|
HC XR FOOT 1 VW
|
Facility
|
IP
|
$291.84
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000125
|
|
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 FOOT 2 VIEWS
|
Facility
|
IP
|
$255.46
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000123
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$166.05 |
| Max. Negotiated Rate |
$229.91 |
| Rate for Payer: Aetna Commercial |
$217.14
|
| Rate for Payer: BCBS Trust/PPO |
$208.53
|
| Rate for Payer: BCN Commercial |
$197.42
|
| Rate for Payer: Cash Price |
$204.37
|
| Rate for Payer: Cofinity Commercial |
$219.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.37
|
| Rate for Payer: Healthscope Commercial |
$229.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.14
|
| Rate for Payer: Nomi Health Commercial |
$209.48
|
| Rate for Payer: PHP Commercial |
$217.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.05
|
| Rate for Payer: Priority Health HMO/PPO |
$222.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$171.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.80
|
| Rate for Payer: UHC Core |
$213.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.59
|
|
|
HC XR FOOT 2 VIEWS
|
Facility
|
OP
|
$255.46
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000123
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$60.67 |
| Max. Negotiated Rate |
$229.91 |
| Rate for Payer: Aetna Commercial |
$217.14
|
| Rate for Payer: Aetna Medicare |
$66.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.83
|
| Rate for Payer: BCBS Complete |
$66.85
|
| Rate for Payer: BCBS MAPPO |
$63.87
|
| Rate for Payer: BCBS Trust/PPO |
$210.01
|
| Rate for Payer: BCN Commercial |
$198.62
|
| Rate for Payer: BCN Medicare Advantage |
$63.87
|
| Rate for Payer: Cash Price |
$204.37
|
| Rate for Payer: Cash Price |
$204.37
|
| Rate for Payer: Cofinity Commercial |
$219.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.87
|
| Rate for Payer: Healthscope Commercial |
$229.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.59
|
| Rate for Payer: Mclaren Medicaid |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.06
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.14
|
| Rate for Payer: Nomi Health Commercial |
$209.48
|
| Rate for Payer: PACE Senior Care Partners |
$60.67
|
| Rate for Payer: PACE SWMI |
$63.87
|
| Rate for Payer: PHP Commercial |
$217.14
|
| Rate for Payer: PHP Medicare Advantage |
$63.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.05
|
| Rate for Payer: Priority Health HMO/PPO |
$222.25
|
| Rate for Payer: Priority Health Medicare |
$64.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$171.16
|
| Rate for Payer: Railroad Medicare Medicare |
$63.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.80
|
| Rate for Payer: UHC Core |
$213.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.87
|
| Rate for Payer: UHC Exchange |
$63.87
|
| Rate for Payer: UHC Medicare Advantage |
$63.87
|
| Rate for Payer: UHCCP Medicaid |
$63.66
|
| Rate for Payer: VA VA |
$63.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.59
|
|
|
HC XR FOOT 2 VIEWS BILATERAL
|
Facility
|
OP
|
$249.90
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000340
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.35 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Aetna Commercial |
$212.41
|
| 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 |
$66.85
|
| 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 |
$187.43
|
| Rate for Payer: Mclaren Medicaid |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.60
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.41
|
| 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 |
$212.41
|
| Rate for Payer: PHP Medicare Advantage |
$62.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.66
|
| 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 |
$63.66
|
| Rate for Payer: VA VA |
$62.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.43
|
|
|
HC XR FOOT 2 VIEWS BILATERAL
|
Facility
|
IP
|
$249.90
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000340
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$162.44 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Aetna Commercial |
$212.41
|
| 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 |
$187.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.41
|
| Rate for Payer: Nomi Health Commercial |
$204.92
|
| Rate for Payer: PHP Commercial |
$212.41
|
| 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 |
$187.43
|
|
|
HC XR FOOT 3 VIEWS
|
Facility
|
OP
|
$357.38
|
|
|
Service Code
|
CPT 73630
|
| Hospital Charge Code |
32000126
|
|
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 FOOT 3 VIEWS
|
Facility
|
IP
|
$357.38
|
|
|
Service Code
|
CPT 73630
|
| Hospital Charge Code |
32000126
|
|
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 FOOT BIL 2 VIEWS
|
Facility
|
OP
|
$291.84
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000124
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$63.66 |
| 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 |
$66.85
|
| 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 |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.61
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| 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 |
$63.66
|
| 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 |
$63.66
|
| Rate for Payer: VA VA |
$72.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.88
|
|
|
HC XR FOOT BIL 2 VIEWS
|
Facility
|
IP
|
$291.84
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
32000124
|
|
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 FOOT BIL 3 VIEWS
|
Facility
|
OP
|
$388.71
|
|
|
Service Code
|
CPT 73630
|
| Hospital Charge Code |
32000127
|
|
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 FOOT BIL 3 VIEWS
|
Facility
|
IP
|
$388.71
|
|
|
Service Code
|
CPT 73630
|
| Hospital Charge Code |
32000127
|
|
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 FOREARM 2 VW
|
Facility
|
OP
|
$306.43
|
|
|
Service Code
|
CPT 73090
|
| Hospital Charge Code |
32000076
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$63.66 |
| 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 |
$66.85
|
| 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 |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.44
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| 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 |
$63.66
|
| 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 |
$63.66
|
| Rate for Payer: VA VA |
$76.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.82
|
|
|
HC XR FOREARM 2 VW
|
Facility
|
IP
|
$306.43
|
|
|
Service Code
|
CPT 73090
|
| Hospital Charge Code |
32000076
|
|
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 FOREARM BIL 2 VW
|
Facility
|
OP
|
$340.34
|
|
|
Service Code
|
CPT 73090
|
| Hospital Charge Code |
32000077
|
|
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 FOREARM BIL 2 VW
|
Facility
|
IP
|
$340.34
|
|
|
Service Code
|
CPT 73090
|
| Hospital Charge Code |
32000077
|
|
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 HAND 2 VW
|
Facility
|
OP
|
$306.43
|
|
|
Service Code
|
CPT 73120
|
| Hospital Charge Code |
32000085
|
|
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 HAND 2 VW
|
Facility
|
IP
|
$306.43
|
|
|
Service Code
|
CPT 73120
|
| Hospital Charge Code |
32000085
|
|
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 HAND 3 VW
|
Facility
|
OP
|
$408.20
|
|
|
Service Code
|
CPT 73130
|
| Hospital Charge Code |
32000087
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$63.66 |
| Max. Negotiated Rate |
$367.38 |
| Rate for Payer: Aetna Commercial |
$346.97
|
| Rate for Payer: Aetna Medicare |
$106.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$127.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$127.56
|
| Rate for Payer: BCBS Complete |
$66.85
|
| Rate for Payer: BCBS MAPPO |
$102.05
|
| Rate for Payer: BCBS Trust/PPO |
$335.58
|
| Rate for Payer: BCN Commercial |
$317.38
|
| Rate for Payer: BCN Medicare Advantage |
$102.05
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cofinity Commercial |
$351.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.05
|
| Rate for Payer: Healthscope Commercial |
$367.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.15
|
| Rate for Payer: Mclaren Medicaid |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.15
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$117.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.97
|
| Rate for Payer: Nomi Health Commercial |
$334.72
|
| Rate for Payer: PACE Senior Care Partners |
$96.95
|
| Rate for Payer: PACE SWMI |
$102.05
|
| Rate for Payer: PHP Commercial |
$346.97
|
| Rate for Payer: PHP Medicare Advantage |
$102.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.33
|
| Rate for Payer: Priority Health HMO/PPO |
$355.13
|
| Rate for Payer: Priority Health Medicare |
$103.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.49
|
| Rate for Payer: Railroad Medicare Medicare |
$102.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.22
|
| Rate for Payer: UHC Core |
$340.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.05
|
| Rate for Payer: UHC Exchange |
$102.05
|
| Rate for Payer: UHC Medicare Advantage |
$102.05
|
| Rate for Payer: UHCCP Medicaid |
$63.66
|
| Rate for Payer: VA VA |
$102.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.15
|
|
|
HC XR HAND 3 VW
|
Facility
|
IP
|
$408.20
|
|
|
Service Code
|
CPT 73130
|
| Hospital Charge Code |
32000087
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$265.33 |
| Max. Negotiated Rate |
$367.38 |
| Rate for Payer: Aetna Commercial |
$346.97
|
| Rate for Payer: BCBS Trust/PPO |
$333.21
|
| Rate for Payer: BCN Commercial |
$315.46
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cofinity Commercial |
$351.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.56
|
| Rate for Payer: Healthscope Commercial |
$367.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.97
|
| Rate for Payer: Nomi Health Commercial |
$334.72
|
| Rate for Payer: PHP Commercial |
$346.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.33
|
| Rate for Payer: Priority Health HMO/PPO |
$355.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.22
|
| Rate for Payer: UHC Core |
$340.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.15
|
|
|
HC XR HANDS BIL 2 VW
|
Facility
|
IP
|
$340.34
|
|
|
Service Code
|
CPT 73120
|
| Hospital Charge Code |
32000086
|
|
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 HANDS BIL 2 VW
|
Facility
|
OP
|
$340.34
|
|
|
Service Code
|
CPT 73120
|
| Hospital Charge Code |
32000086
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$76.88 |
| 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 |
$80.73
|
| 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 |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.34
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| 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 |
$76.88
|
| 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 |
$76.88
|
| Rate for Payer: VA VA |
$85.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.25
|
|
|
HC XR HANDS BIL 3 VW
|
Facility
|
OP
|
$451.65
|
|
|
Service Code
|
CPT 73130
|
| Hospital Charge Code |
32000088
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$63.66 |
| Max. Negotiated Rate |
$406.49 |
| Rate for Payer: Aetna Commercial |
$383.90
|
| Rate for Payer: Aetna Medicare |
$117.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.14
|
| Rate for Payer: BCBS Complete |
$66.85
|
| Rate for Payer: BCBS MAPPO |
$112.91
|
| Rate for Payer: BCBS Trust/PPO |
$371.30
|
| Rate for Payer: BCN Commercial |
$351.16
|
| Rate for Payer: BCN Medicare Advantage |
$112.91
|
| Rate for Payer: Cash Price |
$361.32
|
| Rate for Payer: Cash Price |
$361.32
|
| Rate for Payer: Cofinity Commercial |
$388.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$361.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.91
|
| Rate for Payer: Healthscope Commercial |
$406.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$338.74
|
| Rate for Payer: Mclaren Medicaid |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$118.56
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$129.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$383.90
|
| Rate for Payer: Nomi Health Commercial |
$370.35
|
| Rate for Payer: PACE Senior Care Partners |
$107.27
|
| Rate for Payer: PACE SWMI |
$112.91
|
| Rate for Payer: PHP Commercial |
$383.90
|
| Rate for Payer: PHP Medicare Advantage |
$112.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$293.57
|
| Rate for Payer: Priority Health HMO/PPO |
$392.94
|
| Rate for Payer: Priority Health Medicare |
$114.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$302.61
|
| Rate for Payer: Railroad Medicare Medicare |
$112.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$397.45
|
| Rate for Payer: UHC Core |
$377.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.91
|
| Rate for Payer: UHC Exchange |
$112.91
|
| Rate for Payer: UHC Medicare Advantage |
$112.91
|
| Rate for Payer: UHCCP Medicaid |
$63.66
|
| Rate for Payer: VA VA |
$112.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$338.74
|
|
|
HC XR HANDS BIL 3 VW
|
Facility
|
IP
|
$451.65
|
|
|
Service Code
|
CPT 73130
|
| Hospital Charge Code |
32000088
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$293.57 |
| Max. Negotiated Rate |
$406.49 |
| Rate for Payer: Aetna Commercial |
$383.90
|
| Rate for Payer: BCBS Trust/PPO |
$368.68
|
| Rate for Payer: BCN Commercial |
$349.04
|
| Rate for Payer: Cash Price |
$361.32
|
| Rate for Payer: Cofinity Commercial |
$388.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$361.32
|
| Rate for Payer: Healthscope Commercial |
$406.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$338.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$383.90
|
| Rate for Payer: Nomi Health Commercial |
$370.35
|
| Rate for Payer: PHP Commercial |
$383.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$293.57
|
| Rate for Payer: Priority Health HMO/PPO |
$392.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$302.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$397.45
|
| Rate for Payer: UHC Core |
$377.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$338.74
|
|
|
HC XR HUMERUS 2 VW
|
Facility
|
OP
|
$306.43
|
|
|
Service Code
|
CPT 73060
|
| Hospital Charge Code |
32000069
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$63.66 |
| 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 |
$66.85
|
| 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 |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.44
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| 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 |
$63.66
|
| 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 |
$63.66
|
| Rate for Payer: VA VA |
$76.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.82
|
|
|
HC XR HUMERUS 2 VW
|
Facility
|
IP
|
$306.43
|
|
|
Service Code
|
CPT 73060
|
| Hospital Charge Code |
32000069
|
|
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
|
|
