|
HC MR SPINE THORACIC WO CON
|
Facility
|
IP
|
$1,897.91
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200006
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,157.54 |
| Max. Negotiated Rate |
$1,708.12 |
| Rate for Payer: Aetna Commercial |
$1,613.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,466.70
|
| Rate for Payer: BCN Commercial |
$1,466.70
|
| Rate for Payer: Cash Price |
$1,518.33
|
| Rate for Payer: Cofinity Commercial |
$1,632.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,518.33
|
| Rate for Payer: Healthscope Commercial |
$1,708.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,423.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,613.22
|
| Rate for Payer: PHP Commercial |
$1,613.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,328.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,651.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,157.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,670.16
|
| Rate for Payer: UHC Core |
$1,584.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,423.43
|
|
|
HC MR SPINE THORACIC WO CON
|
Facility
|
OP
|
$1,897.91
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200006
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,708.12 |
| Rate for Payer: Aetna Commercial |
$1,613.22
|
| Rate for Payer: Aetna Medicare |
$493.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$593.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$593.10
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$474.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,475.63
|
| Rate for Payer: BCN Commercial |
$1,475.63
|
| Rate for Payer: BCN Medicare Advantage |
$474.48
|
| Rate for Payer: Cash Price |
$1,518.33
|
| Rate for Payer: Cash Price |
$1,518.33
|
| Rate for Payer: Cofinity Commercial |
$1,632.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,518.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$474.48
|
| Rate for Payer: Healthscope Commercial |
$1,708.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,423.43
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$498.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$545.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,613.22
|
| Rate for Payer: PACE Senior Care Partners |
$450.75
|
| Rate for Payer: PACE SWMI |
$474.48
|
| Rate for Payer: PHP Commercial |
$1,613.22
|
| Rate for Payer: PHP Medicare Advantage |
$474.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,328.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,651.18
|
| Rate for Payer: Priority Health Medicare |
$474.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,157.54
|
| Rate for Payer: Railroad Medicare Medicare |
$474.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,670.16
|
| Rate for Payer: UHC Core |
$1,584.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$474.48
|
| Rate for Payer: UHC Medicare Advantage |
$488.71
|
| Rate for Payer: VA VA |
$474.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,423.43
|
|
|
HC MR SPINE THORACIC WO LIMITED
|
Facility
|
IP
|
$697.17
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200005
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$425.20 |
| Max. Negotiated Rate |
$627.45 |
| Rate for Payer: Aetna Commercial |
$592.59
|
| Rate for Payer: BCBS Trust/PPO |
$538.77
|
| Rate for Payer: BCN Commercial |
$538.77
|
| Rate for Payer: Cash Price |
$557.74
|
| Rate for Payer: Cofinity Commercial |
$599.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.74
|
| Rate for Payer: Healthscope Commercial |
$627.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$592.59
|
| Rate for Payer: PHP Commercial |
$592.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$606.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$425.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$613.51
|
| Rate for Payer: UHC Core |
$582.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.88
|
|
|
HC MR SPINE THORACIC WO LIMITED
|
Facility
|
OP
|
$697.17
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200005
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$627.45 |
| Rate for Payer: Aetna Commercial |
$592.59
|
| Rate for Payer: Aetna Medicare |
$181.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.87
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$174.29
|
| Rate for Payer: BCBS Trust/PPO |
$542.05
|
| Rate for Payer: BCN Commercial |
$542.05
|
| Rate for Payer: BCN Medicare Advantage |
$174.29
|
| Rate for Payer: Cash Price |
$557.74
|
| Rate for Payer: Cash Price |
$557.74
|
| Rate for Payer: Cofinity Commercial |
$599.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.29
|
| Rate for Payer: Healthscope Commercial |
$627.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.88
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$183.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$592.59
|
| Rate for Payer: PACE Senior Care Partners |
$165.58
|
| Rate for Payer: PACE SWMI |
$174.29
|
| Rate for Payer: PHP Commercial |
$592.59
|
| Rate for Payer: PHP Medicare Advantage |
$174.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$606.54
|
| Rate for Payer: Priority Health Medicare |
$174.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$425.20
|
| Rate for Payer: Railroad Medicare Medicare |
$174.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$613.51
|
| Rate for Payer: UHC Core |
$582.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.29
|
| Rate for Payer: UHC Medicare Advantage |
$179.52
|
| Rate for Payer: VA VA |
$174.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.88
|
|
|
HC MR SPINE THORACIC WO W CON
|
Facility
|
OP
|
$2,588.05
|
|
|
Service Code
|
CPT 72157
|
| Hospital Charge Code |
61200015
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$2,329.24 |
| Rate for Payer: Aetna Commercial |
$2,199.84
|
| Rate for Payer: Aetna Medicare |
$672.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$808.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$808.77
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$647.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,012.21
|
| Rate for Payer: BCN Commercial |
$2,012.21
|
| Rate for Payer: BCN Medicare Advantage |
$647.01
|
| Rate for Payer: Cash Price |
$2,070.44
|
| Rate for Payer: Cash Price |
$2,070.44
|
| Rate for Payer: Cofinity Commercial |
$2,225.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,070.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$647.01
|
| Rate for Payer: Healthscope Commercial |
$2,329.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,941.04
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$679.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$744.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,199.84
|
| Rate for Payer: PACE Senior Care Partners |
$614.66
|
| Rate for Payer: PACE SWMI |
$647.01
|
| Rate for Payer: PHP Commercial |
$2,199.84
|
| Rate for Payer: PHP Medicare Advantage |
$647.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,811.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,251.60
|
| Rate for Payer: Priority Health Medicare |
$647.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,578.45
|
| Rate for Payer: Railroad Medicare Medicare |
$647.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,277.48
|
| Rate for Payer: UHC Core |
$2,161.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$647.01
|
| Rate for Payer: UHC Medicare Advantage |
$666.42
|
| Rate for Payer: VA VA |
$647.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,941.04
|
|
|
HC MR SPINE THORACIC WO W CON
|
Facility
|
IP
|
$2,588.05
|
|
|
Service Code
|
CPT 72157
|
| Hospital Charge Code |
61200015
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,578.45 |
| Max. Negotiated Rate |
$2,329.24 |
| Rate for Payer: Aetna Commercial |
$2,199.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,000.05
|
| Rate for Payer: BCN Commercial |
$2,000.05
|
| Rate for Payer: Cash Price |
$2,070.44
|
| Rate for Payer: Cofinity Commercial |
$2,225.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,070.44
|
| Rate for Payer: Healthscope Commercial |
$2,329.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,941.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,199.84
|
| Rate for Payer: PHP Commercial |
$2,199.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,811.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,251.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,578.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,277.48
|
| Rate for Payer: UHC Core |
$2,161.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,941.04
|
|
|
HC MR SPINE THORACIC WO W LTD
|
Facility
|
OP
|
$906.37
|
|
|
Service Code
|
CPT 72157
|
| Hospital Charge Code |
61200016
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$215.26 |
| Max. Negotiated Rate |
$815.73 |
| Rate for Payer: Aetna Commercial |
$770.41
|
| Rate for Payer: Aetna Medicare |
$235.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$283.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$283.24
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$226.59
|
| Rate for Payer: BCBS Trust/PPO |
$704.70
|
| Rate for Payer: BCN Commercial |
$704.70
|
| Rate for Payer: BCN Medicare Advantage |
$226.59
|
| Rate for Payer: Cash Price |
$725.10
|
| Rate for Payer: Cash Price |
$725.10
|
| Rate for Payer: Cofinity Commercial |
$779.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$725.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.59
|
| Rate for Payer: Healthscope Commercial |
$815.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$679.78
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$237.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$260.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$770.41
|
| Rate for Payer: PACE Senior Care Partners |
$215.26
|
| Rate for Payer: PACE SWMI |
$226.59
|
| Rate for Payer: PHP Commercial |
$770.41
|
| Rate for Payer: PHP Medicare Advantage |
$226.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$788.54
|
| Rate for Payer: Priority Health Medicare |
$226.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$552.80
|
| Rate for Payer: Railroad Medicare Medicare |
$226.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$797.61
|
| Rate for Payer: UHC Core |
$756.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.59
|
| Rate for Payer: UHC Medicare Advantage |
$233.39
|
| Rate for Payer: VA VA |
$226.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$679.78
|
|
|
HC MR SPINE THORACIC WO W LTD
|
Facility
|
IP
|
$906.37
|
|
|
Service Code
|
CPT 72157
|
| Hospital Charge Code |
61200016
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$552.80 |
| Max. Negotiated Rate |
$815.73 |
| Rate for Payer: Aetna Commercial |
$770.41
|
| Rate for Payer: BCBS Trust/PPO |
$700.44
|
| Rate for Payer: BCN Commercial |
$700.44
|
| Rate for Payer: Cash Price |
$725.10
|
| Rate for Payer: Cofinity Commercial |
$779.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$725.10
|
| Rate for Payer: Healthscope Commercial |
$815.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$679.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$770.41
|
| Rate for Payer: PHP Commercial |
$770.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$788.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$552.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$797.61
|
| Rate for Payer: UHC Core |
$756.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$679.78
|
|
|
HC MR TEMPOROMANDIBULAR JTS
|
Facility
|
OP
|
$2,032.25
|
|
|
Service Code
|
CPT 70336
|
| Hospital Charge Code |
61000001
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,829.02 |
| Rate for Payer: Aetna Commercial |
$1,727.41
|
| Rate for Payer: Aetna Medicare |
$528.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$635.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$635.08
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$508.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,580.07
|
| Rate for Payer: BCN Commercial |
$1,580.07
|
| Rate for Payer: BCN Medicare Advantage |
$508.06
|
| Rate for Payer: Cash Price |
$1,625.80
|
| Rate for Payer: Cash Price |
$1,625.80
|
| Rate for Payer: Cofinity Commercial |
$1,747.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,625.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$508.06
|
| Rate for Payer: Healthscope Commercial |
$1,829.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,524.19
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$533.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$584.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,727.41
|
| Rate for Payer: PACE Senior Care Partners |
$482.66
|
| Rate for Payer: PACE SWMI |
$508.06
|
| Rate for Payer: PHP Commercial |
$1,727.41
|
| Rate for Payer: PHP Medicare Advantage |
$508.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,422.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,768.06
|
| Rate for Payer: Priority Health Medicare |
$508.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,239.47
|
| Rate for Payer: Railroad Medicare Medicare |
$508.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,788.38
|
| Rate for Payer: UHC Core |
$1,696.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$508.06
|
| Rate for Payer: UHC Medicare Advantage |
$523.30
|
| Rate for Payer: VA VA |
$508.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,524.19
|
|
|
HC MR TEMPOROMANDIBULAR JTS
|
Facility
|
IP
|
$2,032.25
|
|
|
Service Code
|
CPT 70336
|
| Hospital Charge Code |
61000001
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,239.47 |
| Max. Negotiated Rate |
$1,829.02 |
| Rate for Payer: Aetna Commercial |
$1,727.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,570.52
|
| Rate for Payer: BCN Commercial |
$1,570.52
|
| Rate for Payer: Cash Price |
$1,625.80
|
| Rate for Payer: Cofinity Commercial |
$1,747.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,625.80
|
| Rate for Payer: Healthscope Commercial |
$1,829.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,524.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,727.41
|
| Rate for Payer: PHP Commercial |
$1,727.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,422.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,768.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,239.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,788.38
|
| Rate for Payer: UHC Core |
$1,696.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,524.19
|
|
|
HC MR UPPER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
OP
|
$2,533.58
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
61000027
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$2,280.22 |
| Rate for Payer: Aetna Commercial |
$2,153.54
|
| Rate for Payer: Aetna Medicare |
$658.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$791.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$791.74
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$633.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,969.86
|
| Rate for Payer: BCN Commercial |
$1,969.86
|
| Rate for Payer: BCN Medicare Advantage |
$633.40
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cofinity Commercial |
$2,178.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,026.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$633.40
|
| Rate for Payer: Healthscope Commercial |
$2,280.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,900.18
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$665.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$728.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,153.54
|
| Rate for Payer: PACE Senior Care Partners |
$601.73
|
| Rate for Payer: PACE SWMI |
$633.40
|
| Rate for Payer: PHP Commercial |
$2,153.54
|
| Rate for Payer: PHP Medicare Advantage |
$633.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,204.21
|
| Rate for Payer: Priority Health Medicare |
$633.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,545.23
|
| Rate for Payer: Railroad Medicare Medicare |
$633.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,229.55
|
| Rate for Payer: UHC Core |
$2,115.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$633.40
|
| Rate for Payer: UHC Medicare Advantage |
$652.40
|
| Rate for Payer: VA VA |
$633.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,900.18
|
|
|
HC MR UPPER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
IP
|
$2,533.58
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
61000027
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,545.23 |
| Max. Negotiated Rate |
$2,280.22 |
| Rate for Payer: Aetna Commercial |
$2,153.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,957.95
|
| Rate for Payer: BCN Commercial |
$1,957.95
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cofinity Commercial |
$2,178.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,026.86
|
| Rate for Payer: Healthscope Commercial |
$2,280.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,900.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,153.54
|
| Rate for Payer: PHP Commercial |
$2,153.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,204.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,545.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,229.55
|
| Rate for Payer: UHC Core |
$2,115.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,900.18
|
|
|
HC MR UPPER EXTREM ANY JOINT W CON
|
Facility
|
OP
|
$3,436.30
|
|
|
Service Code
|
CPT 73222
|
| Hospital Charge Code |
61000024
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$525.24 |
| Max. Negotiated Rate |
$3,092.67 |
| Rate for Payer: Aetna Commercial |
$2,920.86
|
| Rate for Payer: Aetna Commercial |
$1,947.23
|
| Rate for Payer: Aetna Medicare |
$595.62
|
| Rate for Payer: Aetna Medicare |
$893.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,073.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$715.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$715.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,073.84
|
| Rate for Payer: BCBS Complete |
$551.50
|
| Rate for Payer: BCBS Complete |
$551.50
|
| Rate for Payer: BCBS MAPPO |
$859.08
|
| Rate for Payer: BCBS MAPPO |
$572.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,781.14
|
| Rate for Payer: BCBS Trust/PPO |
$2,671.72
|
| Rate for Payer: BCN Commercial |
$2,671.72
|
| Rate for Payer: BCN Commercial |
$1,781.14
|
| Rate for Payer: BCN Medicare Advantage |
$859.08
|
| Rate for Payer: BCN Medicare Advantage |
$572.72
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cofinity Commercial |
$1,970.14
|
| Rate for Payer: Cofinity Commercial |
$2,955.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,832.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,749.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$859.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$572.72
|
| Rate for Payer: Healthscope Commercial |
$3,092.67
|
| Rate for Payer: Healthscope Commercial |
$2,061.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,577.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,718.14
|
| Rate for Payer: Mclaren Medicaid |
$525.24
|
| Rate for Payer: Mclaren Medicaid |
$525.24
|
| Rate for Payer: Meridian Medicaid |
$551.50
|
| Rate for Payer: Meridian Medicaid |
$551.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$601.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$902.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$987.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$658.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,947.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,920.86
|
| Rate for Payer: PACE Senior Care Partners |
$816.12
|
| Rate for Payer: PACE Senior Care Partners |
$544.08
|
| Rate for Payer: PACE SWMI |
$572.72
|
| Rate for Payer: PACE SWMI |
$859.08
|
| Rate for Payer: PHP Commercial |
$1,947.23
|
| Rate for Payer: PHP Commercial |
$2,920.86
|
| Rate for Payer: PHP Medicare Advantage |
$859.08
|
| Rate for Payer: PHP Medicare Advantage |
$572.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$525.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$525.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,603.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,405.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,989.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,993.05
|
| Rate for Payer: Priority Health Medicare |
$859.08
|
| Rate for Payer: Priority Health Medicare |
$572.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,397.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,095.80
|
| Rate for Payer: Railroad Medicare Medicare |
$859.08
|
| Rate for Payer: Railroad Medicare Medicare |
$572.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,015.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,023.94
|
| Rate for Payer: UHC Core |
$1,912.87
|
| Rate for Payer: UHC Core |
$2,869.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$859.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$572.72
|
| Rate for Payer: UHC Medicare Advantage |
$884.85
|
| Rate for Payer: UHC Medicare Advantage |
$589.90
|
| Rate for Payer: VA VA |
$572.72
|
| Rate for Payer: VA VA |
$859.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,718.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,577.22
|
|
|
HC MR UPPER EXTREM ANY JOINT W CON
|
Facility
|
IP
|
$3,436.30
|
|
|
Service Code
|
CPT 73222
|
| Hospital Charge Code |
61000024
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,095.80 |
| Max. Negotiated Rate |
$3,092.67 |
| Rate for Payer: Aetna Commercial |
$2,920.86
|
| Rate for Payer: Aetna Commercial |
$1,947.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,655.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,770.38
|
| Rate for Payer: BCN Commercial |
$2,655.57
|
| Rate for Payer: BCN Commercial |
$1,770.38
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cofinity Commercial |
$1,970.14
|
| Rate for Payer: Cofinity Commercial |
$2,955.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,832.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,749.04
|
| Rate for Payer: Healthscope Commercial |
$3,092.67
|
| Rate for Payer: Healthscope Commercial |
$2,061.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,718.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,577.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,947.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,920.86
|
| Rate for Payer: PHP Commercial |
$1,947.23
|
| Rate for Payer: PHP Commercial |
$2,920.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,405.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,603.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,989.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,993.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,397.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,095.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,015.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,023.94
|
| Rate for Payer: UHC Core |
$1,912.87
|
| Rate for Payer: UHC Core |
$2,869.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,718.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,577.22
|
|
|
HC MR UPPER EXTREM ANY JOINT WO CON
|
Facility
|
IP
|
$1,995.22
|
|
|
Service Code
|
CPT 73221
|
| Hospital Charge Code |
61000022
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,216.88 |
| Max. Negotiated Rate |
$1,795.70 |
| Rate for Payer: Aetna Commercial |
$1,695.94
|
| Rate for Payer: Aetna Commercial |
$2,543.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,312.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,541.91
|
| Rate for Payer: BCN Commercial |
$1,541.91
|
| Rate for Payer: BCN Commercial |
$2,312.86
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cofinity Commercial |
$2,573.83
|
| Rate for Payer: Cofinity Commercial |
$1,715.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,394.26
|
| Rate for Payer: Healthscope Commercial |
$2,693.55
|
| Rate for Payer: Healthscope Commercial |
$1,795.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,244.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,496.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,695.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,543.91
|
| Rate for Payer: PHP Commercial |
$1,695.94
|
| Rate for Payer: PHP Commercial |
$2,543.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,094.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,396.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,735.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,603.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,825.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,216.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,633.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,755.79
|
| Rate for Payer: UHC Core |
$1,666.01
|
| Rate for Payer: UHC Core |
$2,499.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,244.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,496.42
|
|
|
HC MR UPPER EXTREM ANY JOINT WO CON
|
Facility
|
OP
|
$2,992.83
|
|
|
Service Code
|
CPT 73221
|
| Hospital Charge Code |
61000022
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$2,693.55 |
| Rate for Payer: Aetna Commercial |
$2,543.91
|
| Rate for Payer: Aetna Commercial |
$1,695.94
|
| Rate for Payer: Aetna Medicare |
$778.14
|
| Rate for Payer: Aetna Medicare |
$518.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$935.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$623.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$623.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$935.26
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$498.80
|
| Rate for Payer: BCBS MAPPO |
$748.21
|
| Rate for Payer: BCBS Trust/PPO |
$2,326.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,551.28
|
| Rate for Payer: BCN Commercial |
$1,551.28
|
| Rate for Payer: BCN Commercial |
$2,326.93
|
| Rate for Payer: BCN Medicare Advantage |
$748.21
|
| Rate for Payer: BCN Medicare Advantage |
$498.80
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cofinity Commercial |
$1,715.89
|
| Rate for Payer: Cofinity Commercial |
$2,573.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,394.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$748.21
|
| Rate for Payer: Healthscope Commercial |
$1,795.70
|
| Rate for Payer: Healthscope Commercial |
$2,693.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,496.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,244.62
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$785.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$523.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$860.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$573.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,695.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,543.91
|
| Rate for Payer: PACE Senior Care Partners |
$710.80
|
| Rate for Payer: PACE Senior Care Partners |
$473.86
|
| Rate for Payer: PACE SWMI |
$748.21
|
| Rate for Payer: PACE SWMI |
$498.80
|
| Rate for Payer: PHP Commercial |
$1,695.94
|
| Rate for Payer: PHP Commercial |
$2,543.91
|
| Rate for Payer: PHP Medicare Advantage |
$498.80
|
| Rate for Payer: PHP Medicare Advantage |
$748.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,396.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,094.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,603.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,735.84
|
| Rate for Payer: Priority Health Medicare |
$498.80
|
| Rate for Payer: Priority Health Medicare |
$748.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,825.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,216.88
|
| Rate for Payer: Railroad Medicare Medicare |
$498.80
|
| Rate for Payer: Railroad Medicare Medicare |
$748.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,633.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,755.79
|
| Rate for Payer: UHC Core |
$2,499.01
|
| Rate for Payer: UHC Core |
$1,666.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$498.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$748.21
|
| Rate for Payer: UHC Medicare Advantage |
$770.65
|
| Rate for Payer: UHC Medicare Advantage |
$513.77
|
| Rate for Payer: VA VA |
$498.80
|
| Rate for Payer: VA VA |
$748.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,496.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,244.62
|
|
|
HC MR UPPER EXTREM ANY JOINT WO W CON
|
Facility
|
IP
|
$2,459.37
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
61000026
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,499.97 |
| Max. Negotiated Rate |
$2,213.43 |
| Rate for Payer: Aetna Commercial |
$2,090.46
|
| Rate for Payer: Aetna Commercial |
$3,135.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,850.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,900.60
|
| Rate for Payer: BCN Commercial |
$1,900.60
|
| Rate for Payer: BCN Commercial |
$2,850.90
|
| Rate for Payer: Cash Price |
$2,951.24
|
| Rate for Payer: Cash Price |
$1,967.50
|
| Rate for Payer: Cofinity Commercial |
$2,115.06
|
| Rate for Payer: Cofinity Commercial |
$3,172.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,951.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,967.50
|
| Rate for Payer: Healthscope Commercial |
$3,320.14
|
| Rate for Payer: Healthscope Commercial |
$2,213.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,844.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,766.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,090.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,135.69
|
| Rate for Payer: PHP Commercial |
$2,090.46
|
| Rate for Payer: PHP Commercial |
$3,135.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,721.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,582.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,139.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,209.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,249.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,499.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,164.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,246.36
|
| Rate for Payer: UHC Core |
$2,053.57
|
| Rate for Payer: UHC Core |
$3,080.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,766.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,844.53
|
|
|
HC MR UPPER EXTREM ANY JOINT WO W CON
|
Facility
|
OP
|
$2,459.37
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
61000026
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$2,213.43 |
| Rate for Payer: Aetna Commercial |
$2,090.46
|
| Rate for Payer: Aetna Commercial |
$3,135.69
|
| Rate for Payer: Aetna Medicare |
$639.44
|
| Rate for Payer: Aetna Medicare |
$959.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,152.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,152.83
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$922.26
|
| Rate for Payer: BCBS MAPPO |
$614.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,868.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,912.16
|
| Rate for Payer: BCN Commercial |
$1,912.16
|
| Rate for Payer: BCN Commercial |
$2,868.24
|
| Rate for Payer: BCN Medicare Advantage |
$614.84
|
| Rate for Payer: BCN Medicare Advantage |
$922.26
|
| Rate for Payer: Cash Price |
$2,951.24
|
| Rate for Payer: Cash Price |
$1,967.50
|
| Rate for Payer: Cash Price |
$1,967.50
|
| Rate for Payer: Cash Price |
$2,951.24
|
| Rate for Payer: Cofinity Commercial |
$3,172.58
|
| Rate for Payer: Cofinity Commercial |
$2,115.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,967.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,951.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$922.26
|
| Rate for Payer: Healthscope Commercial |
$2,213.43
|
| Rate for Payer: Healthscope Commercial |
$3,320.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,844.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,766.79
|
| 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 |
$968.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$707.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,060.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,135.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,090.46
|
| Rate for Payer: PACE Senior Care Partners |
$876.15
|
| Rate for Payer: PACE Senior Care Partners |
$584.10
|
| Rate for Payer: PACE SWMI |
$614.84
|
| Rate for Payer: PACE SWMI |
$922.26
|
| Rate for Payer: PHP Commercial |
$3,135.69
|
| Rate for Payer: PHP Commercial |
$2,090.46
|
| Rate for Payer: PHP Medicare Advantage |
$922.26
|
| Rate for Payer: PHP Medicare Advantage |
$614.84
|
| 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 |
$2,582.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,721.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,209.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,139.65
|
| Rate for Payer: Priority Health Medicare |
$922.26
|
| Rate for Payer: Priority Health Medicare |
$614.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,249.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,499.97
|
| Rate for Payer: Railroad Medicare Medicare |
$922.26
|
| Rate for Payer: Railroad Medicare Medicare |
$614.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,164.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,246.36
|
| Rate for Payer: UHC Core |
$2,053.57
|
| Rate for Payer: UHC Core |
$3,080.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$922.26
|
| Rate for Payer: UHC Medicare Advantage |
$949.93
|
| Rate for Payer: UHC Medicare Advantage |
$633.29
|
| Rate for Payer: VA VA |
$614.84
|
| Rate for Payer: VA VA |
$922.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,844.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,766.79
|
|
|
HC MR UPPER EXTREM BIL ANY JOINT W CON
|
Facility
|
IP
|
$2,463.20
|
|
|
Service Code
|
CPT 73222
|
| Hospital Charge Code |
61000025
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,502.31 |
| Max. Negotiated Rate |
$2,216.88 |
| Rate for Payer: Aetna Commercial |
$2,093.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,903.56
|
| Rate for Payer: BCN Commercial |
$1,903.56
|
| Rate for Payer: Cash Price |
$1,970.56
|
| Rate for Payer: Cofinity Commercial |
$2,118.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,970.56
|
| Rate for Payer: Healthscope Commercial |
$2,216.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,847.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,093.72
|
| Rate for Payer: PHP Commercial |
$2,093.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,724.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,142.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,502.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,167.62
|
| Rate for Payer: UHC Core |
$2,056.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,847.40
|
|
|
HC MR UPPER EXTREM BIL ANY JOINT W CON
|
Facility
|
OP
|
$2,463.20
|
|
|
Service Code
|
CPT 73222
|
| Hospital Charge Code |
61000025
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$525.24 |
| Max. Negotiated Rate |
$2,216.88 |
| Rate for Payer: Aetna Commercial |
$2,093.72
|
| Rate for Payer: Aetna Medicare |
$640.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$769.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$769.75
|
| Rate for Payer: BCBS Complete |
$551.50
|
| Rate for Payer: BCBS MAPPO |
$615.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,915.14
|
| Rate for Payer: BCN Commercial |
$1,915.14
|
| Rate for Payer: BCN Medicare Advantage |
$615.80
|
| Rate for Payer: Cash Price |
$1,970.56
|
| Rate for Payer: Cash Price |
$1,970.56
|
| Rate for Payer: Cofinity Commercial |
$2,118.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,970.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$615.80
|
| Rate for Payer: Healthscope Commercial |
$2,216.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,847.40
|
| Rate for Payer: Mclaren Medicaid |
$525.24
|
| Rate for Payer: Meridian Medicaid |
$551.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$646.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$708.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,093.72
|
| Rate for Payer: PACE Senior Care Partners |
$585.01
|
| Rate for Payer: PACE SWMI |
$615.80
|
| Rate for Payer: PHP Commercial |
$2,093.72
|
| Rate for Payer: PHP Medicare Advantage |
$615.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$525.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,724.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,142.98
|
| Rate for Payer: Priority Health Medicare |
$615.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,502.31
|
| Rate for Payer: Railroad Medicare Medicare |
$615.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,167.62
|
| Rate for Payer: UHC Core |
$2,056.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$615.80
|
| Rate for Payer: UHC Medicare Advantage |
$634.27
|
| Rate for Payer: VA VA |
$615.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,847.40
|
|
|
HC MR UPPER EXTREM BIL ANY JOINT WO CON
|
Facility
|
OP
|
$2,252.06
|
|
|
Service Code
|
CPT 73221
|
| Hospital Charge Code |
61000023
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$2,026.85 |
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: Aetna Medicare |
$585.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$703.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$703.77
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$563.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,750.98
|
| Rate for Payer: BCN Commercial |
$1,750.98
|
| Rate for Payer: BCN Medicare Advantage |
$563.02
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cofinity Commercial |
$1,936.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$563.02
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,689.04
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$591.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$647.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,914.25
|
| Rate for Payer: PACE Senior Care Partners |
$534.86
|
| Rate for Payer: PACE SWMI |
$563.02
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: PHP Medicare Advantage |
$563.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,576.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,959.29
|
| Rate for Payer: Priority Health Medicare |
$563.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,373.53
|
| Rate for Payer: Railroad Medicare Medicare |
$563.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,981.81
|
| Rate for Payer: UHC Core |
$1,880.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$563.02
|
| Rate for Payer: UHC Medicare Advantage |
$579.91
|
| Rate for Payer: VA VA |
$563.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.04
|
|
|
HC MR UPPER EXTREM BIL ANY JOINT WO CON
|
Facility
|
IP
|
$2,252.06
|
|
|
Service Code
|
CPT 73221
|
| Hospital Charge Code |
61000023
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,373.53 |
| Max. Negotiated Rate |
$2,026.85 |
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,740.39
|
| Rate for Payer: BCN Commercial |
$1,740.39
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cofinity Commercial |
$1,936.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,689.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,914.25
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,576.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,959.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,373.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,981.81
|
| Rate for Payer: UHC Core |
$1,880.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.04
|
|
|
HC MR UPPER EXTREM BIL NO JOINT W CON
|
Facility
|
IP
|
$2,414.90
|
|
|
Service Code
|
CPT 73219
|
| Hospital Charge Code |
61000019
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,472.85 |
| Max. Negotiated Rate |
$2,173.41 |
| Rate for Payer: Aetna Commercial |
$2,052.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,866.23
|
| Rate for Payer: BCN Commercial |
$1,866.23
|
| Rate for Payer: Cash Price |
$1,931.92
|
| Rate for Payer: Cofinity Commercial |
$2,076.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,931.92
|
| Rate for Payer: Healthscope Commercial |
$2,173.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,811.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,052.66
|
| Rate for Payer: PHP Commercial |
$2,052.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,690.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,100.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,472.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,125.11
|
| Rate for Payer: UHC Core |
$2,016.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,811.18
|
|
|
HC MR UPPER EXTREM BIL NO JOINT W CON
|
Facility
|
OP
|
$2,414.90
|
|
|
Service Code
|
CPT 73219
|
| Hospital Charge Code |
61000019
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$2,173.41 |
| Rate for Payer: Aetna Commercial |
$2,052.66
|
| Rate for Payer: Aetna Medicare |
$627.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$754.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$754.66
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$603.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,877.58
|
| Rate for Payer: BCN Commercial |
$1,877.58
|
| Rate for Payer: BCN Medicare Advantage |
$603.72
|
| Rate for Payer: Cash Price |
$1,931.92
|
| Rate for Payer: Cash Price |
$1,931.92
|
| Rate for Payer: Cofinity Commercial |
$2,076.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,931.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$603.72
|
| Rate for Payer: Healthscope Commercial |
$2,173.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,811.18
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$633.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$694.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,052.66
|
| Rate for Payer: PACE Senior Care Partners |
$573.54
|
| Rate for Payer: PACE SWMI |
$603.72
|
| Rate for Payer: PHP Commercial |
$2,052.66
|
| Rate for Payer: PHP Medicare Advantage |
$603.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,690.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,100.96
|
| Rate for Payer: Priority Health Medicare |
$603.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,472.85
|
| Rate for Payer: Railroad Medicare Medicare |
$603.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,125.11
|
| Rate for Payer: UHC Core |
$2,016.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$603.72
|
| Rate for Payer: UHC Medicare Advantage |
$621.84
|
| Rate for Payer: VA VA |
$603.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,811.18
|
|
|
HC MR UPPER EXTREM BIL NO JOINT WO CON
|
Facility
|
IP
|
$2,252.06
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
61000017
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,373.53 |
| Max. Negotiated Rate |
$2,026.85 |
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,740.39
|
| Rate for Payer: BCN Commercial |
$1,740.39
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cofinity Commercial |
$1,936.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,689.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,914.25
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,576.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,959.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,373.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,981.81
|
| Rate for Payer: UHC Core |
$1,880.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.04
|
|
