|
HC MR MRA LOWR EXTREM WO W
|
Facility
|
OP
|
$2,533.57
|
|
|
Service Code
|
HCPCS C8914
|
| Hospital Charge Code |
61000071
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$2,280.21 |
| Rate for Payer: Aetna Commercial |
$2,153.53
|
| Rate for Payer: Aetna Commercial |
$3,230.31
|
| Rate for Payer: Aetna Medicare |
$988.09
|
| Rate for Payer: Aetna Medicare |
$658.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,187.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$791.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,187.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$791.74
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$633.39
|
| Rate for Payer: BCBS MAPPO |
$950.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,954.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,969.85
|
| Rate for Payer: BCN Commercial |
$2,954.78
|
| Rate for Payer: BCN Commercial |
$1,969.85
|
| Rate for Payer: BCN Medicare Advantage |
$950.09
|
| Rate for Payer: BCN Medicare Advantage |
$633.39
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cofinity Commercial |
$2,178.87
|
| Rate for Payer: Cofinity Commercial |
$3,268.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,026.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,040.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$950.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$633.39
|
| Rate for Payer: Healthscope Commercial |
$3,420.32
|
| Rate for Payer: Healthscope Commercial |
$2,280.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,850.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,900.18
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$997.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$665.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,092.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$728.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,153.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,230.31
|
| Rate for Payer: PACE Senior Care Partners |
$601.72
|
| Rate for Payer: PACE Senior Care Partners |
$902.59
|
| Rate for Payer: PACE SWMI |
$950.09
|
| Rate for Payer: PACE SWMI |
$633.39
|
| Rate for Payer: PHP Commercial |
$2,153.53
|
| Rate for Payer: PHP Commercial |
$3,230.31
|
| Rate for Payer: PHP Medicare Advantage |
$950.09
|
| Rate for Payer: PHP Medicare Advantage |
$633.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,660.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,306.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,204.21
|
| Rate for Payer: Priority Health Medicare |
$950.09
|
| Rate for Payer: Priority Health Medicare |
$633.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,317.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,545.22
|
| Rate for Payer: Railroad Medicare Medicare |
$633.39
|
| Rate for Payer: Railroad Medicare Medicare |
$950.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,229.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,344.32
|
| Rate for Payer: UHC Core |
$2,115.53
|
| Rate for Payer: UHC Core |
$3,173.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$950.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$633.39
|
| Rate for Payer: UHC Medicare Advantage |
$652.39
|
| Rate for Payer: UHC Medicare Advantage |
$978.59
|
| Rate for Payer: VA VA |
$950.09
|
| Rate for Payer: VA VA |
$633.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,900.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,850.27
|
|
|
HC MR MRA NECK W CON
|
Facility
|
OP
|
$2,357.48
|
|
|
Service Code
|
CPT 70548
|
| Hospital Charge Code |
61000008
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$2,121.73 |
| Rate for Payer: Aetna Commercial |
$2,003.86
|
| Rate for Payer: Aetna Medicare |
$612.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$736.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$736.71
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$589.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,832.94
|
| Rate for Payer: BCN Commercial |
$1,832.94
|
| Rate for Payer: BCN Medicare Advantage |
$589.37
|
| Rate for Payer: Cash Price |
$1,885.98
|
| Rate for Payer: Cash Price |
$1,885.98
|
| Rate for Payer: Cofinity Commercial |
$2,027.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,885.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$589.37
|
| Rate for Payer: Healthscope Commercial |
$2,121.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,768.11
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$618.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$677.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,003.86
|
| Rate for Payer: PACE Senior Care Partners |
$559.90
|
| Rate for Payer: PACE SWMI |
$589.37
|
| Rate for Payer: PHP Commercial |
$2,003.86
|
| Rate for Payer: PHP Medicare Advantage |
$589.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,650.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,051.01
|
| Rate for Payer: Priority Health Medicare |
$589.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,437.83
|
| Rate for Payer: Railroad Medicare Medicare |
$589.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,074.58
|
| Rate for Payer: UHC Core |
$1,968.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$589.37
|
| Rate for Payer: UHC Medicare Advantage |
$607.05
|
| Rate for Payer: VA VA |
$589.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,768.11
|
|
|
HC MR MRA NECK W CON
|
Facility
|
IP
|
$2,357.48
|
|
|
Service Code
|
CPT 70548
|
| Hospital Charge Code |
61000008
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,437.83 |
| Max. Negotiated Rate |
$2,121.73 |
| Rate for Payer: Aetna Commercial |
$2,003.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,821.86
|
| Rate for Payer: BCN Commercial |
$1,821.86
|
| Rate for Payer: Cash Price |
$1,885.98
|
| Rate for Payer: Cofinity Commercial |
$2,027.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,885.98
|
| Rate for Payer: Healthscope Commercial |
$2,121.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,768.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,003.86
|
| Rate for Payer: PHP Commercial |
$2,003.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,650.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,051.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,437.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,074.58
|
| Rate for Payer: UHC Core |
$1,968.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,768.11
|
|
|
HC MR MRA NECK WO CON
|
Facility
|
IP
|
$1,965.54
|
|
|
Service Code
|
CPT 70547
|
| Hospital Charge Code |
61000007
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,198.78 |
| Max. Negotiated Rate |
$1,768.99 |
| Rate for Payer: Aetna Commercial |
$1,670.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,518.97
|
| Rate for Payer: BCN Commercial |
$1,518.97
|
| Rate for Payer: Cash Price |
$1,572.43
|
| Rate for Payer: Cofinity Commercial |
$1,690.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,572.43
|
| Rate for Payer: Healthscope Commercial |
$1,768.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,474.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,670.71
|
| Rate for Payer: PHP Commercial |
$1,670.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,375.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,710.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,198.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,729.68
|
| Rate for Payer: UHC Core |
$1,641.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,474.16
|
|
|
HC MR MRA NECK WO CON
|
Facility
|
OP
|
$1,965.54
|
|
|
Service Code
|
CPT 70547
|
| Hospital Charge Code |
61000007
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,768.99 |
| Rate for Payer: Aetna Commercial |
$1,670.71
|
| Rate for Payer: Aetna Medicare |
$511.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$614.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$614.23
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$491.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,528.21
|
| Rate for Payer: BCN Commercial |
$1,528.21
|
| Rate for Payer: BCN Medicare Advantage |
$491.38
|
| Rate for Payer: Cash Price |
$1,572.43
|
| Rate for Payer: Cash Price |
$1,572.43
|
| Rate for Payer: Cofinity Commercial |
$1,690.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,572.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$491.38
|
| Rate for Payer: Healthscope Commercial |
$1,768.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,474.16
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$515.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$565.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,670.71
|
| Rate for Payer: PACE Senior Care Partners |
$466.82
|
| Rate for Payer: PACE SWMI |
$491.38
|
| Rate for Payer: PHP Commercial |
$1,670.71
|
| Rate for Payer: PHP Medicare Advantage |
$491.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,375.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,710.02
|
| Rate for Payer: Priority Health Medicare |
$491.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,198.78
|
| Rate for Payer: Railroad Medicare Medicare |
$491.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,729.68
|
| Rate for Payer: UHC Core |
$1,641.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$491.38
|
| Rate for Payer: UHC Medicare Advantage |
$506.13
|
| Rate for Payer: VA VA |
$491.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,474.16
|
|
|
HC MR MRA NECK WO W CON
|
Facility
|
IP
|
$2,771.09
|
|
|
Service Code
|
CPT 70549
|
| Hospital Charge Code |
61000009
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$1,690.09 |
| Max. Negotiated Rate |
$2,493.98 |
| Rate for Payer: Aetna Commercial |
$2,355.43
|
| Rate for Payer: BCBS Trust/PPO |
$2,141.50
|
| Rate for Payer: BCN Commercial |
$2,141.50
|
| Rate for Payer: Cash Price |
$2,216.87
|
| Rate for Payer: Cofinity Commercial |
$2,383.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,216.87
|
| Rate for Payer: Healthscope Commercial |
$2,493.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,078.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,355.43
|
| Rate for Payer: PHP Commercial |
$2,355.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,939.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,410.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,690.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,438.56
|
| Rate for Payer: UHC Core |
$2,313.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,078.32
|
|
|
HC MR MRA NECK WO W CON
|
Facility
|
OP
|
$2,771.09
|
|
|
Service Code
|
CPT 70549
|
| Hospital Charge Code |
61000009
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$2,493.98 |
| Rate for Payer: Aetna Commercial |
$2,355.43
|
| Rate for Payer: Aetna Medicare |
$720.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$865.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$865.97
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$692.77
|
| Rate for Payer: BCBS Trust/PPO |
$2,154.52
|
| Rate for Payer: BCN Commercial |
$2,154.52
|
| Rate for Payer: BCN Medicare Advantage |
$692.77
|
| Rate for Payer: Cash Price |
$2,216.87
|
| Rate for Payer: Cash Price |
$2,216.87
|
| Rate for Payer: Cofinity Commercial |
$2,383.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,216.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$692.77
|
| Rate for Payer: Healthscope Commercial |
$2,493.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,078.32
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$727.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$796.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,355.43
|
| Rate for Payer: PACE Senior Care Partners |
$658.13
|
| Rate for Payer: PACE SWMI |
$692.77
|
| Rate for Payer: PHP Commercial |
$2,355.43
|
| Rate for Payer: PHP Medicare Advantage |
$692.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,939.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,410.85
|
| Rate for Payer: Priority Health Medicare |
$692.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,690.09
|
| Rate for Payer: Railroad Medicare Medicare |
$692.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,438.56
|
| Rate for Payer: UHC Core |
$2,313.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$692.77
|
| Rate for Payer: UHC Medicare Advantage |
$713.56
|
| Rate for Payer: VA VA |
$692.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,078.32
|
|
|
HC MR MRA PELVIS W CON
|
Facility
|
IP
|
$2,000.90
|
|
|
Service Code
|
HCPCS C8918
|
| Hospital Charge Code |
61800001
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,220.35 |
| Max. Negotiated Rate |
$1,800.81 |
| Rate for Payer: Aetna Commercial |
$1,700.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,546.30
|
| Rate for Payer: BCN Commercial |
$1,546.30
|
| Rate for Payer: Cash Price |
$1,600.72
|
| Rate for Payer: Cofinity Commercial |
$1,720.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,600.72
|
| Rate for Payer: Healthscope Commercial |
$1,800.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,500.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,700.76
|
| Rate for Payer: PHP Commercial |
$1,700.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,400.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,740.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,220.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,760.79
|
| Rate for Payer: UHC Core |
$1,670.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,500.68
|
|
|
HC MR MRA PELVIS W CON
|
Facility
|
OP
|
$2,000.90
|
|
|
Service Code
|
HCPCS C8918
|
| Hospital Charge Code |
61800001
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$1,800.81 |
| Rate for Payer: Aetna Commercial |
$1,700.76
|
| Rate for Payer: Aetna Medicare |
$520.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$625.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$625.28
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$500.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,555.70
|
| Rate for Payer: BCN Commercial |
$1,555.70
|
| Rate for Payer: BCN Medicare Advantage |
$500.22
|
| Rate for Payer: Cash Price |
$1,600.72
|
| Rate for Payer: Cash Price |
$1,600.72
|
| Rate for Payer: Cofinity Commercial |
$1,720.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,600.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$500.22
|
| Rate for Payer: Healthscope Commercial |
$1,800.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,500.68
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$525.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$575.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,700.76
|
| Rate for Payer: PACE Senior Care Partners |
$475.21
|
| Rate for Payer: PACE SWMI |
$500.22
|
| Rate for Payer: PHP Commercial |
$1,700.76
|
| Rate for Payer: PHP Medicare Advantage |
$500.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,400.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,740.78
|
| Rate for Payer: Priority Health Medicare |
$500.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,220.35
|
| Rate for Payer: Railroad Medicare Medicare |
$500.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,760.79
|
| Rate for Payer: UHC Core |
$1,670.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$500.22
|
| Rate for Payer: UHC Medicare Advantage |
$515.23
|
| Rate for Payer: VA VA |
$500.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,500.68
|
|
|
HC MR MRA PELVIS WO CON
|
Facility
|
IP
|
$1,862.90
|
|
|
Service Code
|
HCPCS C8919
|
| Hospital Charge Code |
61800002
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,136.18 |
| Max. Negotiated Rate |
$1,676.61 |
| Rate for Payer: Aetna Commercial |
$1,583.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,439.65
|
| Rate for Payer: BCN Commercial |
$1,439.65
|
| Rate for Payer: Cash Price |
$1,490.32
|
| Rate for Payer: Cofinity Commercial |
$1,602.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,490.32
|
| Rate for Payer: Healthscope Commercial |
$1,676.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,397.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,583.46
|
| Rate for Payer: PHP Commercial |
$1,583.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,304.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,620.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,136.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,639.35
|
| Rate for Payer: UHC Core |
$1,555.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,397.18
|
|
|
HC MR MRA PELVIS WO CON
|
Facility
|
OP
|
$1,862.90
|
|
|
Service Code
|
HCPCS C8919
|
| Hospital Charge Code |
61800002
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,676.61 |
| Rate for Payer: Aetna Commercial |
$1,583.46
|
| Rate for Payer: Aetna Medicare |
$484.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$582.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$582.16
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$465.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,448.40
|
| Rate for Payer: BCN Commercial |
$1,448.40
|
| Rate for Payer: BCN Medicare Advantage |
$465.72
|
| Rate for Payer: Cash Price |
$1,490.32
|
| Rate for Payer: Cash Price |
$1,490.32
|
| Rate for Payer: Cofinity Commercial |
$1,602.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,490.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$465.72
|
| Rate for Payer: Healthscope Commercial |
$1,676.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,397.18
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$489.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$535.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,583.46
|
| Rate for Payer: PACE Senior Care Partners |
$442.44
|
| Rate for Payer: PACE SWMI |
$465.72
|
| Rate for Payer: PHP Commercial |
$1,583.46
|
| Rate for Payer: PHP Medicare Advantage |
$465.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,304.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,620.72
|
| Rate for Payer: Priority Health Medicare |
$465.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,136.18
|
| Rate for Payer: Railroad Medicare Medicare |
$465.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,639.35
|
| Rate for Payer: UHC Core |
$1,555.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$465.72
|
| Rate for Payer: UHC Medicare Advantage |
$479.70
|
| Rate for Payer: VA VA |
$465.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,397.18
|
|
|
HC MR MRA PELVIS WO W CON
|
Facility
|
IP
|
$2,207.90
|
|
|
Service Code
|
HCPCS C8920
|
| Hospital Charge Code |
61800003
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,346.60 |
| Max. Negotiated Rate |
$1,987.11 |
| Rate for Payer: Aetna Commercial |
$1,876.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,706.27
|
| Rate for Payer: BCN Commercial |
$1,706.27
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cofinity Commercial |
$1,898.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,766.32
|
| Rate for Payer: Healthscope Commercial |
$1,987.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,655.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,876.72
|
| Rate for Payer: PHP Commercial |
$1,876.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,545.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,920.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,346.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,942.95
|
| Rate for Payer: UHC Core |
$1,843.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,655.92
|
|
|
HC MR MRA PELVIS WO W CON
|
Facility
|
OP
|
$2,207.90
|
|
|
Service Code
|
HCPCS C8920
|
| Hospital Charge Code |
61800003
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$1,987.11 |
| Rate for Payer: Aetna Commercial |
$1,876.72
|
| Rate for Payer: Aetna Medicare |
$574.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$689.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$689.97
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$551.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,716.64
|
| Rate for Payer: BCN Commercial |
$1,716.64
|
| Rate for Payer: BCN Medicare Advantage |
$551.98
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cofinity Commercial |
$1,898.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,766.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$551.98
|
| Rate for Payer: Healthscope Commercial |
$1,987.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,655.92
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$579.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$634.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,876.72
|
| Rate for Payer: PACE Senior Care Partners |
$524.38
|
| Rate for Payer: PACE SWMI |
$551.98
|
| Rate for Payer: PHP Commercial |
$1,876.72
|
| Rate for Payer: PHP Medicare Advantage |
$551.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,545.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,920.87
|
| Rate for Payer: Priority Health Medicare |
$551.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,346.60
|
| Rate for Payer: Railroad Medicare Medicare |
$551.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,942.95
|
| Rate for Payer: UHC Core |
$1,843.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$551.98
|
| Rate for Payer: UHC Medicare Advantage |
$568.53
|
| Rate for Payer: VA VA |
$551.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,655.92
|
|
|
HC MR MRA SPINAL CANAL W CON
|
Facility
|
OP
|
$1,902.60
|
|
|
Service Code
|
HCPCS C8931
|
| Hospital Charge Code |
61000072
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$1,712.34 |
| Rate for Payer: Aetna Commercial |
$1,617.21
|
| Rate for Payer: Aetna Medicare |
$494.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$594.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$594.56
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$475.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,479.27
|
| Rate for Payer: BCN Commercial |
$1,479.27
|
| Rate for Payer: BCN Medicare Advantage |
$475.65
|
| Rate for Payer: Cash Price |
$1,522.08
|
| Rate for Payer: Cash Price |
$1,522.08
|
| Rate for Payer: Cofinity Commercial |
$1,636.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$475.65
|
| Rate for Payer: Healthscope Commercial |
$1,712.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,426.95
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$499.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$547.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,617.21
|
| Rate for Payer: PACE Senior Care Partners |
$451.87
|
| Rate for Payer: PACE SWMI |
$475.65
|
| Rate for Payer: PHP Commercial |
$1,617.21
|
| Rate for Payer: PHP Medicare Advantage |
$475.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,331.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,655.26
|
| Rate for Payer: Priority Health Medicare |
$475.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,160.40
|
| Rate for Payer: Railroad Medicare Medicare |
$475.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,674.29
|
| Rate for Payer: UHC Core |
$1,588.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$475.65
|
| Rate for Payer: UHC Medicare Advantage |
$489.92
|
| Rate for Payer: VA VA |
$475.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,426.95
|
|
|
HC MR MRA SPINAL CANAL W CON
|
Facility
|
IP
|
$1,902.60
|
|
|
Service Code
|
HCPCS C8931
|
| Hospital Charge Code |
61000072
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,160.40 |
| Max. Negotiated Rate |
$1,712.34 |
| Rate for Payer: Aetna Commercial |
$1,617.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,470.33
|
| Rate for Payer: BCN Commercial |
$1,470.33
|
| Rate for Payer: Cash Price |
$1,522.08
|
| Rate for Payer: Cofinity Commercial |
$1,636.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.08
|
| Rate for Payer: Healthscope Commercial |
$1,712.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,426.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,617.21
|
| Rate for Payer: PHP Commercial |
$1,617.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,331.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,655.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,160.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,674.29
|
| Rate for Payer: UHC Core |
$1,588.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,426.95
|
|
|
HC MR MRA SPINAL CANAL WO CON
|
Facility
|
OP
|
$1,902.60
|
|
|
Service Code
|
HCPCS C8932
|
| Hospital Charge Code |
61000073
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,712.34 |
| Rate for Payer: Aetna Commercial |
$1,617.21
|
| Rate for Payer: Aetna Medicare |
$494.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$594.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$594.56
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$475.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,479.27
|
| Rate for Payer: BCN Commercial |
$1,479.27
|
| Rate for Payer: BCN Medicare Advantage |
$475.65
|
| Rate for Payer: Cash Price |
$1,522.08
|
| Rate for Payer: Cash Price |
$1,522.08
|
| Rate for Payer: Cofinity Commercial |
$1,636.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$475.65
|
| Rate for Payer: Healthscope Commercial |
$1,712.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,426.95
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$499.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$547.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,617.21
|
| Rate for Payer: PACE Senior Care Partners |
$451.87
|
| Rate for Payer: PACE SWMI |
$475.65
|
| Rate for Payer: PHP Commercial |
$1,617.21
|
| Rate for Payer: PHP Medicare Advantage |
$475.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,331.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,655.26
|
| Rate for Payer: Priority Health Medicare |
$475.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,160.40
|
| Rate for Payer: Railroad Medicare Medicare |
$475.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,674.29
|
| Rate for Payer: UHC Core |
$1,588.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$475.65
|
| Rate for Payer: UHC Medicare Advantage |
$489.92
|
| Rate for Payer: VA VA |
$475.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,426.95
|
|
|
HC MR MRA SPINAL CANAL WO CON
|
Facility
|
IP
|
$1,902.60
|
|
|
Service Code
|
HCPCS C8932
|
| Hospital Charge Code |
61000073
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,160.40 |
| Max. Negotiated Rate |
$1,712.34 |
| Rate for Payer: Aetna Commercial |
$1,617.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,470.33
|
| Rate for Payer: BCN Commercial |
$1,470.33
|
| Rate for Payer: Cash Price |
$1,522.08
|
| Rate for Payer: Cofinity Commercial |
$1,636.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.08
|
| Rate for Payer: Healthscope Commercial |
$1,712.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,426.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,617.21
|
| Rate for Payer: PHP Commercial |
$1,617.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,331.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,655.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,160.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,674.29
|
| Rate for Payer: UHC Core |
$1,588.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,426.95
|
|
|
HC MR MRA UPPER EXTREM BIL WO W C
|
Facility
|
IP
|
$2,080.90
|
|
|
Service Code
|
HCPCS C8936
|
| Hospital Charge Code |
61000074
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,269.14 |
| Max. Negotiated Rate |
$1,872.81 |
| Rate for Payer: Aetna Commercial |
$1,768.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,608.12
|
| Rate for Payer: BCN Commercial |
$1,608.12
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cofinity Commercial |
$1,789.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.72
|
| Rate for Payer: Healthscope Commercial |
$1,872.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,560.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,768.76
|
| Rate for Payer: PHP Commercial |
$1,768.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,456.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,810.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,269.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,831.19
|
| Rate for Payer: UHC Core |
$1,737.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,560.68
|
|
|
HC MR MRA UPPER EXTREM BIL WO W C
|
Facility
|
OP
|
$2,080.90
|
|
|
Service Code
|
HCPCS C8936
|
| Hospital Charge Code |
61000074
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$1,872.81 |
| Rate for Payer: Aetna Commercial |
$1,768.76
|
| Rate for Payer: Aetna Medicare |
$541.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$650.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$650.28
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$520.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,617.90
|
| Rate for Payer: BCN Commercial |
$1,617.90
|
| Rate for Payer: BCN Medicare Advantage |
$520.22
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cofinity Commercial |
$1,789.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$520.22
|
| Rate for Payer: Healthscope Commercial |
$1,872.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,560.68
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$546.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$598.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,768.76
|
| Rate for Payer: PACE Senior Care Partners |
$494.21
|
| Rate for Payer: PACE SWMI |
$520.22
|
| Rate for Payer: PHP Commercial |
$1,768.76
|
| Rate for Payer: PHP Medicare Advantage |
$520.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,456.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,810.38
|
| Rate for Payer: Priority Health Medicare |
$520.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,269.14
|
| Rate for Payer: Railroad Medicare Medicare |
$520.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,831.19
|
| Rate for Payer: UHC Core |
$1,737.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$520.22
|
| Rate for Payer: UHC Medicare Advantage |
$535.83
|
| Rate for Payer: VA VA |
$520.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,560.68
|
|
|
HC MR MRA UPPER EXTREMITY BIL W CO
|
Facility
|
IP
|
$2,080.90
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000075
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,269.14 |
| Max. Negotiated Rate |
$1,872.81 |
| Rate for Payer: Aetna Commercial |
$1,768.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,608.12
|
| Rate for Payer: BCN Commercial |
$1,608.12
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cofinity Commercial |
$1,789.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.72
|
| Rate for Payer: Healthscope Commercial |
$1,872.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,560.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,768.76
|
| Rate for Payer: PHP Commercial |
$1,768.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,456.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,810.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,269.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,831.19
|
| Rate for Payer: UHC Core |
$1,737.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,560.68
|
|
|
HC MR MRA UPPER EXTREMITY BIL W CO
|
Facility
|
OP
|
$2,080.90
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000075
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$1,872.81 |
| Rate for Payer: Aetna Commercial |
$1,768.76
|
| Rate for Payer: Aetna Medicare |
$541.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$650.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$650.28
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$520.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,617.90
|
| Rate for Payer: BCN Commercial |
$1,617.90
|
| Rate for Payer: BCN Medicare Advantage |
$520.22
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cofinity Commercial |
$1,789.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$520.22
|
| Rate for Payer: Healthscope Commercial |
$1,872.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,560.68
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$546.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$598.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,768.76
|
| Rate for Payer: PACE Senior Care Partners |
$494.21
|
| Rate for Payer: PACE SWMI |
$520.22
|
| Rate for Payer: PHP Commercial |
$1,768.76
|
| Rate for Payer: PHP Medicare Advantage |
$520.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,456.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,810.38
|
| Rate for Payer: Priority Health Medicare |
$520.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,269.14
|
| Rate for Payer: Railroad Medicare Medicare |
$520.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,831.19
|
| Rate for Payer: UHC Core |
$1,737.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$520.22
|
| Rate for Payer: UHC Medicare Advantage |
$535.83
|
| Rate for Payer: VA VA |
$520.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,560.68
|
|
|
HC MR MRA UPPER EXTREMITY BIL WO C
|
Facility
|
IP
|
$2,080.90
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000076
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,269.14 |
| Max. Negotiated Rate |
$1,872.81 |
| Rate for Payer: Aetna Commercial |
$1,768.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,608.12
|
| Rate for Payer: BCN Commercial |
$1,608.12
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cofinity Commercial |
$1,789.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.72
|
| Rate for Payer: Healthscope Commercial |
$1,872.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,560.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,768.76
|
| Rate for Payer: PHP Commercial |
$1,768.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,456.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,810.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,269.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,831.19
|
| Rate for Payer: UHC Core |
$1,737.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,560.68
|
|
|
HC MR MRA UPPER EXTREMITY BIL WO C
|
Facility
|
OP
|
$2,080.90
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000076
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,872.81 |
| Rate for Payer: Aetna Commercial |
$1,768.76
|
| Rate for Payer: Aetna Medicare |
$541.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$650.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$650.28
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$520.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,617.90
|
| Rate for Payer: BCN Commercial |
$1,617.90
|
| Rate for Payer: BCN Medicare Advantage |
$520.22
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cash Price |
$1,664.72
|
| Rate for Payer: Cofinity Commercial |
$1,789.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$520.22
|
| Rate for Payer: Healthscope Commercial |
$1,872.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,560.68
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$546.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$598.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,768.76
|
| Rate for Payer: PACE Senior Care Partners |
$494.21
|
| Rate for Payer: PACE SWMI |
$520.22
|
| Rate for Payer: PHP Commercial |
$1,768.76
|
| Rate for Payer: PHP Medicare Advantage |
$520.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,456.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,810.38
|
| Rate for Payer: Priority Health Medicare |
$520.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,269.14
|
| Rate for Payer: Railroad Medicare Medicare |
$520.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,831.19
|
| Rate for Payer: UHC Core |
$1,737.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$520.22
|
| Rate for Payer: UHC Medicare Advantage |
$535.83
|
| Rate for Payer: VA VA |
$520.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,560.68
|
|
|
HC MR MRA UPPER EXTREMITY W CO
|
Facility
|
OP
|
$2,854.67
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000077
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$2,569.20 |
| Rate for Payer: Aetna Commercial |
$2,426.47
|
| Rate for Payer: Aetna Commercial |
$1,617.64
|
| Rate for Payer: Aetna Medicare |
$742.21
|
| Rate for Payer: Aetna Medicare |
$494.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$892.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$594.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$594.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$892.08
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$475.78
|
| Rate for Payer: BCBS MAPPO |
$713.67
|
| Rate for Payer: BCBS Trust/PPO |
$2,219.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,479.67
|
| Rate for Payer: BCN Commercial |
$2,219.51
|
| Rate for Payer: BCN Commercial |
$1,479.67
|
| Rate for Payer: BCN Medicare Advantage |
$475.78
|
| Rate for Payer: BCN Medicare Advantage |
$713.67
|
| Rate for Payer: Cash Price |
$1,522.49
|
| Rate for Payer: Cash Price |
$1,522.49
|
| Rate for Payer: Cash Price |
$2,283.74
|
| Rate for Payer: Cash Price |
$2,283.74
|
| Rate for Payer: Cofinity Commercial |
$1,636.67
|
| Rate for Payer: Cofinity Commercial |
$2,455.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,283.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$713.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$475.78
|
| Rate for Payer: Healthscope Commercial |
$1,712.80
|
| Rate for Payer: Healthscope Commercial |
$2,569.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,141.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,427.33
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$499.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$749.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$547.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$820.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,426.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,617.64
|
| Rate for Payer: PACE Senior Care Partners |
$451.99
|
| Rate for Payer: PACE Senior Care Partners |
$677.98
|
| Rate for Payer: PACE SWMI |
$713.67
|
| Rate for Payer: PACE SWMI |
$475.78
|
| Rate for Payer: PHP Commercial |
$2,426.47
|
| Rate for Payer: PHP Commercial |
$1,617.64
|
| Rate for Payer: PHP Medicare Advantage |
$713.67
|
| Rate for Payer: PHP Medicare Advantage |
$475.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,998.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,655.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,483.56
|
| Rate for Payer: Priority Health Medicare |
$475.78
|
| Rate for Payer: Priority Health Medicare |
$713.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,741.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,160.71
|
| Rate for Payer: Railroad Medicare Medicare |
$713.67
|
| Rate for Payer: Railroad Medicare Medicare |
$475.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,674.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,512.11
|
| Rate for Payer: UHC Core |
$2,383.65
|
| Rate for Payer: UHC Core |
$1,589.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$713.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$475.78
|
| Rate for Payer: UHC Medicare Advantage |
$490.05
|
| Rate for Payer: UHC Medicare Advantage |
$735.08
|
| Rate for Payer: VA VA |
$475.78
|
| Rate for Payer: VA VA |
$713.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,427.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,141.00
|
|
|
HC MR MRA UPPER EXTREMITY W CO
|
Facility
|
IP
|
$2,854.67
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000077
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,741.06 |
| Max. Negotiated Rate |
$2,569.20 |
| Rate for Payer: Aetna Commercial |
$2,426.47
|
| Rate for Payer: Aetna Commercial |
$1,617.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,206.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,470.72
|
| Rate for Payer: BCN Commercial |
$1,470.72
|
| Rate for Payer: BCN Commercial |
$2,206.09
|
| Rate for Payer: Cash Price |
$2,283.74
|
| Rate for Payer: Cash Price |
$1,522.49
|
| Rate for Payer: Cofinity Commercial |
$2,455.02
|
| Rate for Payer: Cofinity Commercial |
$1,636.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,283.74
|
| Rate for Payer: Healthscope Commercial |
$2,569.20
|
| Rate for Payer: Healthscope Commercial |
$1,712.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,141.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,427.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,617.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,426.47
|
| Rate for Payer: PHP Commercial |
$2,426.47
|
| Rate for Payer: PHP Commercial |
$1,617.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,998.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,483.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,655.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,741.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,160.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,512.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,674.74
|
| Rate for Payer: UHC Core |
$1,589.10
|
| Rate for Payer: UHC Core |
$2,383.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,141.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,427.33
|
|
