|
HC XR ARTHROGRAM HIP
|
Facility
|
IP
|
$612.31
|
|
|
Service Code
|
CPT 73525
|
| Hospital Charge Code |
32000097
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$398.00 |
| Max. Negotiated Rate |
$612.31 |
| Rate for Payer: Aetna Commercial |
$551.08
|
| Rate for Payer: ASR ASR |
$593.94
|
| Rate for Payer: ASR Commercial |
$593.94
|
| Rate for Payer: BCBS Trust/PPO |
$498.97
|
| Rate for Payer: BCN Commercial |
$474.72
|
| Rate for Payer: Cash Price |
$489.85
|
| Rate for Payer: Cofinity Commercial |
$575.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.85
|
| Rate for Payer: Healthscope Commercial |
$612.31
|
| Rate for Payer: Healthscope Whirlpool |
$593.94
|
| Rate for Payer: Mclaren Commercial |
$551.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.46
|
| Rate for Payer: Nomi Health Commercial |
$502.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$398.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.83
|
|
|
HC XR ARTHROGRAM KNEE
|
Facility
|
OP
|
$612.31
|
|
|
Service Code
|
CPT 73580
|
| Hospital Charge Code |
32000111
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$612.31 |
| Rate for Payer: Aetna Commercial |
$551.08
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: ASR ASR |
$593.94
|
| Rate for Payer: ASR Commercial |
$593.94
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$501.42
|
| Rate for Payer: BCN Commercial |
$474.72
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$489.85
|
| Rate for Payer: Cash Price |
$489.85
|
| Rate for Payer: Cofinity Commercial |
$575.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$612.31
|
| Rate for Payer: Healthscope Whirlpool |
$593.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$551.08
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.46
|
| Rate for Payer: Nomi Health Commercial |
$502.09
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$398.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$536.51
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$429.23
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC XR ARTHROGRAM KNEE
|
Facility
|
IP
|
$612.31
|
|
|
Service Code
|
CPT 73580
|
| Hospital Charge Code |
32000111
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$398.00 |
| Max. Negotiated Rate |
$612.31 |
| Rate for Payer: Aetna Commercial |
$551.08
|
| Rate for Payer: ASR ASR |
$593.94
|
| Rate for Payer: ASR Commercial |
$593.94
|
| Rate for Payer: BCBS Trust/PPO |
$498.97
|
| Rate for Payer: BCN Commercial |
$474.72
|
| Rate for Payer: Cash Price |
$489.85
|
| Rate for Payer: Cofinity Commercial |
$575.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.85
|
| Rate for Payer: Healthscope Commercial |
$612.31
|
| Rate for Payer: Healthscope Whirlpool |
$593.94
|
| Rate for Payer: Mclaren Commercial |
$551.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.46
|
| Rate for Payer: Nomi Health Commercial |
$502.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$398.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.83
|
|
|
HC XR ARTHROGRAM SHOULDER
|
Facility
|
OP
|
$612.31
|
|
|
Service Code
|
CPT 73040
|
| Hospital Charge Code |
32000067
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$612.31 |
| Rate for Payer: Aetna Commercial |
$551.08
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: ASR ASR |
$593.94
|
| Rate for Payer: ASR Commercial |
$593.94
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$501.42
|
| Rate for Payer: BCN Commercial |
$474.72
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$489.85
|
| Rate for Payer: Cash Price |
$489.85
|
| Rate for Payer: Cofinity Commercial |
$575.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$612.31
|
| Rate for Payer: Healthscope Whirlpool |
$593.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$551.08
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.46
|
| Rate for Payer: Nomi Health Commercial |
$502.09
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$398.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$536.51
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$429.23
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC XR ARTHROGRAM SHOULDER
|
Facility
|
IP
|
$612.31
|
|
|
Service Code
|
CPT 73040
|
| Hospital Charge Code |
32000067
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$398.00 |
| Max. Negotiated Rate |
$612.31 |
| Rate for Payer: Aetna Commercial |
$551.08
|
| Rate for Payer: ASR ASR |
$593.94
|
| Rate for Payer: ASR Commercial |
$593.94
|
| Rate for Payer: BCBS Trust/PPO |
$498.97
|
| Rate for Payer: BCN Commercial |
$474.72
|
| Rate for Payer: Cash Price |
$489.85
|
| Rate for Payer: Cofinity Commercial |
$575.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.85
|
| Rate for Payer: Healthscope Commercial |
$612.31
|
| Rate for Payer: Healthscope Whirlpool |
$593.94
|
| Rate for Payer: Mclaren Commercial |
$551.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.46
|
| Rate for Payer: Nomi Health Commercial |
$502.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$398.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.83
|
|
|
HC XR ARTHROGRAM WRIST
|
Facility
|
OP
|
$670.87
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
32000084
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$670.87 |
| Rate for Payer: Aetna Commercial |
$603.78
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: ASR ASR |
$650.74
|
| Rate for Payer: ASR Commercial |
$650.74
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$549.38
|
| Rate for Payer: BCN Commercial |
$520.13
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cofinity Commercial |
$630.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$536.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$670.87
|
| Rate for Payer: Healthscope Whirlpool |
$650.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$603.78
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$570.24
|
| Rate for Payer: Nomi Health Commercial |
$550.11
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$436.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$587.82
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$470.28
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$590.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC XR ARTHROGRAM WRIST
|
Facility
|
IP
|
$670.87
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
32000084
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$436.07 |
| Max. Negotiated Rate |
$670.87 |
| Rate for Payer: Aetna Commercial |
$603.78
|
| Rate for Payer: ASR ASR |
$650.74
|
| Rate for Payer: ASR Commercial |
$650.74
|
| Rate for Payer: BCBS Trust/PPO |
$546.69
|
| Rate for Payer: BCN Commercial |
$520.13
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cofinity Commercial |
$630.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$536.70
|
| Rate for Payer: Healthscope Commercial |
$670.87
|
| Rate for Payer: Healthscope Whirlpool |
$650.74
|
| Rate for Payer: Mclaren Commercial |
$603.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$570.24
|
| Rate for Payer: Nomi Health Commercial |
$550.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$436.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$590.37
|
|
|
HC XR BONE AGE STUDY
|
Facility
|
IP
|
$306.43
|
|
|
Service Code
|
CPT 77072
|
| Hospital Charge Code |
32000253
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$199.18 |
| Max. Negotiated Rate |
$306.43 |
| Rate for Payer: Aetna Commercial |
$275.79
|
| Rate for Payer: ASR ASR |
$297.24
|
| Rate for Payer: ASR Commercial |
$297.24
|
| Rate for Payer: BCBS Trust/PPO |
$249.71
|
| Rate for Payer: BCN Commercial |
$237.58
|
| Rate for Payer: Cash Price |
$245.14
|
| Rate for Payer: Cofinity Commercial |
$288.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.14
|
| Rate for Payer: Healthscope Commercial |
$306.43
|
| Rate for Payer: Healthscope Whirlpool |
$297.24
|
| Rate for Payer: Mclaren Commercial |
$275.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.47
|
| Rate for Payer: Nomi Health Commercial |
$251.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$269.66
|
|
|
HC XR BONE AGE STUDY
|
Facility
|
OP
|
$306.43
|
|
|
Service Code
|
CPT 77072
|
| Hospital Charge Code |
32000253
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$306.43 |
| Rate for Payer: Aetna Commercial |
$275.79
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$297.24
|
| Rate for Payer: ASR Commercial |
$297.24
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$250.94
|
| Rate for Payer: BCN Commercial |
$237.58
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$245.14
|
| Rate for Payer: Cash Price |
$245.14
|
| Rate for Payer: Cofinity Commercial |
$288.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$306.43
|
| Rate for Payer: Healthscope Whirlpool |
$297.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$275.79
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.47
|
| Rate for Payer: Nomi Health Commercial |
$251.27
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$268.49
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$214.81
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$269.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC XR BONE LENGTH STUDY
|
Facility
|
IP
|
$291.84
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
32000254
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$189.70 |
| Max. Negotiated Rate |
$291.84 |
| Rate for Payer: Aetna Commercial |
$262.66
|
| Rate for Payer: ASR ASR |
$283.08
|
| Rate for Payer: ASR Commercial |
$283.08
|
| Rate for Payer: BCBS Trust/PPO |
$237.82
|
| Rate for Payer: BCN Commercial |
$226.26
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$274.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Healthscope Commercial |
$291.84
|
| Rate for Payer: Healthscope Whirlpool |
$283.08
|
| Rate for Payer: Mclaren Commercial |
$262.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$239.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$256.82
|
|
|
HC XR BONE LENGTH STUDY
|
Facility
|
OP
|
$291.84
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
32000254
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$291.84 |
| Rate for Payer: Aetna Commercial |
$262.66
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$283.08
|
| Rate for Payer: ASR Commercial |
$283.08
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$238.99
|
| Rate for Payer: BCN Commercial |
$226.26
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$274.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$291.84
|
| Rate for Payer: Healthscope Whirlpool |
$283.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$262.66
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$239.31
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$255.71
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$204.58
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$256.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC XR BONE SURVEY ADULT COMP
|
Facility
|
OP
|
$612.56
|
|
|
Service Code
|
CPT 77075
|
| Hospital Charge Code |
32000257
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$612.56 |
| Rate for Payer: Aetna Commercial |
$551.30
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$594.18
|
| Rate for Payer: ASR Commercial |
$594.18
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$501.63
|
| Rate for Payer: BCN Commercial |
$474.92
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$490.05
|
| Rate for Payer: Cash Price |
$490.05
|
| Rate for Payer: Cofinity Commercial |
$575.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$490.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$612.56
|
| Rate for Payer: Healthscope Whirlpool |
$594.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$551.30
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.68
|
| Rate for Payer: Nomi Health Commercial |
$502.30
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$398.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$536.73
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$429.40
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$539.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC XR BONE SURVEY ADULT COMP
|
Facility
|
IP
|
$612.56
|
|
|
Service Code
|
CPT 77075
|
| Hospital Charge Code |
32000257
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$398.16 |
| Max. Negotiated Rate |
$612.56 |
| Rate for Payer: Aetna Commercial |
$551.30
|
| Rate for Payer: ASR ASR |
$594.18
|
| Rate for Payer: ASR Commercial |
$594.18
|
| Rate for Payer: BCBS Trust/PPO |
$499.18
|
| Rate for Payer: BCN Commercial |
$474.92
|
| Rate for Payer: Cash Price |
$490.05
|
| Rate for Payer: Cofinity Commercial |
$575.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$490.05
|
| Rate for Payer: Healthscope Commercial |
$612.56
|
| Rate for Payer: Healthscope Whirlpool |
$594.18
|
| Rate for Payer: Mclaren Commercial |
$551.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.68
|
| Rate for Payer: Nomi Health Commercial |
$502.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$398.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$539.05
|
|
|
HC XR BONE SURVEY INFANT
|
Facility
|
OP
|
$387.96
|
|
|
Service Code
|
CPT 77076
|
| Hospital Charge Code |
32000258
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$387.96 |
| Rate for Payer: Aetna Commercial |
$349.16
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$376.32
|
| Rate for Payer: ASR Commercial |
$376.32
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$317.70
|
| Rate for Payer: BCN Commercial |
$300.79
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$310.37
|
| Rate for Payer: Cash Price |
$310.37
|
| Rate for Payer: Cofinity Commercial |
$364.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$387.96
|
| Rate for Payer: Healthscope Whirlpool |
$376.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$349.16
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.77
|
| Rate for Payer: Nomi Health Commercial |
$318.13
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$339.93
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$271.96
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$341.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC XR BONE SURVEY INFANT
|
Facility
|
IP
|
$387.96
|
|
|
Service Code
|
CPT 77076
|
| Hospital Charge Code |
32000258
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$252.17 |
| Max. Negotiated Rate |
$387.96 |
| Rate for Payer: Aetna Commercial |
$349.16
|
| Rate for Payer: ASR ASR |
$376.32
|
| Rate for Payer: ASR Commercial |
$376.32
|
| Rate for Payer: BCBS Trust/PPO |
$316.15
|
| Rate for Payer: BCN Commercial |
$300.79
|
| Rate for Payer: Cash Price |
$310.37
|
| Rate for Payer: Cofinity Commercial |
$364.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.37
|
| Rate for Payer: Healthscope Commercial |
$387.96
|
| Rate for Payer: Healthscope Whirlpool |
$376.32
|
| Rate for Payer: Mclaren Commercial |
$349.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.77
|
| Rate for Payer: Nomi Health Commercial |
$318.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$341.40
|
|
|
HC XR BONE SURVEY (METS) LTD
|
Facility
|
OP
|
$308.12
|
|
|
Service Code
|
CPT 77074
|
| Hospital Charge Code |
32000298
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$308.12 |
| Rate for Payer: Aetna Commercial |
$277.31
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$298.88
|
| Rate for Payer: ASR Commercial |
$298.88
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$252.32
|
| Rate for Payer: BCN Commercial |
$238.89
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$246.50
|
| Rate for Payer: Cash Price |
$246.50
|
| Rate for Payer: Cofinity Commercial |
$289.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$246.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$308.12
|
| Rate for Payer: Healthscope Whirlpool |
$298.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$277.31
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$261.90
|
| Rate for Payer: Nomi Health Commercial |
$252.66
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$269.97
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$215.99
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$271.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC XR BONE SURVEY (METS) LTD
|
Facility
|
IP
|
$308.12
|
|
|
Service Code
|
CPT 77074
|
| Hospital Charge Code |
32000298
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$200.28 |
| Max. Negotiated Rate |
$308.12 |
| Rate for Payer: Aetna Commercial |
$277.31
|
| Rate for Payer: ASR ASR |
$298.88
|
| Rate for Payer: ASR Commercial |
$298.88
|
| Rate for Payer: BCBS Trust/PPO |
$251.09
|
| Rate for Payer: BCN Commercial |
$238.89
|
| Rate for Payer: Cash Price |
$246.50
|
| Rate for Payer: Cofinity Commercial |
$289.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$246.50
|
| Rate for Payer: Healthscope Commercial |
$308.12
|
| Rate for Payer: Healthscope Whirlpool |
$298.88
|
| Rate for Payer: Mclaren Commercial |
$277.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$261.90
|
| Rate for Payer: Nomi Health Commercial |
$252.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$271.15
|
|
|
HC XR CHEST 2 VIEWS
|
Facility
|
IP
|
$303.69
|
|
|
Service Code
|
CPT 71046
|
| Hospital Charge Code |
32400010
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$197.40 |
| Max. Negotiated Rate |
$303.69 |
| Rate for Payer: Aetna Commercial |
$273.32
|
| Rate for Payer: ASR ASR |
$294.58
|
| Rate for Payer: ASR Commercial |
$294.58
|
| Rate for Payer: BCBS Trust/PPO |
$247.48
|
| Rate for Payer: BCN Commercial |
$235.45
|
| Rate for Payer: Cash Price |
$242.95
|
| Rate for Payer: Cofinity Commercial |
$285.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.95
|
| Rate for Payer: Healthscope Commercial |
$303.69
|
| Rate for Payer: Healthscope Whirlpool |
$294.58
|
| Rate for Payer: Mclaren Commercial |
$273.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.14
|
| Rate for Payer: Nomi Health Commercial |
$249.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$197.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$267.25
|
|
|
HC XR CHEST 2 VIEWS
|
Facility
|
OP
|
$303.69
|
|
|
Service Code
|
CPT 71046
|
| Hospital Charge Code |
32400010
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$303.69 |
| Rate for Payer: Aetna Commercial |
$273.32
|
| Rate for Payer: Aetna Medicare |
$85.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: ASR ASR |
$294.58
|
| Rate for Payer: ASR Commercial |
$294.58
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCBS Trust/PPO |
$248.69
|
| Rate for Payer: BCN Commercial |
$235.45
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$242.95
|
| Rate for Payer: Cash Price |
$242.95
|
| Rate for Payer: Cofinity Commercial |
$285.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$303.69
|
| Rate for Payer: Healthscope Whirlpool |
$294.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$85.87
|
| Rate for Payer: Mclaren Commercial |
$273.32
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.14
|
| Rate for Payer: Nomi Health Commercial |
$249.03
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$94.46
|
| Rate for Payer: PHP Medicaid |
$46.03
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$197.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$266.09
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health Narrow Network |
$212.89
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$267.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$133.10
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP DNSP |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: VA VA |
$85.87
|
|
|
HC XR CHEST 3 VIEWS
|
Facility
|
OP
|
$336.47
|
|
|
Service Code
|
CPT 71047
|
| Hospital Charge Code |
32400011
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$336.47 |
| Rate for Payer: Aetna Commercial |
$302.82
|
| Rate for Payer: Aetna Medicare |
$85.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: ASR ASR |
$326.38
|
| Rate for Payer: ASR Commercial |
$326.38
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCBS Trust/PPO |
$275.54
|
| Rate for Payer: BCN Commercial |
$260.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$269.18
|
| Rate for Payer: Cash Price |
$269.18
|
| Rate for Payer: Cofinity Commercial |
$316.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$336.47
|
| Rate for Payer: Healthscope Whirlpool |
$326.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$85.87
|
| Rate for Payer: Mclaren Commercial |
$302.82
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.00
|
| Rate for Payer: Nomi Health Commercial |
$275.91
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$94.46
|
| Rate for Payer: PHP Medicaid |
$46.03
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$294.82
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health Narrow Network |
$235.87
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$296.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$133.10
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP DNSP |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: VA VA |
$85.87
|
|
|
HC XR CHEST 3 VIEWS
|
Facility
|
IP
|
$336.47
|
|
|
Service Code
|
CPT 71047
|
| Hospital Charge Code |
32400011
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$218.71 |
| Max. Negotiated Rate |
$336.47 |
| Rate for Payer: Aetna Commercial |
$302.82
|
| Rate for Payer: ASR ASR |
$326.38
|
| Rate for Payer: ASR Commercial |
$326.38
|
| Rate for Payer: BCBS Trust/PPO |
$274.19
|
| Rate for Payer: BCN Commercial |
$260.87
|
| Rate for Payer: Cash Price |
$269.18
|
| Rate for Payer: Cofinity Commercial |
$316.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.18
|
| Rate for Payer: Healthscope Commercial |
$336.47
|
| Rate for Payer: Healthscope Whirlpool |
$326.38
|
| Rate for Payer: Mclaren Commercial |
$302.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.00
|
| Rate for Payer: Nomi Health Commercial |
$275.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$296.09
|
|
|
HC XR CHEST 4 OR MORE VIEWS
|
Facility
|
OP
|
$369.24
|
|
|
Service Code
|
CPT 71048
|
| Hospital Charge Code |
32400012
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$369.24 |
| Rate for Payer: Aetna Commercial |
$332.32
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$358.16
|
| Rate for Payer: ASR Commercial |
$358.16
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$302.37
|
| Rate for Payer: BCN Commercial |
$286.27
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$295.39
|
| Rate for Payer: Cash Price |
$295.39
|
| Rate for Payer: Cofinity Commercial |
$347.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$295.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$369.24
|
| Rate for Payer: Healthscope Whirlpool |
$358.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$332.32
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.85
|
| Rate for Payer: Nomi Health Commercial |
$302.78
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$323.53
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$258.84
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$324.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC XR CHEST 4 OR MORE VIEWS
|
Facility
|
IP
|
$369.24
|
|
|
Service Code
|
CPT 71048
|
| Hospital Charge Code |
32400012
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$240.01 |
| Max. Negotiated Rate |
$369.24 |
| Rate for Payer: Aetna Commercial |
$332.32
|
| Rate for Payer: ASR ASR |
$358.16
|
| Rate for Payer: ASR Commercial |
$358.16
|
| Rate for Payer: BCBS Trust/PPO |
$300.89
|
| Rate for Payer: BCN Commercial |
$286.27
|
| Rate for Payer: Cash Price |
$295.39
|
| Rate for Payer: Cofinity Commercial |
$347.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$295.39
|
| Rate for Payer: Healthscope Commercial |
$369.24
|
| Rate for Payer: Healthscope Whirlpool |
$358.16
|
| Rate for Payer: Mclaren Commercial |
$332.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.85
|
| Rate for Payer: Nomi Health Commercial |
$302.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$324.93
|
|
|
HC XR CHEST ABD FOREIG BOD CHILD
|
Facility
|
IP
|
$275.97
|
|
|
Service Code
|
CPT 76010
|
| Hospital Charge Code |
32000234
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$179.38 |
| Max. Negotiated Rate |
$275.97 |
| Rate for Payer: Aetna Commercial |
$248.37
|
| Rate for Payer: ASR ASR |
$267.69
|
| Rate for Payer: ASR Commercial |
$267.69
|
| Rate for Payer: BCBS Trust/PPO |
$224.89
|
| Rate for Payer: BCN Commercial |
$213.96
|
| Rate for Payer: Cash Price |
$220.78
|
| Rate for Payer: Cofinity Commercial |
$259.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.78
|
| Rate for Payer: Healthscope Commercial |
$275.97
|
| Rate for Payer: Healthscope Whirlpool |
$267.69
|
| Rate for Payer: Mclaren Commercial |
$248.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.57
|
| Rate for Payer: Nomi Health Commercial |
$226.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$242.85
|
|
|
HC XR CHEST ABD FOREIG BOD CHILD
|
Facility
|
OP
|
$275.97
|
|
|
Service Code
|
CPT 76010
|
| Hospital Charge Code |
32000234
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$275.97 |
| Rate for Payer: Aetna Commercial |
$248.37
|
| Rate for Payer: Aetna Medicare |
$85.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: ASR ASR |
$267.69
|
| Rate for Payer: ASR Commercial |
$267.69
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCBS Trust/PPO |
$225.99
|
| Rate for Payer: BCN Commercial |
$213.96
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$220.78
|
| Rate for Payer: Cash Price |
$220.78
|
| Rate for Payer: Cofinity Commercial |
$259.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$275.97
|
| Rate for Payer: Healthscope Whirlpool |
$267.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$85.87
|
| Rate for Payer: Mclaren Commercial |
$248.37
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.57
|
| Rate for Payer: Nomi Health Commercial |
$226.30
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$94.46
|
| Rate for Payer: PHP Medicaid |
$46.03
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$241.80
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health Narrow Network |
$193.45
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$242.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$133.10
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP DNSP |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: VA VA |
$85.87
|
|
