|
HC XR KNEE BIL 4 VW
|
Facility
|
OP
|
$437.63
|
|
|
Service Code
|
CPT 73564
|
| Hospital Charge Code |
32000109
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$393.87 |
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: Aetna Medicare |
$113.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$136.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$136.76
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$109.41
|
| Rate for Payer: BCBS Trust/PPO |
$359.78
|
| Rate for Payer: BCN Commercial |
$340.26
|
| Rate for Payer: BCN Medicare Advantage |
$109.41
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$376.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.41
|
| Rate for Payer: Healthscope Commercial |
$393.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.22
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.88
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$125.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: Nomi Health Commercial |
$358.86
|
| Rate for Payer: PACE Senior Care Partners |
$103.94
|
| Rate for Payer: PACE SWMI |
$109.41
|
| Rate for Payer: PHP Commercial |
$371.99
|
| Rate for Payer: PHP Medicare Advantage |
$109.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health HMO/PPO |
$380.74
|
| Rate for Payer: Priority Health Medicare |
$110.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.21
|
| Rate for Payer: Railroad Medicare Medicare |
$109.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.11
|
| Rate for Payer: UHC Core |
$365.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.41
|
| Rate for Payer: UHC Exchange |
$109.41
|
| Rate for Payer: UHC Medicare Advantage |
$109.41
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$109.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.22
|
|
|
HC XR KNEES STANDING AP
|
Facility
|
OP
|
$408.20
|
|
|
Service Code
|
CPT 73565
|
| Hospital Charge Code |
32000110
|
|
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 KNEES STANDING AP
|
Facility
|
IP
|
$408.20
|
|
|
Service Code
|
CPT 73565
|
| Hospital Charge Code |
32000110
|
|
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 MANDIBLE LESS THAN 4 VW
|
Facility
|
OP
|
$244.99
|
|
|
Service Code
|
CPT 70100
|
| Hospital Charge Code |
32000005
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$58.19 |
| Max. Negotiated Rate |
$220.49 |
| Rate for Payer: Aetna Commercial |
$208.24
|
| Rate for Payer: Aetna Medicare |
$63.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.56
|
| Rate for Payer: BCBS Complete |
$66.85
|
| Rate for Payer: BCBS MAPPO |
$61.25
|
| Rate for Payer: BCBS Trust/PPO |
$201.41
|
| Rate for Payer: BCN Commercial |
$190.48
|
| Rate for Payer: BCN Medicare Advantage |
$61.25
|
| Rate for Payer: Cash Price |
$195.99
|
| Rate for Payer: Cash Price |
$195.99
|
| Rate for Payer: Cofinity Commercial |
$210.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.25
|
| Rate for Payer: Healthscope Commercial |
$220.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.74
|
| Rate for Payer: Mclaren Medicaid |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.31
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.24
|
| Rate for Payer: Nomi Health Commercial |
$200.89
|
| Rate for Payer: PACE Senior Care Partners |
$58.19
|
| Rate for Payer: PACE SWMI |
$61.25
|
| Rate for Payer: PHP Commercial |
$208.24
|
| Rate for Payer: PHP Medicare Advantage |
$61.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.24
|
| Rate for Payer: Priority Health HMO/PPO |
$213.14
|
| Rate for Payer: Priority Health Medicare |
$61.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.14
|
| Rate for Payer: Railroad Medicare Medicare |
$61.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.59
|
| Rate for Payer: UHC Core |
$204.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.25
|
| Rate for Payer: UHC Exchange |
$61.25
|
| Rate for Payer: UHC Medicare Advantage |
$61.25
|
| Rate for Payer: UHCCP Medicaid |
$63.66
|
| Rate for Payer: VA VA |
$61.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.74
|
|
|
HC XR MANDIBLE LESS THAN 4 VW
|
Facility
|
IP
|
$244.99
|
|
|
Service Code
|
CPT 70100
|
| Hospital Charge Code |
32000005
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$159.24 |
| Max. Negotiated Rate |
$220.49 |
| Rate for Payer: Aetna Commercial |
$208.24
|
| Rate for Payer: BCBS Trust/PPO |
$199.99
|
| Rate for Payer: BCN Commercial |
$189.33
|
| Rate for Payer: Cash Price |
$195.99
|
| Rate for Payer: Cofinity Commercial |
$210.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.99
|
| Rate for Payer: Healthscope Commercial |
$220.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.24
|
| Rate for Payer: Nomi Health Commercial |
$200.89
|
| Rate for Payer: PHP Commercial |
$208.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.24
|
| Rate for Payer: Priority Health HMO/PPO |
$213.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.59
|
| Rate for Payer: UHC Core |
$204.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.74
|
|
|
HC XR MANDIBLE MIN 4 VW
|
Facility
|
IP
|
$459.55
|
|
|
Service Code
|
CPT 70110
|
| Hospital Charge Code |
32000006
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$298.71 |
| Max. Negotiated Rate |
$413.60 |
| Rate for Payer: Aetna Commercial |
$390.62
|
| Rate for Payer: BCBS Trust/PPO |
$375.13
|
| Rate for Payer: BCN Commercial |
$355.14
|
| Rate for Payer: Cash Price |
$367.64
|
| Rate for Payer: Cofinity Commercial |
$395.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.64
|
| Rate for Payer: Healthscope Commercial |
$413.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$344.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.62
|
| Rate for Payer: Nomi Health Commercial |
$376.83
|
| Rate for Payer: PHP Commercial |
$390.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.71
|
| Rate for Payer: Priority Health HMO/PPO |
$399.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$307.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$404.40
|
| Rate for Payer: UHC Core |
$383.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$344.66
|
|
|
HC XR MANDIBLE MIN 4 VW
|
Facility
|
OP
|
$459.55
|
|
|
Service Code
|
CPT 70110
|
| Hospital Charge Code |
32000006
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$413.60 |
| Rate for Payer: Aetna Commercial |
$390.62
|
| Rate for Payer: Aetna Medicare |
$119.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$143.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$143.61
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$114.89
|
| Rate for Payer: BCBS Trust/PPO |
$377.80
|
| Rate for Payer: BCN Commercial |
$357.30
|
| Rate for Payer: BCN Medicare Advantage |
$114.89
|
| Rate for Payer: Cash Price |
$367.64
|
| Rate for Payer: Cash Price |
$367.64
|
| Rate for Payer: Cofinity Commercial |
$395.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.89
|
| Rate for Payer: Healthscope Commercial |
$413.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$344.66
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.63
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$132.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.62
|
| Rate for Payer: Nomi Health Commercial |
$376.83
|
| Rate for Payer: PACE Senior Care Partners |
$109.14
|
| Rate for Payer: PACE SWMI |
$114.89
|
| Rate for Payer: PHP Commercial |
$390.62
|
| Rate for Payer: PHP Medicare Advantage |
$114.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.71
|
| Rate for Payer: Priority Health HMO/PPO |
$399.81
|
| Rate for Payer: Priority Health Medicare |
$116.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$307.90
|
| Rate for Payer: Railroad Medicare Medicare |
$114.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$404.40
|
| Rate for Payer: UHC Core |
$383.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.89
|
| Rate for Payer: UHC Exchange |
$114.89
|
| Rate for Payer: UHC Medicare Advantage |
$114.89
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$114.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$344.66
|
|
|
HC XR MASTOIDS 3 VW PER SIDE
|
Facility
|
OP
|
$117.98
|
|
|
Service Code
|
CPT 70130
|
| Hospital Charge Code |
32000008
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$28.02 |
| Max. Negotiated Rate |
$106.18 |
| Rate for Payer: Aetna Commercial |
$100.28
|
| Rate for Payer: Aetna Medicare |
$30.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.87
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$29.50
|
| Rate for Payer: BCBS Trust/PPO |
$96.99
|
| Rate for Payer: BCN Commercial |
$91.73
|
| Rate for Payer: BCN Medicare Advantage |
$29.50
|
| Rate for Payer: Cash Price |
$94.38
|
| Rate for Payer: Cash Price |
$94.38
|
| Rate for Payer: Cofinity Commercial |
$101.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.50
|
| Rate for Payer: Healthscope Commercial |
$106.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.48
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.97
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.28
|
| Rate for Payer: Nomi Health Commercial |
$96.74
|
| Rate for Payer: PACE Senior Care Partners |
$28.02
|
| Rate for Payer: PACE SWMI |
$29.50
|
| Rate for Payer: PHP Commercial |
$100.28
|
| Rate for Payer: PHP Medicare Advantage |
$29.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.69
|
| Rate for Payer: Priority Health HMO/PPO |
$102.64
|
| Rate for Payer: Priority Health Medicare |
$29.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.05
|
| Rate for Payer: Railroad Medicare Medicare |
$29.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.82
|
| Rate for Payer: UHC Core |
$98.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.50
|
| Rate for Payer: UHC Exchange |
$29.50
|
| Rate for Payer: UHC Medicare Advantage |
$29.50
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$29.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.48
|
|
|
HC XR MASTOIDS 3 VW PER SIDE
|
Facility
|
IP
|
$117.98
|
|
|
Service Code
|
CPT 70130
|
| Hospital Charge Code |
32000008
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$76.69 |
| Max. Negotiated Rate |
$106.18 |
| Rate for Payer: Aetna Commercial |
$100.28
|
| Rate for Payer: BCBS Trust/PPO |
$96.31
|
| Rate for Payer: BCN Commercial |
$91.17
|
| Rate for Payer: Cash Price |
$94.38
|
| Rate for Payer: Cofinity Commercial |
$101.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.38
|
| Rate for Payer: Healthscope Commercial |
$106.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.28
|
| Rate for Payer: Nomi Health Commercial |
$96.74
|
| Rate for Payer: PHP Commercial |
$100.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.69
|
| Rate for Payer: Priority Health HMO/PPO |
$102.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.82
|
| Rate for Payer: UHC Core |
$98.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.48
|
|
|
HC XR MASTOIDS LESS THAN 3 VW
|
Facility
|
IP
|
$111.60
|
|
|
Service Code
|
CPT 70120
|
| Hospital Charge Code |
32000007
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.54 |
| Max. Negotiated Rate |
$100.44 |
| Rate for Payer: Aetna Commercial |
$94.86
|
| Rate for Payer: BCBS Trust/PPO |
$91.10
|
| Rate for Payer: BCN Commercial |
$86.24
|
| Rate for Payer: Cash Price |
$89.28
|
| Rate for Payer: Cofinity Commercial |
$95.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.28
|
| Rate for Payer: Healthscope Commercial |
$100.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.86
|
| Rate for Payer: Nomi Health Commercial |
$91.51
|
| Rate for Payer: PHP Commercial |
$94.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.54
|
| Rate for Payer: Priority Health HMO/PPO |
$97.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.21
|
| Rate for Payer: UHC Core |
$93.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.70
|
|
|
HC XR MASTOIDS LESS THAN 3 VW
|
Facility
|
OP
|
$111.60
|
|
|
Service Code
|
CPT 70120
|
| Hospital Charge Code |
32000007
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$26.50 |
| Max. Negotiated Rate |
$100.44 |
| Rate for Payer: Aetna Commercial |
$94.86
|
| Rate for Payer: Aetna Medicare |
$29.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.88
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$27.90
|
| Rate for Payer: BCBS Trust/PPO |
$91.75
|
| Rate for Payer: BCN Commercial |
$86.77
|
| Rate for Payer: BCN Medicare Advantage |
$27.90
|
| Rate for Payer: Cash Price |
$89.28
|
| Rate for Payer: Cash Price |
$89.28
|
| Rate for Payer: Cofinity Commercial |
$95.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.90
|
| Rate for Payer: Healthscope Commercial |
$100.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.70
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.30
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.86
|
| Rate for Payer: Nomi Health Commercial |
$91.51
|
| Rate for Payer: PACE Senior Care Partners |
$26.50
|
| Rate for Payer: PACE SWMI |
$27.90
|
| Rate for Payer: PHP Commercial |
$94.86
|
| Rate for Payer: PHP Medicare Advantage |
$27.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.54
|
| Rate for Payer: Priority Health HMO/PPO |
$97.09
|
| Rate for Payer: Priority Health Medicare |
$28.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.77
|
| Rate for Payer: Railroad Medicare Medicare |
$27.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.21
|
| Rate for Payer: UHC Core |
$93.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.90
|
| Rate for Payer: UHC Exchange |
$27.90
|
| Rate for Payer: UHC Medicare Advantage |
$27.90
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$27.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.70
|
|
|
HC XR MED EXAM REVIEW
|
Facility
|
OP
|
$594.89
|
|
| Hospital Charge Code |
32000265
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$141.29 |
| Max. Negotiated Rate |
$535.40 |
| Rate for Payer: Aetna Commercial |
$505.66
|
| Rate for Payer: Aetna Medicare |
$154.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$185.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$185.90
|
| Rate for Payer: BCBS Complete |
$237.96
|
| Rate for Payer: BCBS MAPPO |
$148.72
|
| Rate for Payer: BCBS Trust/PPO |
$489.06
|
| Rate for Payer: BCN Commercial |
$462.53
|
| Rate for Payer: BCN Medicare Advantage |
$148.72
|
| Rate for Payer: Cash Price |
$475.91
|
| Rate for Payer: Cofinity Commercial |
$511.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$475.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.72
|
| Rate for Payer: Healthscope Commercial |
$535.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$171.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.66
|
| Rate for Payer: Nomi Health Commercial |
$487.81
|
| Rate for Payer: PACE Senior Care Partners |
$141.29
|
| Rate for Payer: PACE SWMI |
$148.72
|
| Rate for Payer: PHP Commercial |
$505.66
|
| Rate for Payer: PHP Medicare Advantage |
$148.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$386.68
|
| Rate for Payer: Priority Health HMO/PPO |
$517.55
|
| Rate for Payer: Priority Health Medicare |
$150.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$398.58
|
| Rate for Payer: Railroad Medicare Medicare |
$148.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$523.50
|
| Rate for Payer: UHC Core |
$496.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$148.72
|
| Rate for Payer: UHC Exchange |
$148.72
|
| Rate for Payer: UHC Medicare Advantage |
$148.72
|
| Rate for Payer: VA VA |
$148.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.17
|
|
|
HC XR MED EXAM REVIEW
|
Facility
|
IP
|
$594.89
|
|
| Hospital Charge Code |
32000265
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$386.68 |
| Max. Negotiated Rate |
$535.40 |
| Rate for Payer: Aetna Commercial |
$505.66
|
| Rate for Payer: BCBS Trust/PPO |
$485.61
|
| Rate for Payer: BCN Commercial |
$459.73
|
| Rate for Payer: Cash Price |
$475.91
|
| Rate for Payer: Cofinity Commercial |
$511.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$475.91
|
| Rate for Payer: Healthscope Commercial |
$535.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.66
|
| Rate for Payer: Nomi Health Commercial |
$487.81
|
| Rate for Payer: PHP Commercial |
$505.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$386.68
|
| Rate for Payer: Priority Health HMO/PPO |
$517.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$398.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$523.50
|
| Rate for Payer: UHC Core |
$496.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.17
|
|
|
HC XR MYELOGRAM CERVICAL
|
Facility
|
OP
|
$1,011.61
|
|
|
Service Code
|
CPT 72240
|
| Hospital Charge Code |
32000053
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$240.26 |
| Max. Negotiated Rate |
$910.45 |
| Rate for Payer: Aetna Commercial |
$859.87
|
| Rate for Payer: Aetna Medicare |
$263.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$316.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$316.13
|
| Rate for Payer: BCBS Complete |
$599.81
|
| Rate for Payer: BCBS MAPPO |
$252.90
|
| Rate for Payer: BCBS Trust/PPO |
$831.64
|
| Rate for Payer: BCN Commercial |
$786.53
|
| Rate for Payer: BCN Medicare Advantage |
$252.90
|
| Rate for Payer: Cash Price |
$809.29
|
| Rate for Payer: Cash Price |
$809.29
|
| Rate for Payer: Cofinity Commercial |
$869.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$809.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$252.90
|
| Rate for Payer: Healthscope Commercial |
$910.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$758.71
|
| Rate for Payer: Mclaren Medicaid |
$571.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$265.55
|
| Rate for Payer: Meridian Medicaid |
$599.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$290.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$859.87
|
| Rate for Payer: Nomi Health Commercial |
$829.52
|
| Rate for Payer: PACE Senior Care Partners |
$240.26
|
| Rate for Payer: PACE SWMI |
$252.90
|
| Rate for Payer: PHP Commercial |
$859.87
|
| Rate for Payer: PHP Medicare Advantage |
$252.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$571.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$657.55
|
| Rate for Payer: Priority Health HMO/PPO |
$880.10
|
| Rate for Payer: Priority Health Medicare |
$255.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$677.78
|
| Rate for Payer: Railroad Medicare Medicare |
$252.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$890.22
|
| Rate for Payer: UHC Core |
$844.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$252.90
|
| Rate for Payer: UHC Exchange |
$252.90
|
| Rate for Payer: UHC Medicare Advantage |
$252.90
|
| Rate for Payer: UHCCP Medicaid |
$571.21
|
| Rate for Payer: VA VA |
$252.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$758.71
|
|
|
HC XR MYELOGRAM CERVICAL
|
Facility
|
IP
|
$1,011.61
|
|
|
Service Code
|
CPT 72240
|
| Hospital Charge Code |
32000053
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$657.55 |
| Max. Negotiated Rate |
$910.45 |
| Rate for Payer: Aetna Commercial |
$859.87
|
| Rate for Payer: BCBS Trust/PPO |
$825.78
|
| Rate for Payer: BCN Commercial |
$781.77
|
| Rate for Payer: Cash Price |
$809.29
|
| Rate for Payer: Cofinity Commercial |
$869.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$809.29
|
| Rate for Payer: Healthscope Commercial |
$910.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$758.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$859.87
|
| Rate for Payer: Nomi Health Commercial |
$829.52
|
| Rate for Payer: PHP Commercial |
$859.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$657.55
|
| Rate for Payer: Priority Health HMO/PPO |
$880.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$677.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$890.22
|
| Rate for Payer: UHC Core |
$844.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$758.71
|
|
|
HC XR NASAL FACIAL BONES LESS THAN 3 VW
|
Facility
|
IP
|
$135.98
|
|
|
Service Code
|
CPT 70140
|
| Hospital Charge Code |
32000009
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$88.39 |
| Max. Negotiated Rate |
$122.38 |
| Rate for Payer: Aetna Commercial |
$115.58
|
| Rate for Payer: BCBS Trust/PPO |
$111.00
|
| Rate for Payer: BCN Commercial |
$105.09
|
| Rate for Payer: Cash Price |
$108.78
|
| Rate for Payer: Cofinity Commercial |
$116.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.78
|
| Rate for Payer: Healthscope Commercial |
$122.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.58
|
| Rate for Payer: Nomi Health Commercial |
$111.50
|
| Rate for Payer: PHP Commercial |
$115.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.39
|
| Rate for Payer: Priority Health HMO/PPO |
$118.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.66
|
| Rate for Payer: UHC Core |
$113.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.98
|
|
|
HC XR NASAL FACIAL BONES LESS THAN 3 VW
|
Facility
|
OP
|
$135.98
|
|
|
Service Code
|
CPT 70140
|
| Hospital Charge Code |
32000009
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.30 |
| Max. Negotiated Rate |
$122.38 |
| Rate for Payer: Aetna Commercial |
$115.58
|
| Rate for Payer: Aetna Medicare |
$35.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.49
|
| Rate for Payer: BCBS Complete |
$66.85
|
| Rate for Payer: BCBS MAPPO |
$33.99
|
| Rate for Payer: BCBS Trust/PPO |
$111.79
|
| Rate for Payer: BCN Commercial |
$105.72
|
| Rate for Payer: BCN Medicare Advantage |
$33.99
|
| Rate for Payer: Cash Price |
$108.78
|
| Rate for Payer: Cash Price |
$108.78
|
| Rate for Payer: Cofinity Commercial |
$116.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.99
|
| Rate for Payer: Healthscope Commercial |
$122.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.98
|
| Rate for Payer: Mclaren Medicaid |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.69
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.58
|
| Rate for Payer: Nomi Health Commercial |
$111.50
|
| Rate for Payer: PACE Senior Care Partners |
$32.30
|
| Rate for Payer: PACE SWMI |
$33.99
|
| Rate for Payer: PHP Commercial |
$115.58
|
| Rate for Payer: PHP Medicare Advantage |
$33.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.39
|
| Rate for Payer: Priority Health HMO/PPO |
$118.30
|
| Rate for Payer: Priority Health Medicare |
$34.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.11
|
| Rate for Payer: Railroad Medicare Medicare |
$33.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.66
|
| Rate for Payer: UHC Core |
$113.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.99
|
| Rate for Payer: UHC Exchange |
$33.99
|
| Rate for Payer: UHC Medicare Advantage |
$33.99
|
| Rate for Payer: UHCCP Medicaid |
$63.66
|
| Rate for Payer: VA VA |
$33.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.98
|
|
|
HC XR NEPHROTOMOGRAPHY
|
Facility
|
IP
|
$1,224.73
|
|
|
Service Code
|
CPT 74415
|
| Hospital Charge Code |
32000159
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$796.07 |
| Max. Negotiated Rate |
$1,102.26 |
| Rate for Payer: Aetna Commercial |
$1,041.02
|
| Rate for Payer: BCBS Trust/PPO |
$999.75
|
| Rate for Payer: BCN Commercial |
$946.47
|
| Rate for Payer: Cash Price |
$979.78
|
| Rate for Payer: Cofinity Commercial |
$1,053.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$979.78
|
| Rate for Payer: Healthscope Commercial |
$1,102.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$918.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,041.02
|
| Rate for Payer: Nomi Health Commercial |
$1,004.28
|
| Rate for Payer: PHP Commercial |
$1,041.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.07
|
| Rate for Payer: Priority Health HMO/PPO |
$1,065.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$820.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,077.76
|
| Rate for Payer: UHC Core |
$1,022.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$918.55
|
|
|
HC XR NEPHROTOMOGRAPHY
|
Facility
|
OP
|
$1,224.73
|
|
|
Service Code
|
CPT 74415
|
| Hospital Charge Code |
32000159
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$128.71 |
| Max. Negotiated Rate |
$1,102.26 |
| Rate for Payer: Aetna Commercial |
$1,041.02
|
| Rate for Payer: Aetna Medicare |
$318.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.73
|
| Rate for Payer: BCBS Complete |
$135.15
|
| Rate for Payer: BCBS MAPPO |
$306.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,006.85
|
| Rate for Payer: BCN Commercial |
$952.23
|
| Rate for Payer: BCN Medicare Advantage |
$306.18
|
| Rate for Payer: Cash Price |
$979.78
|
| Rate for Payer: Cash Price |
$979.78
|
| Rate for Payer: Cofinity Commercial |
$1,053.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$979.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.18
|
| Rate for Payer: Healthscope Commercial |
$1,102.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$918.55
|
| Rate for Payer: Mclaren Medicaid |
$128.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.49
|
| Rate for Payer: Meridian Medicaid |
$135.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$352.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,041.02
|
| Rate for Payer: Nomi Health Commercial |
$1,004.28
|
| Rate for Payer: PACE Senior Care Partners |
$290.87
|
| Rate for Payer: PACE SWMI |
$306.18
|
| Rate for Payer: PHP Commercial |
$1,041.02
|
| Rate for Payer: PHP Medicare Advantage |
$306.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.07
|
| Rate for Payer: Priority Health HMO/PPO |
$1,065.52
|
| Rate for Payer: Priority Health Medicare |
$309.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$820.57
|
| Rate for Payer: Railroad Medicare Medicare |
$306.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,077.76
|
| Rate for Payer: UHC Core |
$1,022.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.18
|
| Rate for Payer: UHC Exchange |
$306.18
|
| Rate for Payer: UHC Medicare Advantage |
$306.18
|
| Rate for Payer: UHCCP Medicaid |
$128.71
|
| Rate for Payer: VA VA |
$306.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$918.55
|
|
|
HC XR OPTIC FORAMINA
|
Facility
|
IP
|
$272.22
|
|
|
Service Code
|
CPT 70190
|
| Hospital Charge Code |
32000286
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$176.94 |
| Max. Negotiated Rate |
$245.00 |
| Rate for Payer: Aetna Commercial |
$231.39
|
| Rate for Payer: BCBS Trust/PPO |
$222.21
|
| Rate for Payer: BCN Commercial |
$210.37
|
| Rate for Payer: Cash Price |
$217.78
|
| Rate for Payer: Cofinity Commercial |
$234.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.78
|
| Rate for Payer: Healthscope Commercial |
$245.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.39
|
| Rate for Payer: Nomi Health Commercial |
$223.22
|
| Rate for Payer: PHP Commercial |
$231.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.94
|
| Rate for Payer: Priority Health HMO/PPO |
$236.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.55
|
| Rate for Payer: UHC Core |
$227.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.16
|
|
|
HC XR OPTIC FORAMINA
|
Facility
|
OP
|
$272.22
|
|
|
Service Code
|
CPT 70190
|
| Hospital Charge Code |
32000286
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$63.66 |
| Max. Negotiated Rate |
$245.00 |
| Rate for Payer: Aetna Commercial |
$231.39
|
| Rate for Payer: Aetna Medicare |
$70.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.07
|
| Rate for Payer: BCBS Complete |
$66.85
|
| Rate for Payer: BCBS MAPPO |
$68.06
|
| Rate for Payer: BCBS Trust/PPO |
$223.79
|
| Rate for Payer: BCN Commercial |
$211.65
|
| Rate for Payer: BCN Medicare Advantage |
$68.06
|
| Rate for Payer: Cash Price |
$217.78
|
| Rate for Payer: Cash Price |
$217.78
|
| Rate for Payer: Cofinity Commercial |
$234.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.06
|
| Rate for Payer: Healthscope Commercial |
$245.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.16
|
| Rate for Payer: Mclaren Medicaid |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.46
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.39
|
| Rate for Payer: Nomi Health Commercial |
$223.22
|
| Rate for Payer: PACE Senior Care Partners |
$64.65
|
| Rate for Payer: PACE SWMI |
$68.06
|
| Rate for Payer: PHP Commercial |
$231.39
|
| Rate for Payer: PHP Medicare Advantage |
$68.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.94
|
| Rate for Payer: Priority Health HMO/PPO |
$236.83
|
| Rate for Payer: Priority Health Medicare |
$68.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.39
|
| Rate for Payer: Railroad Medicare Medicare |
$68.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.55
|
| Rate for Payer: UHC Core |
$227.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.06
|
| Rate for Payer: UHC Exchange |
$68.06
|
| Rate for Payer: UHC Medicare Advantage |
$68.06
|
| Rate for Payer: UHCCP Medicaid |
$63.66
|
| Rate for Payer: VA VA |
$68.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.16
|
|
|
HC XR ORBITS COMP MIN 4 VW
|
Facility
|
OP
|
$346.92
|
|
|
Service Code
|
CPT 70200
|
| Hospital Charge Code |
32000012
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$76.88 |
| 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 |
$80.73
|
| 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 |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.07
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| 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 |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.50
|
| Rate for Payer: Priority Health HMO/PPO |
$301.82
|
| Rate for Payer: Priority Health 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 |
$76.88
|
| Rate for Payer: VA VA |
$86.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$260.19
|
|
|
HC XR ORBITS COMP MIN 4 VW
|
Facility
|
IP
|
$346.92
|
|
|
Service Code
|
CPT 70200
|
| Hospital Charge Code |
32000012
|
|
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 OS CALCIS BIL MIN 2 VIEWS
|
Facility
|
OP
|
$340.34
|
|
|
Service Code
|
CPT 73650
|
| Hospital Charge Code |
32000129
|
|
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 OS CALCIS BIL MIN 2 VIEWS
|
Facility
|
IP
|
$340.34
|
|
|
Service Code
|
CPT 73650
|
| Hospital Charge Code |
32000129
|
|
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
|
|
