|
HC MR SPINE CERVICAL W CON
|
Facility
|
OP
|
$2,276.80
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200004
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$2,049.12 |
| Rate for Payer: Aetna Commercial |
$1,935.28
|
| Rate for Payer: Aetna Medicare |
$591.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$711.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$711.50
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$569.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,770.21
|
| Rate for Payer: BCN Commercial |
$1,770.21
|
| Rate for Payer: BCN Medicare Advantage |
$569.20
|
| Rate for Payer: Cash Price |
$1,821.44
|
| Rate for Payer: Cash Price |
$1,821.44
|
| Rate for Payer: Cofinity Commercial |
$1,958.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,821.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$569.20
|
| Rate for Payer: Healthscope Commercial |
$2,049.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,707.60
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$597.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$654.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,935.28
|
| Rate for Payer: PACE Senior Care Partners |
$540.74
|
| Rate for Payer: PACE SWMI |
$569.20
|
| Rate for Payer: PHP Commercial |
$1,935.28
|
| Rate for Payer: PHP Medicare Advantage |
$569.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,593.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,980.82
|
| Rate for Payer: Priority Health Medicare |
$569.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,388.62
|
| Rate for Payer: Railroad Medicare Medicare |
$569.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,003.58
|
| Rate for Payer: UHC Core |
$1,901.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$569.20
|
| Rate for Payer: UHC Medicare Advantage |
$586.28
|
| Rate for Payer: VA VA |
$569.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,707.60
|
|
|
HC MR SPINE CERVICAL W CON LTD
|
Facility
|
OP
|
$1,138.00
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200003
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$1,024.20 |
| Rate for Payer: Aetna Commercial |
$967.30
|
| Rate for Payer: Aetna Medicare |
$295.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$355.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$355.62
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$284.50
|
| Rate for Payer: BCBS Trust/PPO |
$884.80
|
| Rate for Payer: BCN Commercial |
$884.80
|
| Rate for Payer: BCN Medicare Advantage |
$284.50
|
| Rate for Payer: Cash Price |
$910.40
|
| Rate for Payer: Cash Price |
$910.40
|
| Rate for Payer: Cofinity Commercial |
$978.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$910.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$284.50
|
| Rate for Payer: Healthscope Commercial |
$1,024.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$853.50
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$298.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$327.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$967.30
|
| Rate for Payer: PACE Senior Care Partners |
$270.28
|
| Rate for Payer: PACE SWMI |
$284.50
|
| Rate for Payer: PHP Commercial |
$967.30
|
| Rate for Payer: PHP Medicare Advantage |
$284.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$990.06
|
| Rate for Payer: Priority Health Medicare |
$284.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$694.07
|
| Rate for Payer: Railroad Medicare Medicare |
$284.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,001.44
|
| Rate for Payer: UHC Core |
$950.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$284.50
|
| Rate for Payer: UHC Medicare Advantage |
$293.04
|
| Rate for Payer: VA VA |
$284.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$853.50
|
|
|
HC MR SPINE CERVICAL W CON LTD
|
Facility
|
IP
|
$1,138.00
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200003
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$694.07 |
| Max. Negotiated Rate |
$1,024.20 |
| Rate for Payer: Aetna Commercial |
$967.30
|
| Rate for Payer: BCBS Trust/PPO |
$879.45
|
| Rate for Payer: BCN Commercial |
$879.45
|
| Rate for Payer: Cash Price |
$910.40
|
| Rate for Payer: Cofinity Commercial |
$978.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$910.40
|
| Rate for Payer: Healthscope Commercial |
$1,024.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$853.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$967.30
|
| Rate for Payer: PHP Commercial |
$967.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$990.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$694.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,001.44
|
| Rate for Payer: UHC Core |
$950.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$853.50
|
|
|
HC MR SPINE CERVICAL WO CON
|
Facility
|
OP
|
$2,243.18
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200002
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$2,018.86 |
| Rate for Payer: Aetna Commercial |
$1,906.70
|
| Rate for Payer: Aetna Medicare |
$583.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$700.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$700.99
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$560.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,744.07
|
| Rate for Payer: BCN Commercial |
$1,744.07
|
| Rate for Payer: BCN Medicare Advantage |
$560.80
|
| Rate for Payer: Cash Price |
$1,794.54
|
| Rate for Payer: Cash Price |
$1,794.54
|
| Rate for Payer: Cofinity Commercial |
$1,929.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,794.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$560.80
|
| Rate for Payer: Healthscope Commercial |
$2,018.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,682.38
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$588.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$644.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,906.70
|
| Rate for Payer: PACE Senior Care Partners |
$532.76
|
| Rate for Payer: PACE SWMI |
$560.80
|
| Rate for Payer: PHP Commercial |
$1,906.70
|
| Rate for Payer: PHP Medicare Advantage |
$560.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,570.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,951.57
|
| Rate for Payer: Priority Health Medicare |
$560.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,368.12
|
| Rate for Payer: Railroad Medicare Medicare |
$560.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,974.00
|
| Rate for Payer: UHC Core |
$1,873.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$560.80
|
| Rate for Payer: UHC Medicare Advantage |
$577.62
|
| Rate for Payer: VA VA |
$560.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,682.38
|
|
|
HC MR SPINE CERVICAL WO CON
|
Facility
|
IP
|
$2,243.18
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200002
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,368.12 |
| Max. Negotiated Rate |
$2,018.86 |
| Rate for Payer: Aetna Commercial |
$1,906.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,733.53
|
| Rate for Payer: BCN Commercial |
$1,733.53
|
| Rate for Payer: Cash Price |
$1,794.54
|
| Rate for Payer: Cofinity Commercial |
$1,929.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,794.54
|
| Rate for Payer: Healthscope Commercial |
$2,018.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,682.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,906.70
|
| Rate for Payer: PHP Commercial |
$1,906.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,570.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,951.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,368.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,974.00
|
| Rate for Payer: UHC Core |
$1,873.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,682.38
|
|
|
HC MR SPINE CERVICAL WO LIMITED
|
Facility
|
IP
|
$1,122.00
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200001
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$684.31 |
| Max. Negotiated Rate |
$1,009.80 |
| Rate for Payer: Aetna Commercial |
$953.70
|
| Rate for Payer: BCBS Trust/PPO |
$867.08
|
| Rate for Payer: BCN Commercial |
$867.08
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$964.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Healthscope Commercial |
$1,009.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$841.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$953.70
|
| Rate for Payer: PHP Commercial |
$953.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$785.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$976.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$684.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$987.36
|
| Rate for Payer: UHC Core |
$936.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$841.50
|
|
|
HC MR SPINE CERVICAL WO LIMITED
|
Facility
|
OP
|
$1,122.00
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200001
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,009.80 |
| Rate for Payer: Aetna Commercial |
$953.70
|
| Rate for Payer: Aetna Medicare |
$291.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$350.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$350.62
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$280.50
|
| Rate for Payer: BCBS Trust/PPO |
$872.36
|
| Rate for Payer: BCN Commercial |
$872.36
|
| Rate for Payer: BCN Medicare Advantage |
$280.50
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$964.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$280.50
|
| Rate for Payer: Healthscope Commercial |
$1,009.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$841.50
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$294.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$322.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$953.70
|
| Rate for Payer: PACE Senior Care Partners |
$266.48
|
| Rate for Payer: PACE SWMI |
$280.50
|
| Rate for Payer: PHP Commercial |
$953.70
|
| Rate for Payer: PHP Medicare Advantage |
$280.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$785.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$976.14
|
| Rate for Payer: Priority Health Medicare |
$280.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$684.31
|
| Rate for Payer: Railroad Medicare Medicare |
$280.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$987.36
|
| Rate for Payer: UHC Core |
$936.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$280.50
|
| Rate for Payer: UHC Medicare Advantage |
$288.92
|
| Rate for Payer: VA VA |
$280.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$841.50
|
|
|
HC MR SPINE CERVICAL WO W CON
|
Facility
|
IP
|
$2,717.54
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200013
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,657.43 |
| Max. Negotiated Rate |
$2,445.79 |
| Rate for Payer: Aetna Commercial |
$2,309.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,100.11
|
| Rate for Payer: BCN Commercial |
$2,100.11
|
| Rate for Payer: Cash Price |
$2,174.03
|
| Rate for Payer: Cofinity Commercial |
$2,337.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,174.03
|
| Rate for Payer: Healthscope Commercial |
$2,445.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,038.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,309.91
|
| Rate for Payer: PHP Commercial |
$2,309.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,902.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,364.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,657.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,391.44
|
| Rate for Payer: UHC Core |
$2,269.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,038.16
|
|
|
HC MR SPINE CERVICAL WO W CON
|
Facility
|
OP
|
$2,717.54
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200013
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$2,445.79 |
| Rate for Payer: Aetna Commercial |
$2,309.91
|
| Rate for Payer: Aetna Medicare |
$706.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$849.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$849.23
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$679.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,112.89
|
| Rate for Payer: BCN Commercial |
$2,112.89
|
| Rate for Payer: BCN Medicare Advantage |
$679.38
|
| Rate for Payer: Cash Price |
$2,174.03
|
| Rate for Payer: Cash Price |
$2,174.03
|
| Rate for Payer: Cofinity Commercial |
$2,337.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,174.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$679.38
|
| Rate for Payer: Healthscope Commercial |
$2,445.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,038.16
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$713.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$781.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,309.91
|
| Rate for Payer: PACE Senior Care Partners |
$645.42
|
| Rate for Payer: PACE SWMI |
$679.38
|
| Rate for Payer: PHP Commercial |
$2,309.91
|
| Rate for Payer: PHP Medicare Advantage |
$679.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,902.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,364.26
|
| Rate for Payer: Priority Health Medicare |
$679.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,657.43
|
| Rate for Payer: Railroad Medicare Medicare |
$679.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,391.44
|
| Rate for Payer: UHC Core |
$2,269.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$679.38
|
| Rate for Payer: UHC Medicare Advantage |
$699.77
|
| Rate for Payer: VA VA |
$679.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,038.16
|
|
|
HC MR SPINE CERVICAL WO W LTD
|
Facility
|
IP
|
$871.49
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200014
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$531.52 |
| Max. Negotiated Rate |
$784.34 |
| Rate for Payer: Aetna Commercial |
$740.77
|
| Rate for Payer: BCBS Trust/PPO |
$673.49
|
| Rate for Payer: BCN Commercial |
$673.49
|
| Rate for Payer: Cash Price |
$697.19
|
| Rate for Payer: Cofinity Commercial |
$749.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$697.19
|
| Rate for Payer: Healthscope Commercial |
$784.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$653.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$740.77
|
| Rate for Payer: PHP Commercial |
$740.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$610.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$758.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$531.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$766.91
|
| Rate for Payer: UHC Core |
$727.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$653.62
|
|
|
HC MR SPINE CERVICAL WO W LTD
|
Facility
|
OP
|
$871.49
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200014
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$206.98 |
| Max. Negotiated Rate |
$784.34 |
| Rate for Payer: Aetna Commercial |
$740.77
|
| Rate for Payer: Aetna Medicare |
$226.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.34
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$217.87
|
| Rate for Payer: BCBS Trust/PPO |
$677.58
|
| Rate for Payer: BCN Commercial |
$677.58
|
| Rate for Payer: BCN Medicare Advantage |
$217.87
|
| Rate for Payer: Cash Price |
$697.19
|
| Rate for Payer: Cash Price |
$697.19
|
| Rate for Payer: Cofinity Commercial |
$749.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$697.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.87
|
| Rate for Payer: Healthscope Commercial |
$784.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$653.62
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$740.77
|
| Rate for Payer: PACE Senior Care Partners |
$206.98
|
| Rate for Payer: PACE SWMI |
$217.87
|
| Rate for Payer: PHP Commercial |
$740.77
|
| Rate for Payer: PHP Medicare Advantage |
$217.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$610.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$758.20
|
| Rate for Payer: Priority Health Medicare |
$217.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$531.52
|
| Rate for Payer: Railroad Medicare Medicare |
$217.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$766.91
|
| Rate for Payer: UHC Core |
$727.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.87
|
| Rate for Payer: UHC Medicare Advantage |
$224.41
|
| Rate for Payer: VA VA |
$217.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$653.62
|
|
|
HC MR SPINE LUMBAR W CON
|
Facility
|
OP
|
$2,199.20
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200012
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$1,979.28 |
| Rate for Payer: Aetna Commercial |
$1,869.32
|
| Rate for Payer: Aetna Medicare |
$571.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$687.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$687.25
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$549.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,709.88
|
| Rate for Payer: BCN Commercial |
$1,709.88
|
| Rate for Payer: BCN Medicare Advantage |
$549.80
|
| Rate for Payer: Cash Price |
$1,759.36
|
| Rate for Payer: Cash Price |
$1,759.36
|
| Rate for Payer: Cofinity Commercial |
$1,891.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,759.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$549.80
|
| Rate for Payer: Healthscope Commercial |
$1,979.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,649.40
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$577.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$632.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,869.32
|
| Rate for Payer: PACE Senior Care Partners |
$522.31
|
| Rate for Payer: PACE SWMI |
$549.80
|
| Rate for Payer: PHP Commercial |
$1,869.32
|
| Rate for Payer: PHP Medicare Advantage |
$549.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,539.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,913.30
|
| Rate for Payer: Priority Health Medicare |
$549.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,341.29
|
| Rate for Payer: Railroad Medicare Medicare |
$549.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,935.30
|
| Rate for Payer: UHC Core |
$1,836.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$549.80
|
| Rate for Payer: UHC Medicare Advantage |
$566.29
|
| Rate for Payer: VA VA |
$549.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,649.40
|
|
|
HC MR SPINE LUMBAR W CON
|
Facility
|
IP
|
$2,199.20
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200012
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,341.29 |
| Max. Negotiated Rate |
$1,979.28 |
| Rate for Payer: Aetna Commercial |
$1,869.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,699.54
|
| Rate for Payer: BCN Commercial |
$1,699.54
|
| Rate for Payer: Cash Price |
$1,759.36
|
| Rate for Payer: Cofinity Commercial |
$1,891.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,759.36
|
| Rate for Payer: Healthscope Commercial |
$1,979.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,649.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,869.32
|
| Rate for Payer: PHP Commercial |
$1,869.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,539.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,913.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,341.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,935.30
|
| Rate for Payer: UHC Core |
$1,836.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,649.40
|
|
|
HC MR SPINE LUMBAR W LTD
|
Facility
|
IP
|
$801.72
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200011
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$488.97 |
| Max. Negotiated Rate |
$721.55 |
| Rate for Payer: Aetna Commercial |
$681.46
|
| Rate for Payer: BCBS Trust/PPO |
$619.57
|
| Rate for Payer: BCN Commercial |
$619.57
|
| Rate for Payer: Cash Price |
$641.38
|
| Rate for Payer: Cofinity Commercial |
$689.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$641.38
|
| Rate for Payer: Healthscope Commercial |
$721.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$601.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$681.46
|
| Rate for Payer: PHP Commercial |
$681.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$697.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$705.51
|
| Rate for Payer: UHC Core |
$669.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$601.29
|
|
|
HC MR SPINE LUMBAR W LTD
|
Facility
|
OP
|
$801.72
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200011
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$190.41 |
| Max. Negotiated Rate |
$721.55 |
| Rate for Payer: Aetna Commercial |
$681.46
|
| Rate for Payer: Aetna Medicare |
$208.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$250.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$250.54
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$200.43
|
| Rate for Payer: BCBS Trust/PPO |
$623.34
|
| Rate for Payer: BCN Commercial |
$623.34
|
| Rate for Payer: BCN Medicare Advantage |
$200.43
|
| Rate for Payer: Cash Price |
$641.38
|
| Rate for Payer: Cash Price |
$641.38
|
| Rate for Payer: Cofinity Commercial |
$689.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$641.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.43
|
| Rate for Payer: Healthscope Commercial |
$721.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$601.29
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$210.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$230.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$681.46
|
| Rate for Payer: PACE Senior Care Partners |
$190.41
|
| Rate for Payer: PACE SWMI |
$200.43
|
| Rate for Payer: PHP Commercial |
$681.46
|
| Rate for Payer: PHP Medicare Advantage |
$200.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$697.50
|
| Rate for Payer: Priority Health Medicare |
$200.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.97
|
| Rate for Payer: Railroad Medicare Medicare |
$200.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$705.51
|
| Rate for Payer: UHC Core |
$669.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$200.43
|
| Rate for Payer: UHC Medicare Advantage |
$206.44
|
| Rate for Payer: VA VA |
$200.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$601.29
|
|
|
HC MR SPINE LUMBAR WO CON
|
Facility
|
OP
|
$2,235.53
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200009
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$2,011.98 |
| Rate for Payer: Aetna Commercial |
$1,900.20
|
| Rate for Payer: Aetna Medicare |
$581.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$698.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$698.60
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$558.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,738.12
|
| Rate for Payer: BCN Commercial |
$1,738.12
|
| Rate for Payer: BCN Medicare Advantage |
$558.88
|
| Rate for Payer: Cash Price |
$1,788.42
|
| Rate for Payer: Cash Price |
$1,788.42
|
| Rate for Payer: Cofinity Commercial |
$1,922.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,788.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.88
|
| Rate for Payer: Healthscope Commercial |
$2,011.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,676.65
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$642.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,900.20
|
| Rate for Payer: PACE Senior Care Partners |
$530.94
|
| Rate for Payer: PACE SWMI |
$558.88
|
| Rate for Payer: PHP Commercial |
$1,900.20
|
| Rate for Payer: PHP Medicare Advantage |
$558.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,564.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,944.91
|
| Rate for Payer: Priority Health Medicare |
$558.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,363.45
|
| Rate for Payer: Railroad Medicare Medicare |
$558.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,967.27
|
| Rate for Payer: UHC Core |
$1,866.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$558.88
|
| Rate for Payer: UHC Medicare Advantage |
$575.65
|
| Rate for Payer: VA VA |
$558.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,676.65
|
|
|
HC MR SPINE LUMBAR WO CON
|
Facility
|
IP
|
$2,235.53
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200009
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,363.45 |
| Max. Negotiated Rate |
$2,011.98 |
| Rate for Payer: Aetna Commercial |
$1,900.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,727.62
|
| Rate for Payer: BCN Commercial |
$1,727.62
|
| Rate for Payer: Cash Price |
$1,788.42
|
| Rate for Payer: Cofinity Commercial |
$1,922.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,788.42
|
| Rate for Payer: Healthscope Commercial |
$2,011.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,676.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,900.20
|
| Rate for Payer: PHP Commercial |
$1,900.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,564.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,944.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,363.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,967.27
|
| Rate for Payer: UHC Core |
$1,866.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,676.65
|
|
|
HC MR SPINE LUMBAR WO LTD
|
Facility
|
OP
|
$2,047.14
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200010
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,842.43 |
| Rate for Payer: Aetna Commercial |
$1,740.07
|
| Rate for Payer: Aetna Medicare |
$532.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$639.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$639.73
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$511.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,591.65
|
| Rate for Payer: BCN Commercial |
$1,591.65
|
| Rate for Payer: BCN Medicare Advantage |
$511.78
|
| Rate for Payer: Cash Price |
$1,637.71
|
| Rate for Payer: Cash Price |
$1,637.71
|
| Rate for Payer: Cofinity Commercial |
$1,760.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,637.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$511.78
|
| Rate for Payer: Healthscope Commercial |
$1,842.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,535.36
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$537.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$588.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,740.07
|
| Rate for Payer: PACE Senior Care Partners |
$486.20
|
| Rate for Payer: PACE SWMI |
$511.78
|
| Rate for Payer: PHP Commercial |
$1,740.07
|
| Rate for Payer: PHP Medicare Advantage |
$511.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,433.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,781.01
|
| Rate for Payer: Priority Health Medicare |
$511.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,248.55
|
| Rate for Payer: Railroad Medicare Medicare |
$511.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,801.48
|
| Rate for Payer: UHC Core |
$1,709.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$511.78
|
| Rate for Payer: UHC Medicare Advantage |
$527.14
|
| Rate for Payer: VA VA |
$511.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,535.36
|
|
|
HC MR SPINE LUMBAR WO LTD
|
Facility
|
IP
|
$2,047.14
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200010
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,248.55 |
| Max. Negotiated Rate |
$1,842.43 |
| Rate for Payer: Aetna Commercial |
$1,740.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,582.03
|
| Rate for Payer: BCN Commercial |
$1,582.03
|
| Rate for Payer: Cash Price |
$1,637.71
|
| Rate for Payer: Cofinity Commercial |
$1,760.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,637.71
|
| Rate for Payer: Healthscope Commercial |
$1,842.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,535.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,740.07
|
| Rate for Payer: PHP Commercial |
$1,740.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,433.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,781.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,248.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,801.48
|
| Rate for Payer: UHC Core |
$1,709.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,535.36
|
|
|
HC MR SPINE LUMBAR WO W CON
|
Facility
|
IP
|
$3,121.05
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200017
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,903.53 |
| Max. Negotiated Rate |
$2,808.94 |
| Rate for Payer: Aetna Commercial |
$2,652.89
|
| Rate for Payer: BCBS Trust/PPO |
$2,411.95
|
| Rate for Payer: BCN Commercial |
$2,411.95
|
| Rate for Payer: Cash Price |
$2,496.84
|
| Rate for Payer: Cofinity Commercial |
$2,684.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,496.84
|
| Rate for Payer: Healthscope Commercial |
$2,808.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,340.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,652.89
|
| Rate for Payer: PHP Commercial |
$2,652.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,184.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,715.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,903.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,746.52
|
| Rate for Payer: UHC Core |
$2,606.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,340.79
|
|
|
HC MR SPINE LUMBAR WO W CON
|
Facility
|
OP
|
$3,121.05
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200017
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$2,808.94 |
| Rate for Payer: Aetna Commercial |
$2,652.89
|
| Rate for Payer: Aetna Medicare |
$811.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$975.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$975.33
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$780.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,426.62
|
| Rate for Payer: BCN Commercial |
$2,426.62
|
| Rate for Payer: BCN Medicare Advantage |
$780.26
|
| Rate for Payer: Cash Price |
$2,496.84
|
| Rate for Payer: Cash Price |
$2,496.84
|
| Rate for Payer: Cofinity Commercial |
$2,684.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,496.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$780.26
|
| Rate for Payer: Healthscope Commercial |
$2,808.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,340.79
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$819.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$897.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,652.89
|
| Rate for Payer: PACE Senior Care Partners |
$741.25
|
| Rate for Payer: PACE SWMI |
$780.26
|
| Rate for Payer: PHP Commercial |
$2,652.89
|
| Rate for Payer: PHP Medicare Advantage |
$780.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,184.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,715.31
|
| Rate for Payer: Priority Health Medicare |
$780.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,903.53
|
| Rate for Payer: Railroad Medicare Medicare |
$780.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,746.52
|
| Rate for Payer: UHC Core |
$2,606.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$780.26
|
| Rate for Payer: UHC Medicare Advantage |
$803.67
|
| Rate for Payer: VA VA |
$780.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,340.79
|
|
|
HC MR SPINE LUMBAR WO W LTD
|
Facility
|
IP
|
$2,858.04
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200018
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,743.12 |
| Max. Negotiated Rate |
$2,572.24 |
| Rate for Payer: Aetna Commercial |
$2,429.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,208.69
|
| Rate for Payer: BCN Commercial |
$2,208.69
|
| Rate for Payer: Cash Price |
$2,286.43
|
| Rate for Payer: Cofinity Commercial |
$2,457.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,286.43
|
| Rate for Payer: Healthscope Commercial |
$2,572.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,143.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,429.33
|
| Rate for Payer: PHP Commercial |
$2,429.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,000.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,486.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,743.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,515.08
|
| Rate for Payer: UHC Core |
$2,386.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,143.53
|
|
|
HC MR SPINE LUMBAR WO W LTD
|
Facility
|
OP
|
$2,858.04
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200018
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$2,572.24 |
| Rate for Payer: Aetna Commercial |
$2,429.33
|
| Rate for Payer: Aetna Medicare |
$743.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$893.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$893.14
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$714.51
|
| Rate for Payer: BCBS Trust/PPO |
$2,222.13
|
| Rate for Payer: BCN Commercial |
$2,222.13
|
| Rate for Payer: BCN Medicare Advantage |
$714.51
|
| Rate for Payer: Cash Price |
$2,286.43
|
| Rate for Payer: Cash Price |
$2,286.43
|
| Rate for Payer: Cofinity Commercial |
$2,457.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,286.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$714.51
|
| Rate for Payer: Healthscope Commercial |
$2,572.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,143.53
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$750.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$821.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,429.33
|
| Rate for Payer: PACE Senior Care Partners |
$678.78
|
| Rate for Payer: PACE SWMI |
$714.51
|
| Rate for Payer: PHP Commercial |
$2,429.33
|
| Rate for Payer: PHP Medicare Advantage |
$714.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,000.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,486.49
|
| Rate for Payer: Priority Health Medicare |
$714.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,743.12
|
| Rate for Payer: Railroad Medicare Medicare |
$714.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,515.08
|
| Rate for Payer: UHC Core |
$2,386.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$714.51
|
| Rate for Payer: UHC Medicare Advantage |
$735.95
|
| Rate for Payer: VA VA |
$714.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,143.53
|
|
|
HC MR SPINE THORACIC W LIMITED
|
Facility
|
OP
|
$1,122.00
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200007
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$1,009.80 |
| Rate for Payer: Aetna Commercial |
$953.70
|
| Rate for Payer: Aetna Medicare |
$291.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$350.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$350.62
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$280.50
|
| Rate for Payer: BCBS Trust/PPO |
$872.36
|
| Rate for Payer: BCN Commercial |
$872.36
|
| Rate for Payer: BCN Medicare Advantage |
$280.50
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$964.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$280.50
|
| Rate for Payer: Healthscope Commercial |
$1,009.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$841.50
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$294.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$322.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$953.70
|
| Rate for Payer: PACE Senior Care Partners |
$266.48
|
| Rate for Payer: PACE SWMI |
$280.50
|
| Rate for Payer: PHP Commercial |
$953.70
|
| Rate for Payer: PHP Medicare Advantage |
$280.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$785.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$976.14
|
| Rate for Payer: Priority Health Medicare |
$280.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$684.31
|
| Rate for Payer: Railroad Medicare Medicare |
$280.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$987.36
|
| Rate for Payer: UHC Core |
$936.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$280.50
|
| Rate for Payer: UHC Medicare Advantage |
$288.92
|
| Rate for Payer: VA VA |
$280.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$841.50
|
|
|
HC MR SPINE THORACIC W LIMITED
|
Facility
|
IP
|
$1,122.00
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200007
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$684.31 |
| Max. Negotiated Rate |
$1,009.80 |
| Rate for Payer: Aetna Commercial |
$953.70
|
| Rate for Payer: BCBS Trust/PPO |
$867.08
|
| Rate for Payer: BCN Commercial |
$867.08
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$964.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Healthscope Commercial |
$1,009.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$841.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$953.70
|
| Rate for Payer: PHP Commercial |
$953.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$785.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$976.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$684.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$987.36
|
| Rate for Payer: UHC Core |
$936.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$841.50
|
|
