Facility
|
OP
|
$1,224.87
|
|
|
Service Code
|
CPT 74280
|
| Hospital Charge Code |
32000146
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$128.71 |
| Max. Negotiated Rate |
$1,102.38 |
| Rate for Payer: Aetna Commercial |
$1,041.14
|
| Rate for Payer: Aetna Medicare |
$318.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.77
|
| Rate for Payer: BCBS Complete |
$135.15
|
| Rate for Payer: BCBS MAPPO |
$306.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,006.97
|
| Rate for Payer: BCN Commercial |
$952.34
|
| Rate for Payer: BCN Medicare Advantage |
$306.22
|
| Rate for Payer: Cash Price |
$979.90
|
| Rate for Payer: Cash Price |
$979.90
|
| Rate for Payer: Cofinity Commercial |
$1,053.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$979.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.22
|
| Rate for Payer: Healthscope Commercial |
$1,102.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$918.65
|
| Rate for Payer: Mclaren Medicaid |
$128.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.53
|
| Rate for Payer: Meridian Medicaid |
$135.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$352.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,041.14
|
| Rate for Payer: Nomi Health Commercial |
$1,004.39
|
| Rate for Payer: PACE Senior Care Partners |
$290.91
|
| Rate for Payer: PACE SWMI |
$306.22
|
| Rate for Payer: PHP Commercial |
$1,041.14
|
| Rate for Payer: PHP Medicare Advantage |
$306.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.17
|
| Rate for Payer: Priority Health HMO/PPO |
$1,065.64
|
| Rate for Payer: Priority Health Medicare |
$309.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$820.66
|
| Rate for Payer: Railroad Medicare Medicare |
$306.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,077.89
|
| Rate for Payer: UHC Core |
$1,022.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.22
|
| Rate for Payer: UHC Exchange |
$306.22
|
| Rate for Payer: UHC Medicare Advantage |
$306.22
|
| Rate for Payer: UHCCP Medicaid |
$128.71
|
| Rate for Payer: VA VA |
$306.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$918.65
|
|
|
HC XR COLON HIGH DENSITY
|
Facility
|
IP
|
$1,224.87
|
|
|
Service Code
|
CPT 74280
|
| Hospital Charge Code |
32000146
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$796.17 |
| Max. Negotiated Rate |
$1,102.38 |
| Rate for Payer: Aetna Commercial |
$1,041.14
|
| Rate for Payer: BCBS Trust/PPO |
$999.86
|
| Rate for Payer: BCN Commercial |
$946.58
|
| Rate for Payer: Cash Price |
$979.90
|
| Rate for Payer: Cofinity Commercial |
$1,053.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$979.90
|
| Rate for Payer: Healthscope Commercial |
$1,102.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$918.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,041.14
|
| Rate for Payer: Nomi Health Commercial |
$1,004.39
|
| Rate for Payer: PHP Commercial |
$1,041.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.17
|
| Rate for Payer: Priority Health HMO/PPO |
$1,065.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$820.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,077.89
|
| Rate for Payer: UHC Core |
$1,022.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$918.65
|
|
|
HC XR COLON THERAPEUTIC FOR INTUS
|
Facility
|
IP
|
$583.28
|
|
|
Service Code
|
CPT 74283
|
| Hospital Charge Code |
32000147
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$379.13 |
| Max. Negotiated Rate |
$524.95 |
| Rate for Payer: Aetna Commercial |
$495.79
|
| Rate for Payer: BCBS Trust/PPO |
$476.13
|
| Rate for Payer: BCN Commercial |
$450.76
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$501.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Healthscope Commercial |
$524.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: Nomi Health Commercial |
$478.29
|
| Rate for Payer: PHP Commercial |
$495.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health HMO/PPO |
$507.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$390.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$513.29
|
| Rate for Payer: UHC Core |
$487.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.46
|
|
|
HC XR COLON THERAPEUTIC FOR INTUS
|
Facility
|
OP
|
$583.28
|
|
|
Service Code
|
CPT 74283
|
| Hospital Charge Code |
32000147
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$128.71 |
| Max. Negotiated Rate |
$524.95 |
| Rate for Payer: Aetna Commercial |
$495.79
|
| Rate for Payer: Aetna Medicare |
$151.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$182.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$182.28
|
| Rate for Payer: BCBS Complete |
$135.15
|
| Rate for Payer: BCBS MAPPO |
$145.82
|
| Rate for Payer: BCBS Trust/PPO |
$479.51
|
| Rate for Payer: BCN Commercial |
$453.50
|
| Rate for Payer: BCN Medicare Advantage |
$145.82
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$501.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.82
|
| Rate for Payer: Healthscope Commercial |
$524.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.46
|
| Rate for Payer: Mclaren Medicaid |
$128.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.11
|
| Rate for Payer: Meridian Medicaid |
$135.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$167.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: Nomi Health Commercial |
$478.29
|
| Rate for Payer: PACE Senior Care Partners |
$138.53
|
| Rate for Payer: PACE SWMI |
$145.82
|
| Rate for Payer: PHP Commercial |
$495.79
|
| Rate for Payer: PHP Medicare Advantage |
$145.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health HMO/PPO |
$507.45
|
| Rate for Payer: Priority Health Medicare |
$147.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$390.80
|
| Rate for Payer: Railroad Medicare Medicare |
$145.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$513.29
|
| Rate for Payer: UHC Core |
$487.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.82
|
| Rate for Payer: UHC Exchange |
$145.82
|
| Rate for Payer: UHC Medicare Advantage |
$145.82
|
| Rate for Payer: UHCCP Medicaid |
$128.71
|
| Rate for Payer: VA VA |
$145.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.46
|
|
|
HC XR CYSTOGRAM MIN 3 VW
|
Facility
|
OP
|
$439.05
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000163
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$104.27 |
| Max. Negotiated Rate |
$395.14 |
| Rate for Payer: Aetna Commercial |
$373.19
|
| Rate for Payer: Aetna Medicare |
$114.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$137.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$137.20
|
| Rate for Payer: BCBS Complete |
$271.13
|
| Rate for Payer: BCBS MAPPO |
$109.76
|
| Rate for Payer: BCBS Trust/PPO |
$360.94
|
| Rate for Payer: BCN Commercial |
$341.36
|
| Rate for Payer: BCN Medicare Advantage |
$109.76
|
| Rate for Payer: Cash Price |
$351.24
|
| Rate for Payer: Cash Price |
$351.24
|
| Rate for Payer: Cofinity Commercial |
$377.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.76
|
| Rate for Payer: Healthscope Commercial |
$395.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.29
|
| Rate for Payer: Mclaren Medicaid |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.25
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$126.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.19
|
| Rate for Payer: Nomi Health Commercial |
$360.02
|
| Rate for Payer: PACE Senior Care Partners |
$104.27
|
| Rate for Payer: PACE SWMI |
$109.76
|
| Rate for Payer: PHP Commercial |
$373.19
|
| Rate for Payer: PHP Medicare Advantage |
$109.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.38
|
| Rate for Payer: Priority Health HMO/PPO |
$381.97
|
| Rate for Payer: Priority Health Medicare |
$110.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$294.16
|
| Rate for Payer: Railroad Medicare Medicare |
$109.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.36
|
| Rate for Payer: UHC Core |
$366.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.76
|
| Rate for Payer: UHC Exchange |
$109.76
|
| Rate for Payer: UHC Medicare Advantage |
$109.76
|
| Rate for Payer: UHCCP Medicaid |
$258.20
|
| Rate for Payer: VA VA |
$109.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.29
|
|
|
HC XR CYSTOGRAM MIN 3 VW
|
Facility
|
IP
|
$439.05
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000163
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$285.38 |
| Max. Negotiated Rate |
$395.14 |
| Rate for Payer: Aetna Commercial |
$373.19
|
| Rate for Payer: BCBS Trust/PPO |
$358.40
|
| Rate for Payer: BCN Commercial |
$339.30
|
| Rate for Payer: Cash Price |
$351.24
|
| Rate for Payer: Cofinity Commercial |
$377.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.24
|
| Rate for Payer: Healthscope Commercial |
$395.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.19
|
| Rate for Payer: Nomi Health Commercial |
$360.02
|
| Rate for Payer: PHP Commercial |
$373.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.38
|
| Rate for Payer: Priority Health HMO/PPO |
$381.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$294.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.36
|
| Rate for Payer: UHC Core |
$366.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.29
|
|
|
HC XR CYSTOGRAM VOIDING
|
Facility
|
OP
|
$510.39
|
|
|
Service Code
|
CPT 74455
|
| Hospital Charge Code |
32000166
|
|
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 |
$183.51
|
| 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: 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: Mclaren Medicaid |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.98
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| 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 Choice Medicaid |
$174.76
|
| 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: UHCCP Medicaid |
$174.76
|
| Rate for Payer: VA VA |
$127.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.79
|
|
|
HC XR CYSTOGRAM VOIDING
|
Facility
|
IP
|
$510.39
|
|
|
Service Code
|
CPT 74455
|
| Hospital Charge Code |
32000166
|
|
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 DEFECOGRAPHY 4 WAY
|
Facility
|
OP
|
$816.54
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000164
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$193.93 |
| Max. Negotiated Rate |
$734.89 |
| Rate for Payer: Aetna Commercial |
$694.06
|
| Rate for Payer: Aetna Medicare |
$212.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$255.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$255.17
|
| Rate for Payer: BCBS Complete |
$271.13
|
| Rate for Payer: BCBS MAPPO |
$204.13
|
| Rate for Payer: BCBS Trust/PPO |
$671.28
|
| Rate for Payer: BCN Commercial |
$634.86
|
| Rate for Payer: BCN Medicare Advantage |
$204.13
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$702.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.13
|
| Rate for Payer: Healthscope Commercial |
$734.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$612.40
|
| Rate for Payer: Mclaren Medicaid |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.34
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$234.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: Nomi Health Commercial |
$669.56
|
| Rate for Payer: PACE Senior Care Partners |
$193.93
|
| Rate for Payer: PACE SWMI |
$204.13
|
| Rate for Payer: PHP Commercial |
$694.06
|
| Rate for Payer: PHP Medicare Advantage |
$204.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health HMO/PPO |
$710.39
|
| Rate for Payer: Priority Health Medicare |
$206.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.08
|
| Rate for Payer: Railroad Medicare Medicare |
$204.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$718.56
|
| Rate for Payer: UHC Core |
$681.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.13
|
| Rate for Payer: UHC Exchange |
$204.13
|
| Rate for Payer: UHC Medicare Advantage |
$204.13
|
| Rate for Payer: UHCCP Medicaid |
$258.20
|
| Rate for Payer: VA VA |
$204.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$612.40
|
|
|
HC XR DEFECOGRAPHY 4 WAY
|
Facility
|
IP
|
$816.54
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000164
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$530.75 |
| Max. Negotiated Rate |
$734.89 |
| Rate for Payer: Aetna Commercial |
$694.06
|
| Rate for Payer: BCBS Trust/PPO |
$666.54
|
| Rate for Payer: BCN Commercial |
$631.02
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$702.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Healthscope Commercial |
$734.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$612.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: Nomi Health Commercial |
$669.56
|
| Rate for Payer: PHP Commercial |
$694.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health HMO/PPO |
$710.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$718.56
|
| Rate for Payer: UHC Core |
$681.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$612.40
|
|
|
HC XR ELBOW 2 BIL VW
|
Facility
|
OP
|
$388.71
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000072
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$63.66 |
| 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 |
$66.85
|
| 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 |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.04
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| 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 |
$63.66
|
| 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 |
$63.66
|
| Rate for Payer: VA VA |
$97.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC XR ELBOW 2 BIL VW
|
Facility
|
IP
|
$388.71
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000072
|
|
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 ELBOW 2 VW
|
Facility
|
IP
|
$357.38
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000071
|
|
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 ELBOW 2 VW
|
Facility
|
OP
|
$357.38
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000071
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$63.66 |
| 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 |
$66.85
|
| 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 |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.81
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| 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 |
$63.66
|
| 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 |
$63.66
|
| Rate for Payer: VA VA |
$89.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
|
HC XR ELBOW BIL 3 VW
|
Facility
|
OP
|
$388.71
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000074
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$63.66 |
| 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 |
$66.85
|
| 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 |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.04
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| 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 |
$63.66
|
| 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 |
$63.66
|
| Rate for Payer: VA VA |
$97.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC XR ELBOW BIL 3 VW
|
Facility
|
IP
|
$388.71
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000074
|
|
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 ELBOW MIN 3 VW
|
Facility
|
IP
|
$357.38
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000073
|
|
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 ELBOW MIN 3 VW
|
Facility
|
OP
|
$357.38
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000073
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$63.66 |
| 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 |
$66.85
|
| 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 |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.81
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| 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 |
$63.66
|
| 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 |
$63.66
|
| Rate for Payer: VA VA |
$89.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
|
HC XR ENDO RETROGRADE CHOLANGIOGR
|
Facility
|
IP
|
$555.66
|
|
|
Service Code
|
CPT 74328
|
| Hospital Charge Code |
32000154
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$361.18 |
| Max. Negotiated Rate |
$500.09 |
| Rate for Payer: Aetna Commercial |
$472.31
|
| Rate for Payer: BCBS Trust/PPO |
$453.59
|
| Rate for Payer: BCN Commercial |
$429.41
|
| Rate for Payer: Cash Price |
$444.53
|
| Rate for Payer: Cofinity Commercial |
$477.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$444.53
|
| Rate for Payer: Healthscope Commercial |
$500.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$416.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$472.31
|
| Rate for Payer: Nomi Health Commercial |
$455.64
|
| Rate for Payer: PHP Commercial |
$472.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$361.18
|
| Rate for Payer: Priority Health HMO/PPO |
$483.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$372.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.98
|
| Rate for Payer: UHC Core |
$463.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$416.75
|
|
|
HC XR ENDO RETROGRADE CHOLANGIOGR
|
Facility
|
OP
|
$555.66
|
|
|
Service Code
|
CPT 74328
|
| Hospital Charge Code |
32000154
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$131.97 |
| Max. Negotiated Rate |
$500.09 |
| Rate for Payer: Aetna Commercial |
$472.31
|
| Rate for Payer: Aetna Medicare |
$144.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.64
|
| Rate for Payer: BCBS Complete |
$222.26
|
| Rate for Payer: BCBS MAPPO |
$138.91
|
| Rate for Payer: BCBS Trust/PPO |
$456.81
|
| Rate for Payer: BCN Commercial |
$432.03
|
| Rate for Payer: BCN Medicare Advantage |
$138.91
|
| Rate for Payer: Cash Price |
$444.53
|
| Rate for Payer: Cofinity Commercial |
$477.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$444.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.91
|
| Rate for Payer: Healthscope Commercial |
$500.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$416.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$472.31
|
| Rate for Payer: Nomi Health Commercial |
$455.64
|
| Rate for Payer: PACE Senior Care Partners |
$131.97
|
| Rate for Payer: PACE SWMI |
$138.91
|
| Rate for Payer: PHP Commercial |
$472.31
|
| Rate for Payer: PHP Medicare Advantage |
$138.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$361.18
|
| Rate for Payer: Priority Health HMO/PPO |
$483.42
|
| Rate for Payer: Priority Health Medicare |
$140.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$372.29
|
| Rate for Payer: Railroad Medicare Medicare |
$138.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.98
|
| Rate for Payer: UHC Core |
$463.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.91
|
| Rate for Payer: UHC Exchange |
$138.91
|
| Rate for Payer: UHC Medicare Advantage |
$138.91
|
| Rate for Payer: VA VA |
$138.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$416.75
|
|
