|
HC WOUND REPAIR SIMPLE UP TO 12.5 CM
|
Facility
|
IP
|
$421.54
|
|
| Hospital Charge Code |
45000073
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$274.00 |
| Max. Negotiated Rate |
$421.54 |
| Rate for Payer: Aetna Commercial |
$379.39
|
| Rate for Payer: ASR ASR |
$408.89
|
| Rate for Payer: ASR Commercial |
$408.89
|
| Rate for Payer: BCBS Trust/PPO |
$343.51
|
| Rate for Payer: BCN Commercial |
$326.82
|
| Rate for Payer: Cash Price |
$337.23
|
| Rate for Payer: Cofinity Commercial |
$396.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.23
|
| Rate for Payer: Healthscope Commercial |
$421.54
|
| Rate for Payer: Healthscope Whirlpool |
$408.89
|
| Rate for Payer: Mclaren Commercial |
$379.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$358.31
|
| Rate for Payer: Nomi Health Commercial |
$345.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$370.96
|
|
|
HC WOUND REPAIR SIMPLE UP TO 12.5 CM
|
Facility
|
OP
|
$421.54
|
|
| Hospital Charge Code |
45000073
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$168.62 |
| Max. Negotiated Rate |
$421.54 |
| Rate for Payer: Aetna Commercial |
$379.39
|
| Rate for Payer: Aetna Medicare |
$210.77
|
| Rate for Payer: ASR ASR |
$408.89
|
| Rate for Payer: ASR Commercial |
$408.89
|
| Rate for Payer: BCBS Complete |
$168.62
|
| Rate for Payer: BCBS Trust/PPO |
$345.20
|
| Rate for Payer: BCN Commercial |
$326.82
|
| Rate for Payer: Cash Price |
$337.23
|
| Rate for Payer: Cofinity Commercial |
$396.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.23
|
| Rate for Payer: Healthscope Commercial |
$421.54
|
| Rate for Payer: Healthscope Whirlpool |
$408.89
|
| Rate for Payer: Mclaren Commercial |
$379.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$358.31
|
| Rate for Payer: Nomi Health Commercial |
$345.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$369.35
|
| Rate for Payer: Priority Health Narrow Network |
$295.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$370.96
|
|
|
HC WRIST-HAND ORTHOSIS
|
Facility
|
OP
|
$122.06
|
|
|
Service Code
|
HCPCS L3908
|
| Hospital Charge Code |
27400016
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$48.82 |
| Max. Negotiated Rate |
$122.06 |
| Rate for Payer: Aetna Commercial |
$109.85
|
| Rate for Payer: Aetna Medicare |
$61.03
|
| Rate for Payer: ASR ASR |
$118.40
|
| Rate for Payer: ASR Commercial |
$118.40
|
| Rate for Payer: BCBS Complete |
$48.82
|
| Rate for Payer: BCBS Trust/PPO |
$99.95
|
| Rate for Payer: BCN Commercial |
$94.63
|
| Rate for Payer: Cash Price |
$97.65
|
| Rate for Payer: Cofinity Commercial |
$114.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.65
|
| Rate for Payer: Healthscope Commercial |
$122.06
|
| Rate for Payer: Healthscope Whirlpool |
$118.40
|
| Rate for Payer: Mclaren Commercial |
$109.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.75
|
| Rate for Payer: Nomi Health Commercial |
$100.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$106.95
|
| Rate for Payer: Priority Health Narrow Network |
$85.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.41
|
|
|
HC WRIST-HAND ORTHOSIS
|
Facility
|
IP
|
$122.06
|
|
|
Service Code
|
HCPCS L3908
|
| Hospital Charge Code |
27400016
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$79.34 |
| Max. Negotiated Rate |
$122.06 |
| Rate for Payer: Aetna Commercial |
$109.85
|
| Rate for Payer: ASR ASR |
$118.40
|
| Rate for Payer: ASR Commercial |
$118.40
|
| Rate for Payer: BCBS Trust/PPO |
$99.47
|
| Rate for Payer: BCN Commercial |
$94.63
|
| Rate for Payer: Cash Price |
$97.65
|
| Rate for Payer: Cofinity Commercial |
$114.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.65
|
| Rate for Payer: Healthscope Commercial |
$122.06
|
| Rate for Payer: Healthscope Whirlpool |
$118.40
|
| Rate for Payer: Mclaren Commercial |
$109.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.75
|
| Rate for Payer: Nomi Health Commercial |
$100.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.41
|
|
|
HC XENON 133 PER 10 MCI
|
Facility
|
IP
|
$250.29
|
|
|
Service Code
|
HCPCS A9558
|
| Hospital Charge Code |
34300024
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$162.69 |
| Max. Negotiated Rate |
$250.29 |
| Rate for Payer: Aetna Commercial |
$225.26
|
| Rate for Payer: ASR ASR |
$242.78
|
| Rate for Payer: ASR Commercial |
$242.78
|
| Rate for Payer: BCBS Trust/PPO |
$203.96
|
| Rate for Payer: BCN Commercial |
$194.05
|
| Rate for Payer: Cash Price |
$200.23
|
| Rate for Payer: Cofinity Commercial |
$235.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.23
|
| Rate for Payer: Healthscope Commercial |
$250.29
|
| Rate for Payer: Healthscope Whirlpool |
$242.78
|
| Rate for Payer: Mclaren Commercial |
$225.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.75
|
| Rate for Payer: Nomi Health Commercial |
$205.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$220.26
|
|
|
HC XENON 133 PER 10 MCI
|
Facility
|
OP
|
$250.29
|
|
|
Service Code
|
HCPCS A9558
|
| Hospital Charge Code |
34300024
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$100.12 |
| Max. Negotiated Rate |
$260.20 |
| Rate for Payer: Aetna Commercial |
$225.26
|
| Rate for Payer: Aetna Medicare |
$125.14
|
| Rate for Payer: ASR ASR |
$242.78
|
| Rate for Payer: ASR Commercial |
$242.78
|
| Rate for Payer: BCBS Complete |
$100.12
|
| Rate for Payer: BCBS Trust/PPO |
$204.96
|
| Rate for Payer: BCN Commercial |
$194.05
|
| Rate for Payer: Cash Price |
$200.23
|
| Rate for Payer: Cash Price |
$200.23
|
| Rate for Payer: Cofinity Commercial |
$235.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.23
|
| Rate for Payer: Healthscope Commercial |
$250.29
|
| Rate for Payer: Healthscope Whirlpool |
$242.78
|
| Rate for Payer: Mclaren Commercial |
$225.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.75
|
| Rate for Payer: Nomi Health Commercial |
$205.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.20
|
| Rate for Payer: Priority Health Narrow Network |
$208.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$220.26
|
|
|
HC XEOMIN PER 1 UNIT (INCOBOTULINUMTOXINA)
|
Facility
|
IP
|
$6.94
|
|
|
Service Code
|
HCPCS J0588
|
| Hospital Charge Code |
63600149
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.51 |
| Max. Negotiated Rate |
$6.94 |
| Rate for Payer: Aetna Commercial |
$6.25
|
| Rate for Payer: ASR ASR |
$6.73
|
| Rate for Payer: ASR Commercial |
$6.73
|
| Rate for Payer: BCBS Trust/PPO |
$5.66
|
| Rate for Payer: BCN Commercial |
$5.38
|
| Rate for Payer: Cash Price |
$5.55
|
| Rate for Payer: Cofinity Commercial |
$6.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.55
|
| Rate for Payer: Healthscope Commercial |
$6.94
|
| Rate for Payer: Healthscope Whirlpool |
$6.73
|
| Rate for Payer: Mclaren Commercial |
$6.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.90
|
| Rate for Payer: Nomi Health Commercial |
$5.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6.11
|
|
|
HC XEOMIN PER 1 UNIT (INCOBOTULINUMTOXINA)
|
Facility
|
OP
|
$6.94
|
|
|
Service Code
|
HCPCS J0588
|
| Hospital Charge Code |
63600149
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.85 |
| Max. Negotiated Rate |
$8.23 |
| Rate for Payer: Aetna Commercial |
$6.25
|
| Rate for Payer: Aetna Medicare |
$5.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.64
|
| Rate for Payer: ASR ASR |
$6.73
|
| Rate for Payer: ASR Commercial |
$6.73
|
| Rate for Payer: BCBS Complete |
$2.99
|
| Rate for Payer: BCBS MAPPO |
$5.31
|
| Rate for Payer: BCBS Trust/PPO |
$5.68
|
| Rate for Payer: BCN Commercial |
$5.38
|
| Rate for Payer: BCN Medicare Advantage |
$5.31
|
| Rate for Payer: Cash Price |
$5.55
|
| Rate for Payer: Cash Price |
$5.55
|
| Rate for Payer: Cofinity Commercial |
$6.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.31
|
| Rate for Payer: Healthscope Commercial |
$6.94
|
| Rate for Payer: Healthscope Whirlpool |
$6.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.31
|
| Rate for Payer: Mclaren Commercial |
$6.25
|
| Rate for Payer: Mclaren Medicaid |
$2.85
|
| Rate for Payer: Mclaren Medicare |
$5.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.58
|
| Rate for Payer: Meridian Medicaid |
$2.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.90
|
| Rate for Payer: Nomi Health Commercial |
$5.69
|
| Rate for Payer: PACE Medicare |
$5.04
|
| Rate for Payer: PACE SWMI |
$5.31
|
| Rate for Payer: PHP Commercial |
$5.84
|
| Rate for Payer: PHP Medicaid |
$2.85
|
| Rate for Payer: PHP Medicare Advantage |
$5.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.53
|
| Rate for Payer: Priority Health Medicare |
$5.31
|
| Rate for Payer: Priority Health Narrow Network |
$4.42
|
| Rate for Payer: Railroad Medicare Medicare |
$5.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.31
|
| Rate for Payer: UHC Exchange |
$8.23
|
| Rate for Payer: UHC Medicare Advantage |
$5.31
|
| Rate for Payer: UHCCP DNSP |
$5.31
|
| Rate for Payer: UHCCP Medicaid |
$2.85
|
| Rate for Payer: VA VA |
$5.31
|
|
|
HC XPRESS-WAY CATHETER
|
Facility
|
IP
|
$1,412.71
|
|
| Hospital Charge Code |
27200226
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$918.26 |
| Max. Negotiated Rate |
$1,412.71 |
| Rate for Payer: Aetna Commercial |
$1,271.44
|
| Rate for Payer: ASR ASR |
$1,370.33
|
| Rate for Payer: ASR Commercial |
$1,370.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,151.22
|
| Rate for Payer: BCN Commercial |
$1,095.27
|
| Rate for Payer: Cash Price |
$1,130.17
|
| Rate for Payer: Cofinity Commercial |
$1,327.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.17
|
| Rate for Payer: Healthscope Commercial |
$1,412.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,370.33
|
| Rate for Payer: Mclaren Commercial |
$1,271.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,200.80
|
| Rate for Payer: Nomi Health Commercial |
$1,158.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$918.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,243.18
|
|
|
HC XPRESS-WAY CATHETER
|
Facility
|
OP
|
$1,412.71
|
|
| Hospital Charge Code |
27200226
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$565.08 |
| Max. Negotiated Rate |
$1,412.71 |
| Rate for Payer: Aetna Commercial |
$1,271.44
|
| Rate for Payer: Aetna Medicare |
$706.36
|
| Rate for Payer: ASR ASR |
$1,370.33
|
| Rate for Payer: ASR Commercial |
$1,370.33
|
| Rate for Payer: BCBS Complete |
$565.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,156.87
|
| Rate for Payer: BCN Commercial |
$1,095.27
|
| Rate for Payer: Cash Price |
$1,130.17
|
| Rate for Payer: Cofinity Commercial |
$1,327.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.17
|
| Rate for Payer: Healthscope Commercial |
$1,412.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,370.33
|
| Rate for Payer: Mclaren Commercial |
$1,271.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,200.80
|
| Rate for Payer: Nomi Health Commercial |
$1,158.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$918.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.82
|
| Rate for Payer: Priority Health Narrow Network |
$990.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,243.18
|
|
|
HC XR ABDOMEN 1 VIEW
|
Facility
|
OP
|
$305.88
|
|
|
Service Code
|
CPT 74018
|
| Hospital Charge Code |
32000325
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$305.88 |
| Rate for Payer: Aetna Commercial |
$275.29
|
| Rate for Payer: Aetna Medicare |
$86.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: ASR ASR |
$296.70
|
| Rate for Payer: ASR Commercial |
$296.70
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$250.49
|
| Rate for Payer: BCN Commercial |
$237.15
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$244.70
|
| Rate for Payer: Cash Price |
$244.70
|
| Rate for Payer: Cofinity Commercial |
$287.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$305.88
|
| Rate for Payer: Healthscope Whirlpool |
$296.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.27
|
| Rate for Payer: Mclaren Commercial |
$275.29
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.00
|
| Rate for Payer: Nomi Health Commercial |
$250.82
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$94.90
|
| Rate for Payer: PHP Medicaid |
$46.24
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.11
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$56.89
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$269.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$133.72
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP DNSP |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: VA VA |
$86.27
|
|
|
HC XR ABDOMEN 1 VIEW
|
Facility
|
IP
|
$305.88
|
|
|
Service Code
|
CPT 74018
|
| Hospital Charge Code |
32000325
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$198.82 |
| Max. Negotiated Rate |
$305.88 |
| Rate for Payer: Aetna Commercial |
$275.29
|
| Rate for Payer: ASR ASR |
$296.70
|
| Rate for Payer: ASR Commercial |
$296.70
|
| Rate for Payer: BCBS Trust/PPO |
$249.26
|
| Rate for Payer: BCN Commercial |
$237.15
|
| Rate for Payer: Cash Price |
$244.70
|
| Rate for Payer: Cofinity Commercial |
$287.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.70
|
| Rate for Payer: Healthscope Commercial |
$305.88
|
| Rate for Payer: Healthscope Whirlpool |
$296.70
|
| Rate for Payer: Mclaren Commercial |
$275.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.00
|
| Rate for Payer: Nomi Health Commercial |
$250.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$269.17
|
|
|
HC XR ABDOMEN 2 VW
|
Facility
|
IP
|
$338.65
|
|
|
Service Code
|
CPT 74019
|
| Hospital Charge Code |
32000326
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$220.12 |
| Max. Negotiated Rate |
$338.65 |
| Rate for Payer: Aetna Commercial |
$304.78
|
| Rate for Payer: ASR ASR |
$328.49
|
| Rate for Payer: ASR Commercial |
$328.49
|
| Rate for Payer: BCBS Trust/PPO |
$275.97
|
| Rate for Payer: BCN Commercial |
$262.56
|
| Rate for Payer: Cash Price |
$270.92
|
| Rate for Payer: Cofinity Commercial |
$318.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.92
|
| Rate for Payer: Healthscope Commercial |
$338.65
|
| Rate for Payer: Healthscope Whirlpool |
$328.49
|
| Rate for Payer: Mclaren Commercial |
$304.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.85
|
| Rate for Payer: Nomi Health Commercial |
$277.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$298.01
|
|
|
HC XR ABDOMEN 2 VW
|
Facility
|
OP
|
$338.65
|
|
|
Service Code
|
CPT 74019
|
| Hospital Charge Code |
32000326
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$338.65 |
| Rate for Payer: Aetna Commercial |
$304.78
|
| Rate for Payer: Aetna Medicare |
$104.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: ASR ASR |
$328.49
|
| Rate for Payer: ASR Commercial |
$328.49
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$277.32
|
| Rate for Payer: BCN Commercial |
$262.56
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$270.92
|
| Rate for Payer: Cash Price |
$270.92
|
| Rate for Payer: Cofinity Commercial |
$318.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$338.65
|
| Rate for Payer: Healthscope Whirlpool |
$328.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.19
|
| Rate for Payer: Mclaren Commercial |
$304.78
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.85
|
| Rate for Payer: Nomi Health Commercial |
$277.69
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$114.61
|
| Rate for Payer: PHP Medicaid |
$55.85
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.94
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$108.75
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$298.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$161.49
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP DNSP |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: VA VA |
$104.19
|
|
|
HC XR ABDOMEN 3 OR MORE VIEWS
|
Facility
|
IP
|
$371.42
|
|
|
Service Code
|
CPT 74021
|
| Hospital Charge Code |
32000327
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$241.42 |
| Max. Negotiated Rate |
$371.42 |
| Rate for Payer: Aetna Commercial |
$334.28
|
| Rate for Payer: ASR ASR |
$360.28
|
| Rate for Payer: ASR Commercial |
$360.28
|
| Rate for Payer: BCBS Trust/PPO |
$302.67
|
| Rate for Payer: BCN Commercial |
$287.96
|
| Rate for Payer: Cash Price |
$297.14
|
| Rate for Payer: Cofinity Commercial |
$349.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.14
|
| Rate for Payer: Healthscope Commercial |
$371.42
|
| Rate for Payer: Healthscope Whirlpool |
$360.28
|
| Rate for Payer: Mclaren Commercial |
$334.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$315.71
|
| Rate for Payer: Nomi Health Commercial |
$304.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$326.85
|
|
|
HC XR ABDOMEN 3 OR MORE VIEWS
|
Facility
|
OP
|
$371.42
|
|
|
Service Code
|
CPT 74021
|
| Hospital Charge Code |
32000327
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$371.42 |
| Rate for Payer: Aetna Commercial |
$334.28
|
| Rate for Payer: Aetna Medicare |
$104.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: ASR ASR |
$360.28
|
| Rate for Payer: ASR Commercial |
$360.28
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$304.16
|
| Rate for Payer: BCN Commercial |
$287.96
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$297.14
|
| Rate for Payer: Cash Price |
$297.14
|
| Rate for Payer: Cofinity Commercial |
$349.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$371.42
|
| Rate for Payer: Healthscope Whirlpool |
$360.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.19
|
| Rate for Payer: Mclaren Commercial |
$334.28
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$315.71
|
| Rate for Payer: Nomi Health Commercial |
$304.56
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$114.61
|
| Rate for Payer: PHP Medicaid |
$55.85
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.94
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$108.75
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$326.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$161.49
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP DNSP |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: VA VA |
$104.19
|
|
|
HC XR ABDOMEN ACUTE
|
Facility
|
IP
|
$490.40
|
|
|
Service Code
|
CPT 74022
|
| Hospital Charge Code |
32000135
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$318.76 |
| Max. Negotiated Rate |
$490.40 |
| Rate for Payer: Aetna Commercial |
$441.36
|
| Rate for Payer: ASR ASR |
$475.69
|
| Rate for Payer: ASR Commercial |
$475.69
|
| Rate for Payer: BCBS Trust/PPO |
$399.63
|
| Rate for Payer: BCN Commercial |
$380.21
|
| Rate for Payer: Cash Price |
$392.32
|
| Rate for Payer: Cofinity Commercial |
$460.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.32
|
| Rate for Payer: Healthscope Commercial |
$490.40
|
| Rate for Payer: Healthscope Whirlpool |
$475.69
|
| Rate for Payer: Mclaren Commercial |
$441.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.84
|
| Rate for Payer: Nomi Health Commercial |
$402.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$431.55
|
|
|
HC XR ABDOMEN ACUTE
|
Facility
|
OP
|
$490.40
|
|
|
Service Code
|
CPT 74022
|
| Hospital Charge Code |
32000135
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$490.40 |
| Rate for Payer: Aetna Commercial |
$441.36
|
| Rate for Payer: Aetna Medicare |
$104.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: ASR ASR |
$475.69
|
| Rate for Payer: ASR Commercial |
$475.69
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$401.59
|
| Rate for Payer: BCN Commercial |
$380.21
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$392.32
|
| Rate for Payer: Cash Price |
$392.32
|
| Rate for Payer: Cofinity Commercial |
$460.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$490.40
|
| Rate for Payer: Healthscope Whirlpool |
$475.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.19
|
| Rate for Payer: Mclaren Commercial |
$441.36
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.84
|
| Rate for Payer: Nomi Health Commercial |
$402.13
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$114.61
|
| Rate for Payer: PHP Medicaid |
$55.85
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$272.85
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$218.28
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$431.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$161.49
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP DNSP |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: VA VA |
$104.19
|
|
|
HC XR AC JOINTS
|
Facility
|
OP
|
$357.38
|
|
|
Service Code
|
CPT 73050
|
| Hospital Charge Code |
32000068
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$357.38 |
| Rate for Payer: Aetna Commercial |
$321.64
|
| Rate for Payer: Aetna Medicare |
$86.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: ASR ASR |
$346.66
|
| Rate for Payer: ASR Commercial |
$346.66
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$292.66
|
| Rate for Payer: BCN Commercial |
$277.08
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$335.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$357.38
|
| Rate for Payer: Healthscope Whirlpool |
$346.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.27
|
| Rate for Payer: Mclaren Commercial |
$321.64
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: Nomi Health Commercial |
$293.05
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$94.90
|
| Rate for Payer: PHP Medicaid |
$46.24
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$185.57
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$148.46
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$314.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$133.72
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP DNSP |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: VA VA |
$86.27
|
|
|
HC XR AC JOINTS
|
Facility
|
IP
|
$357.38
|
|
|
Service Code
|
CPT 73050
|
| Hospital Charge Code |
32000068
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$232.30 |
| Max. Negotiated Rate |
$357.38 |
| Rate for Payer: Aetna Commercial |
$321.64
|
| Rate for Payer: ASR ASR |
$346.66
|
| Rate for Payer: ASR Commercial |
$346.66
|
| Rate for Payer: BCBS Trust/PPO |
$291.23
|
| Rate for Payer: BCN Commercial |
$277.08
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$335.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Healthscope Commercial |
$357.38
|
| Rate for Payer: Healthscope Whirlpool |
$346.66
|
| Rate for Payer: Mclaren Commercial |
$321.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: Nomi Health Commercial |
$293.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$314.49
|
|
|
HC XR ANKLE 1 VW
|
Facility
|
OP
|
$243.21
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000118
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$247.06 |
| Rate for Payer: Aetna Commercial |
$218.89
|
| Rate for Payer: Aetna Medicare |
$86.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: ASR ASR |
$235.91
|
| Rate for Payer: ASR Commercial |
$235.91
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$199.16
|
| Rate for Payer: BCN Commercial |
$188.56
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$194.57
|
| Rate for Payer: Cash Price |
$194.57
|
| Rate for Payer: Cofinity Commercial |
$228.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$243.21
|
| Rate for Payer: Healthscope Whirlpool |
$235.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.27
|
| Rate for Payer: Mclaren Commercial |
$218.89
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.73
|
| Rate for Payer: Nomi Health Commercial |
$199.43
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$94.90
|
| Rate for Payer: PHP Medicaid |
$46.24
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$247.06
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$197.65
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$133.72
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP DNSP |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: VA VA |
$86.27
|
|
|
HC XR ANKLE 1 VW
|
Facility
|
IP
|
$243.21
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000118
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$158.09 |
| Max. Negotiated Rate |
$243.21 |
| Rate for Payer: Aetna Commercial |
$218.89
|
| Rate for Payer: ASR ASR |
$235.91
|
| Rate for Payer: ASR Commercial |
$235.91
|
| Rate for Payer: BCBS Trust/PPO |
$198.19
|
| Rate for Payer: BCN Commercial |
$188.56
|
| Rate for Payer: Cash Price |
$194.57
|
| Rate for Payer: Cofinity Commercial |
$228.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.57
|
| Rate for Payer: Healthscope Commercial |
$243.21
|
| Rate for Payer: Healthscope Whirlpool |
$235.91
|
| Rate for Payer: Mclaren Commercial |
$218.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.73
|
| Rate for Payer: Nomi Health Commercial |
$199.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.02
|
|
|
HC XR ANKLE 2 VIEWS
|
Facility
|
IP
|
$255.46
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000117
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$166.05 |
| Max. Negotiated Rate |
$255.46 |
| Rate for Payer: Aetna Commercial |
$229.91
|
| Rate for Payer: ASR ASR |
$247.80
|
| Rate for Payer: ASR Commercial |
$247.80
|
| Rate for Payer: BCBS Trust/PPO |
$208.17
|
| Rate for Payer: BCN Commercial |
$198.06
|
| Rate for Payer: Cash Price |
$204.37
|
| Rate for Payer: Cofinity Commercial |
$240.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.37
|
| Rate for Payer: Healthscope Commercial |
$255.46
|
| Rate for Payer: Healthscope Whirlpool |
$247.80
|
| Rate for Payer: Mclaren Commercial |
$229.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.14
|
| Rate for Payer: Nomi Health Commercial |
$209.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.80
|
|
|
HC XR ANKLE 2 VIEWS
|
Facility
|
OP
|
$255.46
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000117
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$255.46 |
| Rate for Payer: Aetna Commercial |
$229.91
|
| Rate for Payer: Aetna Medicare |
$86.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: ASR ASR |
$247.80
|
| Rate for Payer: ASR Commercial |
$247.80
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$209.20
|
| Rate for Payer: BCN Commercial |
$198.06
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$204.37
|
| Rate for Payer: Cash Price |
$204.37
|
| Rate for Payer: Cofinity Commercial |
$240.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$255.46
|
| Rate for Payer: Healthscope Whirlpool |
$247.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.27
|
| Rate for Payer: Mclaren Commercial |
$229.91
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.14
|
| Rate for Payer: Nomi Health Commercial |
$209.48
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$94.90
|
| Rate for Payer: PHP Medicaid |
$46.24
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$247.06
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$197.65
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$133.72
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP DNSP |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: VA VA |
$86.27
|
|
|
HC XR ANKLE 2 VIEWS BILATERAL
|
Facility
|
IP
|
$249.90
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000339
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$162.44 |
| Max. Negotiated Rate |
$249.90 |
| Rate for Payer: Aetna Commercial |
$224.91
|
| Rate for Payer: ASR ASR |
$242.40
|
| Rate for Payer: ASR Commercial |
$242.40
|
| Rate for Payer: BCBS Trust/PPO |
$203.64
|
| Rate for Payer: BCN Commercial |
$193.75
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$234.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Healthscope Commercial |
$249.90
|
| Rate for Payer: Healthscope Whirlpool |
$242.40
|
| Rate for Payer: Mclaren Commercial |
$224.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.42
|
| Rate for Payer: Nomi Health Commercial |
$204.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$219.91
|
|
