|
HC XR TIB FIB BIL 2 VW
|
Facility
|
IP
|
$381.09
|
|
|
Service Code
|
CPT 73590
|
| Hospital Charge Code |
32000113
|
|
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 TIB FIB BIL 2 VW
|
Facility
|
OP
|
$381.09
|
|
|
Service Code
|
CPT 73590
|
| Hospital Charge Code |
32000113
|
|
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 TMJ COMPLETE BIL
|
Facility
|
OP
|
$400.20
|
|
|
Service Code
|
CPT 70330
|
| Hospital Charge Code |
32000022
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$400.20 |
| Rate for Payer: Aetna Commercial |
$360.18
|
| 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 |
$388.19
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$310.28
|
| Rate for Payer: BCN Commercial |
$310.28
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cofinity Commercial |
$376.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$400.20
|
| Rate for Payer: Healthscope Whirlpool |
$388.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$80.77
|
| Rate for Payer: Mclaren Commercial |
$360.18
|
| 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 |
$340.17
|
| 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 |
$280.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.20
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$116.16
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$352.18
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: VA VA |
$80.77
|
|
|
HC XR TMJ COMPLETE BIL
|
Facility
|
IP
|
$400.20
|
|
|
Service Code
|
CPT 70330
|
| Hospital Charge Code |
32000022
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$280.14 |
| Max. Negotiated Rate |
$400.20 |
| Rate for Payer: Aetna Commercial |
$360.18
|
| Rate for Payer: ASR ASR |
$388.19
|
| Rate for Payer: BCBS Trust/PPO |
$310.28
|
| Rate for Payer: BCN Commercial |
$310.28
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cofinity Commercial |
$376.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.16
|
| Rate for Payer: Healthscope Commercial |
$400.20
|
| Rate for Payer: Healthscope Whirlpool |
$388.19
|
| Rate for Payer: Mclaren Commercial |
$360.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$352.18
|
|
|
HC XR TMJ LTD
|
Facility
|
IP
|
$109.41
|
|
|
Service Code
|
CPT 70328
|
| Hospital Charge Code |
32000021
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$76.59 |
| Max. Negotiated Rate |
$109.41 |
| Rate for Payer: Aetna Commercial |
$98.47
|
| Rate for Payer: ASR ASR |
$106.13
|
| Rate for Payer: BCBS Trust/PPO |
$84.83
|
| Rate for Payer: BCN Commercial |
$84.83
|
| Rate for Payer: Cash Price |
$87.53
|
| Rate for Payer: Cofinity Commercial |
$102.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.53
|
| Rate for Payer: Healthscope Commercial |
$109.41
|
| Rate for Payer: Healthscope Whirlpool |
$106.13
|
| Rate for Payer: Mclaren Commercial |
$98.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.28
|
|
|
HC XR TMJ LTD
|
Facility
|
OP
|
$109.41
|
|
|
Service Code
|
CPT 70328
|
| Hospital Charge Code |
32000021
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$109.41 |
| Rate for Payer: Aetna Commercial |
$98.47
|
| 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 |
$106.13
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$84.83
|
| Rate for Payer: BCN Commercial |
$84.83
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$87.53
|
| Rate for Payer: Cash Price |
$87.53
|
| Rate for Payer: Cofinity Commercial |
$102.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$109.41
|
| Rate for Payer: Healthscope Whirlpool |
$106.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$80.77
|
| Rate for Payer: Mclaren Commercial |
$98.47
|
| 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 |
$93.00
|
| 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 |
$76.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$99.56
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$77.68
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.28
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: VA VA |
$80.77
|
|
|
HC XR TOES BIL MIN 2 VIEWS
|
Facility
|
IP
|
$219.46
|
|
|
Service Code
|
CPT 73660
|
| Hospital Charge Code |
32000131
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$153.62 |
| Max. Negotiated Rate |
$219.46 |
| Rate for Payer: Aetna Commercial |
$197.51
|
| Rate for Payer: ASR ASR |
$212.88
|
| Rate for Payer: BCBS Trust/PPO |
$170.15
|
| Rate for Payer: BCN Commercial |
$170.15
|
| Rate for Payer: Cash Price |
$175.57
|
| Rate for Payer: Cofinity Commercial |
$206.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.57
|
| Rate for Payer: Healthscope Commercial |
$219.46
|
| Rate for Payer: Healthscope Whirlpool |
$212.88
|
| Rate for Payer: Mclaren Commercial |
$197.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$186.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$193.12
|
|
|
HC XR TOES BIL MIN 2 VIEWS
|
Facility
|
OP
|
$219.46
|
|
|
Service Code
|
CPT 73660
|
| Hospital Charge Code |
32000131
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$219.46 |
| Rate for Payer: Aetna Commercial |
$197.51
|
| 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 |
$212.88
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$170.15
|
| Rate for Payer: BCN Commercial |
$170.15
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$175.57
|
| Rate for Payer: Cash Price |
$175.57
|
| Rate for Payer: Cofinity Commercial |
$206.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$219.46
|
| Rate for Payer: Healthscope Whirlpool |
$212.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$80.77
|
| Rate for Payer: Mclaren Commercial |
$197.51
|
| 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 |
$186.54
|
| 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 |
$153.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.64
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$82.91
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$193.12
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: VA VA |
$80.77
|
|
|
HC XR TOES MIN 2 VIEWS
|
Facility
|
OP
|
$190.24
|
|
|
Service Code
|
CPT 73660
|
| Hospital Charge Code |
32000130
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$190.24 |
| Rate for Payer: Aetna Commercial |
$171.22
|
| 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 |
$184.53
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$147.49
|
| Rate for Payer: BCN Commercial |
$147.49
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$152.19
|
| Rate for Payer: Cash Price |
$152.19
|
| Rate for Payer: Cofinity Commercial |
$178.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$190.24
|
| Rate for Payer: Healthscope Whirlpool |
$184.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$80.77
|
| Rate for Payer: Mclaren Commercial |
$171.22
|
| 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 |
$161.70
|
| 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 |
$133.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.64
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$82.91
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$167.41
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: VA VA |
$80.77
|
|
|
HC XR TOES MIN 2 VIEWS
|
Facility
|
IP
|
$190.24
|
|
|
Service Code
|
CPT 73660
|
| Hospital Charge Code |
32000130
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$133.17 |
| Max. Negotiated Rate |
$190.24 |
| Rate for Payer: Aetna Commercial |
$171.22
|
| Rate for Payer: ASR ASR |
$184.53
|
| Rate for Payer: BCBS Trust/PPO |
$147.49
|
| Rate for Payer: BCN Commercial |
$147.49
|
| Rate for Payer: Cash Price |
$152.19
|
| Rate for Payer: Cofinity Commercial |
$178.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.19
|
| Rate for Payer: Healthscope Commercial |
$190.24
|
| Rate for Payer: Healthscope Whirlpool |
$184.53
|
| Rate for Payer: Mclaren Commercial |
$171.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$161.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$167.41
|
|
|
HC XR UGI GASTRO THIN BARM
|
Facility
|
IP
|
$286.12
|
|
|
Service Code
|
CPT 74240
|
| Hospital Charge Code |
32000138
|
|
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 UGI GASTRO THIN BARM
|
Facility
|
OP
|
$286.12
|
|
|
Service Code
|
CPT 74240
|
| Hospital Charge Code |
32000138
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$286.12 |
| Rate for Payer: Aetna Commercial |
$257.51
|
| 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 |
$277.54
|
| Rate for Payer: BCBS Complete |
$93.81
|
| Rate for Payer: BCBS MAPPO |
$163.32
|
| Rate for Payer: BCBS Trust/PPO |
$221.83
|
| Rate for Payer: BCN Commercial |
$221.83
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| 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 |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$286.12
|
| Rate for Payer: Healthscope Whirlpool |
$277.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$163.32
|
| Rate for Payer: Mclaren Commercial |
$257.51
|
| 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 |
$243.20
|
| 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 |
$200.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.37
|
| Rate for Payer: Priority Health Medicare |
$163.32
|
| Rate for Payer: Priority Health Narrow Network |
$203.15
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$251.79
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: VA VA |
$163.32
|
|
|
HC XR UPPER GI
|
Facility
|
IP
|
$572.10
|
|
|
Service Code
|
CPT 74246
|
| Hospital Charge Code |
32000141
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$400.47 |
| Max. Negotiated Rate |
$572.10 |
| Rate for Payer: Aetna Commercial |
$514.89
|
| Rate for Payer: ASR ASR |
$554.94
|
| Rate for Payer: BCBS Trust/PPO |
$443.55
|
| Rate for Payer: BCN Commercial |
$443.55
|
| Rate for Payer: Cash Price |
$457.68
|
| Rate for Payer: Cofinity Commercial |
$537.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.68
|
| Rate for Payer: Healthscope Commercial |
$572.10
|
| Rate for Payer: Healthscope Whirlpool |
$554.94
|
| Rate for Payer: Mclaren Commercial |
$514.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$503.45
|
|
|
HC XR UPPER GI
|
Facility
|
OP
|
$572.10
|
|
|
Service Code
|
CPT 74246
|
| Hospital Charge Code |
32000141
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$572.10 |
| Rate for Payer: Aetna Commercial |
$514.89
|
| 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 |
$554.94
|
| Rate for Payer: BCBS Complete |
$93.81
|
| Rate for Payer: BCBS MAPPO |
$163.32
|
| Rate for Payer: BCBS Trust/PPO |
$443.55
|
| Rate for Payer: BCN Commercial |
$443.55
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$457.68
|
| Rate for Payer: Cash Price |
$457.68
|
| Rate for Payer: Cofinity Commercial |
$537.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$572.10
|
| Rate for Payer: Healthscope Whirlpool |
$554.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$163.32
|
| Rate for Payer: Mclaren Commercial |
$514.89
|
| 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 |
$486.28
|
| 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 |
$400.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$520.61
|
| Rate for Payer: Priority Health Medicare |
$163.32
|
| Rate for Payer: Priority Health Narrow Network |
$406.19
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$503.45
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: VA VA |
$163.32
|
|
|
HC XR URETHROGRAM RETROGRADE
|
Facility
|
OP
|
$480.00
|
|
|
Service Code
|
CPT 74450
|
| Hospital Charge Code |
32000165
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$480.00 |
| Rate for Payer: Aetna Commercial |
$432.00
|
| 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 |
$465.60
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$372.14
|
| Rate for Payer: BCN Commercial |
$372.14
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$384.00
|
| Rate for Payer: Cash Price |
$384.00
|
| Rate for Payer: Cofinity Commercial |
$451.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$480.00
|
| Rate for Payer: Healthscope Whirlpool |
$465.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.81
|
| Rate for Payer: Mclaren Commercial |
$432.00
|
| 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 |
$408.00
|
| 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 |
$336.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$436.80
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$340.80
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$422.40
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: VA VA |
$217.81
|
|
|
HC XR URETHROGRAM RETROGRADE
|
Facility
|
IP
|
$480.00
|
|
|
Service Code
|
CPT 74450
|
| Hospital Charge Code |
32000165
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$336.00 |
| Max. Negotiated Rate |
$480.00 |
| Rate for Payer: Aetna Commercial |
$432.00
|
| Rate for Payer: ASR ASR |
$465.60
|
| Rate for Payer: BCBS Trust/PPO |
$372.14
|
| Rate for Payer: BCN Commercial |
$372.14
|
| Rate for Payer: Cash Price |
$384.00
|
| Rate for Payer: Cofinity Commercial |
$451.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.00
|
| Rate for Payer: Healthscope Commercial |
$480.00
|
| Rate for Payer: Healthscope Whirlpool |
$465.60
|
| Rate for Payer: Mclaren Commercial |
$432.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$408.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$422.40
|
|
|
HC XR UROGRAPHY INF
|
Facility
|
IP
|
$777.33
|
|
|
Service Code
|
CPT 74410
|
| Hospital Charge Code |
32000293
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$544.13 |
| Max. Negotiated Rate |
$777.33 |
| Rate for Payer: Aetna Commercial |
$699.60
|
| Rate for Payer: ASR ASR |
$754.01
|
| Rate for Payer: BCBS Trust/PPO |
$602.66
|
| Rate for Payer: BCN Commercial |
$602.66
|
| Rate for Payer: Cash Price |
$621.86
|
| Rate for Payer: Cofinity Commercial |
$730.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$621.86
|
| Rate for Payer: Healthscope Commercial |
$777.33
|
| Rate for Payer: Healthscope Whirlpool |
$754.01
|
| Rate for Payer: Mclaren Commercial |
$699.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$660.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$684.05
|
|
|
HC XR UROGRAPHY INF
|
Facility
|
OP
|
$777.33
|
|
|
Service Code
|
CPT 74410
|
| Hospital Charge Code |
32000293
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$777.33 |
| Rate for Payer: Aetna Commercial |
$699.60
|
| 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 |
$754.01
|
| Rate for Payer: BCBS Complete |
$93.81
|
| Rate for Payer: BCBS MAPPO |
$163.32
|
| Rate for Payer: BCBS Trust/PPO |
$602.66
|
| Rate for Payer: BCN Commercial |
$602.66
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$621.86
|
| Rate for Payer: Cash Price |
$621.86
|
| Rate for Payer: Cofinity Commercial |
$730.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$621.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$777.33
|
| Rate for Payer: Healthscope Whirlpool |
$754.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$163.32
|
| Rate for Payer: Mclaren Commercial |
$699.60
|
| 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 |
$660.73
|
| 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 |
$544.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$707.37
|
| Rate for Payer: Priority Health Medicare |
$163.32
|
| Rate for Payer: Priority Health Narrow Network |
$551.90
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$684.05
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: VA VA |
$163.32
|
|
|
HC XR WRIST 2 VW
|
Facility
|
OP
|
$250.45
|
|
|
Service Code
|
CPT 73100
|
| Hospital Charge Code |
32000080
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$250.45 |
| Rate for Payer: Aetna Commercial |
$225.40
|
| 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 |
$242.94
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$194.17
|
| Rate for Payer: BCN Commercial |
$194.17
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$200.36
|
| Rate for Payer: Cash Price |
$200.36
|
| Rate for Payer: Cofinity Commercial |
$235.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$250.45
|
| Rate for Payer: Healthscope Whirlpool |
$242.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$80.77
|
| Rate for Payer: Mclaren Commercial |
$225.40
|
| 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 |
$212.88
|
| 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 |
$175.32
|
| 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 |
$220.40
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: VA VA |
$80.77
|
|
|
HC XR WRIST 2 VW
|
Facility
|
IP
|
$250.45
|
|
|
Service Code
|
CPT 73100
|
| Hospital Charge Code |
32000080
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$175.32 |
| Max. Negotiated Rate |
$250.45 |
| Rate for Payer: Aetna Commercial |
$225.40
|
| Rate for Payer: ASR ASR |
$242.94
|
| Rate for Payer: BCBS Trust/PPO |
$194.17
|
| Rate for Payer: BCN Commercial |
$194.17
|
| Rate for Payer: Cash Price |
$200.36
|
| Rate for Payer: Cofinity Commercial |
$235.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.36
|
| Rate for Payer: Healthscope Commercial |
$250.45
|
| Rate for Payer: Healthscope Whirlpool |
$242.94
|
| Rate for Payer: Mclaren Commercial |
$225.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$212.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$220.40
|
|
|
HC XR WRIST BIL 2 VW
|
Facility
|
IP
|
$286.12
|
|
|
Service Code
|
CPT 73100
|
| Hospital Charge Code |
32000081
|
|
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 WRIST BIL 2 VW
|
Facility
|
OP
|
$286.12
|
|
|
Service Code
|
CPT 73100
|
| Hospital Charge Code |
32000081
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$286.12 |
| Rate for Payer: Aetna Commercial |
$257.51
|
| 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 |
$277.54
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$221.83
|
| Rate for Payer: BCN Commercial |
$221.83
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| 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 |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$286.12
|
| Rate for Payer: Healthscope Whirlpool |
$277.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$80.77
|
| Rate for Payer: Mclaren Commercial |
$257.51
|
| 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 |
$243.20
|
| 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 |
$200.28
|
| 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 |
$251.79
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: VA VA |
$80.77
|
|
|
HC XR WRIST BIL MIN 3 VW
|
Facility
|
OP
|
$442.79
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000083
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$442.79 |
| Rate for Payer: Aetna Commercial |
$398.51
|
| 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 |
$429.51
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$343.30
|
| Rate for Payer: BCN Commercial |
$343.30
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$354.23
|
| Rate for Payer: Cash Price |
$354.23
|
| Rate for Payer: Cofinity Commercial |
$416.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$354.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$442.79
|
| Rate for Payer: Healthscope Whirlpool |
$429.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$80.77
|
| Rate for Payer: Mclaren Commercial |
$398.51
|
| 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 |
$376.37
|
| 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 |
$309.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.36
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$199.49
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$389.66
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: VA VA |
$80.77
|
|
|
HC XR WRIST BIL MIN 3 VW
|
Facility
|
IP
|
$442.79
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000083
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$309.95 |
| Max. Negotiated Rate |
$442.79 |
| Rate for Payer: Aetna Commercial |
$398.51
|
| Rate for Payer: ASR ASR |
$429.51
|
| Rate for Payer: BCBS Trust/PPO |
$343.30
|
| Rate for Payer: BCN Commercial |
$343.30
|
| Rate for Payer: Cash Price |
$354.23
|
| Rate for Payer: Cofinity Commercial |
$416.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$354.23
|
| Rate for Payer: Healthscope Commercial |
$442.79
|
| Rate for Payer: Healthscope Whirlpool |
$429.51
|
| Rate for Payer: Mclaren Commercial |
$398.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$376.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$309.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$389.66
|
|
|
HC XR WRIST MIN 3 VW
|
Facility
|
OP
|
$400.20
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000082
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$400.20 |
| Rate for Payer: Aetna Commercial |
$360.18
|
| 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 |
$388.19
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$310.28
|
| Rate for Payer: BCN Commercial |
$310.28
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cofinity Commercial |
$376.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$400.20
|
| Rate for Payer: Healthscope Whirlpool |
$388.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$80.77
|
| Rate for Payer: Mclaren Commercial |
$360.18
|
| 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 |
$340.17
|
| 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 |
$280.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.36
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$199.49
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$352.18
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: VA VA |
$80.77
|
|
