|
HC XR RIBS INC PA CHST
|
Facility
|
IP
|
$408.20
|
|
|
Service Code
|
CPT 71101
|
| Hospital Charge Code |
32000028
|
|
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 RIBS INC PA CHST
|
Facility
|
OP
|
$408.20
|
|
|
Service Code
|
CPT 71101
|
| Hospital Charge Code |
32000028
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$75.33 |
| 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 |
$79.10
|
| 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 |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.15
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| 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 |
$75.33
|
| 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 |
$75.33
|
| Rate for Payer: VA VA |
$102.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.15
|
|
|
HC XR SACROILIAC JTS 3 VW OR LESS
|
Facility
|
OP
|
$188.76
|
|
|
Service Code
|
CPT 72200
|
| Hospital Charge Code |
32000050
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.83 |
| Max. Negotiated Rate |
$169.88 |
| Rate for Payer: Aetna Commercial |
$160.45
|
| Rate for Payer: Aetna Medicare |
$49.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.99
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$47.19
|
| Rate for Payer: BCBS Trust/PPO |
$155.18
|
| Rate for Payer: BCN Commercial |
$146.76
|
| Rate for Payer: BCN Medicare Advantage |
$47.19
|
| Rate for Payer: Cash Price |
$151.01
|
| Rate for Payer: Cash Price |
$151.01
|
| Rate for Payer: Cofinity Commercial |
$162.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.19
|
| Rate for Payer: Healthscope Commercial |
$169.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$141.57
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.55
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.45
|
| Rate for Payer: Nomi Health Commercial |
$154.78
|
| Rate for Payer: PACE Senior Care Partners |
$44.83
|
| Rate for Payer: PACE SWMI |
$47.19
|
| Rate for Payer: PHP Commercial |
$160.45
|
| Rate for Payer: PHP Medicare Advantage |
$47.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.69
|
| Rate for Payer: Priority Health HMO/PPO |
$164.22
|
| Rate for Payer: Priority Health Medicare |
$47.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.47
|
| Rate for Payer: Railroad Medicare Medicare |
$47.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$166.11
|
| Rate for Payer: UHC Core |
$157.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.19
|
| Rate for Payer: UHC Exchange |
$47.19
|
| Rate for Payer: UHC Medicare Advantage |
$47.19
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$47.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$141.57
|
|
|
HC XR SACROILIAC JTS 3 VW OR LESS
|
Facility
|
IP
|
$188.76
|
|
|
Service Code
|
CPT 72200
|
| Hospital Charge Code |
32000050
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$122.69 |
| Max. Negotiated Rate |
$169.88 |
| Rate for Payer: Aetna Commercial |
$160.45
|
| Rate for Payer: BCBS Trust/PPO |
$154.08
|
| Rate for Payer: BCN Commercial |
$145.87
|
| Rate for Payer: Cash Price |
$151.01
|
| Rate for Payer: Cofinity Commercial |
$162.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.01
|
| Rate for Payer: Healthscope Commercial |
$169.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$141.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.45
|
| Rate for Payer: Nomi Health Commercial |
$154.78
|
| Rate for Payer: PHP Commercial |
$160.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.69
|
| Rate for Payer: Priority Health HMO/PPO |
$164.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$166.11
|
| Rate for Payer: UHC Core |
$157.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$141.57
|
|
|
HC XR SACROILIAC JTS 3 VW OR MORE
|
Facility
|
IP
|
$357.38
|
|
|
Service Code
|
CPT 72202
|
| Hospital Charge Code |
32000051
|
|
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 SACROILIAC JTS 3 VW OR MORE
|
Facility
|
OP
|
$357.38
|
|
|
Service Code
|
CPT 72202
|
| Hospital Charge Code |
32000051
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$75.33 |
| 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 |
$79.10
|
| 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 |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.81
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| 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 |
$75.33
|
| 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 |
$75.33
|
| Rate for Payer: VA VA |
$89.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
|
HC XR SACRUM COCCYX MIN 2 VW
|
Facility
|
IP
|
$306.43
|
|
|
Service Code
|
CPT 72220
|
| Hospital Charge Code |
32000052
|
|
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 SACRUM COCCYX MIN 2 VW
|
Facility
|
OP
|
$306.43
|
|
|
Service Code
|
CPT 72220
|
| Hospital Charge Code |
32000052
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$62.37 |
| 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 |
$65.50
|
| 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 |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.44
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| 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 |
$62.37
|
| 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 |
$62.37
|
| Rate for Payer: VA VA |
$76.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.82
|
|
|
HC XR SCAPULA
|
Facility
|
OP
|
$367.57
|
|
|
Service Code
|
CPT 73010
|
| Hospital Charge Code |
32000062
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$330.81 |
| Rate for Payer: Aetna Commercial |
$312.43
|
| Rate for Payer: Aetna Medicare |
$95.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.87
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$91.89
|
| Rate for Payer: BCBS Trust/PPO |
$302.18
|
| Rate for Payer: BCN Commercial |
$285.79
|
| Rate for Payer: BCN Medicare Advantage |
$91.89
|
| Rate for Payer: Cash Price |
$294.06
|
| Rate for Payer: Cash Price |
$294.06
|
| Rate for Payer: Cofinity Commercial |
$316.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.89
|
| Rate for Payer: Healthscope Commercial |
$330.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$275.68
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.49
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$312.43
|
| Rate for Payer: Nomi Health Commercial |
$301.41
|
| Rate for Payer: PACE Senior Care Partners |
$87.30
|
| Rate for Payer: PACE SWMI |
$91.89
|
| Rate for Payer: PHP Commercial |
$312.43
|
| Rate for Payer: PHP Medicare Advantage |
$91.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.92
|
| Rate for Payer: Priority Health HMO/PPO |
$319.79
|
| Rate for Payer: Priority Health Medicare |
$92.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$246.27
|
| Rate for Payer: Railroad Medicare Medicare |
$91.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.46
|
| Rate for Payer: UHC Core |
$306.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.89
|
| Rate for Payer: UHC Exchange |
$91.89
|
| Rate for Payer: UHC Medicare Advantage |
$91.89
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$91.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$275.68
|
|
|
HC XR SCAPULA
|
Facility
|
IP
|
$367.57
|
|
|
Service Code
|
CPT 73010
|
| Hospital Charge Code |
32000062
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$238.92 |
| Max. Negotiated Rate |
$330.81 |
| Rate for Payer: Aetna Commercial |
$312.43
|
| Rate for Payer: BCBS Trust/PPO |
$300.05
|
| Rate for Payer: BCN Commercial |
$284.06
|
| Rate for Payer: Cash Price |
$294.06
|
| Rate for Payer: Cofinity Commercial |
$316.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.06
|
| Rate for Payer: Healthscope Commercial |
$330.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$275.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$312.43
|
| Rate for Payer: Nomi Health Commercial |
$301.41
|
| Rate for Payer: PHP Commercial |
$312.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.92
|
| Rate for Payer: Priority Health HMO/PPO |
$319.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$246.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.46
|
| Rate for Payer: UHC Core |
$306.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$275.68
|
|
|
HC XR SCAPULA BILATERAL
|
Facility
|
IP
|
$306.00
|
|
|
Service Code
|
CPT 73010
|
| Hospital Charge Code |
32000337
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$198.90 |
| Max. Negotiated Rate |
$275.40 |
| Rate for Payer: Aetna Commercial |
$260.10
|
| Rate for Payer: BCBS Trust/PPO |
$249.79
|
| Rate for Payer: BCN Commercial |
$236.48
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$263.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.80
|
| Rate for Payer: Healthscope Commercial |
$275.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.10
|
| Rate for Payer: Nomi Health Commercial |
$250.92
|
| Rate for Payer: PHP Commercial |
$260.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: Priority Health HMO/PPO |
$266.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$205.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.28
|
| Rate for Payer: UHC Core |
$255.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.50
|
|
|
HC XR SCAPULA BILATERAL
|
Facility
|
OP
|
$306.00
|
|
|
Service Code
|
CPT 73010
|
| Hospital Charge Code |
32000337
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.68 |
| Max. Negotiated Rate |
$275.40 |
| Rate for Payer: Aetna Commercial |
$260.10
|
| Rate for Payer: Aetna Medicare |
$79.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95.62
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$76.50
|
| Rate for Payer: BCBS Trust/PPO |
$251.56
|
| Rate for Payer: BCN Commercial |
$237.92
|
| Rate for Payer: BCN Medicare Advantage |
$76.50
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$263.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.50
|
| Rate for Payer: Healthscope Commercial |
$275.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.50
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.32
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.10
|
| Rate for Payer: Nomi Health Commercial |
$250.92
|
| Rate for Payer: PACE Senior Care Partners |
$72.68
|
| Rate for Payer: PACE SWMI |
$76.50
|
| Rate for Payer: PHP Commercial |
$260.10
|
| Rate for Payer: PHP Medicare Advantage |
$76.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: Priority Health HMO/PPO |
$266.22
|
| Rate for Payer: Priority Health Medicare |
$77.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$205.02
|
| Rate for Payer: Railroad Medicare Medicare |
$76.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.28
|
| Rate for Payer: UHC Core |
$255.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.50
|
| Rate for Payer: UHC Exchange |
$76.50
|
| Rate for Payer: UHC Medicare Advantage |
$76.50
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$76.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.50
|
|
|
HC XR SELLA TURCICA
|
Facility
|
IP
|
$357.38
|
|
|
Service Code
|
CPT 70240
|
| Hospital Charge Code |
32000016
|
|
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 SELLA TURCICA
|
Facility
|
OP
|
$357.38
|
|
|
Service Code
|
CPT 70240
|
| Hospital Charge Code |
32000016
|
|
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 SHOULDER 1 VW
|
Facility
|
OP
|
$132.76
|
|
|
Service Code
|
CPT 73020
|
| Hospital Charge Code |
32000063
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$31.53 |
| Max. Negotiated Rate |
$119.48 |
| Rate for Payer: Aetna Commercial |
$112.85
|
| Rate for Payer: Aetna Medicare |
$34.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.49
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$33.19
|
| Rate for Payer: BCBS Trust/PPO |
$109.14
|
| Rate for Payer: BCN Commercial |
$103.22
|
| Rate for Payer: BCN Medicare Advantage |
$33.19
|
| Rate for Payer: Cash Price |
$106.21
|
| Rate for Payer: Cash Price |
$106.21
|
| Rate for Payer: Cofinity Commercial |
$114.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.19
|
| Rate for Payer: Healthscope Commercial |
$119.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.57
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.85
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.85
|
| Rate for Payer: Nomi Health Commercial |
$108.86
|
| Rate for Payer: PACE Senior Care Partners |
$31.53
|
| Rate for Payer: PACE SWMI |
$33.19
|
| Rate for Payer: PHP Commercial |
$112.85
|
| Rate for Payer: PHP Medicare Advantage |
$33.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.29
|
| Rate for Payer: Priority Health HMO/PPO |
$115.50
|
| Rate for Payer: Priority Health Medicare |
$33.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.95
|
| Rate for Payer: Railroad Medicare Medicare |
$33.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.83
|
| Rate for Payer: UHC Core |
$110.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.19
|
| Rate for Payer: UHC Exchange |
$33.19
|
| Rate for Payer: UHC Medicare Advantage |
$33.19
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$33.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.57
|
|
|
HC XR SHOULDER 1 VW
|
Facility
|
IP
|
$132.76
|
|
|
Service Code
|
CPT 73020
|
| Hospital Charge Code |
32000063
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$86.29 |
| Max. Negotiated Rate |
$119.48 |
| Rate for Payer: Aetna Commercial |
$112.85
|
| Rate for Payer: BCBS Trust/PPO |
$108.37
|
| Rate for Payer: BCN Commercial |
$102.60
|
| Rate for Payer: Cash Price |
$106.21
|
| Rate for Payer: Cofinity Commercial |
$114.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.21
|
| Rate for Payer: Healthscope Commercial |
$119.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.85
|
| Rate for Payer: Nomi Health Commercial |
$108.86
|
| Rate for Payer: PHP Commercial |
$112.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.29
|
| Rate for Payer: Priority Health HMO/PPO |
$115.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.83
|
| Rate for Payer: UHC Core |
$110.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.57
|
|
|
HC XR SHOULDER 1 VW BILATERAL
|
Facility
|
OP
|
$249.90
|
|
|
Service Code
|
CPT 73020
|
| Hospital Charge Code |
32000338
|
|
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 SHOULDER 1 VW BILATERAL
|
Facility
|
IP
|
$249.90
|
|
|
Service Code
|
CPT 73020
|
| Hospital Charge Code |
32000338
|
|
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
|
|
|
HC XR SHOULDER BIL 1 VW
|
Facility
|
OP
|
$175.07
|
|
|
Service Code
|
CPT 73020
|
| Hospital Charge Code |
32000064
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$41.58 |
| Max. Negotiated Rate |
$157.56 |
| Rate for Payer: Aetna Commercial |
$148.81
|
| Rate for Payer: Aetna Medicare |
$45.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54.71
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$43.77
|
| Rate for Payer: BCBS Trust/PPO |
$143.93
|
| Rate for Payer: BCN Commercial |
$136.12
|
| Rate for Payer: BCN Medicare Advantage |
$43.77
|
| Rate for Payer: Cash Price |
$140.06
|
| Rate for Payer: Cash Price |
$140.06
|
| Rate for Payer: Cofinity Commercial |
$150.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.77
|
| Rate for Payer: Healthscope Commercial |
$157.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.30
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.96
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.81
|
| Rate for Payer: Nomi Health Commercial |
$143.56
|
| Rate for Payer: PACE Senior Care Partners |
$41.58
|
| Rate for Payer: PACE SWMI |
$43.77
|
| Rate for Payer: PHP Commercial |
$148.81
|
| Rate for Payer: PHP Medicare Advantage |
$43.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.80
|
| Rate for Payer: Priority Health HMO/PPO |
$152.31
|
| Rate for Payer: Priority Health Medicare |
$44.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.30
|
| Rate for Payer: Railroad Medicare Medicare |
$43.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$154.06
|
| Rate for Payer: UHC Core |
$146.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.77
|
| Rate for Payer: UHC Exchange |
$43.77
|
| Rate for Payer: UHC Medicare Advantage |
$43.77
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$43.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.30
|
|
|
HC XR SHOULDER BIL 1 VW
|
Facility
|
IP
|
$175.07
|
|
|
Service Code
|
CPT 73020
|
| Hospital Charge Code |
32000064
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$113.80 |
| Max. Negotiated Rate |
$157.56 |
| Rate for Payer: Aetna Commercial |
$148.81
|
| Rate for Payer: BCBS Trust/PPO |
$142.91
|
| Rate for Payer: BCN Commercial |
$135.29
|
| Rate for Payer: Cash Price |
$140.06
|
| Rate for Payer: Cofinity Commercial |
$150.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.06
|
| Rate for Payer: Healthscope Commercial |
$157.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.81
|
| Rate for Payer: Nomi Health Commercial |
$143.56
|
| Rate for Payer: PHP Commercial |
$148.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.80
|
| Rate for Payer: Priority Health HMO/PPO |
$152.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$154.06
|
| Rate for Payer: UHC Core |
$146.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.30
|
|
|
HC XR SHOULDER BIL MIN 2 VW
|
Facility
|
OP
|
$451.65
|
|
|
Service Code
|
CPT 73030
|
| Hospital Charge Code |
32000066
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$62.37 |
| Max. Negotiated Rate |
$406.48 |
| 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 |
$65.50
|
| 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 |
$406.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$338.74
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$118.56
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| 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 |
$62.37
|
| 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 |
$62.37
|
| Rate for Payer: VA VA |
$112.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$338.74
|
|
|
HC XR SHOULDER BIL MIN 2 VW
|
Facility
|
IP
|
$451.65
|
|
|
Service Code
|
CPT 73030
|
| Hospital Charge Code |
32000066
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$293.57 |
| Max. Negotiated Rate |
$406.48 |
| 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 |
$406.48
|
| 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 SHOULDER MIN 2 VW
|
Facility
|
OP
|
$408.20
|
|
|
Service Code
|
CPT 73030
|
| Hospital Charge Code |
32000065
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$62.37 |
| 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 |
$65.50
|
| 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 |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.15
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| 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 |
$62.37
|
| 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 |
$62.37
|
| Rate for Payer: VA VA |
$102.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.15
|
|
|
HC XR SHOULDER MIN 2 VW
|
Facility
|
IP
|
$408.20
|
|
|
Service Code
|
CPT 73030
|
| Hospital Charge Code |
32000065
|
|
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 SINUSES LESS THAN 3 VW
|
Facility
|
OP
|
$204.23
|
|
|
Service Code
|
CPT 70210
|
| Hospital Charge Code |
32000013
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$48.50 |
| Max. Negotiated Rate |
$183.81 |
| Rate for Payer: Aetna Commercial |
$173.60
|
| Rate for Payer: Aetna Medicare |
$53.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.82
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$51.06
|
| Rate for Payer: BCBS Trust/PPO |
$167.90
|
| Rate for Payer: BCN Commercial |
$158.79
|
| Rate for Payer: BCN Medicare Advantage |
$51.06
|
| Rate for Payer: Cash Price |
$163.38
|
| Rate for Payer: Cash Price |
$163.38
|
| Rate for Payer: Cofinity Commercial |
$175.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.06
|
| Rate for Payer: Healthscope Commercial |
$183.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.17
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.61
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.60
|
| Rate for Payer: Nomi Health Commercial |
$167.47
|
| Rate for Payer: PACE Senior Care Partners |
$48.50
|
| Rate for Payer: PACE SWMI |
$51.06
|
| Rate for Payer: PHP Commercial |
$173.60
|
| Rate for Payer: PHP Medicare Advantage |
$51.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.75
|
| Rate for Payer: Priority Health HMO/PPO |
$177.68
|
| Rate for Payer: Priority Health Medicare |
$51.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$136.83
|
| Rate for Payer: Railroad Medicare Medicare |
$51.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.72
|
| Rate for Payer: UHC Core |
$170.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.06
|
| Rate for Payer: UHC Exchange |
$51.06
|
| Rate for Payer: UHC Medicare Advantage |
$51.06
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$51.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.17
|
|
