|
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
|
|
|
HC CT SPINE LUMBAR W CON
|
Facility
|
OP
|
$2,016.93
|
|
|
Service Code
|
CPT 72132
|
| Hospital Charge Code |
35200008
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$355.58 |
| Max. Negotiated Rate |
$1,815.24 |
| Rate for Payer: Aetna Commercial |
$1,714.39
|
| Rate for Payer: Aetna Medicare |
$524.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$630.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$630.29
|
| Rate for Payer: BCBS Complete |
$373.33
|
| Rate for Payer: BCBS MAPPO |
$504.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,658.12
|
| Rate for Payer: BCN Commercial |
$1,658.12
|
| Rate for Payer: BCN Medicare Advantage |
$504.23
|
| Rate for Payer: Cash Price |
$1,613.54
|
| Rate for Payer: Cofinity Commercial |
$1,734.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,613.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$504.23
|
| Rate for Payer: Healthscope Commercial |
$1,815.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,512.70
|
| Rate for Payer: Mclaren Medicaid |
$355.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$529.44
|
| Rate for Payer: Meridian Medicaid |
$373.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$579.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$554.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,714.39
|
| Rate for Payer: Nomi Health Commercial |
$1,653.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,512.70
|
| Rate for Payer: PACE Senior Care Partners |
$479.02
|
| Rate for Payer: PACE SWMI |
$504.23
|
| Rate for Payer: PHP Commercial |
$1,714.39
|
| Rate for Payer: PHP Medicare Advantage |
$504.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$355.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,754.73
|
| Rate for Payer: Priority Health Medicare |
$509.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,403.78
|
| Rate for Payer: Railroad Medicare Medicare |
$504.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,774.90
|
| Rate for Payer: UHC Core |
$1,684.14
|
| Rate for Payer: UHC Exchange |
$504.23
|
| Rate for Payer: UHC Medicaid |
$355.58
|
| Rate for Payer: UHC Medicare Advantage |
$504.23
|
| Rate for Payer: UHCCP Medicaid |
$355.58
|
| Rate for Payer: VA VA |
$504.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,512.70
|
|
|
HC CT SPINE LUMBAR W CON
|
Facility
|
IP
|
$2,016.93
|
|
|
Service Code
|
CPT 72132
|
| Hospital Charge Code |
35200008
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,403.78 |
| Max. Negotiated Rate |
$1,815.24 |
| Rate for Payer: Aetna Commercial |
$1,714.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,665.78
|
| Rate for Payer: BCN Commercial |
$1,665.78
|
| Rate for Payer: Cash Price |
$1,613.54
|
| Rate for Payer: Cofinity Commercial |
$1,734.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,613.54
|
| Rate for Payer: Healthscope Commercial |
$1,815.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,512.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,714.39
|
| Rate for Payer: Nomi Health Commercial |
$1,653.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,512.70
|
| Rate for Payer: PHP Commercial |
$1,714.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,754.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,403.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,774.90
|
| Rate for Payer: UHC Core |
$1,684.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,512.70
|
|
|
HC CT SPINE LUMBAR WO CON
|
Facility
|
OP
|
$1,650.28
|
|
|
Service Code
|
CPT 72131
|
| Hospital Charge Code |
35200007
|
|
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 LUMBAR WO CON
|
Facility
|
IP
|
$1,650.28
|
|
|
Service Code
|
CPT 72131
|
| Hospital Charge Code |
35200007
|
|
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 LUMBAR WO W CON
|
Facility
|
OP
|
$2,247.16
|
|
|
Service Code
|
CPT 72133
|
| Hospital Charge Code |
35200009
|
|
Hospital Revenue Code
|
352
|
| 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
|
|
|
HC CT SPINE LUMBAR WO W CON
|
Facility
|
IP
|
$2,247.16
|
|
|
Service Code
|
CPT 72133
|
| Hospital Charge Code |
35200009
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,564.02 |
| Max. Negotiated Rate |
$2,022.44 |
| Rate for Payer: Aetna Commercial |
$1,910.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,855.93
|
| Rate for Payer: BCN Commercial |
$1,855.93
|
| 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: Healthscope Commercial |
$2,022.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,685.37
|
| 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: PHP Commercial |
$1,910.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,955.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,564.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,977.50
|
| Rate for Payer: UHC Core |
$1,876.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,685.37
|
|
|
HC CT SPINE THORACIC W CON
|
Facility
|
IP
|
$2,016.93
|
|
|
Service Code
|
CPT 72129
|
| Hospital Charge Code |
35200006
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,403.78 |
| Max. Negotiated Rate |
$1,815.24 |
| Rate for Payer: Aetna Commercial |
$1,714.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,665.78
|
| Rate for Payer: BCN Commercial |
$1,665.78
|
| Rate for Payer: Cash Price |
$1,613.54
|
| Rate for Payer: Cofinity Commercial |
$1,734.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,613.54
|
| Rate for Payer: Healthscope Commercial |
$1,815.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,512.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,714.39
|
| Rate for Payer: Nomi Health Commercial |
$1,653.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,512.70
|
| Rate for Payer: PHP Commercial |
$1,714.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,754.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,403.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,774.90
|
| Rate for Payer: UHC Core |
$1,684.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,512.70
|
|
|
HC CT SPINE THORACIC W CON
|
Facility
|
OP
|
$2,016.93
|
|
|
Service Code
|
CPT 72129
|
| Hospital Charge Code |
35200006
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$355.58 |
| Max. Negotiated Rate |
$1,815.24 |
| Rate for Payer: Aetna Commercial |
$1,714.39
|
| Rate for Payer: Aetna Medicare |
$524.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$630.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$630.29
|
| Rate for Payer: BCBS Complete |
$373.33
|
| Rate for Payer: BCBS MAPPO |
$504.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,658.12
|
| Rate for Payer: BCN Commercial |
$1,658.12
|
| Rate for Payer: BCN Medicare Advantage |
$504.23
|
| Rate for Payer: Cash Price |
$1,613.54
|
| Rate for Payer: Cofinity Commercial |
$1,734.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,613.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$504.23
|
| Rate for Payer: Healthscope Commercial |
$1,815.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,512.70
|
| Rate for Payer: Mclaren Medicaid |
$355.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$529.44
|
| Rate for Payer: Meridian Medicaid |
$373.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$579.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$554.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,714.39
|
| Rate for Payer: Nomi Health Commercial |
$1,653.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,512.70
|
| Rate for Payer: PACE Senior Care Partners |
$479.02
|
| Rate for Payer: PACE SWMI |
$504.23
|
| Rate for Payer: PHP Commercial |
$1,714.39
|
| Rate for Payer: PHP Medicare Advantage |
$504.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$355.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,754.73
|
| Rate for Payer: Priority Health Medicare |
$509.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,403.78
|
| Rate for Payer: Railroad Medicare Medicare |
$504.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,774.90
|
| Rate for Payer: UHC Core |
$1,684.14
|
| Rate for Payer: UHC Exchange |
$504.23
|
| Rate for Payer: UHC Medicaid |
$355.58
|
| Rate for Payer: UHC Medicare Advantage |
$504.23
|
| Rate for Payer: UHCCP Medicaid |
$355.58
|
| Rate for Payer: VA VA |
$504.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,512.70
|
|
|
HC CT SPINE THORACIC WO CON
|
Facility
|
IP
|
$1,650.28
|
|
|
Service Code
|
CPT 72128
|
| Hospital Charge Code |
35200005
|
|
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 THORACIC WO CON
|
Facility
|
OP
|
$1,650.28
|
|
|
Service Code
|
CPT 72128
|
| Hospital Charge Code |
35200005
|
|
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 THORACIC WO W CON
|
Facility
|
OP
|
$2,247.16
|
|
|
Service Code
|
CPT 72130
|
| Hospital Charge Code |
35000008
|
|
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
|
|
|
HC CT SPINE THORACIC WO W CON
|
Facility
|
IP
|
$2,247.16
|
|
|
Service Code
|
CPT 72130
|
| Hospital Charge Code |
35000008
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,564.02 |
| Max. Negotiated Rate |
$2,022.44 |
| Rate for Payer: Aetna Commercial |
$1,910.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,855.93
|
| Rate for Payer: BCN Commercial |
$1,855.93
|
| 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: Healthscope Commercial |
$2,022.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,685.37
|
| 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: PHP Commercial |
$1,910.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,955.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,564.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,977.50
|
| Rate for Payer: UHC Core |
$1,876.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,685.37
|
|
|
HC CT UPPER EXTREM ANGIO
|
Facility
|
IP
|
$1,871.98
|
|
|
Service Code
|
CPT 73206
|
| Hospital Charge Code |
35000010
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,302.90 |
| Max. Negotiated Rate |
$1,684.78 |
| Rate for Payer: Aetna Commercial |
$1,591.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,546.07
|
| Rate for Payer: BCN Commercial |
$1,546.07
|
| Rate for Payer: Cash Price |
$1,497.58
|
| Rate for Payer: Cofinity Commercial |
$1,609.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,497.58
|
| Rate for Payer: Healthscope Commercial |
$1,684.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,403.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,591.18
|
| Rate for Payer: Nomi Health Commercial |
$1,535.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,403.98
|
| Rate for Payer: PHP Commercial |
$1,591.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,628.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,302.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,647.34
|
| Rate for Payer: UHC Core |
$1,563.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,403.98
|
|
|
HC CT UPPER EXTREM ANGIO
|
Facility
|
OP
|
$1,871.98
|
|
|
Service Code
|
CPT 73206
|
| Hospital Charge Code |
35000010
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$330.03 |
| Max. Negotiated Rate |
$1,684.78 |
| Rate for Payer: Aetna Commercial |
$1,591.18
|
| Rate for Payer: Aetna Medicare |
$486.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$584.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$584.99
|
| Rate for Payer: BCBS Complete |
$346.50
|
| Rate for Payer: BCBS MAPPO |
$468.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,538.95
|
| Rate for Payer: BCN Commercial |
$1,538.95
|
| Rate for Payer: BCN Medicare Advantage |
$468.00
|
| Rate for Payer: Cash Price |
$1,497.58
|
| Rate for Payer: Cofinity Commercial |
$1,609.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,497.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$468.00
|
| Rate for Payer: Healthscope Commercial |
$1,684.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,403.98
|
| Rate for Payer: Mclaren Medicaid |
$330.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$491.39
|
| Rate for Payer: Meridian Medicaid |
$346.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$538.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$514.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,591.18
|
| Rate for Payer: Nomi Health Commercial |
$1,535.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,403.98
|
| Rate for Payer: PACE Senior Care Partners |
$444.60
|
| Rate for Payer: PACE SWMI |
$468.00
|
| Rate for Payer: PHP Commercial |
$1,591.18
|
| Rate for Payer: PHP Medicare Advantage |
$468.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$330.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,628.62
|
| Rate for Payer: Priority Health Medicare |
$472.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,302.90
|
| Rate for Payer: Railroad Medicare Medicare |
$468.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,647.34
|
| Rate for Payer: UHC Core |
$1,563.10
|
| Rate for Payer: UHC Exchange |
$468.00
|
| Rate for Payer: UHC Medicaid |
$330.03
|
| Rate for Payer: UHC Medicare Advantage |
$468.00
|
| Rate for Payer: UHCCP Medicaid |
$330.03
|
| Rate for Payer: VA VA |
$468.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,403.98
|
|
|
HC CT UPPER EXTREMITY W CON
|
Facility
|
OP
|
$1,479.33
|
|
|
Service Code
|
CPT 73201
|
| Hospital Charge Code |
35200014
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$260.81 |
| Max. Negotiated Rate |
$1,331.40 |
| Rate for Payer: Aetna Commercial |
$1,257.43
|
| Rate for Payer: Aetna Medicare |
$384.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$462.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$462.29
|
| Rate for Payer: BCBS Complete |
$273.82
|
| Rate for Payer: BCBS MAPPO |
$369.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,216.16
|
| Rate for Payer: BCN Commercial |
$1,216.16
|
| Rate for Payer: BCN Medicare Advantage |
$369.83
|
| Rate for Payer: Cash Price |
$1,183.46
|
| Rate for Payer: Cofinity Commercial |
$1,272.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,183.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$369.83
|
| Rate for Payer: Healthscope Commercial |
$1,331.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,109.50
|
| Rate for Payer: Mclaren Medicaid |
$260.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$388.32
|
| Rate for Payer: Meridian Medicaid |
$273.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$425.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$406.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,257.43
|
| Rate for Payer: Nomi Health Commercial |
$1,213.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,109.50
|
| Rate for Payer: PACE Senior Care Partners |
$351.34
|
| Rate for Payer: PACE SWMI |
$369.83
|
| Rate for Payer: PHP Commercial |
$1,257.43
|
| Rate for Payer: PHP Medicare Advantage |
$369.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,287.02
|
| Rate for Payer: Priority Health Medicare |
$373.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,029.61
|
| Rate for Payer: Railroad Medicare Medicare |
$369.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,301.81
|
| Rate for Payer: UHC Core |
$1,235.24
|
| Rate for Payer: UHC Exchange |
$369.83
|
| Rate for Payer: UHC Medicaid |
$260.81
|
| Rate for Payer: UHC Medicare Advantage |
$369.83
|
| Rate for Payer: UHCCP Medicaid |
$260.81
|
| Rate for Payer: VA VA |
$369.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,109.50
|
|
|
HC CT UPPER EXTREMITY W CON
|
Facility
|
IP
|
$1,479.33
|
|
|
Service Code
|
CPT 73201
|
| Hospital Charge Code |
35200014
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,029.61 |
| Max. Negotiated Rate |
$1,331.40 |
| Rate for Payer: Aetna Commercial |
$1,257.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,221.78
|
| Rate for Payer: BCN Commercial |
$1,221.78
|
| Rate for Payer: Cash Price |
$1,183.46
|
| Rate for Payer: Cofinity Commercial |
$1,272.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,183.46
|
| Rate for Payer: Healthscope Commercial |
$1,331.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,109.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,257.43
|
| Rate for Payer: Nomi Health Commercial |
$1,213.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,109.50
|
| Rate for Payer: PHP Commercial |
$1,257.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,287.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,029.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,301.81
|
| Rate for Payer: UHC Core |
$1,235.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,109.50
|
|
|
HC CT UPPER EXTREMITY WO CON
|
Facility
|
IP
|
$1,239.49
|
|
|
Service Code
|
CPT 73200
|
| Hospital Charge Code |
35200013
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$862.69 |
| Max. Negotiated Rate |
$1,115.54 |
| Rate for Payer: Aetna Commercial |
$1,053.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,023.69
|
| Rate for Payer: BCN Commercial |
$1,023.69
|
| Rate for Payer: Cash Price |
$991.59
|
| Rate for Payer: Cofinity Commercial |
$1,065.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$991.59
|
| Rate for Payer: Healthscope Commercial |
$1,115.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$929.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,053.57
|
| Rate for Payer: Nomi Health Commercial |
$1,016.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$929.62
|
| Rate for Payer: PHP Commercial |
$1,053.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,078.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$862.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,090.75
|
| Rate for Payer: UHC Core |
$1,034.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$929.62
|
|
|
HC CT UPPER EXTREMITY WO CON
|
Facility
|
OP
|
$1,239.49
|
|
|
Service Code
|
CPT 73200
|
| Hospital Charge Code |
35200013
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$218.52 |
| Max. Negotiated Rate |
$1,115.54 |
| Rate for Payer: Aetna Commercial |
$1,053.57
|
| Rate for Payer: Aetna Medicare |
$322.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$387.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$387.34
|
| Rate for Payer: BCBS Complete |
$229.43
|
| Rate for Payer: BCBS MAPPO |
$309.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,018.98
|
| Rate for Payer: BCN Commercial |
$1,018.98
|
| Rate for Payer: BCN Medicare Advantage |
$309.87
|
| Rate for Payer: Cash Price |
$991.59
|
| Rate for Payer: Cofinity Commercial |
$1,065.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$991.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.87
|
| Rate for Payer: Healthscope Commercial |
$1,115.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$929.62
|
| Rate for Payer: Mclaren Medicaid |
$218.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$325.37
|
| Rate for Payer: Meridian Medicaid |
$229.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$356.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$340.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,053.57
|
| Rate for Payer: Nomi Health Commercial |
$1,016.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$929.62
|
| Rate for Payer: PACE Senior Care Partners |
$294.38
|
| Rate for Payer: PACE SWMI |
$309.87
|
| Rate for Payer: PHP Commercial |
$1,053.57
|
| Rate for Payer: PHP Medicare Advantage |
$309.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,078.36
|
| Rate for Payer: Priority Health Medicare |
$312.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$862.69
|
| Rate for Payer: Railroad Medicare Medicare |
$309.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,090.75
|
| Rate for Payer: UHC Core |
$1,034.97
|
| Rate for Payer: UHC Exchange |
$309.87
|
| Rate for Payer: UHC Medicaid |
$218.52
|
| Rate for Payer: UHC Medicare Advantage |
$309.87
|
| Rate for Payer: UHCCP Medicaid |
$218.52
|
| Rate for Payer: VA VA |
$309.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$929.62
|
|
|
HC CT UPPER EXTREMITY WO W CON
|
Facility
|
IP
|
$1,724.67
|
|
|
Service Code
|
CPT 73202
|
| Hospital Charge Code |
35200015
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,200.37 |
| Max. Negotiated Rate |
$1,552.20 |
| Rate for Payer: Aetna Commercial |
$1,465.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,424.40
|
| Rate for Payer: BCN Commercial |
$1,424.40
|
| Rate for Payer: Cash Price |
$1,379.74
|
| Rate for Payer: Cofinity Commercial |
$1,483.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,379.74
|
| Rate for Payer: Healthscope Commercial |
$1,552.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,293.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,465.97
|
| Rate for Payer: Nomi Health Commercial |
$1,414.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,293.50
|
| Rate for Payer: PHP Commercial |
$1,465.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,500.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,200.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,517.71
|
| Rate for Payer: UHC Core |
$1,440.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,293.50
|
|
|
HC CT UPPER EXTREMITY WO W CON
|
Facility
|
OP
|
$1,724.67
|
|
|
Service Code
|
CPT 73202
|
| Hospital Charge Code |
35200015
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$304.06 |
| Max. Negotiated Rate |
$1,552.20 |
| Rate for Payer: Aetna Commercial |
$1,465.97
|
| Rate for Payer: Aetna Medicare |
$448.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$538.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$538.96
|
| Rate for Payer: BCBS Complete |
$319.24
|
| Rate for Payer: BCBS MAPPO |
$431.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,417.85
|
| Rate for Payer: BCN Commercial |
$1,417.85
|
| Rate for Payer: BCN Medicare Advantage |
$431.17
|
| Rate for Payer: Cash Price |
$1,379.74
|
| Rate for Payer: Cofinity Commercial |
$1,483.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,379.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$431.17
|
| Rate for Payer: Healthscope Commercial |
$1,552.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,293.50
|
| Rate for Payer: Mclaren Medicaid |
$304.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$452.73
|
| Rate for Payer: Meridian Medicaid |
$319.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$495.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$474.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,465.97
|
| Rate for Payer: Nomi Health Commercial |
$1,414.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,293.50
|
| Rate for Payer: PACE Senior Care Partners |
$409.61
|
| Rate for Payer: PACE SWMI |
$431.17
|
| Rate for Payer: PHP Commercial |
$1,465.97
|
| Rate for Payer: PHP Medicare Advantage |
$431.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$304.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,500.46
|
| Rate for Payer: Priority Health Medicare |
$435.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,200.37
|
| Rate for Payer: Railroad Medicare Medicare |
$431.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,517.71
|
| Rate for Payer: UHC Core |
$1,440.10
|
| Rate for Payer: UHC Exchange |
$431.17
|
| Rate for Payer: UHC Medicaid |
$304.06
|
| Rate for Payer: UHC Medicare Advantage |
$431.17
|
| Rate for Payer: UHCCP Medicaid |
$304.06
|
| Rate for Payer: VA VA |
$431.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,293.50
|
|
|
HC CT VIRTUAL COLONOSCOPY SCREENING
|
Facility
|
OP
|
$1,034.26
|
|
|
Service Code
|
CPT 74263
|
| Hospital Charge Code |
35000014
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$182.34 |
| Max. Negotiated Rate |
$930.83 |
| Rate for Payer: Aetna Commercial |
$879.12
|
| Rate for Payer: Aetna Medicare |
$268.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$323.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$323.21
|
| Rate for Payer: BCBS Complete |
$191.44
|
| Rate for Payer: BCBS MAPPO |
$258.56
|
| Rate for Payer: BCBS Trust/PPO |
$850.27
|
| Rate for Payer: BCN Commercial |
$850.27
|
| Rate for Payer: BCN Medicare Advantage |
$258.56
|
| Rate for Payer: Cash Price |
$827.41
|
| Rate for Payer: Cofinity Commercial |
$889.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$827.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$258.56
|
| Rate for Payer: Healthscope Commercial |
$930.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$775.70
|
| Rate for Payer: Mclaren Medicaid |
$182.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$271.49
|
| Rate for Payer: Meridian Medicaid |
$191.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$297.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$284.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$879.12
|
| Rate for Payer: Nomi Health Commercial |
$848.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$775.70
|
| Rate for Payer: PACE Senior Care Partners |
$245.64
|
| Rate for Payer: PACE SWMI |
$258.56
|
| Rate for Payer: PHP Commercial |
$879.12
|
| Rate for Payer: PHP Medicare Advantage |
$258.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$182.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$899.81
|
| Rate for Payer: Priority Health Medicare |
$261.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$719.84
|
| Rate for Payer: Railroad Medicare Medicare |
$258.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$910.15
|
| Rate for Payer: UHC Core |
$863.61
|
| Rate for Payer: UHC Exchange |
$258.56
|
| Rate for Payer: UHC Medicaid |
$182.34
|
| Rate for Payer: UHC Medicare Advantage |
$258.56
|
| Rate for Payer: UHCCP Medicaid |
$182.34
|
| Rate for Payer: VA VA |
$258.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$775.70
|
|
|
HC CT VIRTUAL COLONOSCOPY SCREENING
|
Facility
|
IP
|
$1,034.26
|
|
|
Service Code
|
CPT 74263
|
| Hospital Charge Code |
35000014
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$719.84 |
| Max. Negotiated Rate |
$930.83 |
| Rate for Payer: Aetna Commercial |
$879.12
|
| Rate for Payer: BCBS Trust/PPO |
$854.20
|
| Rate for Payer: BCN Commercial |
$854.20
|
| Rate for Payer: Cash Price |
$827.41
|
| Rate for Payer: Cofinity Commercial |
$889.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$827.41
|
| Rate for Payer: Healthscope Commercial |
$930.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$775.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$879.12
|
| Rate for Payer: Nomi Health Commercial |
$848.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$775.70
|
| Rate for Payer: PHP Commercial |
$879.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$899.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$719.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$910.15
|
| Rate for Payer: UHC Core |
$863.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$775.70
|
|
|
HC CT VIRTUAL COLON W CON DIAG
|
Facility
|
IP
|
$1,312.26
|
|
|
Service Code
|
CPT 74262
|
| Hospital Charge Code |
35000013
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$913.33 |
| Max. Negotiated Rate |
$1,181.03 |
| Rate for Payer: Aetna Commercial |
$1,115.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,083.80
|
| Rate for Payer: BCN Commercial |
$1,083.80
|
| Rate for Payer: Cash Price |
$1,049.81
|
| Rate for Payer: Cofinity Commercial |
$1,128.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,049.81
|
| Rate for Payer: Healthscope Commercial |
$1,181.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$984.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,115.42
|
| Rate for Payer: Nomi Health Commercial |
$1,076.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$984.20
|
| Rate for Payer: PHP Commercial |
$1,115.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,141.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$913.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,154.79
|
| Rate for Payer: UHC Core |
$1,095.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$984.20
|
|
|
HC CT VIRTUAL COLON W CON DIAG
|
Facility
|
OP
|
$1,312.26
|
|
|
Service Code
|
CPT 74262
|
| Hospital Charge Code |
35000013
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$231.35 |
| Max. Negotiated Rate |
$1,181.03 |
| Rate for Payer: Aetna Commercial |
$1,115.42
|
| Rate for Payer: Aetna Medicare |
$341.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.08
|
| Rate for Payer: BCBS Complete |
$242.90
|
| Rate for Payer: BCBS MAPPO |
$328.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,078.81
|
| Rate for Payer: BCN Commercial |
$1,078.81
|
| Rate for Payer: BCN Medicare Advantage |
$328.06
|
| Rate for Payer: Cash Price |
$1,049.81
|
| Rate for Payer: Cofinity Commercial |
$1,128.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,049.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.06
|
| Rate for Payer: Healthscope Commercial |
$1,181.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$984.20
|
| Rate for Payer: Mclaren Medicaid |
$231.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$344.47
|
| Rate for Payer: Meridian Medicaid |
$242.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$360.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,115.42
|
| Rate for Payer: Nomi Health Commercial |
$1,076.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$984.20
|
| Rate for Payer: PACE Senior Care Partners |
$311.66
|
| Rate for Payer: PACE SWMI |
$328.06
|
| Rate for Payer: PHP Commercial |
$1,115.42
|
| Rate for Payer: PHP Medicare Advantage |
$328.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$231.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,141.67
|
| Rate for Payer: Priority Health Medicare |
$331.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$913.33
|
| Rate for Payer: Railroad Medicare Medicare |
$328.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,154.79
|
| Rate for Payer: UHC Core |
$1,095.74
|
| Rate for Payer: UHC Exchange |
$328.06
|
| Rate for Payer: UHC Medicaid |
$231.35
|
| Rate for Payer: UHC Medicare Advantage |
$328.06
|
| Rate for Payer: UHCCP Medicaid |
$231.35
|
| Rate for Payer: VA VA |
$328.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$984.20
|
|
