|
HC XR CHEST SINGLE VIEW
|
Facility
|
OP
|
$265.61
|
|
|
Service Code
|
CPT 71045
|
| Hospital Charge Code |
32400009
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$265.61 |
| Rate for Payer: Aetna Commercial |
$239.05
|
| 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 |
$257.64
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$205.93
|
| Rate for Payer: BCN Commercial |
$205.93
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$212.49
|
| 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: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$265.61
|
| Rate for Payer: Healthscope Whirlpool |
$257.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$80.77
|
| Rate for Payer: Mclaren Commercial |
$239.05
|
| 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 |
$225.77
|
| 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 |
$185.93
|
| 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 |
$233.74
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: VA VA |
$80.77
|
|
|
HC XR CHOLANGIOGRAM IN OR
|
Facility
|
IP
|
$500.38
|
|
|
Service Code
|
CPT 74300
|
| Hospital Charge Code |
32000149
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$350.27 |
| Max. Negotiated Rate |
$500.38 |
| Rate for Payer: Aetna Commercial |
$450.34
|
| Rate for Payer: ASR ASR |
$485.37
|
| Rate for Payer: BCBS Trust/PPO |
$387.94
|
| Rate for Payer: BCN Commercial |
$387.94
|
| Rate for Payer: Cash Price |
$400.30
|
| Rate for Payer: Cofinity Commercial |
$470.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.30
|
| Rate for Payer: Healthscope Commercial |
$500.38
|
| Rate for Payer: Healthscope Whirlpool |
$485.37
|
| Rate for Payer: Mclaren Commercial |
$450.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$425.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$440.33
|
|
|
HC XR CHOLANGIOGRAM IN OR
|
Facility
|
OP
|
$500.38
|
|
|
Service Code
|
CPT 74300
|
| Hospital Charge Code |
32000149
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$200.15 |
| Max. Negotiated Rate |
$535.15 |
| Rate for Payer: Aetna Commercial |
$450.34
|
| Rate for Payer: ASR ASR |
$485.37
|
| Rate for Payer: BCBS Complete |
$200.15
|
| Rate for Payer: BCBS Trust/PPO |
$387.94
|
| Rate for Payer: BCN Commercial |
$387.94
|
| Rate for Payer: Cash Price |
$400.30
|
| Rate for Payer: Cash Price |
$400.30
|
| Rate for Payer: Cofinity Commercial |
$470.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.30
|
| Rate for Payer: Healthscope Commercial |
$500.38
|
| Rate for Payer: Healthscope Whirlpool |
$485.37
|
| Rate for Payer: Mclaren Commercial |
$450.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$425.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$535.15
|
| Rate for Payer: Priority Health Narrow Network |
$428.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$440.33
|
|
|
HC XR CLAVICLE
|
Facility
|
IP
|
$310.28
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000060
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$217.20 |
| Max. Negotiated Rate |
$310.28 |
| Rate for Payer: Aetna Commercial |
$279.25
|
| Rate for Payer: ASR ASR |
$300.97
|
| Rate for Payer: BCBS Trust/PPO |
$240.56
|
| Rate for Payer: BCN Commercial |
$240.56
|
| Rate for Payer: Cash Price |
$248.22
|
| Rate for Payer: Cofinity Commercial |
$291.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.22
|
| Rate for Payer: Healthscope Commercial |
$310.28
|
| Rate for Payer: Healthscope Whirlpool |
$300.97
|
| Rate for Payer: Mclaren Commercial |
$279.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$263.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$273.05
|
|
|
HC XR CLAVICLE
|
Facility
|
OP
|
$310.28
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000060
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$310.28 |
| Rate for Payer: Aetna Commercial |
$279.25
|
| 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 |
$300.97
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$240.56
|
| Rate for Payer: BCN Commercial |
$240.56
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$248.22
|
| Rate for Payer: Cash Price |
$248.22
|
| Rate for Payer: Cofinity Commercial |
$291.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$310.28
|
| Rate for Payer: Healthscope Whirlpool |
$300.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$80.77
|
| Rate for Payer: Mclaren Commercial |
$279.25
|
| 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 |
$263.74
|
| 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 |
$217.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$230.90
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$184.72
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$273.05
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: VA VA |
$80.77
|
|
|
HC XR CLAVICLE BIL
|
Facility
|
OP
|
$333.67
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000061
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$333.67 |
| Rate for Payer: Aetna Commercial |
$300.30
|
| 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 |
$323.66
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$258.69
|
| Rate for Payer: BCN Commercial |
$258.69
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$266.94
|
| Rate for Payer: Cash Price |
$266.94
|
| Rate for Payer: Cofinity Commercial |
$313.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$333.67
|
| Rate for Payer: Healthscope Whirlpool |
$323.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$80.77
|
| Rate for Payer: Mclaren Commercial |
$300.30
|
| 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 |
$283.62
|
| 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 |
$233.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$230.90
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$184.72
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$293.63
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: VA VA |
$80.77
|
|
|
HC XR CLAVICLE BIL
|
Facility
|
IP
|
$333.67
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000061
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$233.57 |
| Max. Negotiated Rate |
$333.67 |
| Rate for Payer: Aetna Commercial |
$300.30
|
| Rate for Payer: ASR ASR |
$323.66
|
| Rate for Payer: BCBS Trust/PPO |
$258.69
|
| Rate for Payer: BCN Commercial |
$258.69
|
| Rate for Payer: Cash Price |
$266.94
|
| Rate for Payer: Cofinity Commercial |
$313.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.94
|
| Rate for Payer: Healthscope Commercial |
$333.67
|
| Rate for Payer: Healthscope Whirlpool |
$323.66
|
| Rate for Payer: Mclaren Commercial |
$300.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$283.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$293.63
|
|
|
HC XR COLON
|
Facility
|
OP
|
$840.63
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
32000273
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$840.63 |
| Rate for Payer: Aetna Commercial |
$756.57
|
| Rate for Payer: Aetna Medicare |
$163.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.15
|
| Rate for Payer: ASR ASR |
$815.41
|
| Rate for Payer: BCBS Complete |
$93.81
|
| Rate for Payer: BCBS MAPPO |
$163.32
|
| Rate for Payer: BCBS Trust/PPO |
$651.74
|
| Rate for Payer: BCN Commercial |
$651.74
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$672.50
|
| Rate for Payer: Cash Price |
$672.50
|
| Rate for Payer: Cofinity Commercial |
$790.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$672.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$840.63
|
| Rate for Payer: Healthscope Whirlpool |
$815.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$163.32
|
| Rate for Payer: Mclaren Commercial |
$756.57
|
| Rate for Payer: Mclaren Medicaid |
$89.34
|
| Rate for Payer: Mclaren Medicare |
$163.32
|
| Rate for Payer: Meridian Medicaid |
$93.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$714.54
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$179.65
|
| Rate for Payer: PHP Medicaid |
$89.34
|
| Rate for Payer: PHP Medicare Advantage |
$163.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$588.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$401.75
|
| Rate for Payer: Priority Health Medicare |
$163.32
|
| Rate for Payer: Priority Health Narrow Network |
$321.40
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$739.75
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: VA VA |
$163.32
|
|
|
HC XR COLON
|
Facility
|
IP
|
$840.63
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
32000273
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$588.44 |
| Max. Negotiated Rate |
$840.63 |
| Rate for Payer: Aetna Commercial |
$756.57
|
| Rate for Payer: ASR ASR |
$815.41
|
| Rate for Payer: BCBS Trust/PPO |
$651.74
|
| Rate for Payer: BCN Commercial |
$651.74
|
| Rate for Payer: Cash Price |
$672.50
|
| Rate for Payer: Cofinity Commercial |
$790.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$672.50
|
| Rate for Payer: Healthscope Commercial |
$840.63
|
| Rate for Payer: Healthscope Whirlpool |
$815.41
|
| Rate for Payer: Mclaren Commercial |
$756.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$714.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$588.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$739.75
|
|
|
HC XR COLON HIGH DENSITY
|
Facility
|
IP
|
$1,200.85
|
|
|
Service Code
|
CPT 74280
|
| Hospital Charge Code |
32000146
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$840.60 |
| Max. Negotiated Rate |
$1,200.85 |
| Rate for Payer: Aetna Commercial |
$1,080.76
|
| Rate for Payer: ASR ASR |
$1,164.82
|
| Rate for Payer: BCBS Trust/PPO |
$931.02
|
| Rate for Payer: BCN Commercial |
$931.02
|
| Rate for Payer: Cash Price |
$960.68
|
| Rate for Payer: Cofinity Commercial |
$1,128.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$960.68
|
| Rate for Payer: Healthscope Commercial |
$1,200.85
|
| Rate for Payer: Healthscope Whirlpool |
$1,164.82
|
| Rate for Payer: Mclaren Commercial |
$1,080.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,020.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$840.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,056.75
|
|
|
HC XR COLON HIGH DENSITY
|
Facility
|
OP
|
$1,200.85
|
|
|
Service Code
|
CPT 74280
|
| Hospital Charge Code |
32000146
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,200.85 |
| Rate for Payer: Aetna Commercial |
$1,080.76
|
| Rate for Payer: Aetna Medicare |
$163.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.15
|
| Rate for Payer: ASR ASR |
$1,164.82
|
| Rate for Payer: BCBS Complete |
$93.81
|
| Rate for Payer: BCBS MAPPO |
$163.32
|
| Rate for Payer: BCBS Trust/PPO |
$931.02
|
| Rate for Payer: BCN Commercial |
$931.02
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$960.68
|
| Rate for Payer: Cash Price |
$960.68
|
| Rate for Payer: Cofinity Commercial |
$1,128.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$960.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$1,200.85
|
| Rate for Payer: Healthscope Whirlpool |
$1,164.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$163.32
|
| Rate for Payer: Mclaren Commercial |
$1,080.76
|
| Rate for Payer: Mclaren Medicaid |
$89.34
|
| Rate for Payer: Mclaren Medicare |
$163.32
|
| Rate for Payer: Meridian Medicaid |
$93.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,020.72
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$179.65
|
| Rate for Payer: PHP Medicaid |
$89.34
|
| Rate for Payer: PHP Medicare Advantage |
$163.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$840.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$517.20
|
| Rate for Payer: Priority Health Medicare |
$163.32
|
| Rate for Payer: Priority Health Narrow Network |
$413.76
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,056.75
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: VA VA |
$163.32
|
|
|
HC XR COLON THERAPEUTIC FOR INTUS
|
Facility
|
IP
|
$571.84
|
|
|
Service Code
|
CPT 74283
|
| Hospital Charge Code |
32000147
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$400.29 |
| Max. Negotiated Rate |
$571.84 |
| Rate for Payer: Aetna Commercial |
$514.66
|
| Rate for Payer: ASR ASR |
$554.68
|
| Rate for Payer: BCBS Trust/PPO |
$443.35
|
| Rate for Payer: BCN Commercial |
$443.35
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cofinity Commercial |
$537.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.47
|
| Rate for Payer: Healthscope Commercial |
$571.84
|
| Rate for Payer: Healthscope Whirlpool |
$554.68
|
| Rate for Payer: Mclaren Commercial |
$514.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$503.22
|
|
|
HC XR COLON THERAPEUTIC FOR INTUS
|
Facility
|
OP
|
$571.84
|
|
|
Service Code
|
CPT 74283
|
| Hospital Charge Code |
32000147
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$571.84 |
| Rate for Payer: Aetna Commercial |
$514.66
|
| Rate for Payer: Aetna Medicare |
$163.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.15
|
| Rate for Payer: ASR ASR |
$554.68
|
| Rate for Payer: BCBS Complete |
$93.81
|
| Rate for Payer: BCBS MAPPO |
$163.32
|
| Rate for Payer: BCBS Trust/PPO |
$443.35
|
| Rate for Payer: BCN Commercial |
$443.35
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cofinity Commercial |
$537.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$571.84
|
| Rate for Payer: Healthscope Whirlpool |
$554.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$163.32
|
| Rate for Payer: Mclaren Commercial |
$514.66
|
| Rate for Payer: Mclaren Medicaid |
$89.34
|
| Rate for Payer: Mclaren Medicare |
$163.32
|
| Rate for Payer: Meridian Medicaid |
$93.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.06
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$179.65
|
| Rate for Payer: PHP Medicaid |
$89.34
|
| Rate for Payer: PHP Medicare Advantage |
$163.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$520.37
|
| Rate for Payer: Priority Health Medicare |
$163.32
|
| Rate for Payer: Priority Health Narrow Network |
$406.01
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$503.22
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: VA VA |
$163.32
|
|
|
HC XR CYSTOGRAM MIN 3 VW
|
Facility
|
IP
|
$430.44
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000163
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$301.31 |
| Max. Negotiated Rate |
$430.44 |
| Rate for Payer: Aetna Commercial |
$387.40
|
| Rate for Payer: ASR ASR |
$417.53
|
| Rate for Payer: BCBS Trust/PPO |
$333.72
|
| Rate for Payer: BCN Commercial |
$333.72
|
| Rate for Payer: Cash Price |
$344.35
|
| Rate for Payer: Cofinity Commercial |
$404.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.35
|
| Rate for Payer: Healthscope Commercial |
$430.44
|
| Rate for Payer: Healthscope Whirlpool |
$417.53
|
| Rate for Payer: Mclaren Commercial |
$387.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$378.79
|
|
|
HC XR CYSTOGRAM MIN 3 VW
|
Facility
|
OP
|
$430.44
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000163
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$430.44 |
| Rate for Payer: Aetna Commercial |
$387.40
|
| 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 |
$417.53
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$333.72
|
| Rate for Payer: BCN Commercial |
$333.72
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$344.35
|
| Rate for Payer: Cash Price |
$344.35
|
| Rate for Payer: Cofinity Commercial |
$404.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$430.44
|
| Rate for Payer: Healthscope Whirlpool |
$417.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$387.40
|
| 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 |
$365.87
|
| 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 |
$301.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$389.44
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$311.55
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$378.79
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC XR CYSTOGRAM VOIDING
|
Facility
|
IP
|
$500.38
|
|
|
Service Code
|
CPT 74455
|
| Hospital Charge Code |
32000166
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$350.27 |
| Max. Negotiated Rate |
$500.38 |
| Rate for Payer: Aetna Commercial |
$450.34
|
| Rate for Payer: ASR ASR |
$485.37
|
| Rate for Payer: BCBS Trust/PPO |
$387.94
|
| Rate for Payer: BCN Commercial |
$387.94
|
| Rate for Payer: Cash Price |
$400.30
|
| Rate for Payer: Cofinity Commercial |
$470.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.30
|
| Rate for Payer: Healthscope Commercial |
$500.38
|
| Rate for Payer: Healthscope Whirlpool |
$485.37
|
| Rate for Payer: Mclaren Commercial |
$450.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$425.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$440.33
|
|
|
HC XR CYSTOGRAM VOIDING
|
Facility
|
OP
|
$500.38
|
|
|
Service Code
|
CPT 74455
|
| Hospital Charge Code |
32000166
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$500.38 |
| Rate for Payer: Aetna Commercial |
$450.34
|
| Rate for Payer: Aetna Medicare |
$217.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: ASR ASR |
$485.37
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$387.94
|
| Rate for Payer: BCN Commercial |
$387.94
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$400.30
|
| Rate for Payer: Cash Price |
$400.30
|
| Rate for Payer: Cofinity Commercial |
$470.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$500.38
|
| Rate for Payer: Healthscope Whirlpool |
$485.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.81
|
| Rate for Payer: Mclaren Commercial |
$450.34
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$425.32
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$239.59
|
| Rate for Payer: PHP Medicaid |
$119.14
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$437.66
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$350.13
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$440.33
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: VA VA |
$217.81
|
|
|
HC XR DEFECOGRAPHY 4 WAY
|
Facility
|
OP
|
$800.53
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000164
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$800.53 |
| Rate for Payer: Aetna Commercial |
$720.48
|
| 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 |
$776.51
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$620.65
|
| Rate for Payer: BCN Commercial |
$620.65
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$752.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$800.53
|
| Rate for Payer: Healthscope Whirlpool |
$776.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$720.48
|
| 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 |
$680.45
|
| 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 |
$560.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$389.44
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$311.55
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$704.47
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC XR DEFECOGRAPHY 4 WAY
|
Facility
|
IP
|
$800.53
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000164
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$560.37 |
| Max. Negotiated Rate |
$800.53 |
| Rate for Payer: Aetna Commercial |
$720.48
|
| Rate for Payer: ASR ASR |
$776.51
|
| Rate for Payer: BCBS Trust/PPO |
$620.65
|
| Rate for Payer: BCN Commercial |
$620.65
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$752.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Healthscope Commercial |
$800.53
|
| Rate for Payer: Healthscope Whirlpool |
$776.51
|
| Rate for Payer: Mclaren Commercial |
$720.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$704.47
|
|
|
HC XR ELBOW 2 BIL VW
|
Facility
|
OP
|
$381.09
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000072
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$381.09 |
| Rate for Payer: Aetna Commercial |
$342.98
|
| 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 |
$369.66
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$295.46
|
| Rate for Payer: BCN Commercial |
$295.46
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$358.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$381.09
|
| Rate for Payer: Healthscope Whirlpool |
$369.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$80.77
|
| Rate for Payer: Mclaren Commercial |
$342.98
|
| 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 |
$323.93
|
| 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 |
$266.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$224.73
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$179.78
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$335.36
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: VA VA |
$80.77
|
|
|
HC XR ELBOW 2 BIL VW
|
Facility
|
IP
|
$381.09
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000072
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$266.76 |
| Max. Negotiated Rate |
$381.09 |
| Rate for Payer: Aetna Commercial |
$342.98
|
| Rate for Payer: ASR ASR |
$369.66
|
| Rate for Payer: BCBS Trust/PPO |
$295.46
|
| Rate for Payer: BCN Commercial |
$295.46
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$358.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Healthscope Commercial |
$381.09
|
| Rate for Payer: Healthscope Whirlpool |
$369.66
|
| Rate for Payer: Mclaren Commercial |
$342.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$335.36
|
|
|
HC XR ELBOW 2 VW
|
Facility
|
IP
|
$350.37
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000071
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$245.26 |
| Max. Negotiated Rate |
$350.37 |
| Rate for Payer: Aetna Commercial |
$315.33
|
| Rate for Payer: ASR ASR |
$339.86
|
| Rate for Payer: BCBS Trust/PPO |
$271.64
|
| Rate for Payer: BCN Commercial |
$271.64
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cofinity Commercial |
$329.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.30
|
| Rate for Payer: Healthscope Commercial |
$350.37
|
| Rate for Payer: Healthscope Whirlpool |
$339.86
|
| Rate for Payer: Mclaren Commercial |
$315.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.33
|
|
|
HC XR ELBOW 2 VW
|
Facility
|
OP
|
$350.37
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000071
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$350.37 |
| Rate for Payer: Aetna Commercial |
$315.33
|
| 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 |
$339.86
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$271.64
|
| Rate for Payer: BCN Commercial |
$271.64
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cofinity Commercial |
$329.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$350.37
|
| Rate for Payer: Healthscope Whirlpool |
$339.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$80.77
|
| Rate for Payer: Mclaren Commercial |
$315.33
|
| 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 |
$297.81
|
| 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 |
$245.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$224.73
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$179.78
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.33
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: VA VA |
$80.77
|
|
|
HC XR ELBOW BIL 3 VW
|
Facility
|
OP
|
$381.09
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000074
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$381.09 |
| Rate for Payer: Aetna Commercial |
$342.98
|
| 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 |
$369.66
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$295.46
|
| Rate for Payer: BCN Commercial |
$295.46
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$358.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$381.09
|
| Rate for Payer: Healthscope Whirlpool |
$369.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$80.77
|
| Rate for Payer: Mclaren Commercial |
$342.98
|
| 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 |
$323.93
|
| 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 |
$266.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$242.17
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$193.74
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$335.36
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: VA VA |
$80.77
|
|
|
HC XR ELBOW BIL 3 VW
|
Facility
|
IP
|
$381.09
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000074
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$266.76 |
| Max. Negotiated Rate |
$381.09 |
| Rate for Payer: Aetna Commercial |
$342.98
|
| Rate for Payer: ASR ASR |
$369.66
|
| Rate for Payer: BCBS Trust/PPO |
$295.46
|
| Rate for Payer: BCN Commercial |
$295.46
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$358.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Healthscope Commercial |
$381.09
|
| Rate for Payer: Healthscope Whirlpool |
$369.66
|
| Rate for Payer: Mclaren Commercial |
$342.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$335.36
|
|
