|
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 |
$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 ELBOW BIL 3 VW
|
Facility
|
OP
|
$388.71
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000074
|
|
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 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
|
OP
|
$357.38
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000073
|
|
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 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 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 |
$138.92
|
| Rate for Payer: BCBS Trust/PPO |
$456.81
|
| Rate for Payer: BCN Commercial |
$432.03
|
| Rate for Payer: BCN Medicare Advantage |
$138.92
|
| 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 |
$138.92
|
| Rate for Payer: Healthscope Commercial |
$500.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$416.74
|
| 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 |
$138.92
|
| Rate for Payer: PHP Commercial |
$472.31
|
| Rate for Payer: PHP Medicare Advantage |
$138.92
|
| 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 |
$138.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.98
|
| Rate for Payer: UHC Core |
$463.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.92
|
| Rate for Payer: UHC Exchange |
$138.92
|
| Rate for Payer: UHC Medicare Advantage |
$138.92
|
| Rate for Payer: VA VA |
$138.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$416.74
|
|
|
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 |
$416.74
|
| 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 |
$416.74
|
|
|
HC XR ESOPHAGEAL DILATION
|
Facility
|
IP
|
$263.05
|
|
|
Service Code
|
CPT 74360
|
| Hospital Charge Code |
32000297
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$170.98 |
| Max. Negotiated Rate |
$236.74 |
| Rate for Payer: Aetna Commercial |
$223.59
|
| Rate for Payer: BCBS Trust/PPO |
$214.73
|
| Rate for Payer: BCN Commercial |
$203.29
|
| Rate for Payer: Cash Price |
$210.44
|
| Rate for Payer: Cofinity Commercial |
$226.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.44
|
| Rate for Payer: Healthscope Commercial |
$236.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.59
|
| Rate for Payer: Nomi Health Commercial |
$215.70
|
| Rate for Payer: PHP Commercial |
$223.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.98
|
| Rate for Payer: Priority Health HMO/PPO |
$228.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.48
|
| Rate for Payer: UHC Core |
$219.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.29
|
|
|
HC XR ESOPHAGEAL DILATION
|
Facility
|
OP
|
$263.05
|
|
|
Service Code
|
CPT 74360
|
| Hospital Charge Code |
32000297
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$62.47 |
| Max. Negotiated Rate |
$236.74 |
| Rate for Payer: Aetna Commercial |
$223.59
|
| Rate for Payer: Aetna Medicare |
$68.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.20
|
| Rate for Payer: BCBS Complete |
$105.22
|
| Rate for Payer: BCBS MAPPO |
$65.76
|
| Rate for Payer: BCBS Trust/PPO |
$216.25
|
| Rate for Payer: BCN Commercial |
$204.52
|
| Rate for Payer: BCN Medicare Advantage |
$65.76
|
| Rate for Payer: Cash Price |
$210.44
|
| Rate for Payer: Cofinity Commercial |
$226.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.76
|
| Rate for Payer: Healthscope Commercial |
$236.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.59
|
| Rate for Payer: Nomi Health Commercial |
$215.70
|
| Rate for Payer: PACE Senior Care Partners |
$62.47
|
| Rate for Payer: PACE SWMI |
$65.76
|
| Rate for Payer: PHP Commercial |
$223.59
|
| Rate for Payer: PHP Medicare Advantage |
$65.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.98
|
| Rate for Payer: Priority Health HMO/PPO |
$228.85
|
| Rate for Payer: Priority Health Medicare |
$66.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.24
|
| Rate for Payer: Railroad Medicare Medicare |
$65.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.48
|
| Rate for Payer: UHC Core |
$219.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.76
|
| Rate for Payer: UHC Exchange |
$65.76
|
| Rate for Payer: UHC Medicare Advantage |
$65.76
|
| Rate for Payer: VA VA |
$65.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.29
|
|
|
HC XR ESOPHAGUS
|
Facility
|
IP
|
$642.88
|
|
|
Service Code
|
CPT 74220
|
| Hospital Charge Code |
32000136
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$417.87 |
| Max. Negotiated Rate |
$578.59 |
| Rate for Payer: Aetna Commercial |
$546.45
|
| Rate for Payer: BCBS Trust/PPO |
$524.78
|
| Rate for Payer: BCN Commercial |
$496.82
|
| Rate for Payer: Cash Price |
$514.30
|
| Rate for Payer: Cofinity Commercial |
$552.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$514.30
|
| Rate for Payer: Healthscope Commercial |
$578.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$482.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$546.45
|
| Rate for Payer: Nomi Health Commercial |
$527.16
|
| Rate for Payer: PHP Commercial |
$546.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$417.87
|
| Rate for Payer: Priority Health HMO/PPO |
$559.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$430.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$565.73
|
| Rate for Payer: UHC Core |
$536.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$482.16
|
|
|
HC XR ESOPHAGUS
|
Facility
|
OP
|
$642.88
|
|
|
Service Code
|
CPT 74220
|
| Hospital Charge Code |
32000136
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$126.11 |
| Max. Negotiated Rate |
$578.59 |
| Rate for Payer: Aetna Commercial |
$546.45
|
| Rate for Payer: Aetna Medicare |
$167.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$200.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$200.90
|
| Rate for Payer: BCBS Complete |
$132.42
|
| Rate for Payer: BCBS MAPPO |
$160.72
|
| Rate for Payer: BCBS Trust/PPO |
$528.51
|
| Rate for Payer: BCN Commercial |
$499.84
|
| Rate for Payer: BCN Medicare Advantage |
$160.72
|
| Rate for Payer: Cash Price |
$514.30
|
| Rate for Payer: Cash Price |
$514.30
|
| Rate for Payer: Cofinity Commercial |
$552.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$514.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.72
|
| Rate for Payer: Healthscope Commercial |
$578.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$482.16
|
| Rate for Payer: Mclaren Medicaid |
$126.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$168.76
|
| Rate for Payer: Meridian Medicaid |
$132.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$184.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$546.45
|
| Rate for Payer: Nomi Health Commercial |
$527.16
|
| Rate for Payer: PACE Senior Care Partners |
$152.68
|
| Rate for Payer: PACE SWMI |
$160.72
|
| Rate for Payer: PHP Commercial |
$546.45
|
| Rate for Payer: PHP Medicare Advantage |
$160.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$417.87
|
| Rate for Payer: Priority Health HMO/PPO |
$559.31
|
| Rate for Payer: Priority Health Medicare |
$162.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$430.73
|
| Rate for Payer: Railroad Medicare Medicare |
$160.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$565.73
|
| Rate for Payer: UHC Core |
$536.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$160.72
|
| Rate for Payer: UHC Exchange |
$160.72
|
| Rate for Payer: UHC Medicare Advantage |
$160.72
|
| Rate for Payer: UHCCP Medicaid |
$126.11
|
| Rate for Payer: VA VA |
$160.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$482.16
|
|
|
HC XR ESOPHAGUS FB
|
Facility
|
OP
|
$491.00
|
|
|
Service Code
|
HCPCS 74235
|
| Hospital Charge Code |
32000296
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$116.61 |
| Max. Negotiated Rate |
$441.90 |
| Rate for Payer: Aetna Commercial |
$417.35
|
| Rate for Payer: Aetna Medicare |
$127.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$153.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$153.44
|
| Rate for Payer: BCBS Complete |
$196.40
|
| Rate for Payer: BCBS MAPPO |
$122.75
|
| Rate for Payer: BCBS Trust/PPO |
$403.65
|
| Rate for Payer: BCN Commercial |
$381.75
|
| Rate for Payer: BCN Medicare Advantage |
$122.75
|
| Rate for Payer: Cash Price |
$392.80
|
| Rate for Payer: Cofinity Commercial |
$422.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.75
|
| Rate for Payer: Healthscope Commercial |
$441.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$368.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$141.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$417.35
|
| Rate for Payer: Nomi Health Commercial |
$402.62
|
| Rate for Payer: PACE Senior Care Partners |
$116.61
|
| Rate for Payer: PACE SWMI |
$122.75
|
| Rate for Payer: PHP Commercial |
$417.35
|
| Rate for Payer: PHP Medicare Advantage |
$122.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$319.15
|
| Rate for Payer: Priority Health HMO/PPO |
$427.17
|
| Rate for Payer: Priority Health Medicare |
$123.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$328.97
|
| Rate for Payer: Railroad Medicare Medicare |
$122.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$432.08
|
| Rate for Payer: UHC Core |
$409.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.75
|
| Rate for Payer: UHC Exchange |
$122.75
|
| Rate for Payer: UHC Medicare Advantage |
$122.75
|
| Rate for Payer: VA VA |
$122.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$368.25
|
|
|
HC XR ESOPHAGUS FB
|
Facility
|
IP
|
$491.00
|
|
|
Service Code
|
HCPCS 74235
|
| Hospital Charge Code |
32000296
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$319.15 |
| Max. Negotiated Rate |
$441.90 |
| Rate for Payer: Aetna Commercial |
$417.35
|
| Rate for Payer: BCBS Trust/PPO |
$400.80
|
| Rate for Payer: BCN Commercial |
$379.44
|
| Rate for Payer: Cash Price |
$392.80
|
| Rate for Payer: Cofinity Commercial |
$422.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.80
|
| Rate for Payer: Healthscope Commercial |
$441.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$368.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$417.35
|
| Rate for Payer: Nomi Health Commercial |
$402.62
|
| Rate for Payer: PHP Commercial |
$417.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$319.15
|
| Rate for Payer: Priority Health HMO/PPO |
$427.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$328.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$432.08
|
| Rate for Payer: UHC Core |
$409.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$368.25
|
|
|
HC XR ESOPHAGUS HIGH DENSITY
|
Facility
|
OP
|
$642.88
|
|
|
Service Code
|
CPT 74221
|
| Hospital Charge Code |
32000330
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$126.11 |
| Max. Negotiated Rate |
$578.59 |
| Rate for Payer: Aetna Commercial |
$546.45
|
| Rate for Payer: Aetna Medicare |
$167.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$200.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$200.90
|
| Rate for Payer: BCBS Complete |
$132.42
|
| Rate for Payer: BCBS MAPPO |
$160.72
|
| Rate for Payer: BCBS Trust/PPO |
$528.51
|
| Rate for Payer: BCN Commercial |
$499.84
|
| Rate for Payer: BCN Medicare Advantage |
$160.72
|
| Rate for Payer: Cash Price |
$514.30
|
| Rate for Payer: Cash Price |
$514.30
|
| Rate for Payer: Cofinity Commercial |
$552.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$514.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.72
|
| Rate for Payer: Healthscope Commercial |
$578.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$482.16
|
| Rate for Payer: Mclaren Medicaid |
$126.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$168.76
|
| Rate for Payer: Meridian Medicaid |
$132.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$184.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$546.45
|
| Rate for Payer: Nomi Health Commercial |
$527.16
|
| Rate for Payer: PACE Senior Care Partners |
$152.68
|
| Rate for Payer: PACE SWMI |
$160.72
|
| Rate for Payer: PHP Commercial |
$546.45
|
| Rate for Payer: PHP Medicare Advantage |
$160.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$417.87
|
| Rate for Payer: Priority Health HMO/PPO |
$559.31
|
| Rate for Payer: Priority Health Medicare |
$162.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$430.73
|
| Rate for Payer: Railroad Medicare Medicare |
$160.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$565.73
|
| Rate for Payer: UHC Core |
$536.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$160.72
|
| Rate for Payer: UHC Exchange |
$160.72
|
| Rate for Payer: UHC Medicare Advantage |
$160.72
|
| Rate for Payer: UHCCP Medicaid |
$126.11
|
| Rate for Payer: VA VA |
$160.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$482.16
|
|
|
HC XR ESOPHAGUS HIGH DENSITY
|
Facility
|
IP
|
$642.88
|
|
|
Service Code
|
CPT 74221
|
| Hospital Charge Code |
32000330
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$417.87 |
| Max. Negotiated Rate |
$578.59 |
| Rate for Payer: Aetna Commercial |
$546.45
|
| Rate for Payer: BCBS Trust/PPO |
$524.78
|
| Rate for Payer: BCN Commercial |
$496.82
|
| Rate for Payer: Cash Price |
$514.30
|
| Rate for Payer: Cofinity Commercial |
$552.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$514.30
|
| Rate for Payer: Healthscope Commercial |
$578.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$482.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$546.45
|
| Rate for Payer: Nomi Health Commercial |
$527.16
|
| Rate for Payer: PHP Commercial |
$546.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$417.87
|
| Rate for Payer: Priority Health HMO/PPO |
$559.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$430.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$565.73
|
| Rate for Payer: UHC Core |
$536.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$482.16
|
|
|
HC XR EYE FOREIGN BODY PRE MRI
|
Facility
|
OP
|
$459.68
|
|
|
Service Code
|
CPT 70030
|
| Hospital Charge Code |
32000305
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$62.37 |
| Max. Negotiated Rate |
$413.71 |
| Rate for Payer: Aetna Commercial |
$390.73
|
| Rate for Payer: Aetna Medicare |
$119.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$143.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$143.65
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$114.92
|
| Rate for Payer: BCBS Trust/PPO |
$377.90
|
| Rate for Payer: BCN Commercial |
$357.40
|
| Rate for Payer: BCN Medicare Advantage |
$114.92
|
| Rate for Payer: Cash Price |
$367.74
|
| Rate for Payer: Cash Price |
$367.74
|
| Rate for Payer: Cofinity Commercial |
$395.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.92
|
| Rate for Payer: Healthscope Commercial |
$413.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$344.76
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.67
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$132.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.73
|
| Rate for Payer: Nomi Health Commercial |
$376.94
|
| Rate for Payer: PACE Senior Care Partners |
$109.17
|
| Rate for Payer: PACE SWMI |
$114.92
|
| Rate for Payer: PHP Commercial |
$390.73
|
| Rate for Payer: PHP Medicare Advantage |
$114.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.79
|
| Rate for Payer: Priority Health HMO/PPO |
$399.92
|
| Rate for Payer: Priority Health Medicare |
$116.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$307.99
|
| Rate for Payer: Railroad Medicare Medicare |
$114.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$404.52
|
| Rate for Payer: UHC Core |
$383.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.92
|
| Rate for Payer: UHC Exchange |
$114.92
|
| Rate for Payer: UHC Medicare Advantage |
$114.92
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$114.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$344.76
|
|
|
HC XR EYE FOREIGN BODY PRE MRI
|
Facility
|
IP
|
$459.68
|
|
|
Service Code
|
CPT 70030
|
| Hospital Charge Code |
32000305
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$298.79 |
| Max. Negotiated Rate |
$413.71 |
| Rate for Payer: Aetna Commercial |
$390.73
|
| Rate for Payer: BCBS Trust/PPO |
$375.24
|
| Rate for Payer: BCN Commercial |
$355.24
|
| Rate for Payer: Cash Price |
$367.74
|
| Rate for Payer: Cofinity Commercial |
$395.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.74
|
| Rate for Payer: Healthscope Commercial |
$413.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$344.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.73
|
| Rate for Payer: Nomi Health Commercial |
$376.94
|
| Rate for Payer: PHP Commercial |
$390.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.79
|
| Rate for Payer: Priority Health HMO/PPO |
$399.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$307.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$404.52
|
| Rate for Payer: UHC Core |
$383.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$344.76
|
|
|
HC XR EYE FOR FOREIGN BODY
|
Facility
|
OP
|
$459.68
|
|
|
Service Code
|
CPT 70030
|
| Hospital Charge Code |
32000004
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$62.37 |
| Max. Negotiated Rate |
$413.71 |
| Rate for Payer: Aetna Commercial |
$390.73
|
| Rate for Payer: Aetna Medicare |
$119.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$143.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$143.65
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$114.92
|
| Rate for Payer: BCBS Trust/PPO |
$377.90
|
| Rate for Payer: BCN Commercial |
$357.40
|
| Rate for Payer: BCN Medicare Advantage |
$114.92
|
| Rate for Payer: Cash Price |
$367.74
|
| Rate for Payer: Cash Price |
$367.74
|
| Rate for Payer: Cofinity Commercial |
$395.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.92
|
| Rate for Payer: Healthscope Commercial |
$413.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$344.76
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.67
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$132.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.73
|
| Rate for Payer: Nomi Health Commercial |
$376.94
|
| Rate for Payer: PACE Senior Care Partners |
$109.17
|
| Rate for Payer: PACE SWMI |
$114.92
|
| Rate for Payer: PHP Commercial |
$390.73
|
| Rate for Payer: PHP Medicare Advantage |
$114.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.79
|
| Rate for Payer: Priority Health HMO/PPO |
$399.92
|
| Rate for Payer: Priority Health Medicare |
$116.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$307.99
|
| Rate for Payer: Railroad Medicare Medicare |
$114.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$404.52
|
| Rate for Payer: UHC Core |
$383.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.92
|
| Rate for Payer: UHC Exchange |
$114.92
|
| Rate for Payer: UHC Medicare Advantage |
$114.92
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$114.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$344.76
|
|
|
HC XR EYE FOR FOREIGN BODY
|
Facility
|
IP
|
$459.68
|
|
|
Service Code
|
CPT 70030
|
| Hospital Charge Code |
32000004
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$298.79 |
| Max. Negotiated Rate |
$413.71 |
| Rate for Payer: Aetna Commercial |
$390.73
|
| Rate for Payer: BCBS Trust/PPO |
$375.24
|
| Rate for Payer: BCN Commercial |
$355.24
|
| Rate for Payer: Cash Price |
$367.74
|
| Rate for Payer: Cofinity Commercial |
$395.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.74
|
| Rate for Payer: Healthscope Commercial |
$413.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$344.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.73
|
| Rate for Payer: Nomi Health Commercial |
$376.94
|
| Rate for Payer: PHP Commercial |
$390.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.79
|
| Rate for Payer: Priority Health HMO/PPO |
$399.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$307.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$404.52
|
| Rate for Payer: UHC Core |
$383.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$344.76
|
|
|
HC XR FACIAL BONES MIN 3 VW
|
Facility
|
IP
|
$346.92
|
|
|
Service Code
|
CPT 70150
|
| Hospital Charge Code |
32000010
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$225.50 |
| Max. Negotiated Rate |
$312.23 |
| Rate for Payer: Aetna Commercial |
$294.88
|
| Rate for Payer: BCBS Trust/PPO |
$283.19
|
| Rate for Payer: BCN Commercial |
$268.10
|
| Rate for Payer: Cash Price |
$277.54
|
| Rate for Payer: Cofinity Commercial |
$298.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.54
|
| Rate for Payer: Healthscope Commercial |
$312.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$260.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.88
|
| Rate for Payer: Nomi Health Commercial |
$284.47
|
| Rate for Payer: PHP Commercial |
$294.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.50
|
| Rate for Payer: Priority Health HMO/PPO |
$301.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$232.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$305.29
|
| Rate for Payer: UHC Core |
$289.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$260.19
|
|
|
HC XR FACIAL BONES MIN 3 VW
|
Facility
|
OP
|
$346.92
|
|
|
Service Code
|
CPT 70150
|
| Hospital Charge Code |
32000010
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$312.23 |
| Rate for Payer: Aetna Commercial |
$294.88
|
| Rate for Payer: Aetna Medicare |
$90.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.41
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$86.73
|
| Rate for Payer: BCBS Trust/PPO |
$285.20
|
| Rate for Payer: BCN Commercial |
$269.73
|
| Rate for Payer: BCN Medicare Advantage |
$86.73
|
| Rate for Payer: Cash Price |
$277.54
|
| Rate for Payer: Cash Price |
$277.54
|
| Rate for Payer: Cofinity Commercial |
$298.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.73
|
| Rate for Payer: Healthscope Commercial |
$312.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$260.19
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.07
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.88
|
| Rate for Payer: Nomi Health Commercial |
$284.47
|
| Rate for Payer: PACE Senior Care Partners |
$82.39
|
| Rate for Payer: PACE SWMI |
$86.73
|
| Rate for Payer: PHP Commercial |
$294.88
|
| Rate for Payer: PHP Medicare Advantage |
$86.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.50
|
| Rate for Payer: Priority Health HMO/PPO |
$301.82
|
| Rate for Payer: Priority Health Medicare |
$87.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$232.44
|
| Rate for Payer: Railroad Medicare Medicare |
$86.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$305.29
|
| Rate for Payer: UHC Core |
$289.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.73
|
| Rate for Payer: UHC Exchange |
$86.73
|
| Rate for Payer: UHC Medicare Advantage |
$86.73
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$86.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$260.19
|
|
|
HC XR FEMUR 1 VIEW BILATERAL
|
Facility
|
OP
|
$249.90
|
|
|
Service Code
|
CPT 73551
|
| Hospital Charge Code |
32000341
|
|
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 FEMUR 1 VIEW BILATERAL
|
Facility
|
IP
|
$249.90
|
|
|
Service Code
|
CPT 73551
|
| Hospital Charge Code |
32000341
|
|
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
|
|
