|
HC MR CARDIAC FOR MORPHOLOGY WO CON
|
Facility
|
OP
|
$2,196.70
|
|
|
Service Code
|
CPT 75557
|
| Hospital Charge Code |
61000046
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$387.28 |
| Max. Negotiated Rate |
$1,977.03 |
| Rate for Payer: Aetna Commercial |
$1,867.19
|
| Rate for Payer: Aetna Medicare |
$571.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$686.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$686.47
|
| Rate for Payer: BCBS Complete |
$406.61
|
| Rate for Payer: BCBS MAPPO |
$549.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,805.91
|
| Rate for Payer: BCN Commercial |
$1,805.91
|
| Rate for Payer: BCN Medicare Advantage |
$549.17
|
| Rate for Payer: Cash Price |
$1,757.36
|
| Rate for Payer: Cofinity Commercial |
$1,889.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,757.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$549.17
|
| Rate for Payer: Healthscope Commercial |
$1,977.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,647.53
|
| Rate for Payer: Mclaren Medicaid |
$387.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$576.63
|
| Rate for Payer: Meridian Medicaid |
$406.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$631.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$604.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,867.19
|
| Rate for Payer: Nomi Health Commercial |
$1,801.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,647.53
|
| Rate for Payer: PACE Senior Care Partners |
$521.72
|
| Rate for Payer: PACE SWMI |
$549.17
|
| Rate for Payer: PHP Commercial |
$1,867.19
|
| Rate for Payer: PHP Medicare Advantage |
$549.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$387.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,911.13
|
| Rate for Payer: Priority Health Medicare |
$554.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,528.90
|
| Rate for Payer: Railroad Medicare Medicare |
$549.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,933.10
|
| Rate for Payer: UHC Core |
$1,834.24
|
| Rate for Payer: UHC Exchange |
$549.17
|
| Rate for Payer: UHC Medicaid |
$387.28
|
| Rate for Payer: UHC Medicare Advantage |
$549.17
|
| Rate for Payer: UHCCP Medicaid |
$387.28
|
| Rate for Payer: VA VA |
$549.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,647.53
|
|
|
HC MR CARDIAC FOR MORPHOLOGY WO CON
|
Facility
|
IP
|
$2,196.70
|
|
|
Service Code
|
CPT 75557
|
| Hospital Charge Code |
61000046
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,528.90 |
| Max. Negotiated Rate |
$1,977.03 |
| Rate for Payer: Aetna Commercial |
$1,867.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,814.25
|
| Rate for Payer: BCN Commercial |
$1,814.25
|
| Rate for Payer: Cash Price |
$1,757.36
|
| Rate for Payer: Cofinity Commercial |
$1,889.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,757.36
|
| Rate for Payer: Healthscope Commercial |
$1,977.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,647.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,867.19
|
| Rate for Payer: Nomi Health Commercial |
$1,801.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,647.53
|
| Rate for Payer: PHP Commercial |
$1,867.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,911.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,528.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,933.10
|
| Rate for Payer: UHC Core |
$1,834.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,647.53
|
|
|
HC MR CARDIAC MORP AND FUNC WO W CON
|
Facility
|
IP
|
$1,010.80
|
|
|
Service Code
|
CPT 75561
|
| Hospital Charge Code |
61000047
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$703.52 |
| Max. Negotiated Rate |
$909.72 |
| Rate for Payer: Aetna Commercial |
$859.18
|
| Rate for Payer: BCBS Trust/PPO |
$834.82
|
| Rate for Payer: BCN Commercial |
$834.82
|
| Rate for Payer: Cash Price |
$808.64
|
| Rate for Payer: Cofinity Commercial |
$869.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$808.64
|
| Rate for Payer: Healthscope Commercial |
$909.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$758.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$859.18
|
| Rate for Payer: Nomi Health Commercial |
$828.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$758.10
|
| Rate for Payer: PHP Commercial |
$859.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$879.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$703.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$889.50
|
| Rate for Payer: UHC Core |
$844.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$758.10
|
|
|
HC MR CARDIAC MORP AND FUNC WO W CON
|
Facility
|
OP
|
$1,010.80
|
|
|
Service Code
|
CPT 75561
|
| Hospital Charge Code |
61000047
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$178.20 |
| Max. Negotiated Rate |
$909.72 |
| Rate for Payer: Aetna Commercial |
$859.18
|
| Rate for Payer: Aetna Medicare |
$262.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$315.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$315.88
|
| Rate for Payer: BCBS Complete |
$187.10
|
| Rate for Payer: BCBS MAPPO |
$252.70
|
| Rate for Payer: BCBS Trust/PPO |
$830.98
|
| Rate for Payer: BCN Commercial |
$830.98
|
| Rate for Payer: BCN Medicare Advantage |
$252.70
|
| Rate for Payer: Cash Price |
$808.64
|
| Rate for Payer: Cofinity Commercial |
$869.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$808.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$252.70
|
| Rate for Payer: Healthscope Commercial |
$909.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$758.10
|
| Rate for Payer: Mclaren Medicaid |
$178.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$265.33
|
| Rate for Payer: Meridian Medicaid |
$187.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$290.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$277.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$859.18
|
| Rate for Payer: Nomi Health Commercial |
$828.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$758.10
|
| Rate for Payer: PACE Senior Care Partners |
$240.06
|
| Rate for Payer: PACE SWMI |
$252.70
|
| Rate for Payer: PHP Commercial |
$859.18
|
| Rate for Payer: PHP Medicare Advantage |
$252.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$178.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$879.40
|
| Rate for Payer: Priority Health Medicare |
$255.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$703.52
|
| Rate for Payer: Railroad Medicare Medicare |
$252.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$889.50
|
| Rate for Payer: UHC Core |
$844.02
|
| Rate for Payer: UHC Exchange |
$252.70
|
| Rate for Payer: UHC Medicaid |
$178.20
|
| Rate for Payer: UHC Medicare Advantage |
$252.70
|
| Rate for Payer: UHCCP Medicaid |
$178.20
|
| Rate for Payer: VA VA |
$252.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$758.10
|
|
|
HC MR CARDIAC VELOCITY MAPPING
|
Facility
|
IP
|
$1,264.09
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
61000048
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$879.81 |
| Max. Negotiated Rate |
$1,137.68 |
| Rate for Payer: Aetna Commercial |
$1,074.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,044.01
|
| Rate for Payer: BCN Commercial |
$1,044.01
|
| Rate for Payer: Cash Price |
$1,011.27
|
| Rate for Payer: Cofinity Commercial |
$1,087.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,011.27
|
| Rate for Payer: Healthscope Commercial |
$1,137.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$948.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,074.48
|
| Rate for Payer: Nomi Health Commercial |
$1,036.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$948.07
|
| Rate for Payer: PHP Commercial |
$1,074.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,099.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$879.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,112.40
|
| Rate for Payer: UHC Core |
$1,055.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$948.07
|
|
|
HC MR CARDIAC VELOCITY MAPPING
|
Facility
|
OP
|
$1,264.09
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
61000048
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$222.86 |
| Max. Negotiated Rate |
$1,137.68 |
| Rate for Payer: Aetna Commercial |
$1,074.48
|
| Rate for Payer: Aetna Medicare |
$328.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$395.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$395.03
|
| Rate for Payer: BCBS Complete |
$233.98
|
| Rate for Payer: BCBS MAPPO |
$316.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,039.21
|
| Rate for Payer: BCN Commercial |
$1,039.21
|
| Rate for Payer: BCN Medicare Advantage |
$316.02
|
| Rate for Payer: Cash Price |
$1,011.27
|
| Rate for Payer: Cofinity Commercial |
$1,087.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,011.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$316.02
|
| Rate for Payer: Healthscope Commercial |
$1,137.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$948.07
|
| Rate for Payer: Mclaren Medicaid |
$222.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$331.82
|
| Rate for Payer: Meridian Medicaid |
$233.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$363.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$347.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,074.48
|
| Rate for Payer: Nomi Health Commercial |
$1,036.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$948.07
|
| Rate for Payer: PACE Senior Care Partners |
$300.22
|
| Rate for Payer: PACE SWMI |
$316.02
|
| Rate for Payer: PHP Commercial |
$1,074.48
|
| Rate for Payer: PHP Medicare Advantage |
$316.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,099.76
|
| Rate for Payer: Priority Health Medicare |
$319.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$879.81
|
| Rate for Payer: Railroad Medicare Medicare |
$316.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,112.40
|
| Rate for Payer: UHC Core |
$1,055.52
|
| Rate for Payer: UHC Exchange |
$316.02
|
| Rate for Payer: UHC Medicaid |
$222.86
|
| Rate for Payer: UHC Medicare Advantage |
$316.02
|
| Rate for Payer: UHCCP Medicaid |
$222.86
|
| Rate for Payer: VA VA |
$316.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$948.07
|
|
|
HC MR CHEST W CON
|
Facility
|
OP
|
$2,379.66
|
|
|
Service Code
|
CPT 71551
|
| Hospital Charge Code |
61000011
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$419.53 |
| Max. Negotiated Rate |
$2,141.69 |
| Rate for Payer: Aetna Commercial |
$2,022.71
|
| Rate for Payer: Aetna Medicare |
$618.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$743.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$743.64
|
| Rate for Payer: BCBS Complete |
$440.48
|
| Rate for Payer: BCBS MAPPO |
$594.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,956.32
|
| Rate for Payer: BCN Commercial |
$1,956.32
|
| Rate for Payer: BCN Medicare Advantage |
$594.91
|
| Rate for Payer: Cash Price |
$1,903.73
|
| Rate for Payer: Cofinity Commercial |
$2,046.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,903.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$594.91
|
| Rate for Payer: Healthscope Commercial |
$2,141.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,784.74
|
| Rate for Payer: Mclaren Medicaid |
$419.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$624.66
|
| Rate for Payer: Meridian Medicaid |
$440.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$684.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$654.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,022.71
|
| Rate for Payer: Nomi Health Commercial |
$1,951.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,784.74
|
| Rate for Payer: PACE Senior Care Partners |
$565.17
|
| Rate for Payer: PACE SWMI |
$594.91
|
| Rate for Payer: PHP Commercial |
$2,022.71
|
| Rate for Payer: PHP Medicare Advantage |
$594.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,070.30
|
| Rate for Payer: Priority Health Medicare |
$600.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,656.24
|
| Rate for Payer: Railroad Medicare Medicare |
$594.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,094.10
|
| Rate for Payer: UHC Core |
$1,987.02
|
| Rate for Payer: UHC Exchange |
$594.91
|
| Rate for Payer: UHC Medicaid |
$419.53
|
| Rate for Payer: UHC Medicare Advantage |
$594.91
|
| Rate for Payer: UHCCP Medicaid |
$419.53
|
| Rate for Payer: VA VA |
$594.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,784.74
|
|
|
HC MR CHEST W CON
|
Facility
|
IP
|
$2,379.66
|
|
|
Service Code
|
CPT 71551
|
| Hospital Charge Code |
61000011
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,656.24 |
| Max. Negotiated Rate |
$2,141.69 |
| Rate for Payer: Aetna Commercial |
$2,022.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,965.36
|
| Rate for Payer: BCN Commercial |
$1,965.36
|
| Rate for Payer: Cash Price |
$1,903.73
|
| Rate for Payer: Cofinity Commercial |
$2,046.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,903.73
|
| Rate for Payer: Healthscope Commercial |
$2,141.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,784.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,022.71
|
| Rate for Payer: Nomi Health Commercial |
$1,951.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,784.74
|
| Rate for Payer: PHP Commercial |
$2,022.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,070.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,656.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,094.10
|
| Rate for Payer: UHC Core |
$1,987.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,784.74
|
|
|
HC MR CHEST WO CON
|
Facility
|
OP
|
$2,072.90
|
|
|
Service Code
|
CPT 71550
|
| Hospital Charge Code |
61000010
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$365.45 |
| Max. Negotiated Rate |
$1,865.61 |
| Rate for Payer: Aetna Commercial |
$1,761.96
|
| Rate for Payer: Aetna Medicare |
$538.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$647.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$647.78
|
| Rate for Payer: BCBS Complete |
$383.69
|
| Rate for Payer: BCBS MAPPO |
$518.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,704.13
|
| Rate for Payer: BCN Commercial |
$1,704.13
|
| Rate for Payer: BCN Medicare Advantage |
$518.23
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cofinity Commercial |
$1,782.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,658.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$518.23
|
| Rate for Payer: Healthscope Commercial |
$1,865.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,554.67
|
| Rate for Payer: Mclaren Medicaid |
$365.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$544.14
|
| Rate for Payer: Meridian Medicaid |
$383.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$595.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$570.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,761.96
|
| Rate for Payer: Nomi Health Commercial |
$1,699.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,554.67
|
| Rate for Payer: PACE Senior Care Partners |
$492.31
|
| Rate for Payer: PACE SWMI |
$518.23
|
| Rate for Payer: PHP Commercial |
$1,761.96
|
| Rate for Payer: PHP Medicare Advantage |
$518.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$365.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,803.42
|
| Rate for Payer: Priority Health Medicare |
$523.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,442.74
|
| Rate for Payer: Railroad Medicare Medicare |
$518.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,824.15
|
| Rate for Payer: UHC Core |
$1,730.87
|
| Rate for Payer: UHC Exchange |
$518.23
|
| Rate for Payer: UHC Medicaid |
$365.45
|
| Rate for Payer: UHC Medicare Advantage |
$518.23
|
| Rate for Payer: UHCCP Medicaid |
$365.45
|
| Rate for Payer: VA VA |
$518.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,554.67
|
|
|
HC MR CHEST WO CON
|
Facility
|
IP
|
$2,072.90
|
|
|
Service Code
|
CPT 71550
|
| Hospital Charge Code |
61000010
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,442.74 |
| Max. Negotiated Rate |
$1,865.61 |
| Rate for Payer: Aetna Commercial |
$1,761.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,712.01
|
| Rate for Payer: BCN Commercial |
$1,712.01
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cofinity Commercial |
$1,782.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,658.32
|
| Rate for Payer: Healthscope Commercial |
$1,865.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,554.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,761.96
|
| Rate for Payer: Nomi Health Commercial |
$1,699.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,554.67
|
| Rate for Payer: PHP Commercial |
$1,761.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,803.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,442.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,824.15
|
| Rate for Payer: UHC Core |
$1,730.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,554.67
|
|
|
HC MR CHEST WO W CON
|
Facility
|
IP
|
$3,113.86
|
|
|
Service Code
|
CPT 71552
|
| Hospital Charge Code |
61000012
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,167.25 |
| Max. Negotiated Rate |
$2,802.47 |
| Rate for Payer: Aetna Commercial |
$2,646.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,571.74
|
| Rate for Payer: BCN Commercial |
$2,571.74
|
| Rate for Payer: Cash Price |
$2,491.09
|
| Rate for Payer: Cofinity Commercial |
$2,677.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,491.09
|
| Rate for Payer: Healthscope Commercial |
$2,802.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,335.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,646.78
|
| Rate for Payer: Nomi Health Commercial |
$2,553.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,335.39
|
| Rate for Payer: PHP Commercial |
$2,646.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,709.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,167.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,740.20
|
| Rate for Payer: UHC Core |
$2,600.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,335.39
|
|
|
HC MR CHEST WO W CON
|
Facility
|
OP
|
$3,113.86
|
|
|
Service Code
|
CPT 71552
|
| Hospital Charge Code |
61000012
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$548.97 |
| Max. Negotiated Rate |
$2,802.47 |
| Rate for Payer: Aetna Commercial |
$2,646.78
|
| Rate for Payer: Aetna Medicare |
$809.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$973.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$973.08
|
| Rate for Payer: BCBS Complete |
$576.38
|
| Rate for Payer: BCBS MAPPO |
$778.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,559.90
|
| Rate for Payer: BCN Commercial |
$2,559.90
|
| Rate for Payer: BCN Medicare Advantage |
$778.47
|
| Rate for Payer: Cash Price |
$2,491.09
|
| Rate for Payer: Cofinity Commercial |
$2,677.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,491.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$778.47
|
| Rate for Payer: Healthscope Commercial |
$2,802.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,335.39
|
| Rate for Payer: Mclaren Medicaid |
$548.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$817.39
|
| Rate for Payer: Meridian Medicaid |
$576.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$895.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$856.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,646.78
|
| Rate for Payer: Nomi Health Commercial |
$2,553.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,335.39
|
| Rate for Payer: PACE Senior Care Partners |
$739.54
|
| Rate for Payer: PACE SWMI |
$778.47
|
| Rate for Payer: PHP Commercial |
$2,646.78
|
| Rate for Payer: PHP Medicare Advantage |
$778.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$548.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,709.06
|
| Rate for Payer: Priority Health Medicare |
$786.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,167.25
|
| Rate for Payer: Railroad Medicare Medicare |
$778.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,740.20
|
| Rate for Payer: UHC Core |
$2,600.07
|
| Rate for Payer: UHC Exchange |
$778.47
|
| Rate for Payer: UHC Medicaid |
$548.97
|
| Rate for Payer: UHC Medicare Advantage |
$778.47
|
| Rate for Payer: UHCCP Medicaid |
$548.97
|
| Rate for Payer: VA VA |
$778.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,335.39
|
|
|
HC MR ELASTOGRAPHY
|
Facility
|
IP
|
$367.18
|
|
|
Service Code
|
CPT 76391
|
| Hospital Charge Code |
61000089
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$255.56 |
| Max. Negotiated Rate |
$330.46 |
| Rate for Payer: Aetna Commercial |
$312.10
|
| Rate for Payer: BCBS Trust/PPO |
$303.25
|
| Rate for Payer: BCN Commercial |
$303.25
|
| Rate for Payer: Cash Price |
$293.74
|
| Rate for Payer: Cofinity Commercial |
$315.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.74
|
| Rate for Payer: Healthscope Commercial |
$330.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$275.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$312.10
|
| Rate for Payer: Nomi Health Commercial |
$301.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$275.38
|
| Rate for Payer: PHP Commercial |
$312.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$319.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$255.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.12
|
| Rate for Payer: UHC Core |
$306.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$275.38
|
|
|
HC MR ELASTOGRAPHY
|
Facility
|
OP
|
$367.18
|
|
|
Service Code
|
CPT 76391
|
| Hospital Charge Code |
61000089
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$64.73 |
| Max. Negotiated Rate |
$330.46 |
| Rate for Payer: Aetna Commercial |
$312.10
|
| Rate for Payer: Aetna Medicare |
$95.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.74
|
| Rate for Payer: BCBS Complete |
$67.97
|
| Rate for Payer: BCBS MAPPO |
$91.80
|
| Rate for Payer: BCBS Trust/PPO |
$301.86
|
| Rate for Payer: BCN Commercial |
$301.86
|
| Rate for Payer: BCN Medicare Advantage |
$91.80
|
| Rate for Payer: Cash Price |
$293.74
|
| Rate for Payer: Cofinity Commercial |
$315.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.80
|
| Rate for Payer: Healthscope Commercial |
$330.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$275.38
|
| Rate for Payer: Mclaren Medicaid |
$64.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.38
|
| Rate for Payer: Meridian Medicaid |
$67.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$312.10
|
| Rate for Payer: Nomi Health Commercial |
$301.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$275.38
|
| Rate for Payer: PACE Senior Care Partners |
$87.21
|
| Rate for Payer: PACE SWMI |
$91.80
|
| Rate for Payer: PHP Commercial |
$312.10
|
| Rate for Payer: PHP Medicare Advantage |
$91.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$319.45
|
| Rate for Payer: Priority Health Medicare |
$92.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$255.56
|
| Rate for Payer: Railroad Medicare Medicare |
$91.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.12
|
| Rate for Payer: UHC Core |
$306.60
|
| Rate for Payer: UHC Exchange |
$91.80
|
| Rate for Payer: UHC Medicaid |
$64.73
|
| Rate for Payer: UHC Medicare Advantage |
$91.80
|
| Rate for Payer: UHCCP Medicaid |
$64.73
|
| Rate for Payer: VA VA |
$91.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$275.38
|
|
|
HC MR FAST BREAST SCREEN SELF PAY
|
Facility
|
OP
|
$269.05
|
|
| Hospital Charge Code |
61000093
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$47.43 |
| Max. Negotiated Rate |
$242.15 |
| Rate for Payer: Aetna Commercial |
$228.69
|
| Rate for Payer: Aetna Medicare |
$69.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$84.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$84.08
|
| Rate for Payer: BCBS Complete |
$49.80
|
| Rate for Payer: BCBS MAPPO |
$67.26
|
| Rate for Payer: BCBS Trust/PPO |
$221.19
|
| Rate for Payer: BCN Commercial |
$221.19
|
| Rate for Payer: BCN Medicare Advantage |
$67.26
|
| Rate for Payer: Cash Price |
$215.24
|
| Rate for Payer: Cofinity Commercial |
$231.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.26
|
| Rate for Payer: Healthscope Commercial |
$242.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.79
|
| Rate for Payer: Mclaren Medicaid |
$47.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.63
|
| Rate for Payer: Meridian Medicaid |
$49.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$73.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.69
|
| Rate for Payer: Nomi Health Commercial |
$220.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.79
|
| Rate for Payer: PACE Senior Care Partners |
$63.90
|
| Rate for Payer: PACE SWMI |
$67.26
|
| Rate for Payer: PHP Commercial |
$228.69
|
| Rate for Payer: PHP Medicare Advantage |
$67.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$234.07
|
| Rate for Payer: Priority Health Medicare |
$67.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.26
|
| Rate for Payer: Railroad Medicare Medicare |
$67.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.76
|
| Rate for Payer: UHC Core |
$224.66
|
| Rate for Payer: UHC Exchange |
$67.26
|
| Rate for Payer: UHC Medicaid |
$47.43
|
| Rate for Payer: UHC Medicare Advantage |
$67.26
|
| Rate for Payer: UHCCP Medicaid |
$47.43
|
| Rate for Payer: VA VA |
$67.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.79
|
|
|
HC MR FAST BREAST SCREEN SELF PAY
|
Facility
|
IP
|
$269.05
|
|
| Hospital Charge Code |
61000093
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.26 |
| Max. Negotiated Rate |
$242.15 |
| Rate for Payer: Aetna Commercial |
$228.69
|
| Rate for Payer: BCBS Trust/PPO |
$222.21
|
| Rate for Payer: BCN Commercial |
$222.21
|
| Rate for Payer: Cash Price |
$215.24
|
| Rate for Payer: Cofinity Commercial |
$231.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.24
|
| Rate for Payer: Healthscope Commercial |
$242.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.69
|
| Rate for Payer: Nomi Health Commercial |
$220.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.79
|
| Rate for Payer: PHP Commercial |
$228.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$234.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.76
|
| Rate for Payer: UHC Core |
$224.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.79
|
|
|
HC MR GUIDANCE FOR NEEDLE PLACEMENT
|
Facility
|
IP
|
$1,066.51
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100004
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$742.29 |
| Max. Negotiated Rate |
$959.86 |
| Rate for Payer: Aetna Commercial |
$906.53
|
| Rate for Payer: BCBS Trust/PPO |
$880.83
|
| Rate for Payer: BCN Commercial |
$880.83
|
| Rate for Payer: Cash Price |
$853.21
|
| Rate for Payer: Cofinity Commercial |
$917.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$853.21
|
| Rate for Payer: Healthscope Commercial |
$959.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$799.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$906.53
|
| Rate for Payer: Nomi Health Commercial |
$874.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$799.88
|
| Rate for Payer: PHP Commercial |
$906.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$927.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$742.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$938.53
|
| Rate for Payer: UHC Core |
$890.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$799.88
|
|
|
HC MR GUIDANCE FOR NEEDLE PLACEMENT
|
Facility
|
OP
|
$1,066.51
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100004
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$188.03 |
| Max. Negotiated Rate |
$959.86 |
| Rate for Payer: Aetna Commercial |
$906.53
|
| Rate for Payer: Aetna Medicare |
$277.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$333.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$333.28
|
| Rate for Payer: BCBS Complete |
$197.41
|
| Rate for Payer: BCBS MAPPO |
$266.63
|
| Rate for Payer: BCBS Trust/PPO |
$876.78
|
| Rate for Payer: BCN Commercial |
$876.78
|
| Rate for Payer: BCN Medicare Advantage |
$266.63
|
| Rate for Payer: Cash Price |
$853.21
|
| Rate for Payer: Cofinity Commercial |
$917.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$853.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$266.63
|
| Rate for Payer: Healthscope Commercial |
$959.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$799.88
|
| Rate for Payer: Mclaren Medicaid |
$188.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$279.96
|
| Rate for Payer: Meridian Medicaid |
$197.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$306.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$293.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$906.53
|
| Rate for Payer: Nomi Health Commercial |
$874.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$799.88
|
| Rate for Payer: PACE Senior Care Partners |
$253.30
|
| Rate for Payer: PACE SWMI |
$266.63
|
| Rate for Payer: PHP Commercial |
$906.53
|
| Rate for Payer: PHP Medicare Advantage |
$266.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$927.86
|
| Rate for Payer: Priority Health Medicare |
$269.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$742.29
|
| Rate for Payer: Railroad Medicare Medicare |
$266.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$938.53
|
| Rate for Payer: UHC Core |
$890.54
|
| Rate for Payer: UHC Exchange |
$266.63
|
| Rate for Payer: UHC Medicaid |
$188.03
|
| Rate for Payer: UHC Medicare Advantage |
$266.63
|
| Rate for Payer: UHCCP Medicaid |
$188.03
|
| Rate for Payer: VA VA |
$266.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$799.88
|
|
|
HC MR LOWER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
IP
|
$3,075.28
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000040
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,140.39 |
| Max. Negotiated Rate |
$2,767.75 |
| Rate for Payer: Aetna Commercial |
$2,613.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,539.87
|
| Rate for Payer: BCN Commercial |
$2,539.87
|
| Rate for Payer: Cash Price |
$2,460.22
|
| Rate for Payer: Cofinity Commercial |
$2,644.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,460.22
|
| Rate for Payer: Healthscope Commercial |
$2,767.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,306.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,613.99
|
| Rate for Payer: Nomi Health Commercial |
$2,521.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,306.46
|
| Rate for Payer: PHP Commercial |
$2,613.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,675.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,140.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,706.25
|
| Rate for Payer: UHC Core |
$2,567.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,306.46
|
|
|
HC MR LOWER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
OP
|
$3,075.28
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000040
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$542.17 |
| Max. Negotiated Rate |
$2,767.75 |
| Rate for Payer: Aetna Commercial |
$2,613.99
|
| Rate for Payer: Aetna Medicare |
$799.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$961.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$961.02
|
| Rate for Payer: BCBS Complete |
$569.23
|
| Rate for Payer: BCBS MAPPO |
$768.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,528.19
|
| Rate for Payer: BCN Commercial |
$2,528.19
|
| Rate for Payer: BCN Medicare Advantage |
$768.82
|
| Rate for Payer: Cash Price |
$2,460.22
|
| Rate for Payer: Cofinity Commercial |
$2,644.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,460.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$768.82
|
| Rate for Payer: Healthscope Commercial |
$2,767.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,306.46
|
| Rate for Payer: Mclaren Medicaid |
$542.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$807.26
|
| Rate for Payer: Meridian Medicaid |
$569.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$884.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$845.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,613.99
|
| Rate for Payer: Nomi Health Commercial |
$2,521.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,306.46
|
| Rate for Payer: PACE Senior Care Partners |
$730.38
|
| Rate for Payer: PACE SWMI |
$768.82
|
| Rate for Payer: PHP Commercial |
$2,613.99
|
| Rate for Payer: PHP Medicare Advantage |
$768.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$542.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,675.49
|
| Rate for Payer: Priority Health Medicare |
$776.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,140.39
|
| Rate for Payer: Railroad Medicare Medicare |
$768.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,706.25
|
| Rate for Payer: UHC Core |
$2,567.86
|
| Rate for Payer: UHC Exchange |
$768.82
|
| Rate for Payer: UHC Medicaid |
$542.17
|
| Rate for Payer: UHC Medicare Advantage |
$768.82
|
| Rate for Payer: UHCCP Medicaid |
$542.17
|
| Rate for Payer: VA VA |
$768.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,306.46
|
|
|
HC MR LOWER EXTREM ANY JOINT W CON
|
Facility
|
OP
|
$2,297.10
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000037
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$404.98 |
| Max. Negotiated Rate |
$2,067.39 |
| Rate for Payer: Aetna Commercial |
$1,952.54
|
| Rate for Payer: Aetna Commercial |
$2,928.80
|
| Rate for Payer: Aetna Medicare |
$895.87
|
| Rate for Payer: Aetna Medicare |
$597.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,076.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$717.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$717.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,076.77
|
| Rate for Payer: BCBS Complete |
$425.19
|
| Rate for Payer: BCBS Complete |
$637.79
|
| Rate for Payer: BCBS MAPPO |
$574.27
|
| Rate for Payer: BCBS MAPPO |
$861.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,888.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,832.67
|
| Rate for Payer: BCN Commercial |
$2,832.67
|
| Rate for Payer: BCN Commercial |
$1,888.45
|
| Rate for Payer: BCN Medicare Advantage |
$861.41
|
| Rate for Payer: BCN Medicare Advantage |
$574.27
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cash Price |
$2,756.52
|
| Rate for Payer: Cofinity Commercial |
$1,975.51
|
| Rate for Payer: Cofinity Commercial |
$2,963.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,756.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$861.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$574.27
|
| Rate for Payer: Healthscope Commercial |
$2,067.39
|
| Rate for Payer: Healthscope Commercial |
$3,101.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,722.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,584.24
|
| Rate for Payer: Mclaren Medicaid |
$607.47
|
| Rate for Payer: Mclaren Medicaid |
$404.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$904.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$602.99
|
| Rate for Payer: Meridian Medicaid |
$425.19
|
| Rate for Payer: Meridian Medicaid |
$637.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$990.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$660.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$947.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$631.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,928.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.54
|
| Rate for Payer: Nomi Health Commercial |
$2,825.43
|
| Rate for Payer: Nomi Health Commercial |
$1,883.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,722.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,584.24
|
| Rate for Payer: PACE Senior Care Partners |
$818.34
|
| Rate for Payer: PACE Senior Care Partners |
$545.56
|
| Rate for Payer: PACE SWMI |
$861.41
|
| Rate for Payer: PACE SWMI |
$574.27
|
| Rate for Payer: PHP Commercial |
$1,952.54
|
| Rate for Payer: PHP Commercial |
$2,928.80
|
| Rate for Payer: PHP Medicare Advantage |
$574.27
|
| Rate for Payer: PHP Medicare Advantage |
$861.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$607.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$404.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,997.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,998.48
|
| Rate for Payer: Priority Health Medicare |
$870.03
|
| Rate for Payer: Priority Health Medicare |
$580.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,598.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,398.17
|
| Rate for Payer: Railroad Medicare Medicare |
$574.27
|
| Rate for Payer: Railroad Medicare Medicare |
$861.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,021.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,032.17
|
| Rate for Payer: UHC Core |
$2,877.12
|
| Rate for Payer: UHC Core |
$1,918.08
|
| Rate for Payer: UHC Exchange |
$861.41
|
| Rate for Payer: UHC Exchange |
$574.27
|
| Rate for Payer: UHC Medicaid |
$607.47
|
| Rate for Payer: UHC Medicaid |
$404.98
|
| Rate for Payer: UHC Medicare Advantage |
$574.27
|
| Rate for Payer: UHC Medicare Advantage |
$861.41
|
| Rate for Payer: UHCCP Medicaid |
$404.98
|
| Rate for Payer: UHCCP Medicaid |
$607.47
|
| Rate for Payer: VA VA |
$574.27
|
| Rate for Payer: VA VA |
$861.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,584.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,722.83
|
|
|
HC MR LOWER EXTREM ANY JOINT W CON
|
Facility
|
IP
|
$2,297.10
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000037
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,598.78 |
| Max. Negotiated Rate |
$2,067.39 |
| Rate for Payer: Aetna Commercial |
$1,952.54
|
| Rate for Payer: Aetna Commercial |
$2,928.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,897.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,845.76
|
| Rate for Payer: BCN Commercial |
$1,897.17
|
| Rate for Payer: BCN Commercial |
$2,845.76
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cash Price |
$2,756.52
|
| Rate for Payer: Cofinity Commercial |
$2,963.26
|
| Rate for Payer: Cofinity Commercial |
$1,975.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,756.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Healthscope Commercial |
$2,067.39
|
| Rate for Payer: Healthscope Commercial |
$3,101.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,722.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,584.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,928.80
|
| Rate for Payer: Nomi Health Commercial |
$1,883.62
|
| Rate for Payer: Nomi Health Commercial |
$2,825.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,722.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,584.24
|
| Rate for Payer: PHP Commercial |
$2,928.80
|
| Rate for Payer: PHP Commercial |
$1,952.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,997.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,998.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,598.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,398.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,021.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,032.17
|
| Rate for Payer: UHC Core |
$1,918.08
|
| Rate for Payer: UHC Core |
$2,877.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,722.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,584.24
|
|
|
HC MR LOWER EXTREM ANY JOINT WO CON
|
Facility
|
IP
|
$1,971.56
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000035
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,372.21 |
| Max. Negotiated Rate |
$1,774.40 |
| Rate for Payer: Aetna Commercial |
$1,675.83
|
| Rate for Payer: Aetna Commercial |
$2,513.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.31
|
| Rate for Payer: BCBS Trust/PPO |
$2,442.47
|
| Rate for Payer: BCN Commercial |
$1,628.31
|
| Rate for Payer: BCN Commercial |
$2,442.47
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Cash Price |
$2,365.87
|
| Rate for Payer: Cofinity Commercial |
$2,543.31
|
| Rate for Payer: Cofinity Commercial |
$1,695.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,365.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,577.25
|
| Rate for Payer: Healthscope Commercial |
$1,774.40
|
| Rate for Payer: Healthscope Commercial |
$2,661.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,478.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,218.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,675.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,513.74
|
| Rate for Payer: Nomi Health Commercial |
$1,616.68
|
| Rate for Payer: Nomi Health Commercial |
$2,425.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,478.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,218.01
|
| Rate for Payer: PHP Commercial |
$2,513.74
|
| Rate for Payer: PHP Commercial |
$1,675.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,572.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,715.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,372.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,058.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,734.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,602.46
|
| Rate for Payer: UHC Core |
$1,646.25
|
| Rate for Payer: UHC Core |
$2,469.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,478.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,218.01
|
|
|
HC MR LOWER EXTREM ANY JOINT WO CON
|
Facility
|
OP
|
$1,971.56
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000035
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$347.59 |
| Max. Negotiated Rate |
$1,774.40 |
| Rate for Payer: Aetna Commercial |
$1,675.83
|
| Rate for Payer: Aetna Commercial |
$2,513.74
|
| Rate for Payer: Aetna Medicare |
$768.91
|
| Rate for Payer: Aetna Medicare |
$512.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$924.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$616.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$616.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$924.17
|
| Rate for Payer: BCBS Complete |
$364.94
|
| Rate for Payer: BCBS Complete |
$547.40
|
| Rate for Payer: BCBS MAPPO |
$492.89
|
| Rate for Payer: BCBS MAPPO |
$739.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,620.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,431.23
|
| Rate for Payer: BCN Commercial |
$2,431.23
|
| Rate for Payer: BCN Commercial |
$1,620.82
|
| Rate for Payer: BCN Medicare Advantage |
$739.34
|
| Rate for Payer: BCN Medicare Advantage |
$492.89
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Cash Price |
$2,365.87
|
| Rate for Payer: Cofinity Commercial |
$1,695.54
|
| Rate for Payer: Cofinity Commercial |
$2,543.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,365.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,577.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$739.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$492.89
|
| Rate for Payer: Healthscope Commercial |
$1,774.40
|
| Rate for Payer: Healthscope Commercial |
$2,661.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,478.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,218.01
|
| Rate for Payer: Mclaren Medicaid |
$521.38
|
| Rate for Payer: Mclaren Medicaid |
$347.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$776.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$517.53
|
| Rate for Payer: Meridian Medicaid |
$364.94
|
| Rate for Payer: Meridian Medicaid |
$547.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$850.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$566.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$813.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$542.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,513.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,675.83
|
| Rate for Payer: Nomi Health Commercial |
$2,425.02
|
| Rate for Payer: Nomi Health Commercial |
$1,616.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,478.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,218.01
|
| Rate for Payer: PACE Senior Care Partners |
$702.37
|
| Rate for Payer: PACE Senior Care Partners |
$468.25
|
| Rate for Payer: PACE SWMI |
$739.34
|
| Rate for Payer: PACE SWMI |
$492.89
|
| Rate for Payer: PHP Commercial |
$1,675.83
|
| Rate for Payer: PHP Commercial |
$2,513.74
|
| Rate for Payer: PHP Medicare Advantage |
$492.89
|
| Rate for Payer: PHP Medicare Advantage |
$739.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$521.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,572.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,715.26
|
| Rate for Payer: Priority Health Medicare |
$746.73
|
| Rate for Payer: Priority Health Medicare |
$497.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,372.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,058.31
|
| Rate for Payer: Railroad Medicare Medicare |
$492.89
|
| Rate for Payer: Railroad Medicare Medicare |
$739.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,734.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,602.46
|
| Rate for Payer: UHC Core |
$2,469.38
|
| Rate for Payer: UHC Core |
$1,646.25
|
| Rate for Payer: UHC Exchange |
$739.34
|
| Rate for Payer: UHC Exchange |
$492.89
|
| Rate for Payer: UHC Medicaid |
$521.38
|
| Rate for Payer: UHC Medicaid |
$347.59
|
| Rate for Payer: UHC Medicare Advantage |
$492.89
|
| Rate for Payer: UHC Medicare Advantage |
$739.34
|
| Rate for Payer: UHCCP Medicaid |
$347.59
|
| Rate for Payer: UHCCP Medicaid |
$521.38
|
| Rate for Payer: VA VA |
$492.89
|
| Rate for Payer: VA VA |
$739.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,218.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,478.67
|
|
|
HC MR LOWER EXTREM ANY JOINT WO W CON
|
Facility
|
OP
|
$2,584.24
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000039
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$455.60 |
| Max. Negotiated Rate |
$2,325.82 |
| Rate for Payer: Aetna Commercial |
$2,196.60
|
| Rate for Payer: Aetna Commercial |
$3,294.91
|
| Rate for Payer: Aetna Medicare |
$1,007.86
|
| Rate for Payer: Aetna Medicare |
$671.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,211.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$807.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$807.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,211.37
|
| Rate for Payer: BCBS Complete |
$478.34
|
| Rate for Payer: BCBS Complete |
$717.52
|
| Rate for Payer: BCBS MAPPO |
$646.06
|
| Rate for Payer: BCBS MAPPO |
$969.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,124.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,186.76
|
| Rate for Payer: BCN Commercial |
$3,186.76
|
| Rate for Payer: BCN Commercial |
$2,124.50
|
| Rate for Payer: BCN Medicare Advantage |
$969.09
|
| Rate for Payer: BCN Medicare Advantage |
$646.06
|
| Rate for Payer: Cash Price |
$2,067.39
|
| Rate for Payer: Cash Price |
$3,101.10
|
| Rate for Payer: Cofinity Commercial |
$2,222.45
|
| Rate for Payer: Cofinity Commercial |
$3,333.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,101.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,067.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$969.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$646.06
|
| Rate for Payer: Healthscope Commercial |
$2,325.82
|
| Rate for Payer: Healthscope Commercial |
$3,488.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,938.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,907.28
|
| Rate for Payer: Mclaren Medicaid |
$683.40
|
| Rate for Payer: Mclaren Medicaid |
$455.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,017.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$678.36
|
| Rate for Payer: Meridian Medicaid |
$478.34
|
| Rate for Payer: Meridian Medicaid |
$717.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,114.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$742.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,066.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$710.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,294.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,196.60
|
| Rate for Payer: Nomi Health Commercial |
$3,178.62
|
| Rate for Payer: Nomi Health Commercial |
$2,119.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,938.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,907.28
|
| Rate for Payer: PACE Senior Care Partners |
$920.64
|
| Rate for Payer: PACE Senior Care Partners |
$613.76
|
| Rate for Payer: PACE SWMI |
$969.09
|
| Rate for Payer: PACE SWMI |
$646.06
|
| Rate for Payer: PHP Commercial |
$2,196.60
|
| Rate for Payer: PHP Commercial |
$3,294.91
|
| Rate for Payer: PHP Medicare Advantage |
$646.06
|
| Rate for Payer: PHP Medicare Advantage |
$969.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$683.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,372.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,248.29
|
| Rate for Payer: Priority Health Medicare |
$978.78
|
| Rate for Payer: Priority Health Medicare |
$652.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,798.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,697.95
|
| Rate for Payer: Railroad Medicare Medicare |
$646.06
|
| Rate for Payer: Railroad Medicare Medicare |
$969.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,274.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,411.21
|
| Rate for Payer: UHC Core |
$3,236.77
|
| Rate for Payer: UHC Core |
$2,157.84
|
| Rate for Payer: UHC Exchange |
$969.09
|
| Rate for Payer: UHC Exchange |
$646.06
|
| Rate for Payer: UHC Medicaid |
$683.40
|
| Rate for Payer: UHC Medicaid |
$455.60
|
| Rate for Payer: UHC Medicare Advantage |
$646.06
|
| Rate for Payer: UHC Medicare Advantage |
$969.09
|
| Rate for Payer: UHCCP Medicaid |
$455.60
|
| Rate for Payer: UHCCP Medicaid |
$683.40
|
| Rate for Payer: VA VA |
$646.06
|
| Rate for Payer: VA VA |
$969.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,907.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,938.18
|
|
