|
HC XR BONE SURVEY ADULT COMP
|
Facility
|
IP
|
$624.81
|
|
|
Service Code
|
CPT 77075
|
| Hospital Charge Code |
32000257
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$468.61 |
| Max. Negotiated Rate |
$624.81 |
| Rate for Payer: Aetna Commercial |
$562.33
|
| Rate for Payer: ASR ASR |
$606.07
|
| Rate for Payer: BCBS Trust/PPO |
$513.09
|
| Rate for Payer: BCN Commercial |
$513.09
|
| 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: Healthscope Commercial |
$606.07
|
| Rate for Payer: Healthscope Whirlpool |
$624.81
|
| Rate for Payer: Mclaren Commercial |
$562.33
|
| 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: UHC All Payor (Choice/PPO) + Core |
$549.83
|
|
|
HC XR BONE SURVEY INFANT
|
Facility
|
OP
|
$395.72
|
|
|
Service Code
|
CPT 77076
|
| Hospital Charge Code |
32000258
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$395.72 |
| Rate for Payer: Aetna Commercial |
$356.15
|
| 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 |
$383.85
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$326.27
|
| Rate for Payer: BCN Commercial |
$326.27
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$316.58
|
| Rate for Payer: Cash Price |
$316.58
|
| Rate for Payer: Cofinity Commercial |
$371.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$383.85
|
| Rate for Payer: Healthscope Whirlpool |
$395.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$356.15
|
| 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 |
$336.36
|
| Rate for Payer: Nomi Health Commercial |
$324.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$296.79
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$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 |
$359.54
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$287.63
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$348.23
|
| 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 SURVEY INFANT
|
Facility
|
IP
|
$395.72
|
|
|
Service Code
|
CPT 77076
|
| Hospital Charge Code |
32000258
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$296.79 |
| Max. Negotiated Rate |
$395.72 |
| Rate for Payer: Aetna Commercial |
$356.15
|
| Rate for Payer: ASR ASR |
$383.85
|
| Rate for Payer: BCBS Trust/PPO |
$324.97
|
| Rate for Payer: BCN Commercial |
$324.97
|
| Rate for Payer: Cash Price |
$316.58
|
| Rate for Payer: Cofinity Commercial |
$371.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.58
|
| Rate for Payer: Healthscope Commercial |
$383.85
|
| Rate for Payer: Healthscope Whirlpool |
$395.72
|
| Rate for Payer: Mclaren Commercial |
$356.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$336.36
|
| Rate for Payer: Nomi Health Commercial |
$324.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$296.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$348.23
|
|
|
HC XR BONE SURVEY (METS) LTD
|
Facility
|
IP
|
$314.28
|
|
|
Service Code
|
CPT 77074
|
| Hospital Charge Code |
32000298
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$235.71 |
| Max. Negotiated Rate |
$314.28 |
| Rate for Payer: Aetna Commercial |
$282.85
|
| Rate for Payer: ASR ASR |
$304.85
|
| Rate for Payer: BCBS Trust/PPO |
$258.09
|
| Rate for Payer: BCN Commercial |
$258.09
|
| Rate for Payer: Cash Price |
$251.42
|
| Rate for Payer: Cofinity Commercial |
$295.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$251.42
|
| Rate for Payer: Healthscope Commercial |
$304.85
|
| Rate for Payer: Healthscope Whirlpool |
$314.28
|
| Rate for Payer: Mclaren Commercial |
$282.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$267.14
|
| Rate for Payer: Nomi Health Commercial |
$257.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$235.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$276.57
|
|
|
HC XR BONE SURVEY (METS) LTD
|
Facility
|
OP
|
$314.28
|
|
|
Service Code
|
CPT 77074
|
| Hospital Charge Code |
32000298
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$314.28 |
| Rate for Payer: Aetna Commercial |
$282.85
|
| 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 |
$304.85
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$259.12
|
| Rate for Payer: BCN Commercial |
$259.12
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$251.42
|
| Rate for Payer: Cash Price |
$251.42
|
| Rate for Payer: Cofinity Commercial |
$295.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$251.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$304.85
|
| Rate for Payer: Healthscope Whirlpool |
$314.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$282.85
|
| 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 |
$267.14
|
| Rate for Payer: Nomi Health Commercial |
$257.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$235.71
|
| 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 |
$275.37
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$220.31
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$276.57
|
| 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 CHEST 2 VIEWS
|
Facility
|
IP
|
$309.76
|
|
|
Service Code
|
CPT 71046
|
| Hospital Charge Code |
32400010
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$232.32 |
| Max. Negotiated Rate |
$309.76 |
| Rate for Payer: Aetna Commercial |
$278.78
|
| Rate for Payer: ASR ASR |
$300.47
|
| Rate for Payer: BCBS Trust/PPO |
$254.37
|
| Rate for Payer: BCN Commercial |
$254.37
|
| Rate for Payer: Cash Price |
$247.81
|
| Rate for Payer: Cofinity Commercial |
$291.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.81
|
| Rate for Payer: Healthscope Commercial |
$300.47
|
| Rate for Payer: Healthscope Whirlpool |
$309.76
|
| Rate for Payer: Mclaren Commercial |
$278.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.30
|
| Rate for Payer: Nomi Health Commercial |
$254.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$232.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$272.59
|
|
|
HC XR CHEST 2 VIEWS
|
Facility
|
OP
|
$309.76
|
|
|
Service Code
|
CPT 71046
|
| Hospital Charge Code |
32400010
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$309.76 |
| Rate for Payer: Aetna Commercial |
$278.78
|
| 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 |
$300.47
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$255.40
|
| Rate for Payer: BCN Commercial |
$255.40
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$247.81
|
| Rate for Payer: Cash Price |
$247.81
|
| Rate for Payer: Cofinity Commercial |
$291.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$300.47
|
| Rate for Payer: Healthscope Whirlpool |
$309.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$278.78
|
| 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 |
$263.30
|
| Rate for Payer: Nomi Health Commercial |
$254.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$232.32
|
| 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 |
$78.40
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health Narrow Network |
$62.72
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$272.59
|
| 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 CHEST 3 VIEWS
|
Facility
|
OP
|
$343.20
|
|
|
Service Code
|
CPT 71047
|
| Hospital Charge Code |
32400011
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$343.20 |
| Rate for Payer: Aetna Commercial |
$308.88
|
| 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 |
$332.90
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$282.97
|
| Rate for Payer: BCN Commercial |
$282.97
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$274.56
|
| Rate for Payer: Cash Price |
$274.56
|
| Rate for Payer: Cofinity Commercial |
$322.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$332.90
|
| Rate for Payer: Healthscope Whirlpool |
$343.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$308.88
|
| 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 |
$291.72
|
| Rate for Payer: Nomi Health Commercial |
$281.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.40
|
| 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 |
$78.40
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health Narrow Network |
$62.72
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$302.02
|
| 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 CHEST 3 VIEWS
|
Facility
|
IP
|
$343.20
|
|
|
Service Code
|
CPT 71047
|
| Hospital Charge Code |
32400011
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$257.40 |
| Max. Negotiated Rate |
$343.20 |
| Rate for Payer: Aetna Commercial |
$308.88
|
| Rate for Payer: ASR ASR |
$332.90
|
| Rate for Payer: BCBS Trust/PPO |
$281.84
|
| Rate for Payer: BCN Commercial |
$281.84
|
| Rate for Payer: Cash Price |
$274.56
|
| Rate for Payer: Cofinity Commercial |
$322.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.56
|
| Rate for Payer: Healthscope Commercial |
$332.90
|
| Rate for Payer: Healthscope Whirlpool |
$343.20
|
| Rate for Payer: Mclaren Commercial |
$308.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.72
|
| Rate for Payer: Nomi Health Commercial |
$281.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$302.02
|
|
|
HC XR CHEST 4 OR MORE VIEWS
|
Facility
|
IP
|
$376.62
|
|
|
Service Code
|
CPT 71048
|
| Hospital Charge Code |
32400012
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$282.46 |
| Max. Negotiated Rate |
$376.62 |
| Rate for Payer: Aetna Commercial |
$338.96
|
| Rate for Payer: ASR ASR |
$365.32
|
| Rate for Payer: BCBS Trust/PPO |
$309.28
|
| Rate for Payer: BCN Commercial |
$309.28
|
| Rate for Payer: Cash Price |
$301.30
|
| Rate for Payer: Cofinity Commercial |
$354.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$301.30
|
| Rate for Payer: Healthscope Commercial |
$365.32
|
| Rate for Payer: Healthscope Whirlpool |
$376.62
|
| Rate for Payer: Mclaren Commercial |
$338.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$320.13
|
| Rate for Payer: Nomi Health Commercial |
$308.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$331.43
|
|
|
HC XR CHEST 4 OR MORE VIEWS
|
Facility
|
OP
|
$376.62
|
|
|
Service Code
|
CPT 71048
|
| Hospital Charge Code |
32400012
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$376.62 |
| Rate for Payer: Aetna Commercial |
$338.96
|
| 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 |
$365.32
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$310.52
|
| Rate for Payer: BCN Commercial |
$310.52
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$301.30
|
| Rate for Payer: Cash Price |
$301.30
|
| Rate for Payer: Cofinity Commercial |
$354.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$301.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$365.32
|
| Rate for Payer: Healthscope Whirlpool |
$376.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$338.96
|
| 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 |
$320.13
|
| Rate for Payer: Nomi Health Commercial |
$308.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.46
|
| 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 |
$149.88
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$119.90
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$331.43
|
| 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 CHEST ABD FOREIG BOD CHILD
|
Facility
|
OP
|
$281.49
|
|
|
Service Code
|
CPT 76010
|
| Hospital Charge Code |
32000234
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$281.49 |
| Rate for Payer: Aetna Commercial |
$253.34
|
| 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 |
$273.05
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$232.09
|
| Rate for Payer: BCN Commercial |
$232.09
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$225.19
|
| Rate for Payer: Cash Price |
$225.19
|
| Rate for Payer: Cofinity Commercial |
$264.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$273.05
|
| Rate for Payer: Healthscope Whirlpool |
$281.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$253.34
|
| 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 |
$239.27
|
| Rate for Payer: Nomi Health Commercial |
$230.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$211.12
|
| 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 |
$246.64
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health Narrow Network |
$197.32
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$247.71
|
| 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 CHEST ABD FOREIG BOD CHILD
|
Facility
|
IP
|
$281.49
|
|
|
Service Code
|
CPT 76010
|
| Hospital Charge Code |
32000234
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$211.12 |
| Max. Negotiated Rate |
$281.49 |
| Rate for Payer: Aetna Commercial |
$253.34
|
| Rate for Payer: ASR ASR |
$273.05
|
| Rate for Payer: BCBS Trust/PPO |
$231.16
|
| Rate for Payer: BCN Commercial |
$231.16
|
| Rate for Payer: Cash Price |
$225.19
|
| Rate for Payer: Cofinity Commercial |
$264.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.19
|
| Rate for Payer: Healthscope Commercial |
$273.05
|
| Rate for Payer: Healthscope Whirlpool |
$281.49
|
| Rate for Payer: Mclaren Commercial |
$253.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.27
|
| Rate for Payer: Nomi Health Commercial |
$230.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$211.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$247.71
|
|
|
HC XR CHEST SINGLE VIEW
|
Facility
|
OP
|
$276.34
|
|
|
Service Code
|
CPT 71045
|
| Hospital Charge Code |
32400009
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$276.34 |
| Rate for Payer: Aetna Commercial |
$248.71
|
| 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 |
$268.05
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$227.84
|
| Rate for Payer: BCN Commercial |
$227.84
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$221.07
|
| Rate for Payer: Cash Price |
$221.07
|
| Rate for Payer: Cofinity Commercial |
$259.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$268.05
|
| Rate for Payer: Healthscope Whirlpool |
$276.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$248.71
|
| 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 |
$234.89
|
| Rate for Payer: Nomi Health Commercial |
$226.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$207.25
|
| 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 |
$78.40
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health Narrow Network |
$62.72
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$243.18
|
| 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 CHEST SINGLE VIEW
|
Facility
|
IP
|
$276.34
|
|
|
Service Code
|
CPT 71045
|
| Hospital Charge Code |
32400009
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$207.25 |
| Max. Negotiated Rate |
$276.34 |
| Rate for Payer: Aetna Commercial |
$248.71
|
| Rate for Payer: ASR ASR |
$268.05
|
| Rate for Payer: BCBS Trust/PPO |
$226.93
|
| Rate for Payer: BCN Commercial |
$226.93
|
| Rate for Payer: Cash Price |
$221.07
|
| Rate for Payer: Cofinity Commercial |
$259.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.07
|
| Rate for Payer: Healthscope Commercial |
$268.05
|
| Rate for Payer: Healthscope Whirlpool |
$276.34
|
| Rate for Payer: Mclaren Commercial |
$248.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.89
|
| Rate for Payer: Nomi Health Commercial |
$226.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$207.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$243.18
|
|
|
HC XR CHOLANGIOGRAM IN OR
|
Facility
|
IP
|
$520.60
|
|
|
Service Code
|
CPT 74300
|
| Hospital Charge Code |
32000149
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$390.45 |
| Max. Negotiated Rate |
$520.60 |
| Rate for Payer: Aetna Commercial |
$468.54
|
| Rate for Payer: ASR ASR |
$504.98
|
| Rate for Payer: BCBS Trust/PPO |
$427.52
|
| Rate for Payer: BCN Commercial |
$427.52
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cofinity Commercial |
$489.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.48
|
| Rate for Payer: Healthscope Commercial |
$504.98
|
| Rate for Payer: Healthscope Whirlpool |
$520.60
|
| Rate for Payer: Mclaren Commercial |
$468.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.51
|
| Rate for Payer: Nomi Health Commercial |
$426.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$458.13
|
|
|
HC XR CHOLANGIOGRAM IN OR
|
Facility
|
OP
|
$520.60
|
|
|
Service Code
|
CPT 74300
|
| Hospital Charge Code |
32000149
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$192.62 |
| Max. Negotiated Rate |
$631.30 |
| Rate for Payer: Aetna Commercial |
$468.54
|
| Rate for Payer: Aetna Medicare |
$192.62
|
| Rate for Payer: ASR ASR |
$504.98
|
| Rate for Payer: BCBS Complete |
$208.24
|
| Rate for Payer: BCBS Trust/PPO |
$429.23
|
| Rate for Payer: BCN Commercial |
$429.23
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cofinity Commercial |
$489.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.48
|
| Rate for Payer: Healthscope Commercial |
$504.98
|
| Rate for Payer: Healthscope Whirlpool |
$520.60
|
| Rate for Payer: Mclaren Commercial |
$468.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$416.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.51
|
| Rate for Payer: Nomi Health Commercial |
$426.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$631.30
|
| Rate for Payer: Priority Health Narrow Network |
$505.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$458.13
|
|
|
HC XR CLAVICLE
|
Facility
|
OP
|
$322.82
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000060
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$322.82 |
| Rate for Payer: Aetna Commercial |
$290.54
|
| 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 |
$313.14
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$266.17
|
| Rate for Payer: BCN Commercial |
$266.17
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$258.26
|
| Rate for Payer: Cash Price |
$258.26
|
| Rate for Payer: Cofinity Commercial |
$303.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$313.14
|
| Rate for Payer: Healthscope Whirlpool |
$322.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$290.54
|
| 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 |
$274.40
|
| Rate for Payer: Nomi Health Commercial |
$264.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$242.12
|
| 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 |
$284.08
|
| 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 CLAVICLE
|
Facility
|
IP
|
$322.82
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000060
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$242.12 |
| Max. Negotiated Rate |
$322.82 |
| Rate for Payer: Aetna Commercial |
$290.54
|
| Rate for Payer: ASR ASR |
$313.14
|
| Rate for Payer: BCBS Trust/PPO |
$265.10
|
| Rate for Payer: BCN Commercial |
$265.10
|
| Rate for Payer: Cash Price |
$258.26
|
| Rate for Payer: Cofinity Commercial |
$303.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.26
|
| Rate for Payer: Healthscope Commercial |
$313.14
|
| Rate for Payer: Healthscope Whirlpool |
$322.82
|
| Rate for Payer: Mclaren Commercial |
$290.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274.40
|
| Rate for Payer: Nomi Health Commercial |
$264.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$242.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$284.08
|
|
|
HC XR CLAVICLE BIL
|
Facility
|
IP
|
$347.15
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000061
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$260.36 |
| Max. Negotiated Rate |
$347.15 |
| Rate for Payer: Aetna Commercial |
$312.44
|
| Rate for Payer: ASR ASR |
$336.74
|
| Rate for Payer: BCBS Trust/PPO |
$285.08
|
| Rate for Payer: BCN Commercial |
$285.08
|
| Rate for Payer: Cash Price |
$277.72
|
| Rate for Payer: Cofinity Commercial |
$326.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.72
|
| Rate for Payer: Healthscope Commercial |
$336.74
|
| Rate for Payer: Healthscope Whirlpool |
$347.15
|
| Rate for Payer: Mclaren Commercial |
$312.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$295.08
|
| Rate for Payer: Nomi Health Commercial |
$284.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$260.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$305.49
|
|
|
HC XR CLAVICLE BIL
|
Facility
|
OP
|
$347.15
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000061
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$347.15 |
| Rate for Payer: Aetna Commercial |
$312.44
|
| 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 |
$336.74
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$286.23
|
| Rate for Payer: BCN Commercial |
$286.23
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$277.72
|
| Rate for Payer: Cash Price |
$277.72
|
| Rate for Payer: Cofinity Commercial |
$326.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$336.74
|
| Rate for Payer: Healthscope Whirlpool |
$347.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$312.44
|
| 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 |
$295.08
|
| Rate for Payer: Nomi Health Commercial |
$284.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$260.36
|
| 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 |
$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 |
$305.49
|
| 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 COLON
|
Facility
|
OP
|
$874.59
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
32000273
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$874.59 |
| Rate for Payer: Aetna Commercial |
$787.13
|
| Rate for Payer: Aetna Medicare |
$174.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: ASR ASR |
$848.35
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$721.10
|
| Rate for Payer: BCN Commercial |
$721.10
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$699.67
|
| Rate for Payer: Cash Price |
$699.67
|
| Rate for Payer: Cofinity Commercial |
$822.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$699.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$848.35
|
| Rate for Payer: Healthscope Whirlpool |
$874.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.77
|
| Rate for Payer: Mclaren Commercial |
$787.13
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$95.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$743.40
|
| Rate for Payer: Nomi Health Commercial |
$717.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$655.94
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$192.25
|
| Rate for Payer: PHP Medicaid |
$93.68
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$473.93
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health Narrow Network |
$379.14
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$769.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$270.89
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP DNSP |
$174.77
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
|
HC XR COLON
|
Facility
|
IP
|
$874.59
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
32000273
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$655.94 |
| Max. Negotiated Rate |
$874.59 |
| Rate for Payer: Aetna Commercial |
$787.13
|
| Rate for Payer: ASR ASR |
$848.35
|
| Rate for Payer: BCBS Trust/PPO |
$718.21
|
| Rate for Payer: BCN Commercial |
$718.21
|
| Rate for Payer: Cash Price |
$699.67
|
| Rate for Payer: Cofinity Commercial |
$822.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$699.67
|
| Rate for Payer: Healthscope Commercial |
$848.35
|
| Rate for Payer: Healthscope Whirlpool |
$874.59
|
| Rate for Payer: Mclaren Commercial |
$787.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$743.40
|
| Rate for Payer: Nomi Health Commercial |
$717.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$655.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$769.64
|
|
|
HC XR COLON HIGH DENSITY
|
Facility
|
OP
|
$1,249.37
|
|
|
Service Code
|
CPT 74280
|
| Hospital Charge Code |
32000146
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$1,249.37 |
| Rate for Payer: Aetna Commercial |
$1,124.43
|
| Rate for Payer: Aetna Medicare |
$174.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: ASR ASR |
$1,211.89
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,030.11
|
| Rate for Payer: BCN Commercial |
$1,030.11
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$999.50
|
| Rate for Payer: Cash Price |
$999.50
|
| Rate for Payer: Cofinity Commercial |
$1,174.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$999.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$1,211.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,249.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.77
|
| Rate for Payer: Mclaren Commercial |
$1,124.43
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$95.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,061.96
|
| Rate for Payer: Nomi Health Commercial |
$1,024.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$937.03
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$192.25
|
| Rate for Payer: PHP Medicaid |
$93.68
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$610.12
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health Narrow Network |
$488.10
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,099.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$270.89
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP DNSP |
$174.77
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
|
HC XR COLON HIGH DENSITY
|
Facility
|
IP
|
$1,249.37
|
|
|
Service Code
|
CPT 74280
|
| Hospital Charge Code |
32000146
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$937.03 |
| Max. Negotiated Rate |
$1,249.37 |
| Rate for Payer: Aetna Commercial |
$1,124.43
|
| Rate for Payer: ASR ASR |
$1,211.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,025.98
|
| Rate for Payer: BCN Commercial |
$1,025.98
|
| Rate for Payer: Cash Price |
$999.50
|
| Rate for Payer: Cofinity Commercial |
$1,174.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$999.50
|
| Rate for Payer: Healthscope Commercial |
$1,211.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,249.37
|
| Rate for Payer: Mclaren Commercial |
$1,124.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,061.96
|
| Rate for Payer: Nomi Health Commercial |
$1,024.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$937.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,099.45
|
|
