|
HC XR ANKLE 2 VIEWS
|
Facility
|
OP
|
$260.57
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000117
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$272.38 |
| Rate for Payer: Aetna Commercial |
$234.51
|
| Rate for Payer: Aetna Medicare |
$86.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: ASR ASR |
$252.75
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$214.84
|
| Rate for Payer: BCN Commercial |
$214.84
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$208.46
|
| Rate for Payer: Cash Price |
$208.46
|
| Rate for Payer: Cofinity Commercial |
$244.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$252.75
|
| Rate for Payer: Healthscope Whirlpool |
$260.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$234.51
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$47.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.48
|
| Rate for Payer: Nomi Health Commercial |
$213.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.43
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$95.38
|
| Rate for Payer: PHP Medicaid |
$46.48
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$272.38
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health Narrow Network |
$217.90
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$229.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$134.40
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP DNSP |
$86.71
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XR ANKLE 2 VIEWS
|
Facility
|
IP
|
$260.57
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000117
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$195.43 |
| Max. Negotiated Rate |
$260.57 |
| Rate for Payer: Aetna Commercial |
$234.51
|
| Rate for Payer: ASR ASR |
$252.75
|
| Rate for Payer: BCBS Trust/PPO |
$213.98
|
| Rate for Payer: BCN Commercial |
$213.98
|
| Rate for Payer: Cash Price |
$208.46
|
| Rate for Payer: Cofinity Commercial |
$244.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.46
|
| Rate for Payer: Healthscope Commercial |
$252.75
|
| Rate for Payer: Healthscope Whirlpool |
$260.57
|
| Rate for Payer: Mclaren Commercial |
$234.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.48
|
| Rate for Payer: Nomi Health Commercial |
$213.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$229.30
|
|
|
HC XR ANKLE 2 VIEWS BILATERAL
|
Facility
|
OP
|
$254.90
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000339
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$272.38 |
| Rate for Payer: Aetna Commercial |
$229.41
|
| Rate for Payer: Aetna Medicare |
$86.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: ASR ASR |
$247.25
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$210.17
|
| Rate for Payer: BCN Commercial |
$210.17
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Commercial |
$239.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$247.25
|
| Rate for Payer: Healthscope Whirlpool |
$254.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$229.41
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$47.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Nomi Health Commercial |
$209.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.18
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$95.38
|
| Rate for Payer: PHP Medicaid |
$46.48
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$272.38
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health Narrow Network |
$217.90
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$134.40
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP DNSP |
$86.71
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XR ANKLE 2 VIEWS BILATERAL
|
Facility
|
IP
|
$254.90
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000339
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$191.18 |
| Max. Negotiated Rate |
$254.90 |
| Rate for Payer: Aetna Commercial |
$229.41
|
| Rate for Payer: ASR ASR |
$247.25
|
| Rate for Payer: BCBS Trust/PPO |
$209.32
|
| Rate for Payer: BCN Commercial |
$209.32
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Commercial |
$239.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Healthscope Commercial |
$247.25
|
| Rate for Payer: Healthscope Whirlpool |
$254.90
|
| Rate for Payer: Mclaren Commercial |
$229.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Nomi Health Commercial |
$209.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.31
|
|
|
HC XR ANKLE BIL 2 VW
|
Facility
|
IP
|
$297.68
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000120
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$223.26 |
| Max. Negotiated Rate |
$297.68 |
| Rate for Payer: Aetna Commercial |
$267.91
|
| Rate for Payer: ASR ASR |
$288.75
|
| Rate for Payer: BCBS Trust/PPO |
$244.45
|
| Rate for Payer: BCN Commercial |
$244.45
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cofinity Commercial |
$279.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.14
|
| Rate for Payer: Healthscope Commercial |
$288.75
|
| Rate for Payer: Healthscope Whirlpool |
$297.68
|
| Rate for Payer: Mclaren Commercial |
$267.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.03
|
| Rate for Payer: Nomi Health Commercial |
$244.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$261.96
|
|
|
HC XR ANKLE BIL 2 VW
|
Facility
|
OP
|
$297.68
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000120
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$297.68 |
| Rate for Payer: Aetna Commercial |
$267.91
|
| Rate for Payer: Aetna Medicare |
$86.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: ASR ASR |
$288.75
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$245.44
|
| Rate for Payer: BCN Commercial |
$245.44
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cofinity Commercial |
$279.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$288.75
|
| Rate for Payer: Healthscope Whirlpool |
$297.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$267.91
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$47.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.03
|
| Rate for Payer: Nomi Health Commercial |
$244.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.26
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$95.38
|
| Rate for Payer: PHP Medicaid |
$46.48
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$272.38
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health Narrow Network |
$217.90
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$261.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$134.40
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP DNSP |
$86.71
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XR ANKLE BIL MIN 3 VW
|
Facility
|
OP
|
$396.48
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
32000122
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$396.48 |
| Rate for Payer: Aetna Commercial |
$356.83
|
| Rate for Payer: Aetna Medicare |
$86.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: ASR ASR |
$384.59
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$326.90
|
| Rate for Payer: BCN Commercial |
$326.90
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Commercial |
$372.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$384.59
|
| Rate for Payer: Healthscope Whirlpool |
$396.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$356.83
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$47.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$325.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$95.38
|
| Rate for Payer: PHP Medicaid |
$46.48
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$285.68
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health Narrow Network |
$228.55
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$348.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$134.40
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP DNSP |
$86.71
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XR ANKLE BIL MIN 3 VW
|
Facility
|
IP
|
$396.48
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
32000122
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$297.36 |
| Max. Negotiated Rate |
$396.48 |
| Rate for Payer: Aetna Commercial |
$356.83
|
| Rate for Payer: ASR ASR |
$384.59
|
| Rate for Payer: BCBS Trust/PPO |
$325.59
|
| Rate for Payer: BCN Commercial |
$325.59
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Commercial |
$372.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Healthscope Commercial |
$384.59
|
| Rate for Payer: Healthscope Whirlpool |
$396.48
|
| Rate for Payer: Mclaren Commercial |
$356.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$325.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$348.90
|
|
|
HC XR ANKLE MIN 3 VIEWS
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
32000121
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$364.53 |
| Rate for Payer: Aetna Commercial |
$328.08
|
| Rate for Payer: Aetna Medicare |
$86.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: ASR ASR |
$353.59
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$300.55
|
| Rate for Payer: BCN Commercial |
$300.55
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Commercial |
$342.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$353.59
|
| Rate for Payer: Healthscope Whirlpool |
$364.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$328.08
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$47.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$298.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$95.38
|
| Rate for Payer: PHP Medicaid |
$46.48
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$285.68
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health Narrow Network |
$228.55
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$320.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$134.40
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP DNSP |
$86.71
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XR ANKLE MIN 3 VIEWS
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
32000121
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$273.40 |
| Max. Negotiated Rate |
$364.53 |
| Rate for Payer: Aetna Commercial |
$328.08
|
| Rate for Payer: ASR ASR |
$353.59
|
| Rate for Payer: BCBS Trust/PPO |
$299.35
|
| Rate for Payer: BCN Commercial |
$299.35
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Commercial |
$342.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Healthscope Commercial |
$353.59
|
| Rate for Payer: Healthscope Whirlpool |
$364.53
|
| Rate for Payer: Mclaren Commercial |
$328.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$298.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$320.79
|
|
|
HC XR ARTHROGRAM ELBOW
|
Facility
|
IP
|
$624.56
|
|
|
Service Code
|
CPT 73085
|
| Hospital Charge Code |
32000075
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$468.42 |
| Max. Negotiated Rate |
$624.56 |
| Rate for Payer: Aetna Commercial |
$562.10
|
| Rate for Payer: ASR ASR |
$605.82
|
| Rate for Payer: BCBS Trust/PPO |
$512.89
|
| Rate for Payer: BCN Commercial |
$512.89
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Commercial |
$587.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Healthscope Commercial |
$605.82
|
| Rate for Payer: Healthscope Whirlpool |
$624.56
|
| Rate for Payer: Mclaren Commercial |
$562.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Nomi Health Commercial |
$512.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$549.61
|
|
|
HC XR ARTHROGRAM ELBOW
|
Facility
|
OP
|
$624.56
|
|
|
Service Code
|
CPT 73085
|
| Hospital Charge Code |
32000075
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$624.56 |
| Rate for Payer: Aetna Commercial |
$562.10
|
| Rate for Payer: Aetna Medicare |
$347.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: ASR ASR |
$605.82
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$514.95
|
| Rate for Payer: BCN Commercial |
$514.95
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Commercial |
$587.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$605.82
|
| Rate for Payer: Healthscope Whirlpool |
$624.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$562.10
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$190.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Nomi Health Commercial |
$512.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$547.24
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$437.82
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$549.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC XR ARTHROGRAM HIP
|
Facility
|
IP
|
$624.56
|
|
|
Service Code
|
CPT 73525
|
| Hospital Charge Code |
32000097
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$468.42 |
| Max. Negotiated Rate |
$624.56 |
| Rate for Payer: Aetna Commercial |
$562.10
|
| Rate for Payer: ASR ASR |
$605.82
|
| Rate for Payer: BCBS Trust/PPO |
$512.89
|
| Rate for Payer: BCN Commercial |
$512.89
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Commercial |
$587.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Healthscope Commercial |
$605.82
|
| Rate for Payer: Healthscope Whirlpool |
$624.56
|
| Rate for Payer: Mclaren Commercial |
$562.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Nomi Health Commercial |
$512.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$549.61
|
|
|
HC XR ARTHROGRAM HIP
|
Facility
|
OP
|
$624.56
|
|
|
Service Code
|
CPT 73525
|
| Hospital Charge Code |
32000097
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$665.80 |
| Rate for Payer: Aetna Commercial |
$562.10
|
| Rate for Payer: Aetna Medicare |
$347.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: ASR ASR |
$605.82
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$514.95
|
| Rate for Payer: BCN Commercial |
$514.95
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Commercial |
$587.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$605.82
|
| Rate for Payer: Healthscope Whirlpool |
$624.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$562.10
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$190.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Nomi Health Commercial |
$512.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$665.80
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$532.64
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$549.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC XR ARTHROGRAM KNEE
|
Facility
|
IP
|
$624.56
|
|
|
Service Code
|
CPT 73580
|
| Hospital Charge Code |
32000111
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$468.42 |
| Max. Negotiated Rate |
$624.56 |
| Rate for Payer: Aetna Commercial |
$562.10
|
| Rate for Payer: ASR ASR |
$605.82
|
| Rate for Payer: BCBS Trust/PPO |
$512.89
|
| Rate for Payer: BCN Commercial |
$512.89
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Commercial |
$587.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Healthscope Commercial |
$605.82
|
| Rate for Payer: Healthscope Whirlpool |
$624.56
|
| Rate for Payer: Mclaren Commercial |
$562.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Nomi Health Commercial |
$512.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$549.61
|
|
|
HC XR ARTHROGRAM KNEE
|
Facility
|
OP
|
$624.56
|
|
|
Service Code
|
CPT 73580
|
| Hospital Charge Code |
32000111
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$665.80 |
| Rate for Payer: Aetna Commercial |
$562.10
|
| Rate for Payer: Aetna Medicare |
$347.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: ASR ASR |
$605.82
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$514.95
|
| Rate for Payer: BCN Commercial |
$514.95
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Commercial |
$587.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$605.82
|
| Rate for Payer: Healthscope Whirlpool |
$624.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$562.10
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$190.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Nomi Health Commercial |
$512.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$665.80
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$532.64
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$549.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC XR ARTHROGRAM SHOULDER
|
Facility
|
IP
|
$624.56
|
|
|
Service Code
|
CPT 73040
|
| Hospital Charge Code |
32000067
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$468.42 |
| Max. Negotiated Rate |
$624.56 |
| Rate for Payer: Aetna Commercial |
$562.10
|
| Rate for Payer: ASR ASR |
$605.82
|
| Rate for Payer: BCBS Trust/PPO |
$512.89
|
| Rate for Payer: BCN Commercial |
$512.89
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Commercial |
$587.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Healthscope Commercial |
$605.82
|
| Rate for Payer: Healthscope Whirlpool |
$624.56
|
| Rate for Payer: Mclaren Commercial |
$562.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Nomi Health Commercial |
$512.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$549.61
|
|
|
HC XR ARTHROGRAM SHOULDER
|
Facility
|
OP
|
$624.56
|
|
|
Service Code
|
CPT 73040
|
| Hospital Charge Code |
32000067
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$665.80 |
| Rate for Payer: Aetna Commercial |
$562.10
|
| Rate for Payer: Aetna Medicare |
$347.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: ASR ASR |
$605.82
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$514.95
|
| Rate for Payer: BCN Commercial |
$514.95
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cash Price |
$499.65
|
| Rate for Payer: Cofinity Commercial |
$587.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$605.82
|
| Rate for Payer: Healthscope Whirlpool |
$624.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$562.10
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$190.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.88
|
| Rate for Payer: Nomi Health Commercial |
$512.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.42
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$665.80
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$532.64
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$549.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC XR ARTHROGRAM WRIST
|
Facility
|
IP
|
$684.29
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
32000084
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$513.22 |
| Max. Negotiated Rate |
$684.29 |
| Rate for Payer: Aetna Commercial |
$615.86
|
| Rate for Payer: ASR ASR |
$663.76
|
| Rate for Payer: BCBS Trust/PPO |
$561.94
|
| Rate for Payer: BCN Commercial |
$561.94
|
| Rate for Payer: Cash Price |
$547.43
|
| Rate for Payer: Cofinity Commercial |
$643.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$547.43
|
| Rate for Payer: Healthscope Commercial |
$663.76
|
| Rate for Payer: Healthscope Whirlpool |
$684.29
|
| Rate for Payer: Mclaren Commercial |
$615.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$581.65
|
| Rate for Payer: Nomi Health Commercial |
$561.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$513.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$602.18
|
|
|
HC XR ARTHROGRAM WRIST
|
Facility
|
OP
|
$684.29
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
32000084
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$684.29 |
| Rate for Payer: Aetna Commercial |
$615.86
|
| Rate for Payer: Aetna Medicare |
$347.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: ASR ASR |
$663.76
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$564.20
|
| Rate for Payer: BCN Commercial |
$564.20
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$547.43
|
| Rate for Payer: Cash Price |
$547.43
|
| Rate for Payer: Cofinity Commercial |
$643.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$547.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$663.76
|
| Rate for Payer: Healthscope Whirlpool |
$684.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$615.86
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$190.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$581.65
|
| Rate for Payer: Nomi Health Commercial |
$561.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$513.22
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$599.57
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$479.69
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$602.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC XR BONE AGE STUDY
|
Facility
|
OP
|
$312.56
|
|
|
Service Code
|
CPT 77072
|
| Hospital Charge Code |
32000253
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$312.56 |
| Rate for Payer: Aetna Commercial |
$281.30
|
| Rate for Payer: Aetna Medicare |
$104.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: ASR ASR |
$303.18
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$257.71
|
| Rate for Payer: BCN Commercial |
$257.71
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$250.05
|
| Rate for Payer: Cash Price |
$250.05
|
| Rate for Payer: Cofinity Commercial |
$293.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$250.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$303.18
|
| Rate for Payer: Healthscope Whirlpool |
$312.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$281.30
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$57.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.68
|
| Rate for Payer: Nomi Health Commercial |
$256.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.42
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$114.59
|
| Rate for Payer: PHP Medicaid |
$55.84
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$237.27
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$189.81
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$275.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$161.46
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP DNSP |
$104.17
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC XR BONE AGE STUDY
|
Facility
|
IP
|
$312.56
|
|
|
Service Code
|
CPT 77072
|
| Hospital Charge Code |
32000253
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$234.42 |
| Max. Negotiated Rate |
$312.56 |
| Rate for Payer: Aetna Commercial |
$281.30
|
| Rate for Payer: ASR ASR |
$303.18
|
| Rate for Payer: BCBS Trust/PPO |
$256.67
|
| Rate for Payer: BCN Commercial |
$256.67
|
| Rate for Payer: Cash Price |
$250.05
|
| Rate for Payer: Cofinity Commercial |
$293.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$250.05
|
| Rate for Payer: Healthscope Commercial |
$303.18
|
| Rate for Payer: Healthscope Whirlpool |
$312.56
|
| Rate for Payer: Mclaren Commercial |
$281.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.68
|
| Rate for Payer: Nomi Health Commercial |
$256.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$275.05
|
|
|
HC XR BONE LENGTH STUDY
|
Facility
|
OP
|
$297.68
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
32000254
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$297.68 |
| Rate for Payer: Aetna Commercial |
$267.91
|
| Rate for Payer: Aetna Medicare |
$104.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: ASR ASR |
$288.75
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$245.44
|
| Rate for Payer: BCN Commercial |
$245.44
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cofinity Commercial |
$279.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$288.75
|
| Rate for Payer: Healthscope Whirlpool |
$297.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$267.91
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$57.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.03
|
| Rate for Payer: Nomi Health Commercial |
$244.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.26
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$114.59
|
| Rate for Payer: PHP Medicaid |
$55.84
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$251.19
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$200.95
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$261.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$161.46
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP DNSP |
$104.17
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC XR BONE LENGTH STUDY
|
Facility
|
IP
|
$297.68
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
32000254
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$223.26 |
| Max. Negotiated Rate |
$297.68 |
| Rate for Payer: Aetna Commercial |
$267.91
|
| Rate for Payer: ASR ASR |
$288.75
|
| Rate for Payer: BCBS Trust/PPO |
$244.45
|
| Rate for Payer: BCN Commercial |
$244.45
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cofinity Commercial |
$279.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.14
|
| Rate for Payer: Healthscope Commercial |
$288.75
|
| Rate for Payer: Healthscope Whirlpool |
$297.68
|
| Rate for Payer: Mclaren Commercial |
$267.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.03
|
| Rate for Payer: Nomi Health Commercial |
$244.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$261.96
|
|
|
HC XR BONE SURVEY ADULT COMP
|
Facility
|
OP
|
$624.81
|
|
|
Service Code
|
CPT 77075
|
| Hospital Charge Code |
32000257
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$624.81 |
| Rate for Payer: Aetna Commercial |
$562.33
|
| Rate for Payer: Aetna Medicare |
$104.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: ASR ASR |
$606.07
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$515.16
|
| Rate for Payer: BCN Commercial |
$515.16
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$499.85
|
| Rate for Payer: Cash Price |
$499.85
|
| Rate for Payer: Cofinity Commercial |
$587.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$606.07
|
| Rate for Payer: Healthscope Whirlpool |
$624.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$562.33
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$57.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$531.09
|
| Rate for Payer: Nomi Health Commercial |
$512.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.61
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$114.59
|
| Rate for Payer: PHP Medicaid |
$55.84
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$273.58
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$218.86
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$549.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$161.46
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP DNSP |
$104.17
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
