|
HC XR ANKLE 2 VIEWS BILATERAL
|
Facility
|
OP
|
$254.90
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000339
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$280.42 |
| Rate for Payer: Aetna American Axle |
$165.69
|
| Rate for Payer: Aetna Commercial |
$216.66
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$59.93
|
| Rate for Payer: BCN Commercial |
$59.93
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Advantage |
$178.43
|
| Rate for Payer: Cofinity Commercial |
$219.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$229.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$178.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.18
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.18
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$216.66
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$160.59
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.69
|
| Rate for Payer: UHC Core |
$132.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$100.18
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: UMR Bronson Commercial |
$94.31
|
| Rate for Payer: VA VA |
$86.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.18
|
|
|
HC XR ANKLE BIL 2 VW
|
Facility
|
OP
|
$297.68
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000120
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$280.42 |
| Rate for Payer: Aetna American Axle |
$193.49
|
| Rate for Payer: Aetna Commercial |
$253.03
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$59.93
|
| Rate for Payer: BCN Commercial |
$59.93
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cofinity Advantage |
$208.38
|
| Rate for Payer: Cofinity Commercial |
$256.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$267.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$208.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.26
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.03
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.26
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$253.03
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$187.54
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.49
|
| Rate for Payer: UHC Core |
$155.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$116.99
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: UMR Bronson Commercial |
$110.14
|
| Rate for Payer: VA VA |
$86.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.26
|
|
|
HC XR ANKLE BIL 2 VW
|
Facility
|
IP
|
$297.68
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000120
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$130.98 |
| Max. Negotiated Rate |
$267.91 |
| Rate for Payer: Aetna American Axle |
$193.49
|
| Rate for Payer: Aetna Commercial |
$253.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.49
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cofinity Advantage |
$208.38
|
| Rate for Payer: Cofinity Commercial |
$256.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.14
|
| Rate for Payer: Healthscope Commercial |
$267.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$208.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.26
|
| Rate for Payer: PHP Commercial |
$253.03
|
| Rate for Payer: Priority Health SBD |
$187.54
|
| Rate for Payer: UMR Bronson Commercial |
$130.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.26
|
|
|
HC XR ANKLE BIL MIN 3 VW
|
Facility
|
OP
|
$396.48
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
32000122
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$356.83 |
| Rate for Payer: Aetna American Axle |
$257.71
|
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$68.96
|
| Rate for Payer: BCN Commercial |
$68.96
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Advantage |
$277.54
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$277.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.36
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$249.78
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.71
|
| Rate for Payer: UHC Core |
$206.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$155.82
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: UMR Bronson Commercial |
$146.70
|
| Rate for Payer: VA VA |
$86.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.36
|
|
|
HC XR ANKLE BIL MIN 3 VW
|
Facility
|
IP
|
$396.48
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
32000122
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$174.45 |
| Max. Negotiated Rate |
$356.83 |
| Rate for Payer: Aetna American Axle |
$257.71
|
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.71
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Advantage |
$277.54
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$277.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: Priority Health SBD |
$249.78
|
| Rate for Payer: UMR Bronson Commercial |
$174.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.36
|
|
|
HC XR ANKLE MIN 3 VIEWS
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
32000121
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$328.08 |
| Rate for Payer: Aetna American Axle |
$236.94
|
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$68.96
|
| Rate for Payer: BCN Commercial |
$68.96
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Advantage |
$255.17
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$255.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.40
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$229.65
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.94
|
| Rate for Payer: UHC Core |
$189.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$143.26
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: UMR Bronson Commercial |
$134.88
|
| Rate for Payer: VA VA |
$86.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.40
|
|
|
HC XR ANKLE MIN 3 VIEWS
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
32000121
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$160.39 |
| Max. Negotiated Rate |
$328.08 |
| Rate for Payer: Aetna American Axle |
$236.94
|
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.94
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Advantage |
$255.17
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$255.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: Priority Health SBD |
$229.65
|
| Rate for Payer: UMR Bronson Commercial |
$160.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.40
|
|
|
HC XR ARTHROGRAM ELBOW
|
Facility
|
OP
|
$624.56
|
|
|
Service Code
|
CPT 73085
|
| Hospital Charge Code |
32000075
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$178.13 |
| Max. Negotiated Rate |
$1,124.16 |
| Rate for Payer: Aetna American Axle |
$405.96
|
| Rate for Payer: Aetna Commercial |
$530.88
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$178.13
|
| Rate for Payer: BCN Commercial |
$178.13
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Advantage |
$437.19
|
| Rate for Payer: Cofinity Commercial |
$537.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$562.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$437.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.42
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$530.88
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$393.47
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$405.96
|
| Rate for Payer: UHC Core |
$325.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$245.45
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: UMR Bronson Commercial |
$231.09
|
| Rate for Payer: VA VA |
$347.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.42
|
|
|
HC XR ARTHROGRAM ELBOW
|
Facility
|
IP
|
$624.56
|
|
|
Service Code
|
CPT 73085
|
| Hospital Charge Code |
32000075
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$274.81 |
| Max. Negotiated Rate |
$562.10 |
| Rate for Payer: Aetna American Axle |
$405.96
|
| Rate for Payer: Aetna Commercial |
$530.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.96
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Advantage |
$437.19
|
| Rate for Payer: Cofinity Commercial |
$537.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Healthscope Commercial |
$562.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$437.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: PHP Commercial |
$530.88
|
| Rate for Payer: Priority Health SBD |
$393.47
|
| Rate for Payer: UMR Bronson Commercial |
$274.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.42
|
|
|
HC XR ARTHROGRAM HIP
|
Facility
|
IP
|
$624.56
|
|
|
Service Code
|
CPT 73525
|
| Hospital Charge Code |
32000097
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$274.81 |
| Max. Negotiated Rate |
$562.10 |
| Rate for Payer: Aetna American Axle |
$405.96
|
| Rate for Payer: Aetna Commercial |
$530.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.96
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Advantage |
$437.19
|
| Rate for Payer: Cofinity Commercial |
$537.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Healthscope Commercial |
$562.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$437.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: PHP Commercial |
$530.88
|
| Rate for Payer: Priority Health SBD |
$393.47
|
| Rate for Payer: UMR Bronson Commercial |
$274.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.42
|
|
|
HC XR ARTHROGRAM HIP
|
Facility
|
OP
|
$624.56
|
|
|
Service Code
|
CPT 73525
|
| Hospital Charge Code |
32000097
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,124.16 |
| Rate for Payer: Aetna American Axle |
$405.96
|
| Rate for Payer: Aetna Commercial |
$530.88
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$238.89
|
| Rate for Payer: BCN Commercial |
$238.89
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Advantage |
$437.19
|
| Rate for Payer: Cofinity Commercial |
$537.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$562.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$437.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.42
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$530.88
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$393.47
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$405.96
|
| Rate for Payer: UHC Core |
$325.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$245.45
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: UMR Bronson Commercial |
$231.09
|
| Rate for Payer: VA VA |
$347.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.42
|
|
|
HC XR ARTHROGRAM KNEE
|
Facility
|
IP
|
$624.56
|
|
|
Service Code
|
CPT 73580
|
| Hospital Charge Code |
32000111
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$274.81 |
| Max. Negotiated Rate |
$562.10 |
| Rate for Payer: Aetna American Axle |
$405.96
|
| Rate for Payer: Aetna Commercial |
$530.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.96
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Advantage |
$437.19
|
| Rate for Payer: Cofinity Commercial |
$537.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Healthscope Commercial |
$562.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$437.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: PHP Commercial |
$530.88
|
| Rate for Payer: Priority Health SBD |
$393.47
|
| Rate for Payer: UMR Bronson Commercial |
$274.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.42
|
|
|
HC XR ARTHROGRAM KNEE
|
Facility
|
OP
|
$624.56
|
|
|
Service Code
|
CPT 73580
|
| Hospital Charge Code |
32000111
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,124.16 |
| Rate for Payer: Aetna American Axle |
$405.96
|
| Rate for Payer: Aetna Commercial |
$530.88
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$190.44
|
| Rate for Payer: BCN Commercial |
$190.44
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Advantage |
$437.19
|
| Rate for Payer: Cofinity Commercial |
$537.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$562.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$437.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.42
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$530.88
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$393.47
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$405.96
|
| Rate for Payer: UHC Core |
$325.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$245.45
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: UMR Bronson Commercial |
$231.09
|
| Rate for Payer: VA VA |
$347.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.42
|
|
|
HC XR ARTHROGRAM SHOULDER
|
Facility
|
OP
|
$624.56
|
|
|
Service Code
|
CPT 73040
|
| Hospital Charge Code |
32000067
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,124.16 |
| Rate for Payer: Aetna American Axle |
$405.96
|
| Rate for Payer: Aetna Commercial |
$530.88
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$252.83
|
| Rate for Payer: BCN Commercial |
$252.83
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Advantage |
$437.19
|
| Rate for Payer: Cofinity Commercial |
$537.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$562.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$437.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.42
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$530.88
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$393.47
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$405.96
|
| Rate for Payer: UHC Core |
$325.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$245.45
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: UMR Bronson Commercial |
$231.09
|
| Rate for Payer: VA VA |
$347.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.42
|
|
|
HC XR ARTHROGRAM SHOULDER
|
Facility
|
IP
|
$624.56
|
|
|
Service Code
|
CPT 73040
|
| Hospital Charge Code |
32000067
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$274.81 |
| Max. Negotiated Rate |
$562.10 |
| Rate for Payer: Aetna American Axle |
$405.96
|
| Rate for Payer: Aetna Commercial |
$530.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.96
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Advantage |
$437.19
|
| Rate for Payer: Cofinity Commercial |
$537.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Healthscope Commercial |
$562.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$437.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: PHP Commercial |
$530.88
|
| Rate for Payer: Priority Health SBD |
$393.47
|
| Rate for Payer: UMR Bronson Commercial |
$274.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.42
|
|
|
HC XR ARTHROGRAM WRIST
|
Facility
|
OP
|
$684.29
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
32000084
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,124.16 |
| Rate for Payer: Aetna American Axle |
$444.79
|
| Rate for Payer: Aetna Commercial |
$581.65
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$444.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$256.12
|
| Rate for Payer: BCN Commercial |
$256.12
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$547.43
|
| Rate for Payer: Cash Price |
$547.43
|
| Rate for Payer: Cofinity Advantage |
$479.00
|
| Rate for Payer: Cofinity Commercial |
$588.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$547.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$615.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$479.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$513.22
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$581.65
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$513.22
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$581.65
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$431.10
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$444.79
|
| Rate for Payer: UHC Core |
$356.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$268.93
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: UMR Bronson Commercial |
$253.19
|
| Rate for Payer: VA VA |
$347.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$513.22
|
|
|
HC XR ARTHROGRAM WRIST
|
Facility
|
IP
|
$684.29
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
32000084
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$301.09 |
| Max. Negotiated Rate |
$615.86 |
| Rate for Payer: Aetna American Axle |
$444.79
|
| Rate for Payer: Aetna Commercial |
$581.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$444.79
|
| Rate for Payer: Cash Price |
$547.43
|
| Rate for Payer: Cofinity Advantage |
$479.00
|
| Rate for Payer: Cofinity Commercial |
$588.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$547.43
|
| Rate for Payer: Healthscope Commercial |
$615.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$479.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$513.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$581.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$513.22
|
| Rate for Payer: PHP Commercial |
$581.65
|
| Rate for Payer: Priority Health SBD |
$431.10
|
| Rate for Payer: UMR Bronson Commercial |
$301.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$513.22
|
|
|
HC XR BONE AGE STUDY
|
Facility
|
OP
|
$312.56
|
|
|
Service Code
|
CPT 77072
|
| Hospital Charge Code |
32000253
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$41.04 |
| Max. Negotiated Rate |
$336.87 |
| Rate for Payer: Aetna American Axle |
$203.16
|
| Rate for Payer: Aetna Commercial |
$265.68
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$41.04
|
| Rate for Payer: BCN Commercial |
$41.04
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$250.05
|
| Rate for Payer: Cash Price |
$250.05
|
| Rate for Payer: Cofinity Advantage |
$218.79
|
| Rate for Payer: Cofinity Commercial |
$268.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$250.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$281.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$218.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.42
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.68
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.42
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$265.68
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$196.91
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.16
|
| Rate for Payer: UHC Core |
$162.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$122.84
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$115.65
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.42
|
|
|
HC XR BONE AGE STUDY
|
Facility
|
IP
|
$312.56
|
|
|
Service Code
|
CPT 77072
|
| Hospital Charge Code |
32000253
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$137.53 |
| Max. Negotiated Rate |
$281.30 |
| Rate for Payer: Aetna American Axle |
$203.16
|
| Rate for Payer: Aetna Commercial |
$265.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.16
|
| Rate for Payer: Cash Price |
$250.05
|
| Rate for Payer: Cofinity Advantage |
$218.79
|
| Rate for Payer: Cofinity Commercial |
$268.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$250.05
|
| Rate for Payer: Healthscope Commercial |
$281.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$218.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.42
|
| Rate for Payer: PHP Commercial |
$265.68
|
| Rate for Payer: Priority Health SBD |
$196.91
|
| Rate for Payer: UMR Bronson Commercial |
$137.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.42
|
|
|
HC XR BONE LENGTH STUDY
|
Facility
|
IP
|
$297.68
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
32000254
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$130.98 |
| Max. Negotiated Rate |
$267.91 |
| Rate for Payer: Aetna American Axle |
$193.49
|
| Rate for Payer: Aetna Commercial |
$253.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.49
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cofinity Advantage |
$208.38
|
| Rate for Payer: Cofinity Commercial |
$256.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.14
|
| Rate for Payer: Healthscope Commercial |
$267.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$208.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.26
|
| Rate for Payer: PHP Commercial |
$253.03
|
| Rate for Payer: Priority Health SBD |
$187.54
|
| Rate for Payer: UMR Bronson Commercial |
$130.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.26
|
|
|
HC XR BONE LENGTH STUDY
|
Facility
|
OP
|
$297.68
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
32000254
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$336.87 |
| Rate for Payer: Aetna American Axle |
$193.49
|
| Rate for Payer: Aetna Commercial |
$253.03
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$79.62
|
| Rate for Payer: BCN Commercial |
$79.62
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cofinity Advantage |
$208.38
|
| Rate for Payer: Cofinity Commercial |
$256.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$267.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$208.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.26
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.03
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.26
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$253.03
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$187.54
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.49
|
| Rate for Payer: UHC Core |
$155.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$116.99
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$110.14
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.26
|
|
|
HC XR BONE SURVEY ADULT COMP
|
Facility
|
IP
|
$624.81
|
|
|
Service Code
|
CPT 77075
|
| Hospital Charge Code |
32000257
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$274.92 |
| Max. Negotiated Rate |
$562.33 |
| Rate for Payer: Aetna American Axle |
$406.13
|
| Rate for Payer: Aetna Commercial |
$531.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.13
|
| Rate for Payer: Cash Price |
$499.85
|
| Rate for Payer: Cofinity Advantage |
$437.37
|
| Rate for Payer: Cofinity Commercial |
$537.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.85
|
| Rate for Payer: Healthscope Commercial |
$562.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$437.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$531.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.61
|
| Rate for Payer: PHP Commercial |
$531.09
|
| Rate for Payer: Priority Health SBD |
$393.63
|
| Rate for Payer: UMR Bronson Commercial |
$274.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.61
|
|
|
HC XR BONE SURVEY ADULT COMP
|
Facility
|
OP
|
$624.81
|
|
|
Service Code
|
CPT 77075
|
| Hospital Charge Code |
32000257
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$562.33 |
| Rate for Payer: Aetna American Axle |
$406.13
|
| Rate for Payer: Aetna Commercial |
$531.09
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$179.78
|
| Rate for Payer: BCN Commercial |
$179.78
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$499.85
|
| Rate for Payer: Cash Price |
$499.85
|
| Rate for Payer: Cofinity Advantage |
$437.37
|
| Rate for Payer: Cofinity Commercial |
$537.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$562.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$437.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.61
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$531.09
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.61
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$531.09
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$393.63
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$406.13
|
| Rate for Payer: UHC Core |
$325.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$245.55
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$231.18
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.61
|
|
|
HC XR BONE SURVEY INFANT
|
Facility
|
OP
|
$395.72
|
|
|
Service Code
|
CPT 77076
|
| Hospital Charge Code |
32000258
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$356.15 |
| Rate for Payer: Aetna American Axle |
$257.22
|
| Rate for Payer: Aetna Commercial |
$336.36
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$181.41
|
| Rate for Payer: BCN Commercial |
$181.41
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$316.58
|
| Rate for Payer: Cash Price |
$316.58
|
| Rate for Payer: Cofinity Advantage |
$277.00
|
| Rate for Payer: Cofinity Commercial |
$340.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$356.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$277.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$296.79
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$336.36
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$296.79
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$336.36
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$249.30
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.22
|
| Rate for Payer: UHC Core |
$206.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$155.52
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$146.42
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$296.79
|
|
|
HC XR BONE SURVEY INFANT
|
Facility
|
IP
|
$395.72
|
|
|
Service Code
|
CPT 77076
|
| Hospital Charge Code |
32000258
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$174.12 |
| Max. Negotiated Rate |
$356.15 |
| Rate for Payer: Aetna American Axle |
$257.22
|
| Rate for Payer: Aetna Commercial |
$336.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.22
|
| Rate for Payer: Cash Price |
$316.58
|
| Rate for Payer: Cofinity Advantage |
$277.00
|
| Rate for Payer: Cofinity Commercial |
$340.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.58
|
| Rate for Payer: Healthscope Commercial |
$356.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$277.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$296.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$336.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$296.79
|
| Rate for Payer: PHP Commercial |
$336.36
|
| Rate for Payer: Priority Health SBD |
$249.30
|
| Rate for Payer: UMR Bronson Commercial |
$174.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$296.79
|
|
