|
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 BONE SURVEY (METS) LTD
|
Facility
|
OP
|
$308.12
|
|
|
Service Code
|
CPT 77074
|
| Hospital Charge Code |
32000298
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$308.12 |
| Rate for Payer: Aetna Commercial |
$277.31
|
| 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 |
$298.88
|
| Rate for Payer: ASR Commercial |
$298.88
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$252.32
|
| Rate for Payer: BCN Commercial |
$238.89
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| 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 |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$308.12
|
| Rate for Payer: Healthscope Whirlpool |
$298.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.19
|
| Rate for Payer: Mclaren Commercial |
$277.31
|
| 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 |
$261.90
|
| Rate for Payer: Nomi Health Commercial |
$252.66
|
| 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 |
$200.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$269.97
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$215.99
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$271.15
|
| 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 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 |
$46.24 |
| Max. Negotiated Rate |
$303.69 |
| Rate for Payer: Aetna Commercial |
$273.32
|
| 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 |
$294.58
|
| Rate for Payer: ASR Commercial |
$294.58
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$248.69
|
| Rate for Payer: BCN Commercial |
$235.45
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| 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 |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$303.69
|
| Rate for Payer: Healthscope Whirlpool |
$294.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.27
|
| Rate for Payer: Mclaren Commercial |
$273.32
|
| 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 |
$258.14
|
| Rate for Payer: Nomi Health Commercial |
$249.03
|
| 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 |
$197.40
|
| 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 |
$267.25
|
| 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 CHEST 3 VIEWS
|
Facility
|
OP
|
$336.47
|
|
|
Service Code
|
CPT 71047
|
| Hospital Charge Code |
32400011
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$336.47 |
| Rate for Payer: Aetna Commercial |
$302.82
|
| 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 |
$326.38
|
| Rate for Payer: ASR Commercial |
$326.38
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$275.54
|
| Rate for Payer: BCN Commercial |
$260.87
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| 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 |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$336.47
|
| Rate for Payer: Healthscope Whirlpool |
$326.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.27
|
| Rate for Payer: Mclaren Commercial |
$302.82
|
| 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 |
$286.00
|
| Rate for Payer: Nomi Health Commercial |
$275.91
|
| 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 |
$218.71
|
| 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 |
$296.09
|
| 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 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
|
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 4 OR MORE VIEWS
|
Facility
|
OP
|
$369.24
|
|
|
Service Code
|
CPT 71048
|
| Hospital Charge Code |
32400012
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$369.24 |
| Rate for Payer: Aetna Commercial |
$332.32
|
| 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 |
$358.16
|
| Rate for Payer: ASR Commercial |
$358.16
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$302.37
|
| Rate for Payer: BCN Commercial |
$286.27
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| 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 |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$369.24
|
| Rate for Payer: Healthscope Whirlpool |
$358.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.19
|
| Rate for Payer: Mclaren Commercial |
$332.32
|
| 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 |
$313.85
|
| Rate for Payer: Nomi Health Commercial |
$302.78
|
| 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 |
$240.01
|
| 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 |
$324.93
|
| 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 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 |
$46.24 |
| Max. Negotiated Rate |
$275.97 |
| Rate for Payer: Aetna Commercial |
$248.37
|
| 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 |
$267.69
|
| Rate for Payer: ASR Commercial |
$267.69
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$225.99
|
| Rate for Payer: BCN Commercial |
$213.96
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| 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 |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$275.97
|
| Rate for Payer: Healthscope Whirlpool |
$267.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.27
|
| Rate for Payer: Mclaren Commercial |
$248.37
|
| 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 |
$234.57
|
| Rate for Payer: Nomi Health Commercial |
$226.30
|
| 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 |
$179.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$241.80
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$193.45
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$242.85
|
| 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 CHEST SINGLE VIEW
|
Facility
|
OP
|
$270.92
|
|
|
Service Code
|
CPT 71045
|
| Hospital Charge Code |
32400009
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$270.92 |
| Rate for Payer: Aetna Commercial |
$243.83
|
| 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 |
$262.79
|
| Rate for Payer: ASR Commercial |
$262.79
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$221.86
|
| Rate for Payer: BCN Commercial |
$210.04
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$216.74
|
| Rate for Payer: Cash Price |
$216.74
|
| Rate for Payer: Cofinity Commercial |
$254.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$270.92
|
| Rate for Payer: Healthscope Whirlpool |
$262.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.27
|
| Rate for Payer: Mclaren Commercial |
$243.83
|
| 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 |
$230.28
|
| Rate for Payer: Nomi Health Commercial |
$222.15
|
| 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 |
$176.10
|
| 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 |
$238.41
|
| 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 CHEST SINGLE VIEW
|
Facility
|
IP
|
$270.92
|
|
|
Service Code
|
CPT 71045
|
| Hospital Charge Code |
32400009
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$176.10 |
| Max. Negotiated Rate |
$270.92 |
| Rate for Payer: Aetna Commercial |
$243.83
|
| Rate for Payer: ASR ASR |
$262.79
|
| Rate for Payer: ASR Commercial |
$262.79
|
| Rate for Payer: BCBS Trust/PPO |
$220.77
|
| Rate for Payer: BCN Commercial |
$210.04
|
| Rate for Payer: Cash Price |
$216.74
|
| Rate for Payer: Cofinity Commercial |
$254.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.74
|
| Rate for Payer: Healthscope Commercial |
$270.92
|
| Rate for Payer: Healthscope Whirlpool |
$262.79
|
| Rate for Payer: Mclaren Commercial |
$243.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.28
|
| Rate for Payer: Nomi Health Commercial |
$222.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$238.41
|
|
|
HC XR CHOLANGIOGRAM IN OR
|
Facility
|
IP
|
$510.39
|
|
|
Service Code
|
CPT 74300
|
| Hospital Charge Code |
32000149
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$331.75 |
| Max. Negotiated Rate |
$510.39 |
| Rate for Payer: Aetna Commercial |
$459.35
|
| Rate for Payer: ASR ASR |
$495.08
|
| Rate for Payer: ASR Commercial |
$495.08
|
| Rate for Payer: BCBS Trust/PPO |
$415.92
|
| Rate for Payer: BCN Commercial |
$395.71
|
| Rate for Payer: Cash Price |
$408.31
|
| Rate for Payer: Cofinity Commercial |
$479.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.31
|
| Rate for Payer: Healthscope Commercial |
$510.39
|
| Rate for Payer: Healthscope Whirlpool |
$495.08
|
| Rate for Payer: Mclaren Commercial |
$459.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.83
|
| Rate for Payer: Nomi Health Commercial |
$418.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$449.14
|
|
|
HC XR CHOLANGIOGRAM IN OR
|
Facility
|
OP
|
$510.39
|
|
|
Service Code
|
CPT 74300
|
| Hospital Charge Code |
32000149
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$204.16 |
| Max. Negotiated Rate |
$572.61 |
| Rate for Payer: Aetna Commercial |
$459.35
|
| Rate for Payer: Aetna Medicare |
$255.20
|
| Rate for Payer: ASR ASR |
$495.08
|
| Rate for Payer: ASR Commercial |
$495.08
|
| Rate for Payer: BCBS Complete |
$204.16
|
| Rate for Payer: BCBS Trust/PPO |
$417.96
|
| Rate for Payer: BCN Commercial |
$395.71
|
| Rate for Payer: Cash Price |
$408.31
|
| Rate for Payer: Cash Price |
$408.31
|
| Rate for Payer: Cofinity Commercial |
$479.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.31
|
| Rate for Payer: Healthscope Commercial |
$510.39
|
| Rate for Payer: Healthscope Whirlpool |
$495.08
|
| Rate for Payer: Mclaren Commercial |
$459.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.83
|
| Rate for Payer: Nomi Health Commercial |
$418.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$572.61
|
| Rate for Payer: Priority Health Narrow Network |
$458.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$449.14
|
|
|
HC XR CLAVICLE
|
Facility
|
OP
|
$316.49
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000060
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$316.49 |
| Rate for Payer: Aetna Commercial |
$284.84
|
| 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 |
$307.00
|
| Rate for Payer: ASR Commercial |
$307.00
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$259.17
|
| Rate for Payer: BCN Commercial |
$245.37
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$253.19
|
| Rate for Payer: Cash Price |
$253.19
|
| Rate for Payer: Cofinity Commercial |
$297.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$253.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$316.49
|
| Rate for Payer: Healthscope Whirlpool |
$307.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.27
|
| Rate for Payer: Mclaren Commercial |
$284.84
|
| 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 |
$269.02
|
| Rate for Payer: Nomi Health Commercial |
$259.52
|
| 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 |
$205.72
|
| 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 |
$278.51
|
| 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 CLAVICLE
|
Facility
|
IP
|
$316.49
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000060
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$205.72 |
| Max. Negotiated Rate |
$316.49 |
| Rate for Payer: Aetna Commercial |
$284.84
|
| Rate for Payer: ASR ASR |
$307.00
|
| Rate for Payer: ASR Commercial |
$307.00
|
| Rate for Payer: BCBS Trust/PPO |
$257.91
|
| Rate for Payer: BCN Commercial |
$245.37
|
| Rate for Payer: Cash Price |
$253.19
|
| Rate for Payer: Cofinity Commercial |
$297.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$253.19
|
| Rate for Payer: Healthscope Commercial |
$316.49
|
| Rate for Payer: Healthscope Whirlpool |
$307.00
|
| Rate for Payer: Mclaren Commercial |
$284.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$269.02
|
| Rate for Payer: Nomi Health Commercial |
$259.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$278.51
|
|
|
HC XR CLAVICLE BIL
|
Facility
|
OP
|
$340.34
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000061
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$340.34 |
| Rate for Payer: Aetna Commercial |
$306.31
|
| 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 |
$330.13
|
| Rate for Payer: ASR Commercial |
$330.13
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$278.70
|
| Rate for Payer: BCN Commercial |
$263.87
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$319.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$340.34
|
| Rate for Payer: Healthscope Whirlpool |
$330.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.27
|
| Rate for Payer: Mclaren Commercial |
$306.31
|
| 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 |
$289.29
|
| Rate for Payer: Nomi Health Commercial |
$279.08
|
| 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 |
$221.22
|
| 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 |
$299.50
|
| 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 CLAVICLE BIL
|
Facility
|
IP
|
$340.34
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000061
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$221.22 |
| Max. Negotiated Rate |
$340.34 |
| Rate for Payer: Aetna Commercial |
$306.31
|
| Rate for Payer: ASR ASR |
$330.13
|
| Rate for Payer: ASR Commercial |
$330.13
|
| Rate for Payer: BCBS Trust/PPO |
$277.34
|
| Rate for Payer: BCN Commercial |
$263.87
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$319.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Healthscope Commercial |
$340.34
|
| Rate for Payer: Healthscope Whirlpool |
$330.13
|
| Rate for Payer: Mclaren Commercial |
$306.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.29
|
| Rate for Payer: Nomi Health Commercial |
$279.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$299.50
|
|
|
HC XR COLON
|
Facility
|
OP
|
$857.44
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
32000273
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$93.49 |
| Max. Negotiated Rate |
$857.44 |
| Rate for Payer: Aetna Commercial |
$771.70
|
| Rate for Payer: Aetna Medicare |
$174.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.02
|
| Rate for Payer: ASR ASR |
$831.72
|
| Rate for Payer: ASR Commercial |
$831.72
|
| Rate for Payer: BCBS Complete |
$98.16
|
| Rate for Payer: BCBS MAPPO |
$174.42
|
| Rate for Payer: BCBS Trust/PPO |
$702.16
|
| Rate for Payer: BCN Commercial |
$664.77
|
| Rate for Payer: BCN Medicare Advantage |
$174.42
|
| Rate for Payer: Cash Price |
$685.95
|
| Rate for Payer: Cash Price |
$685.95
|
| Rate for Payer: Cofinity Commercial |
$805.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$685.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.42
|
| Rate for Payer: Healthscope Commercial |
$857.44
|
| Rate for Payer: Healthscope Whirlpool |
$831.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.42
|
| Rate for Payer: Mclaren Commercial |
$771.70
|
| Rate for Payer: Mclaren Medicaid |
$93.49
|
| Rate for Payer: Mclaren Medicare |
$174.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.14
|
| Rate for Payer: Meridian Medicaid |
$98.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$728.82
|
| Rate for Payer: Nomi Health Commercial |
$703.10
|
| Rate for Payer: PACE Medicare |
$165.70
|
| Rate for Payer: PACE SWMI |
$174.42
|
| Rate for Payer: PHP Commercial |
$191.86
|
| Rate for Payer: PHP Medicaid |
$93.49
|
| Rate for Payer: PHP Medicare Advantage |
$174.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$557.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$429.87
|
| Rate for Payer: Priority Health Medicare |
$174.42
|
| Rate for Payer: Priority Health Narrow Network |
$343.90
|
| Rate for Payer: Railroad Medicare Medicare |
$174.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$754.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.42
|
| Rate for Payer: UHC Exchange |
$270.35
|
| Rate for Payer: UHC Medicare Advantage |
$174.42
|
| Rate for Payer: UHCCP DNSP |
$174.42
|
| Rate for Payer: UHCCP Medicaid |
$93.49
|
| Rate for Payer: VA VA |
$174.42
|
|
|
HC XR COLON
|
Facility
|
IP
|
$857.44
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
32000273
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$557.34 |
| Max. Negotiated Rate |
$857.44 |
| Rate for Payer: Aetna Commercial |
$771.70
|
| Rate for Payer: ASR ASR |
$831.72
|
| Rate for Payer: ASR Commercial |
$831.72
|
| Rate for Payer: BCBS Trust/PPO |
$698.73
|
| Rate for Payer: BCN Commercial |
$664.77
|
| Rate for Payer: Cash Price |
$685.95
|
| Rate for Payer: Cofinity Commercial |
$805.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$685.95
|
| Rate for Payer: Healthscope Commercial |
$857.44
|
| Rate for Payer: Healthscope Whirlpool |
$831.72
|
| Rate for Payer: Mclaren Commercial |
$771.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$728.82
|
| Rate for Payer: Nomi Health Commercial |
$703.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$557.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$754.55
|
|
|
HC XR COLON HIGH DENSITY
|
Facility
|
IP
|
$1,224.87
|
|
|
Service Code
|
CPT 74280
|
| Hospital Charge Code |
32000146
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$796.17 |
| Max. Negotiated Rate |
$1,224.87 |
| Rate for Payer: Aetna Commercial |
$1,102.38
|
| Rate for Payer: ASR ASR |
$1,188.12
|
| Rate for Payer: ASR Commercial |
$1,188.12
|
| Rate for Payer: BCBS Trust/PPO |
$998.15
|
| Rate for Payer: BCN Commercial |
$949.64
|
| Rate for Payer: Cash Price |
$979.90
|
| Rate for Payer: Cofinity Commercial |
$1,151.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$979.90
|
| Rate for Payer: Healthscope Commercial |
$1,224.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,188.12
|
| Rate for Payer: Mclaren Commercial |
$1,102.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,041.14
|
| Rate for Payer: Nomi Health Commercial |
$1,004.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,077.89
|
|
|
HC XR COLON HIGH DENSITY
|
Facility
|
OP
|
$1,224.87
|
|
|
Service Code
|
CPT 74280
|
| Hospital Charge Code |
32000146
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$93.49 |
| Max. Negotiated Rate |
$1,224.87 |
| Rate for Payer: Aetna Commercial |
$1,102.38
|
| Rate for Payer: Aetna Medicare |
$174.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.02
|
| Rate for Payer: ASR ASR |
$1,188.12
|
| Rate for Payer: ASR Commercial |
$1,188.12
|
| Rate for Payer: BCBS Complete |
$98.16
|
| Rate for Payer: BCBS MAPPO |
$174.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.05
|
| Rate for Payer: BCN Commercial |
$949.64
|
| Rate for Payer: BCN Medicare Advantage |
$174.42
|
| Rate for Payer: Cash Price |
$979.90
|
| Rate for Payer: Cash Price |
$979.90
|
| Rate for Payer: Cofinity Commercial |
$1,151.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$979.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.42
|
| Rate for Payer: Healthscope Commercial |
$1,224.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,188.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.42
|
| Rate for Payer: Mclaren Commercial |
$1,102.38
|
| Rate for Payer: Mclaren Medicaid |
$93.49
|
| Rate for Payer: Mclaren Medicare |
$174.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.14
|
| Rate for Payer: Meridian Medicaid |
$98.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,041.14
|
| Rate for Payer: Nomi Health Commercial |
$1,004.39
|
| Rate for Payer: PACE Medicare |
$165.70
|
| Rate for Payer: PACE SWMI |
$174.42
|
| Rate for Payer: PHP Commercial |
$191.86
|
| Rate for Payer: PHP Medicaid |
$93.49
|
| Rate for Payer: PHP Medicare Advantage |
$174.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$553.40
|
| Rate for Payer: Priority Health Medicare |
$174.42
|
| Rate for Payer: Priority Health Narrow Network |
$442.72
|
| Rate for Payer: Railroad Medicare Medicare |
$174.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,077.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.42
|
| Rate for Payer: UHC Exchange |
$270.35
|
| Rate for Payer: UHC Medicare Advantage |
$174.42
|
| Rate for Payer: UHCCP DNSP |
$174.42
|
| Rate for Payer: UHCCP Medicaid |
$93.49
|
| Rate for Payer: VA VA |
$174.42
|
|
|
HC XR COLON THERAPEUTIC FOR INTUS
|
Facility
|
IP
|
$583.28
|
|
|
Service Code
|
CPT 74283
|
| Hospital Charge Code |
32000147
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$379.13 |
| Max. Negotiated Rate |
$583.28 |
| Rate for Payer: Aetna Commercial |
$524.95
|
| Rate for Payer: ASR ASR |
$565.78
|
| Rate for Payer: ASR Commercial |
$565.78
|
| Rate for Payer: BCBS Trust/PPO |
$475.31
|
| Rate for Payer: BCN Commercial |
$452.22
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$548.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Healthscope Commercial |
$583.28
|
| Rate for Payer: Healthscope Whirlpool |
$565.78
|
| Rate for Payer: Mclaren Commercial |
$524.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: Nomi Health Commercial |
$478.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$513.29
|
|
|
HC XR COLON THERAPEUTIC FOR INTUS
|
Facility
|
OP
|
$583.28
|
|
|
Service Code
|
CPT 74283
|
| Hospital Charge Code |
32000147
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$93.49 |
| Max. Negotiated Rate |
$583.28 |
| Rate for Payer: Aetna Commercial |
$524.95
|
| Rate for Payer: Aetna Medicare |
$174.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.02
|
| Rate for Payer: ASR ASR |
$565.78
|
| Rate for Payer: ASR Commercial |
$565.78
|
| Rate for Payer: BCBS Complete |
$98.16
|
| Rate for Payer: BCBS MAPPO |
$174.42
|
| Rate for Payer: BCBS Trust/PPO |
$477.65
|
| Rate for Payer: BCN Commercial |
$452.22
|
| Rate for Payer: BCN Medicare Advantage |
$174.42
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$548.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.42
|
| Rate for Payer: Healthscope Commercial |
$583.28
|
| Rate for Payer: Healthscope Whirlpool |
$565.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.42
|
| Rate for Payer: Mclaren Commercial |
$524.95
|
| Rate for Payer: Mclaren Medicaid |
$93.49
|
| Rate for Payer: Mclaren Medicare |
$174.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.14
|
| Rate for Payer: Meridian Medicaid |
$98.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: Nomi Health Commercial |
$478.29
|
| Rate for Payer: PACE Medicare |
$165.70
|
| Rate for Payer: PACE SWMI |
$174.42
|
| Rate for Payer: PHP Commercial |
$191.86
|
| Rate for Payer: PHP Medicaid |
$93.49
|
| Rate for Payer: PHP Medicare Advantage |
$174.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$511.07
|
| Rate for Payer: Priority Health Medicare |
$174.42
|
| Rate for Payer: Priority Health Narrow Network |
$408.88
|
| Rate for Payer: Railroad Medicare Medicare |
$174.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$513.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.42
|
| Rate for Payer: UHC Exchange |
$270.35
|
| Rate for Payer: UHC Medicare Advantage |
$174.42
|
| Rate for Payer: UHCCP DNSP |
$174.42
|
| Rate for Payer: UHCCP Medicaid |
$93.49
|
| Rate for Payer: VA VA |
$174.42
|
|
|
HC XR CYSTOGRAM MIN 3 VW
|
Facility
|
IP
|
$439.05
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000163
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$285.38 |
| Max. Negotiated Rate |
$439.05 |
| Rate for Payer: Aetna Commercial |
$395.14
|
| Rate for Payer: ASR ASR |
$425.88
|
| Rate for Payer: ASR Commercial |
$425.88
|
| Rate for Payer: BCBS Trust/PPO |
$357.78
|
| Rate for Payer: BCN Commercial |
$340.40
|
| Rate for Payer: Cash Price |
$351.24
|
| Rate for Payer: Cofinity Commercial |
$412.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.24
|
| Rate for Payer: Healthscope Commercial |
$439.05
|
| Rate for Payer: Healthscope Whirlpool |
$425.88
|
| Rate for Payer: Mclaren Commercial |
$395.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.19
|
| Rate for Payer: Nomi Health Commercial |
$360.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$386.36
|
|
