|
HC XR ARTHROGRAM KNEE
|
Facility
|
OP
|
$600.30
|
|
|
Service Code
|
CPT 73580
|
| Hospital Charge Code |
32000111
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$600.30 |
| Rate for Payer: Aetna Commercial |
$540.27
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: ASR ASR |
$582.29
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$465.41
|
| Rate for Payer: BCN Commercial |
$465.41
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$480.24
|
| Rate for Payer: Cash Price |
$480.24
|
| Rate for Payer: Cofinity Commercial |
$564.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$600.30
|
| Rate for Payer: Healthscope Whirlpool |
$582.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$540.27
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.26
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$564.39
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$451.51
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$528.26
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC XR ARTHROGRAM KNEE
|
Facility
|
IP
|
$600.30
|
|
|
Service Code
|
CPT 73580
|
| Hospital Charge Code |
32000111
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$420.21 |
| Max. Negotiated Rate |
$600.30 |
| Rate for Payer: Aetna Commercial |
$540.27
|
| Rate for Payer: ASR ASR |
$582.29
|
| Rate for Payer: BCBS Trust/PPO |
$465.41
|
| Rate for Payer: BCN Commercial |
$465.41
|
| Rate for Payer: Cash Price |
$480.24
|
| Rate for Payer: Cofinity Commercial |
$564.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.24
|
| Rate for Payer: Healthscope Commercial |
$600.30
|
| Rate for Payer: Healthscope Whirlpool |
$582.29
|
| Rate for Payer: Mclaren Commercial |
$540.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$528.26
|
|
|
HC XR ARTHROGRAM SHOULDER
|
Facility
|
OP
|
$600.30
|
|
|
Service Code
|
CPT 73040
|
| Hospital Charge Code |
32000067
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$600.30 |
| Rate for Payer: Aetna Commercial |
$540.27
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: ASR ASR |
$582.29
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$465.41
|
| Rate for Payer: BCN Commercial |
$465.41
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$480.24
|
| Rate for Payer: Cash Price |
$480.24
|
| Rate for Payer: Cofinity Commercial |
$564.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$600.30
|
| Rate for Payer: Healthscope Whirlpool |
$582.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$540.27
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.26
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$564.39
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$451.51
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$528.26
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC XR ARTHROGRAM SHOULDER
|
Facility
|
IP
|
$600.30
|
|
|
Service Code
|
CPT 73040
|
| Hospital Charge Code |
32000067
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$420.21 |
| Max. Negotiated Rate |
$600.30 |
| Rate for Payer: Aetna Commercial |
$540.27
|
| Rate for Payer: ASR ASR |
$582.29
|
| Rate for Payer: BCBS Trust/PPO |
$465.41
|
| Rate for Payer: BCN Commercial |
$465.41
|
| Rate for Payer: Cash Price |
$480.24
|
| Rate for Payer: Cofinity Commercial |
$564.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.24
|
| Rate for Payer: Healthscope Commercial |
$600.30
|
| Rate for Payer: Healthscope Whirlpool |
$582.29
|
| Rate for Payer: Mclaren Commercial |
$540.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$528.26
|
|
|
HC XR ARTHROGRAM WRIST
|
Facility
|
IP
|
$657.72
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
32000084
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$460.40 |
| Max. Negotiated Rate |
$657.72 |
| Rate for Payer: Aetna Commercial |
$591.95
|
| Rate for Payer: ASR ASR |
$637.99
|
| Rate for Payer: BCBS Trust/PPO |
$509.93
|
| Rate for Payer: BCN Commercial |
$509.93
|
| Rate for Payer: Cash Price |
$526.18
|
| Rate for Payer: Cofinity Commercial |
$618.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$526.18
|
| Rate for Payer: Healthscope Commercial |
$657.72
|
| Rate for Payer: Healthscope Whirlpool |
$637.99
|
| Rate for Payer: Mclaren Commercial |
$591.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$559.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$460.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$578.79
|
|
|
HC XR ARTHROGRAM WRIST
|
Facility
|
OP
|
$657.72
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
32000084
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$657.72 |
| Rate for Payer: Aetna Commercial |
$591.95
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: ASR ASR |
$637.99
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$509.93
|
| Rate for Payer: BCN Commercial |
$509.93
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$526.18
|
| Rate for Payer: Cash Price |
$526.18
|
| Rate for Payer: Cofinity Commercial |
$618.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$526.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$657.72
|
| Rate for Payer: Healthscope Whirlpool |
$637.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$591.95
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$559.06
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$460.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$598.53
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$466.98
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$578.79
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC XR BONE AGE STUDY
|
Facility
|
IP
|
$300.42
|
|
|
Service Code
|
CPT 77072
|
| Hospital Charge Code |
32000253
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$210.29 |
| Max. Negotiated Rate |
$300.42 |
| Rate for Payer: Aetna Commercial |
$270.38
|
| Rate for Payer: ASR ASR |
$291.41
|
| Rate for Payer: BCBS Trust/PPO |
$232.92
|
| Rate for Payer: BCN Commercial |
$232.92
|
| Rate for Payer: Cash Price |
$240.34
|
| Rate for Payer: Cofinity Commercial |
$282.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.34
|
| Rate for Payer: Healthscope Commercial |
$300.42
|
| Rate for Payer: Healthscope Whirlpool |
$291.41
|
| Rate for Payer: Mclaren Commercial |
$270.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$255.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$264.37
|
|
|
HC XR BONE AGE STUDY
|
Facility
|
OP
|
$300.42
|
|
|
Service Code
|
CPT 77072
|
| Hospital Charge Code |
32000253
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$300.42 |
| Rate for Payer: Aetna Commercial |
$270.38
|
| Rate for Payer: Aetna Medicare |
$97.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: ASR ASR |
$291.41
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$232.92
|
| Rate for Payer: BCN Commercial |
$232.92
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$240.34
|
| Rate for Payer: Cash Price |
$240.34
|
| Rate for Payer: Cofinity Commercial |
$282.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$300.42
|
| Rate for Payer: Healthscope Whirlpool |
$291.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$97.72
|
| Rate for Payer: Mclaren Commercial |
$270.38
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$255.36
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$107.49
|
| Rate for Payer: PHP Medicaid |
$53.45
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$201.13
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$160.90
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$264.37
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: VA VA |
$97.72
|
|
|
HC XR BONE LENGTH STUDY
|
Facility
|
OP
|
$286.12
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
32000254
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$286.12 |
| Rate for Payer: Aetna Commercial |
$257.51
|
| Rate for Payer: Aetna Medicare |
$97.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: ASR ASR |
$277.54
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$221.83
|
| Rate for Payer: BCN Commercial |
$221.83
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$228.90
|
| Rate for Payer: Cash Price |
$228.90
|
| Rate for Payer: Cofinity Commercial |
$268.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$286.12
|
| Rate for Payer: Healthscope Whirlpool |
$277.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$97.72
|
| Rate for Payer: Mclaren Commercial |
$257.51
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$243.20
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$107.49
|
| Rate for Payer: PHP Medicaid |
$53.45
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.93
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$170.34
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$251.79
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: VA VA |
$97.72
|
|
|
HC XR BONE LENGTH STUDY
|
Facility
|
IP
|
$286.12
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
32000254
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$200.28 |
| Max. Negotiated Rate |
$286.12 |
| Rate for Payer: Aetna Commercial |
$257.51
|
| Rate for Payer: ASR ASR |
$277.54
|
| Rate for Payer: BCBS Trust/PPO |
$221.83
|
| Rate for Payer: BCN Commercial |
$221.83
|
| Rate for Payer: Cash Price |
$228.90
|
| Rate for Payer: Cofinity Commercial |
$268.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.90
|
| Rate for Payer: Healthscope Commercial |
$286.12
|
| Rate for Payer: Healthscope Whirlpool |
$277.54
|
| Rate for Payer: Mclaren Commercial |
$257.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$243.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$251.79
|
|
|
HC XR BONE SURVEY ADULT COMP
|
Facility
|
IP
|
$600.55
|
|
|
Service Code
|
CPT 77075
|
| Hospital Charge Code |
32000257
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$420.38 |
| Max. Negotiated Rate |
$600.55 |
| Rate for Payer: Aetna Commercial |
$540.50
|
| Rate for Payer: ASR ASR |
$582.53
|
| Rate for Payer: BCBS Trust/PPO |
$465.61
|
| Rate for Payer: BCN Commercial |
$465.61
|
| Rate for Payer: Cash Price |
$480.44
|
| Rate for Payer: Cofinity Commercial |
$564.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.44
|
| Rate for Payer: Healthscope Commercial |
$600.55
|
| Rate for Payer: Healthscope Whirlpool |
$582.53
|
| Rate for Payer: Mclaren Commercial |
$540.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$528.48
|
|
|
HC XR BONE SURVEY ADULT COMP
|
Facility
|
OP
|
$600.55
|
|
|
Service Code
|
CPT 77075
|
| Hospital Charge Code |
32000257
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$600.55 |
| Rate for Payer: Aetna Commercial |
$540.50
|
| Rate for Payer: Aetna Medicare |
$97.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: ASR ASR |
$582.53
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$465.61
|
| Rate for Payer: BCN Commercial |
$465.61
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$480.44
|
| Rate for Payer: Cash Price |
$480.44
|
| Rate for Payer: Cofinity Commercial |
$564.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$600.55
|
| Rate for Payer: Healthscope Whirlpool |
$582.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$97.72
|
| Rate for Payer: Mclaren Commercial |
$540.50
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.47
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$107.49
|
| Rate for Payer: PHP Medicaid |
$53.45
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$231.91
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$185.53
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$528.48
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: VA VA |
$97.72
|
|
|
HC XR BONE SURVEY INFANT
|
Facility
|
IP
|
$380.35
|
|
|
Service Code
|
CPT 77076
|
| Hospital Charge Code |
32000258
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$266.24 |
| Max. Negotiated Rate |
$380.35 |
| Rate for Payer: Aetna Commercial |
$342.32
|
| Rate for Payer: ASR ASR |
$368.94
|
| Rate for Payer: BCBS Trust/PPO |
$294.89
|
| Rate for Payer: BCN Commercial |
$294.89
|
| Rate for Payer: Cash Price |
$304.28
|
| Rate for Payer: Cofinity Commercial |
$357.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.28
|
| Rate for Payer: Healthscope Commercial |
$380.35
|
| Rate for Payer: Healthscope Whirlpool |
$368.94
|
| Rate for Payer: Mclaren Commercial |
$342.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$334.71
|
|
|
HC XR BONE SURVEY INFANT
|
Facility
|
OP
|
$380.35
|
|
|
Service Code
|
CPT 77076
|
| Hospital Charge Code |
32000258
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$380.35 |
| Rate for Payer: Aetna Commercial |
$342.32
|
| Rate for Payer: Aetna Medicare |
$97.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: ASR ASR |
$368.94
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$294.89
|
| Rate for Payer: BCN Commercial |
$294.89
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$304.28
|
| Rate for Payer: Cash Price |
$304.28
|
| Rate for Payer: Cofinity Commercial |
$357.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$380.35
|
| Rate for Payer: Healthscope Whirlpool |
$368.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$97.72
|
| Rate for Payer: Mclaren Commercial |
$342.32
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.30
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$107.49
|
| Rate for Payer: PHP Medicaid |
$53.45
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.78
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$243.82
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$334.71
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: VA VA |
$97.72
|
|
|
HC XR BONE SURVEY (METS) LTD
|
Facility
|
OP
|
$302.08
|
|
|
Service Code
|
CPT 77074
|
| Hospital Charge Code |
32000298
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$302.08 |
| Rate for Payer: Aetna Commercial |
$271.87
|
| Rate for Payer: Aetna Medicare |
$97.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: ASR ASR |
$293.02
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$234.20
|
| Rate for Payer: BCN Commercial |
$234.20
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$241.66
|
| Rate for Payer: Cash Price |
$241.66
|
| Rate for Payer: Cofinity Commercial |
$283.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$241.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$302.08
|
| Rate for Payer: Healthscope Whirlpool |
$293.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$97.72
|
| Rate for Payer: Mclaren Commercial |
$271.87
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$256.77
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$107.49
|
| Rate for Payer: PHP Medicaid |
$53.45
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$274.89
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$214.48
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$265.83
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: VA VA |
$97.72
|
|
|
HC XR BONE SURVEY (METS) LTD
|
Facility
|
IP
|
$302.08
|
|
|
Service Code
|
CPT 77074
|
| Hospital Charge Code |
32000298
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$211.46 |
| Max. Negotiated Rate |
$302.08 |
| Rate for Payer: Aetna Commercial |
$271.87
|
| Rate for Payer: ASR ASR |
$293.02
|
| Rate for Payer: BCBS Trust/PPO |
$234.20
|
| Rate for Payer: BCN Commercial |
$234.20
|
| Rate for Payer: Cash Price |
$241.66
|
| Rate for Payer: Cofinity Commercial |
$283.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$241.66
|
| Rate for Payer: Healthscope Commercial |
$302.08
|
| Rate for Payer: Healthscope Whirlpool |
$293.02
|
| Rate for Payer: Mclaren Commercial |
$271.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$256.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$265.83
|
|
|
HC XR CHEST 2 VIEWS
|
Facility
|
OP
|
$297.74
|
|
|
Service Code
|
CPT 71046
|
| Hospital Charge Code |
32400010
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$297.74 |
| Rate for Payer: Aetna Commercial |
$267.97
|
| Rate for Payer: Aetna Medicare |
$80.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: ASR ASR |
$288.81
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$230.84
|
| Rate for Payer: BCN Commercial |
$230.84
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$238.19
|
| Rate for Payer: Cash Price |
$238.19
|
| Rate for Payer: Cofinity Commercial |
$279.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$297.74
|
| Rate for Payer: Healthscope Whirlpool |
$288.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$80.77
|
| Rate for Payer: Mclaren Commercial |
$267.97
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$253.08
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$88.85
|
| Rate for Payer: PHP Medicaid |
$44.18
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.46
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$53.17
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$262.01
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: VA VA |
$80.77
|
|
|
HC XR CHEST 2 VIEWS
|
Facility
|
IP
|
$297.74
|
|
|
Service Code
|
CPT 71046
|
| Hospital Charge Code |
32400010
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$208.42 |
| Max. Negotiated Rate |
$297.74 |
| Rate for Payer: Aetna Commercial |
$267.97
|
| Rate for Payer: ASR ASR |
$288.81
|
| Rate for Payer: BCBS Trust/PPO |
$230.84
|
| Rate for Payer: BCN Commercial |
$230.84
|
| Rate for Payer: Cash Price |
$238.19
|
| Rate for Payer: Cofinity Commercial |
$279.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.19
|
| Rate for Payer: Healthscope Commercial |
$297.74
|
| Rate for Payer: Healthscope Whirlpool |
$288.81
|
| Rate for Payer: Mclaren Commercial |
$267.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$253.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$262.01
|
|
|
HC XR CHEST 3 VIEWS
|
Facility
|
OP
|
$329.87
|
|
|
Service Code
|
CPT 71047
|
| Hospital Charge Code |
32400011
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$329.87 |
| Rate for Payer: Aetna Commercial |
$296.88
|
| Rate for Payer: Aetna Medicare |
$80.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: ASR ASR |
$319.97
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$255.75
|
| Rate for Payer: BCN Commercial |
$255.75
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$263.90
|
| Rate for Payer: Cash Price |
$263.90
|
| Rate for Payer: Cofinity Commercial |
$310.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$329.87
|
| Rate for Payer: Healthscope Whirlpool |
$319.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$80.77
|
| Rate for Payer: Mclaren Commercial |
$296.88
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.39
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$88.85
|
| Rate for Payer: PHP Medicaid |
$44.18
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.46
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$53.17
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$290.29
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: VA VA |
$80.77
|
|
|
HC XR CHEST 3 VIEWS
|
Facility
|
IP
|
$329.87
|
|
|
Service Code
|
CPT 71047
|
| Hospital Charge Code |
32400011
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$230.91 |
| Max. Negotiated Rate |
$329.87 |
| Rate for Payer: Aetna Commercial |
$296.88
|
| Rate for Payer: ASR ASR |
$319.97
|
| Rate for Payer: BCBS Trust/PPO |
$255.75
|
| Rate for Payer: BCN Commercial |
$255.75
|
| Rate for Payer: Cash Price |
$263.90
|
| Rate for Payer: Cofinity Commercial |
$310.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.90
|
| Rate for Payer: Healthscope Commercial |
$329.87
|
| Rate for Payer: Healthscope Whirlpool |
$319.97
|
| Rate for Payer: Mclaren Commercial |
$296.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$290.29
|
|
|
HC XR CHEST 4 OR MORE VIEWS
|
Facility
|
IP
|
$362.00
|
|
|
Service Code
|
CPT 71048
|
| Hospital Charge Code |
32400012
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$253.40 |
| Max. Negotiated Rate |
$362.00 |
| Rate for Payer: Aetna Commercial |
$325.80
|
| Rate for Payer: ASR ASR |
$351.14
|
| Rate for Payer: BCBS Trust/PPO |
$280.66
|
| Rate for Payer: BCN Commercial |
$280.66
|
| Rate for Payer: Cash Price |
$289.60
|
| Rate for Payer: Cofinity Commercial |
$340.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.60
|
| Rate for Payer: Healthscope Commercial |
$362.00
|
| Rate for Payer: Healthscope Whirlpool |
$351.14
|
| Rate for Payer: Mclaren Commercial |
$325.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$307.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$318.56
|
|
|
HC XR CHEST 4 OR MORE VIEWS
|
Facility
|
OP
|
$362.00
|
|
|
Service Code
|
CPT 71048
|
| Hospital Charge Code |
32400012
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$362.00 |
| Rate for Payer: Aetna Commercial |
$325.80
|
| Rate for Payer: Aetna Medicare |
$97.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: ASR ASR |
$351.14
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$280.66
|
| Rate for Payer: BCN Commercial |
$280.66
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$289.60
|
| Rate for Payer: Cash Price |
$289.60
|
| Rate for Payer: Cofinity Commercial |
$340.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$362.00
|
| Rate for Payer: Healthscope Whirlpool |
$351.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$97.72
|
| Rate for Payer: Mclaren Commercial |
$325.80
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$307.70
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$107.49
|
| Rate for Payer: PHP Medicaid |
$53.45
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.05
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$101.64
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$318.56
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: VA VA |
$97.72
|
|
|
HC XR CHEST ABD FOREIG BOD CHILD
|
Facility
|
IP
|
$270.56
|
|
|
Service Code
|
CPT 76010
|
| Hospital Charge Code |
32000234
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$189.39 |
| Max. Negotiated Rate |
$270.56 |
| Rate for Payer: Aetna Commercial |
$243.50
|
| Rate for Payer: ASR ASR |
$262.44
|
| Rate for Payer: BCBS Trust/PPO |
$209.77
|
| Rate for Payer: BCN Commercial |
$209.77
|
| Rate for Payer: Cash Price |
$216.45
|
| Rate for Payer: Cofinity Commercial |
$254.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.45
|
| Rate for Payer: Healthscope Commercial |
$270.56
|
| Rate for Payer: Healthscope Whirlpool |
$262.44
|
| Rate for Payer: Mclaren Commercial |
$243.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$238.09
|
|
|
HC XR CHEST ABD FOREIG BOD CHILD
|
Facility
|
OP
|
$270.56
|
|
|
Service Code
|
CPT 76010
|
| Hospital Charge Code |
32000234
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$270.56 |
| Rate for Payer: Aetna Commercial |
$243.50
|
| Rate for Payer: Aetna Medicare |
$80.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: ASR ASR |
$262.44
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$209.77
|
| Rate for Payer: BCN Commercial |
$209.77
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$216.45
|
| Rate for Payer: Cash Price |
$216.45
|
| Rate for Payer: Cofinity Commercial |
$254.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$270.56
|
| Rate for Payer: Healthscope Whirlpool |
$262.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$80.77
|
| Rate for Payer: Mclaren Commercial |
$243.50
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.98
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$88.85
|
| Rate for Payer: PHP Medicaid |
$44.18
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$246.21
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$192.10
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$238.09
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: VA VA |
$80.77
|
|
|
HC XR CHEST SINGLE VIEW
|
Facility
|
IP
|
$265.61
|
|
|
Service Code
|
CPT 71045
|
| Hospital Charge Code |
32400009
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$185.93 |
| Max. Negotiated Rate |
$265.61 |
| Rate for Payer: Aetna Commercial |
$239.05
|
| Rate for Payer: ASR ASR |
$257.64
|
| Rate for Payer: BCBS Trust/PPO |
$205.93
|
| Rate for Payer: BCN Commercial |
$205.93
|
| Rate for Payer: Cash Price |
$212.49
|
| Rate for Payer: Cofinity Commercial |
$249.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.49
|
| Rate for Payer: Healthscope Commercial |
$265.61
|
| Rate for Payer: Healthscope Whirlpool |
$257.64
|
| Rate for Payer: Mclaren Commercial |
$239.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$225.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$233.74
|
|
