|
HC CT PLEURAL FIBRINOLYSIS SUB DAY
|
Facility
|
IP
|
$1,003.66
|
|
|
Service Code
|
CPT 32562
|
| Hospital Charge Code |
36100322
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$698.55 |
| Max. Negotiated Rate |
$903.29 |
| Rate for Payer: Aetna Commercial |
$853.11
|
| Rate for Payer: BCBS Trust/PPO |
$828.92
|
| Rate for Payer: BCN Commercial |
$828.92
|
| Rate for Payer: Cash Price |
$802.93
|
| Rate for Payer: Cofinity Commercial |
$863.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$802.93
|
| Rate for Payer: Healthscope Commercial |
$903.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$752.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$853.11
|
| Rate for Payer: Nomi Health Commercial |
$823.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$752.75
|
| Rate for Payer: PHP Commercial |
$853.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$873.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$698.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$883.22
|
| Rate for Payer: UHC Core |
$838.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$752.75
|
|
|
HC CT PLEURAL FIBRINOLYSIS SUB DAY
|
Facility
|
OP
|
$1,003.66
|
|
|
Service Code
|
CPT 32562
|
| Hospital Charge Code |
36100322
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$176.95 |
| Max. Negotiated Rate |
$903.29 |
| Rate for Payer: Aetna Commercial |
$853.11
|
| Rate for Payer: Aetna Medicare |
$260.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$313.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$313.64
|
| Rate for Payer: BCBS Complete |
$185.78
|
| Rate for Payer: BCBS MAPPO |
$250.91
|
| Rate for Payer: BCBS Trust/PPO |
$825.11
|
| Rate for Payer: BCN Commercial |
$825.11
|
| Rate for Payer: BCN Medicare Advantage |
$250.91
|
| Rate for Payer: Cash Price |
$802.93
|
| Rate for Payer: Cofinity Commercial |
$863.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$802.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$250.91
|
| Rate for Payer: Healthscope Commercial |
$903.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$752.75
|
| Rate for Payer: Mclaren Medicaid |
$176.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$263.46
|
| Rate for Payer: Meridian Medicaid |
$185.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$288.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$276.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$853.11
|
| Rate for Payer: Nomi Health Commercial |
$823.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$752.75
|
| Rate for Payer: PACE Senior Care Partners |
$238.37
|
| Rate for Payer: PACE SWMI |
$250.91
|
| Rate for Payer: PHP Commercial |
$853.11
|
| Rate for Payer: PHP Medicare Advantage |
$250.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$176.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$873.18
|
| Rate for Payer: Priority Health Medicare |
$253.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$698.55
|
| Rate for Payer: Railroad Medicare Medicare |
$250.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$883.22
|
| Rate for Payer: UHC Core |
$838.06
|
| Rate for Payer: UHC Exchange |
$250.91
|
| Rate for Payer: UHC Medicaid |
$176.95
|
| Rate for Payer: UHC Medicare Advantage |
$250.91
|
| Rate for Payer: UHCCP Medicaid |
$176.95
|
| Rate for Payer: VA VA |
$250.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$752.75
|
|
|
HC CT RF/MICROWAVE ABLATION
|
Facility
|
OP
|
$1,118.51
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000042
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$197.19 |
| Max. Negotiated Rate |
$1,006.66 |
| Rate for Payer: Aetna Commercial |
$950.73
|
| Rate for Payer: Aetna Medicare |
$290.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$349.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$349.53
|
| Rate for Payer: BCBS Complete |
$207.04
|
| Rate for Payer: BCBS MAPPO |
$279.63
|
| Rate for Payer: BCBS Trust/PPO |
$919.53
|
| Rate for Payer: BCN Commercial |
$919.53
|
| Rate for Payer: BCN Medicare Advantage |
$279.63
|
| Rate for Payer: Cash Price |
$894.81
|
| Rate for Payer: Cofinity Commercial |
$961.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$894.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.63
|
| Rate for Payer: Healthscope Commercial |
$1,006.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$838.88
|
| Rate for Payer: Mclaren Medicaid |
$197.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$293.61
|
| Rate for Payer: Meridian Medicaid |
$207.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$321.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$307.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$950.73
|
| Rate for Payer: Nomi Health Commercial |
$917.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$838.88
|
| Rate for Payer: PACE Senior Care Partners |
$265.65
|
| Rate for Payer: PACE SWMI |
$279.63
|
| Rate for Payer: PHP Commercial |
$950.73
|
| Rate for Payer: PHP Medicare Advantage |
$279.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$197.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$973.10
|
| Rate for Payer: Priority Health Medicare |
$282.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$778.48
|
| Rate for Payer: Railroad Medicare Medicare |
$279.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.29
|
| Rate for Payer: UHC Core |
$933.96
|
| Rate for Payer: UHC Exchange |
$279.63
|
| Rate for Payer: UHC Medicaid |
$197.19
|
| Rate for Payer: UHC Medicare Advantage |
$279.63
|
| Rate for Payer: UHCCP Medicaid |
$197.19
|
| Rate for Payer: VA VA |
$279.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$838.88
|
|
|
HC CT RF/MICROWAVE ABLATION
|
Facility
|
IP
|
$1,118.51
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000042
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$778.48 |
| Max. Negotiated Rate |
$1,006.66 |
| Rate for Payer: Aetna Commercial |
$950.73
|
| Rate for Payer: BCBS Trust/PPO |
$923.78
|
| Rate for Payer: BCN Commercial |
$923.78
|
| Rate for Payer: Cash Price |
$894.81
|
| Rate for Payer: Cofinity Commercial |
$961.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$894.81
|
| Rate for Payer: Healthscope Commercial |
$1,006.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$838.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$950.73
|
| Rate for Payer: Nomi Health Commercial |
$917.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$838.88
|
| Rate for Payer: PHP Commercial |
$950.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$973.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$778.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.29
|
| Rate for Payer: UHC Core |
$933.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$838.88
|
|
|
HC CTRL NASAL HEMRRG ANT COMPLEX
|
Facility
|
OP
|
$449.45
|
|
|
Service Code
|
CPT 30903
|
| Hospital Charge Code |
76100414
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$79.24 |
| Max. Negotiated Rate |
$404.50 |
| Rate for Payer: Aetna Commercial |
$382.03
|
| Rate for Payer: Aetna Medicare |
$116.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$140.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$140.45
|
| Rate for Payer: BCBS Complete |
$83.19
|
| Rate for Payer: BCBS MAPPO |
$112.36
|
| Rate for Payer: BCBS Trust/PPO |
$369.49
|
| Rate for Payer: BCN Commercial |
$369.49
|
| Rate for Payer: BCN Medicare Advantage |
$112.36
|
| Rate for Payer: Cash Price |
$359.56
|
| Rate for Payer: Cofinity Commercial |
$386.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$359.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.36
|
| Rate for Payer: Healthscope Commercial |
$404.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.09
|
| Rate for Payer: Mclaren Medicaid |
$79.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.98
|
| Rate for Payer: Meridian Medicaid |
$83.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$129.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$123.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.03
|
| Rate for Payer: Nomi Health Commercial |
$368.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$337.09
|
| Rate for Payer: PACE Senior Care Partners |
$106.74
|
| Rate for Payer: PACE SWMI |
$112.36
|
| Rate for Payer: PHP Commercial |
$382.03
|
| Rate for Payer: PHP Medicare Advantage |
$112.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$391.02
|
| Rate for Payer: Priority Health Medicare |
$113.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$312.82
|
| Rate for Payer: Railroad Medicare Medicare |
$112.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$395.52
|
| Rate for Payer: UHC Core |
$375.29
|
| Rate for Payer: UHC Exchange |
$112.36
|
| Rate for Payer: UHC Medicaid |
$79.24
|
| Rate for Payer: UHC Medicare Advantage |
$112.36
|
| Rate for Payer: UHCCP Medicaid |
$79.24
|
| Rate for Payer: VA VA |
$112.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.09
|
|
|
HC CTRL NASAL HEMRRG ANT COMPLEX
|
Facility
|
IP
|
$449.45
|
|
|
Service Code
|
CPT 30903
|
| Hospital Charge Code |
76100414
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$312.82 |
| Max. Negotiated Rate |
$404.50 |
| Rate for Payer: Aetna Commercial |
$382.03
|
| Rate for Payer: BCBS Trust/PPO |
$371.20
|
| Rate for Payer: BCN Commercial |
$371.20
|
| Rate for Payer: Cash Price |
$359.56
|
| Rate for Payer: Cofinity Commercial |
$386.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$359.56
|
| Rate for Payer: Healthscope Commercial |
$404.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.03
|
| Rate for Payer: Nomi Health Commercial |
$368.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$337.09
|
| Rate for Payer: PHP Commercial |
$382.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$391.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$312.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$395.52
|
| Rate for Payer: UHC Core |
$375.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.09
|
|
|
HC CTRL NASAL HEMRRG POSTERIOR PACKS/CAUTERY SUBSQ
|
Facility
|
OP
|
$608.63
|
|
|
Service Code
|
CPT 30906
|
| Hospital Charge Code |
76100394
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$107.30 |
| Max. Negotiated Rate |
$547.77 |
| Rate for Payer: Aetna Commercial |
$517.34
|
| Rate for Payer: Aetna Medicare |
$158.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.20
|
| Rate for Payer: BCBS Complete |
$112.66
|
| Rate for Payer: BCBS MAPPO |
$152.16
|
| Rate for Payer: BCBS Trust/PPO |
$500.35
|
| Rate for Payer: BCN Commercial |
$500.35
|
| Rate for Payer: BCN Medicare Advantage |
$152.16
|
| Rate for Payer: Cash Price |
$486.90
|
| Rate for Payer: Cofinity Commercial |
$523.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$486.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.16
|
| Rate for Payer: Healthscope Commercial |
$547.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$456.47
|
| Rate for Payer: Mclaren Medicaid |
$107.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$159.77
|
| Rate for Payer: Meridian Medicaid |
$112.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$167.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$517.34
|
| Rate for Payer: Nomi Health Commercial |
$499.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$456.47
|
| Rate for Payer: PACE Senior Care Partners |
$144.55
|
| Rate for Payer: PACE SWMI |
$152.16
|
| Rate for Payer: PHP Commercial |
$517.34
|
| Rate for Payer: PHP Medicare Advantage |
$152.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$529.51
|
| Rate for Payer: Priority Health Medicare |
$153.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$423.61
|
| Rate for Payer: Railroad Medicare Medicare |
$152.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$535.59
|
| Rate for Payer: UHC Core |
$508.21
|
| Rate for Payer: UHC Exchange |
$152.16
|
| Rate for Payer: UHC Medicaid |
$107.30
|
| Rate for Payer: UHC Medicare Advantage |
$152.16
|
| Rate for Payer: UHCCP Medicaid |
$107.30
|
| Rate for Payer: VA VA |
$152.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$456.47
|
|
|
HC CTRL NASAL HEMRRG POSTERIOR PACKS/CAUTERY SUBSQ
|
Facility
|
IP
|
$608.63
|
|
|
Service Code
|
CPT 30906
|
| Hospital Charge Code |
76100394
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$423.61 |
| Max. Negotiated Rate |
$547.77 |
| Rate for Payer: Aetna Commercial |
$517.34
|
| Rate for Payer: BCBS Trust/PPO |
$502.67
|
| Rate for Payer: BCN Commercial |
$502.67
|
| Rate for Payer: Cash Price |
$486.90
|
| Rate for Payer: Cofinity Commercial |
$523.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$486.90
|
| Rate for Payer: Healthscope Commercial |
$547.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$456.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$517.34
|
| Rate for Payer: Nomi Health Commercial |
$499.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$456.47
|
| Rate for Payer: PHP Commercial |
$517.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$529.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$423.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$535.59
|
| Rate for Payer: UHC Core |
$508.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$456.47
|
|
|
HC CT SI JTS W CON
|
Facility
|
OP
|
$719.60
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000025
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$126.87 |
| Max. Negotiated Rate |
$647.64 |
| Rate for Payer: Aetna Commercial |
$611.66
|
| Rate for Payer: Aetna Medicare |
$187.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$224.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$224.88
|
| Rate for Payer: BCBS Complete |
$133.20
|
| Rate for Payer: BCBS MAPPO |
$179.90
|
| Rate for Payer: BCBS Trust/PPO |
$591.58
|
| Rate for Payer: BCN Commercial |
$591.58
|
| Rate for Payer: BCN Medicare Advantage |
$179.90
|
| Rate for Payer: Cash Price |
$575.68
|
| Rate for Payer: Cofinity Commercial |
$618.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.90
|
| Rate for Payer: Healthscope Commercial |
$647.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$539.70
|
| Rate for Payer: Mclaren Medicaid |
$126.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.90
|
| Rate for Payer: Meridian Medicaid |
$133.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$206.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$197.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.66
|
| Rate for Payer: Nomi Health Commercial |
$590.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.70
|
| Rate for Payer: PACE Senior Care Partners |
$170.91
|
| Rate for Payer: PACE SWMI |
$179.90
|
| Rate for Payer: PHP Commercial |
$611.66
|
| Rate for Payer: PHP Medicare Advantage |
$179.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$626.05
|
| Rate for Payer: Priority Health Medicare |
$181.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$500.84
|
| Rate for Payer: Railroad Medicare Medicare |
$179.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$633.25
|
| Rate for Payer: UHC Core |
$600.87
|
| Rate for Payer: UHC Exchange |
$179.90
|
| Rate for Payer: UHC Medicaid |
$126.87
|
| Rate for Payer: UHC Medicare Advantage |
$179.90
|
| Rate for Payer: UHCCP Medicaid |
$126.87
|
| Rate for Payer: VA VA |
$179.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$539.70
|
|
|
HC CT SI JTS W CON
|
Facility
|
IP
|
$719.60
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000025
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$500.84 |
| Max. Negotiated Rate |
$647.64 |
| Rate for Payer: Aetna Commercial |
$611.66
|
| Rate for Payer: BCBS Trust/PPO |
$594.32
|
| Rate for Payer: BCN Commercial |
$594.32
|
| Rate for Payer: Cash Price |
$575.68
|
| Rate for Payer: Cofinity Commercial |
$618.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.68
|
| Rate for Payer: Healthscope Commercial |
$647.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$539.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.66
|
| Rate for Payer: Nomi Health Commercial |
$590.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.70
|
| Rate for Payer: PHP Commercial |
$611.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$626.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$500.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$633.25
|
| Rate for Payer: UHC Core |
$600.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$539.70
|
|
|
HC CT SI JTS WO CON
|
Facility
|
IP
|
$719.60
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000023
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$500.84 |
| Max. Negotiated Rate |
$647.64 |
| Rate for Payer: Aetna Commercial |
$611.66
|
| Rate for Payer: BCBS Trust/PPO |
$594.32
|
| Rate for Payer: BCN Commercial |
$594.32
|
| Rate for Payer: Cash Price |
$575.68
|
| Rate for Payer: Cofinity Commercial |
$618.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.68
|
| Rate for Payer: Healthscope Commercial |
$647.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$539.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.66
|
| Rate for Payer: Nomi Health Commercial |
$590.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.70
|
| Rate for Payer: PHP Commercial |
$611.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$626.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$500.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$633.25
|
| Rate for Payer: UHC Core |
$600.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$539.70
|
|
|
HC CT SI JTS WO CON
|
Facility
|
OP
|
$719.60
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000023
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$126.87 |
| Max. Negotiated Rate |
$647.64 |
| Rate for Payer: Aetna Commercial |
$611.66
|
| Rate for Payer: Aetna Medicare |
$187.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$224.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$224.88
|
| Rate for Payer: BCBS Complete |
$133.20
|
| Rate for Payer: BCBS MAPPO |
$179.90
|
| Rate for Payer: BCBS Trust/PPO |
$591.58
|
| Rate for Payer: BCN Commercial |
$591.58
|
| Rate for Payer: BCN Medicare Advantage |
$179.90
|
| Rate for Payer: Cash Price |
$575.68
|
| Rate for Payer: Cofinity Commercial |
$618.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.90
|
| Rate for Payer: Healthscope Commercial |
$647.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$539.70
|
| Rate for Payer: Mclaren Medicaid |
$126.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.90
|
| Rate for Payer: Meridian Medicaid |
$133.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$206.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$197.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.66
|
| Rate for Payer: Nomi Health Commercial |
$590.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.70
|
| Rate for Payer: PACE Senior Care Partners |
$170.91
|
| Rate for Payer: PACE SWMI |
$179.90
|
| Rate for Payer: PHP Commercial |
$611.66
|
| Rate for Payer: PHP Medicare Advantage |
$179.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$626.05
|
| Rate for Payer: Priority Health Medicare |
$181.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$500.84
|
| Rate for Payer: Railroad Medicare Medicare |
$179.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$633.25
|
| Rate for Payer: UHC Core |
$600.87
|
| Rate for Payer: UHC Exchange |
$179.90
|
| Rate for Payer: UHC Medicaid |
$126.87
|
| Rate for Payer: UHC Medicare Advantage |
$179.90
|
| Rate for Payer: UHCCP Medicaid |
$126.87
|
| Rate for Payer: VA VA |
$179.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$539.70
|
|
|
HC CT SI JTS WO W CON
|
Facility
|
IP
|
$719.60
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000026
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$500.84 |
| Max. Negotiated Rate |
$647.64 |
| Rate for Payer: Aetna Commercial |
$611.66
|
| Rate for Payer: BCBS Trust/PPO |
$594.32
|
| Rate for Payer: BCN Commercial |
$594.32
|
| Rate for Payer: Cash Price |
$575.68
|
| Rate for Payer: Cofinity Commercial |
$618.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.68
|
| Rate for Payer: Healthscope Commercial |
$647.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$539.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.66
|
| Rate for Payer: Nomi Health Commercial |
$590.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.70
|
| Rate for Payer: PHP Commercial |
$611.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$626.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$500.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$633.25
|
| Rate for Payer: UHC Core |
$600.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$539.70
|
|
|
HC CT SI JTS WO W CON
|
Facility
|
OP
|
$719.60
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000026
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$126.87 |
| Max. Negotiated Rate |
$647.64 |
| Rate for Payer: Aetna Commercial |
$611.66
|
| Rate for Payer: Aetna Medicare |
$187.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$224.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$224.88
|
| Rate for Payer: BCBS Complete |
$133.20
|
| Rate for Payer: BCBS MAPPO |
$179.90
|
| Rate for Payer: BCBS Trust/PPO |
$591.58
|
| Rate for Payer: BCN Commercial |
$591.58
|
| Rate for Payer: BCN Medicare Advantage |
$179.90
|
| Rate for Payer: Cash Price |
$575.68
|
| Rate for Payer: Cofinity Commercial |
$618.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.90
|
| Rate for Payer: Healthscope Commercial |
$647.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$539.70
|
| Rate for Payer: Mclaren Medicaid |
$126.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.90
|
| Rate for Payer: Meridian Medicaid |
$133.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$206.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$197.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.66
|
| Rate for Payer: Nomi Health Commercial |
$590.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.70
|
| Rate for Payer: PACE Senior Care Partners |
$170.91
|
| Rate for Payer: PACE SWMI |
$179.90
|
| Rate for Payer: PHP Commercial |
$611.66
|
| Rate for Payer: PHP Medicare Advantage |
$179.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$626.05
|
| Rate for Payer: Priority Health Medicare |
$181.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$500.84
|
| Rate for Payer: Railroad Medicare Medicare |
$179.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$633.25
|
| Rate for Payer: UHC Core |
$600.87
|
| Rate for Payer: UHC Exchange |
$179.90
|
| Rate for Payer: UHC Medicaid |
$126.87
|
| Rate for Payer: UHC Medicare Advantage |
$179.90
|
| Rate for Payer: UHCCP Medicaid |
$126.87
|
| Rate for Payer: VA VA |
$179.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$539.70
|
|
|
HC CT SOFT TISS NECK W CON
|
Facility
|
OP
|
$1,666.95
|
|
|
Service Code
|
CPT 70491
|
| Hospital Charge Code |
35000002
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$293.88 |
| Max. Negotiated Rate |
$1,500.26 |
| Rate for Payer: Aetna Commercial |
$1,416.91
|
| Rate for Payer: Aetna Medicare |
$433.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$520.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$520.92
|
| Rate for Payer: BCBS Complete |
$308.55
|
| Rate for Payer: BCBS MAPPO |
$416.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,370.40
|
| Rate for Payer: BCN Commercial |
$1,370.40
|
| Rate for Payer: BCN Medicare Advantage |
$416.74
|
| Rate for Payer: Cash Price |
$1,333.56
|
| Rate for Payer: Cofinity Commercial |
$1,433.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,333.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.74
|
| Rate for Payer: Healthscope Commercial |
$1,500.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,250.21
|
| Rate for Payer: Mclaren Medicaid |
$293.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.57
|
| Rate for Payer: Meridian Medicaid |
$308.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$458.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,416.91
|
| Rate for Payer: Nomi Health Commercial |
$1,366.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,250.21
|
| Rate for Payer: PACE Senior Care Partners |
$395.90
|
| Rate for Payer: PACE SWMI |
$416.74
|
| Rate for Payer: PHP Commercial |
$1,416.91
|
| Rate for Payer: PHP Medicare Advantage |
$416.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$293.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,450.25
|
| Rate for Payer: Priority Health Medicare |
$420.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,160.20
|
| Rate for Payer: Railroad Medicare Medicare |
$416.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,466.92
|
| Rate for Payer: UHC Core |
$1,391.90
|
| Rate for Payer: UHC Exchange |
$416.74
|
| Rate for Payer: UHC Medicaid |
$293.88
|
| Rate for Payer: UHC Medicare Advantage |
$416.74
|
| Rate for Payer: UHCCP Medicaid |
$293.88
|
| Rate for Payer: VA VA |
$416.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,250.21
|
|
|
HC CT SOFT TISS NECK W CON
|
Facility
|
IP
|
$1,666.95
|
|
|
Service Code
|
CPT 70491
|
| Hospital Charge Code |
35000002
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,160.20 |
| Max. Negotiated Rate |
$1,500.26 |
| Rate for Payer: Aetna Commercial |
$1,416.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,376.73
|
| Rate for Payer: BCN Commercial |
$1,376.73
|
| Rate for Payer: Cash Price |
$1,333.56
|
| Rate for Payer: Cofinity Commercial |
$1,433.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,333.56
|
| Rate for Payer: Healthscope Commercial |
$1,500.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,250.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,416.91
|
| Rate for Payer: Nomi Health Commercial |
$1,366.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,250.21
|
| Rate for Payer: PHP Commercial |
$1,416.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,450.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,160.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,466.92
|
| Rate for Payer: UHC Core |
$1,391.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,250.21
|
|
|
HC CT SOFT TISS NECK WO CON
|
Facility
|
IP
|
$1,410.88
|
|
|
Service Code
|
CPT 70490
|
| Hospital Charge Code |
35000001
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$981.97 |
| Max. Negotiated Rate |
$1,269.79 |
| Rate for Payer: Aetna Commercial |
$1,199.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,165.25
|
| Rate for Payer: BCN Commercial |
$1,165.25
|
| Rate for Payer: Cash Price |
$1,128.70
|
| Rate for Payer: Cofinity Commercial |
$1,213.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,128.70
|
| Rate for Payer: Healthscope Commercial |
$1,269.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,058.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,199.25
|
| Rate for Payer: Nomi Health Commercial |
$1,156.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,058.16
|
| Rate for Payer: PHP Commercial |
$1,199.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,227.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$981.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,241.57
|
| Rate for Payer: UHC Core |
$1,178.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,058.16
|
|
|
HC CT SOFT TISS NECK WO CON
|
Facility
|
OP
|
$1,410.88
|
|
|
Service Code
|
CPT 70490
|
| Hospital Charge Code |
35000001
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$248.74 |
| Max. Negotiated Rate |
$1,269.79 |
| Rate for Payer: Aetna Commercial |
$1,199.25
|
| Rate for Payer: Aetna Medicare |
$366.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$440.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$440.90
|
| Rate for Payer: BCBS Complete |
$261.15
|
| Rate for Payer: BCBS MAPPO |
$352.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,159.88
|
| Rate for Payer: BCN Commercial |
$1,159.88
|
| Rate for Payer: BCN Medicare Advantage |
$352.72
|
| Rate for Payer: Cash Price |
$1,128.70
|
| Rate for Payer: Cofinity Commercial |
$1,213.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,128.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.72
|
| Rate for Payer: Healthscope Commercial |
$1,269.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,058.16
|
| Rate for Payer: Mclaren Medicaid |
$248.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.36
|
| Rate for Payer: Meridian Medicaid |
$261.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$405.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$387.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,199.25
|
| Rate for Payer: Nomi Health Commercial |
$1,156.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,058.16
|
| Rate for Payer: PACE Senior Care Partners |
$335.08
|
| Rate for Payer: PACE SWMI |
$352.72
|
| Rate for Payer: PHP Commercial |
$1,199.25
|
| Rate for Payer: PHP Medicare Advantage |
$352.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,227.47
|
| Rate for Payer: Priority Health Medicare |
$356.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$981.97
|
| Rate for Payer: Railroad Medicare Medicare |
$352.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,241.57
|
| Rate for Payer: UHC Core |
$1,178.08
|
| Rate for Payer: UHC Exchange |
$352.72
|
| Rate for Payer: UHC Medicaid |
$248.74
|
| Rate for Payer: UHC Medicare Advantage |
$352.72
|
| Rate for Payer: UHCCP Medicaid |
$248.74
|
| Rate for Payer: VA VA |
$352.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,058.16
|
|
|
HC CT SOFT TISS NECK WO W CON
|
Facility
|
OP
|
$1,919.09
|
|
|
Service Code
|
CPT 70492
|
| Hospital Charge Code |
35000003
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$338.34 |
| Max. Negotiated Rate |
$1,727.18 |
| Rate for Payer: Aetna Commercial |
$1,631.23
|
| Rate for Payer: Aetna Medicare |
$498.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$599.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$599.72
|
| Rate for Payer: BCBS Complete |
$355.22
|
| Rate for Payer: BCBS MAPPO |
$479.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,577.68
|
| Rate for Payer: BCN Commercial |
$1,577.68
|
| Rate for Payer: BCN Medicare Advantage |
$479.77
|
| Rate for Payer: Cash Price |
$1,535.27
|
| Rate for Payer: Cofinity Commercial |
$1,650.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,535.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$479.77
|
| Rate for Payer: Healthscope Commercial |
$1,727.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,439.32
|
| Rate for Payer: Mclaren Medicaid |
$338.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$503.76
|
| Rate for Payer: Meridian Medicaid |
$355.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$551.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$527.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,631.23
|
| Rate for Payer: Nomi Health Commercial |
$1,573.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,439.32
|
| Rate for Payer: PACE Senior Care Partners |
$455.78
|
| Rate for Payer: PACE SWMI |
$479.77
|
| Rate for Payer: PHP Commercial |
$1,631.23
|
| Rate for Payer: PHP Medicare Advantage |
$479.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$338.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,669.61
|
| Rate for Payer: Priority Health Medicare |
$484.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,335.69
|
| Rate for Payer: Railroad Medicare Medicare |
$479.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,688.80
|
| Rate for Payer: UHC Core |
$1,602.44
|
| Rate for Payer: UHC Exchange |
$479.77
|
| Rate for Payer: UHC Medicaid |
$338.34
|
| Rate for Payer: UHC Medicare Advantage |
$479.77
|
| Rate for Payer: UHCCP Medicaid |
$338.34
|
| Rate for Payer: VA VA |
$479.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,439.32
|
|
|
HC CT SOFT TISS NECK WO W CON
|
Facility
|
IP
|
$1,919.09
|
|
|
Service Code
|
CPT 70492
|
| Hospital Charge Code |
35000003
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,335.69 |
| Max. Negotiated Rate |
$1,727.18 |
| Rate for Payer: Aetna Commercial |
$1,631.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,584.98
|
| Rate for Payer: BCN Commercial |
$1,584.98
|
| Rate for Payer: Cash Price |
$1,535.27
|
| Rate for Payer: Cofinity Commercial |
$1,650.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,535.27
|
| Rate for Payer: Healthscope Commercial |
$1,727.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,439.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,631.23
|
| Rate for Payer: Nomi Health Commercial |
$1,573.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,439.32
|
| Rate for Payer: PHP Commercial |
$1,631.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,669.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,335.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,688.80
|
| Rate for Payer: UHC Core |
$1,602.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,439.32
|
|
|
HC CT SPINE CERVICAL W CON
|
Facility
|
OP
|
$1,977.38
|
|
|
Service Code
|
CPT 72126
|
| Hospital Charge Code |
35200004
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$348.61 |
| Max. Negotiated Rate |
$1,779.64 |
| Rate for Payer: Aetna Commercial |
$1,680.77
|
| Rate for Payer: Aetna Medicare |
$514.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$617.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$617.93
|
| Rate for Payer: BCBS Complete |
$366.01
|
| Rate for Payer: BCBS MAPPO |
$494.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,625.60
|
| Rate for Payer: BCN Commercial |
$1,625.60
|
| Rate for Payer: BCN Medicare Advantage |
$494.35
|
| Rate for Payer: Cash Price |
$1,581.90
|
| Rate for Payer: Cofinity Commercial |
$1,700.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,581.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$494.35
|
| Rate for Payer: Healthscope Commercial |
$1,779.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,483.04
|
| Rate for Payer: Mclaren Medicaid |
$348.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$519.06
|
| Rate for Payer: Meridian Medicaid |
$366.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$568.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$543.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,680.77
|
| Rate for Payer: Nomi Health Commercial |
$1,621.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,483.04
|
| Rate for Payer: PACE Senior Care Partners |
$469.63
|
| Rate for Payer: PACE SWMI |
$494.35
|
| Rate for Payer: PHP Commercial |
$1,680.77
|
| Rate for Payer: PHP Medicare Advantage |
$494.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,720.32
|
| Rate for Payer: Priority Health Medicare |
$499.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,376.26
|
| Rate for Payer: Railroad Medicare Medicare |
$494.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,740.09
|
| Rate for Payer: UHC Core |
$1,651.11
|
| Rate for Payer: UHC Exchange |
$494.35
|
| Rate for Payer: UHC Medicaid |
$348.61
|
| Rate for Payer: UHC Medicare Advantage |
$494.35
|
| Rate for Payer: UHCCP Medicaid |
$348.61
|
| Rate for Payer: VA VA |
$494.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,483.04
|
|
|
HC CT SPINE CERVICAL W CON
|
Facility
|
IP
|
$1,977.38
|
|
|
Service Code
|
CPT 72126
|
| Hospital Charge Code |
35200004
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,376.26 |
| Max. Negotiated Rate |
$1,779.64 |
| Rate for Payer: Aetna Commercial |
$1,680.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,633.12
|
| Rate for Payer: BCN Commercial |
$1,633.12
|
| Rate for Payer: Cash Price |
$1,581.90
|
| Rate for Payer: Cofinity Commercial |
$1,700.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,581.90
|
| Rate for Payer: Healthscope Commercial |
$1,779.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,483.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,680.77
|
| Rate for Payer: Nomi Health Commercial |
$1,621.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,483.04
|
| Rate for Payer: PHP Commercial |
$1,680.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,720.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,376.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,740.09
|
| Rate for Payer: UHC Core |
$1,651.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,483.04
|
|
|
HC CT SPINE CERVICAL WO CON
|
Facility
|
IP
|
$1,650.28
|
|
|
Service Code
|
CPT 72125
|
| Hospital Charge Code |
35200003
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,148.59 |
| Max. Negotiated Rate |
$1,485.25 |
| Rate for Payer: Aetna Commercial |
$1,402.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,362.97
|
| Rate for Payer: BCN Commercial |
$1,362.97
|
| Rate for Payer: Cash Price |
$1,320.22
|
| Rate for Payer: Cofinity Commercial |
$1,419.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,320.22
|
| Rate for Payer: Healthscope Commercial |
$1,485.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,237.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,402.74
|
| Rate for Payer: Nomi Health Commercial |
$1,353.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,237.71
|
| Rate for Payer: PHP Commercial |
$1,402.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,435.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,148.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,452.25
|
| Rate for Payer: UHC Core |
$1,377.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,237.71
|
|
|
HC CT SPINE CERVICAL WO CON
|
Facility
|
OP
|
$1,650.28
|
|
|
Service Code
|
CPT 72125
|
| Hospital Charge Code |
35200003
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$290.94 |
| Max. Negotiated Rate |
$1,485.25 |
| Rate for Payer: Aetna Commercial |
$1,402.74
|
| Rate for Payer: Aetna Medicare |
$429.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$515.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$515.71
|
| Rate for Payer: BCBS Complete |
$305.47
|
| Rate for Payer: BCBS MAPPO |
$412.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,356.70
|
| Rate for Payer: BCN Commercial |
$1,356.70
|
| Rate for Payer: BCN Medicare Advantage |
$412.57
|
| Rate for Payer: Cash Price |
$1,320.22
|
| Rate for Payer: Cofinity Commercial |
$1,419.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,320.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$412.57
|
| Rate for Payer: Healthscope Commercial |
$1,485.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,237.71
|
| Rate for Payer: Mclaren Medicaid |
$290.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$433.20
|
| Rate for Payer: Meridian Medicaid |
$305.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$474.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$453.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,402.74
|
| Rate for Payer: Nomi Health Commercial |
$1,353.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,237.71
|
| Rate for Payer: PACE Senior Care Partners |
$391.94
|
| Rate for Payer: PACE SWMI |
$412.57
|
| Rate for Payer: PHP Commercial |
$1,402.74
|
| Rate for Payer: PHP Medicare Advantage |
$412.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$290.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,435.74
|
| Rate for Payer: Priority Health Medicare |
$416.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,148.59
|
| Rate for Payer: Railroad Medicare Medicare |
$412.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,452.25
|
| Rate for Payer: UHC Core |
$1,377.98
|
| Rate for Payer: UHC Exchange |
$412.57
|
| Rate for Payer: UHC Medicaid |
$290.94
|
| Rate for Payer: UHC Medicare Advantage |
$412.57
|
| Rate for Payer: UHCCP Medicaid |
$290.94
|
| Rate for Payer: VA VA |
$412.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,237.71
|
|
|
HC CT SPINE CERVICAL WO W CON
|
Facility
|
OP
|
$2,247.16
|
|
|
Service Code
|
CPT 72127
|
| Hospital Charge Code |
35000007
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$396.17 |
| Max. Negotiated Rate |
$2,022.44 |
| Rate for Payer: Aetna Commercial |
$1,910.09
|
| Rate for Payer: Aetna Medicare |
$584.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$702.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$702.24
|
| Rate for Payer: BCBS Complete |
$415.95
|
| Rate for Payer: BCBS MAPPO |
$561.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,847.39
|
| Rate for Payer: BCN Commercial |
$1,847.39
|
| Rate for Payer: BCN Medicare Advantage |
$561.79
|
| Rate for Payer: Cash Price |
$1,797.73
|
| Rate for Payer: Cofinity Commercial |
$1,932.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,797.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.79
|
| Rate for Payer: Healthscope Commercial |
$2,022.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,685.37
|
| Rate for Payer: Mclaren Medicaid |
$396.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.88
|
| Rate for Payer: Meridian Medicaid |
$415.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$646.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$617.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,910.09
|
| Rate for Payer: Nomi Health Commercial |
$1,842.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,685.37
|
| Rate for Payer: PACE Senior Care Partners |
$533.70
|
| Rate for Payer: PACE SWMI |
$561.79
|
| Rate for Payer: PHP Commercial |
$1,910.09
|
| Rate for Payer: PHP Medicare Advantage |
$561.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,955.03
|
| Rate for Payer: Priority Health Medicare |
$567.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,564.02
|
| Rate for Payer: Railroad Medicare Medicare |
$561.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,977.50
|
| Rate for Payer: UHC Core |
$1,876.38
|
| Rate for Payer: UHC Exchange |
$561.79
|
| Rate for Payer: UHC Medicaid |
$396.17
|
| Rate for Payer: UHC Medicare Advantage |
$561.79
|
| Rate for Payer: UHCCP Medicaid |
$396.17
|
| Rate for Payer: VA VA |
$561.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,685.37
|
|
