|
HC MR SPINE CERVICAL W CON LTD
|
Facility
|
IP
|
$1,183.98
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200003
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$824.05 |
| Max. Negotiated Rate |
$1,065.58 |
| Rate for Payer: Aetna Commercial |
$1,006.38
|
| Rate for Payer: BCBS Trust/PPO |
$977.85
|
| Rate for Payer: BCN Commercial |
$977.85
|
| Rate for Payer: Cash Price |
$947.18
|
| Rate for Payer: Cofinity Commercial |
$1,018.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$947.18
|
| Rate for Payer: Healthscope Commercial |
$1,065.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$887.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,006.38
|
| Rate for Payer: Nomi Health Commercial |
$970.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$887.99
|
| Rate for Payer: PHP Commercial |
$1,006.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,030.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$824.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,041.90
|
| Rate for Payer: UHC Core |
$988.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$887.99
|
|
|
HC MR SPINE CERVICAL WO CON
|
Facility
|
IP
|
$2,333.80
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200002
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,624.32 |
| Max. Negotiated Rate |
$2,100.42 |
| Rate for Payer: Aetna Commercial |
$1,983.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,927.49
|
| Rate for Payer: BCN Commercial |
$1,927.49
|
| Rate for Payer: Cash Price |
$1,867.04
|
| Rate for Payer: Cofinity Commercial |
$2,007.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,867.04
|
| Rate for Payer: Healthscope Commercial |
$2,100.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,750.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,983.73
|
| Rate for Payer: Nomi Health Commercial |
$1,913.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,750.35
|
| Rate for Payer: PHP Commercial |
$1,983.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,030.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,624.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,053.74
|
| Rate for Payer: UHC Core |
$1,948.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,750.35
|
|
|
HC MR SPINE CERVICAL WO CON
|
Facility
|
OP
|
$2,333.80
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200002
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$411.45 |
| Max. Negotiated Rate |
$2,100.42 |
| Rate for Payer: Aetna Commercial |
$1,983.73
|
| Rate for Payer: Aetna Medicare |
$606.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$729.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$729.31
|
| Rate for Payer: BCBS Complete |
$431.99
|
| Rate for Payer: BCBS MAPPO |
$583.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,918.62
|
| Rate for Payer: BCN Commercial |
$1,918.62
|
| Rate for Payer: BCN Medicare Advantage |
$583.45
|
| Rate for Payer: Cash Price |
$1,867.04
|
| Rate for Payer: Cofinity Commercial |
$2,007.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,867.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$583.45
|
| Rate for Payer: Healthscope Commercial |
$2,100.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,750.35
|
| Rate for Payer: Mclaren Medicaid |
$411.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$612.62
|
| Rate for Payer: Meridian Medicaid |
$431.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$670.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$641.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,983.73
|
| Rate for Payer: Nomi Health Commercial |
$1,913.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,750.35
|
| Rate for Payer: PACE Senior Care Partners |
$554.28
|
| Rate for Payer: PACE SWMI |
$583.45
|
| Rate for Payer: PHP Commercial |
$1,983.73
|
| Rate for Payer: PHP Medicare Advantage |
$583.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$411.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,030.41
|
| Rate for Payer: Priority Health Medicare |
$589.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,624.32
|
| Rate for Payer: Railroad Medicare Medicare |
$583.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,053.74
|
| Rate for Payer: UHC Core |
$1,948.72
|
| Rate for Payer: UHC Exchange |
$583.45
|
| Rate for Payer: UHC Medicaid |
$411.45
|
| Rate for Payer: UHC Medicare Advantage |
$583.45
|
| Rate for Payer: UHCCP Medicaid |
$411.45
|
| Rate for Payer: VA VA |
$583.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,750.35
|
|
|
HC MR SPINE CERVICAL WO LIMITED
|
Facility
|
OP
|
$1,167.33
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200001
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$205.80 |
| Max. Negotiated Rate |
$1,050.60 |
| Rate for Payer: Aetna Commercial |
$992.23
|
| Rate for Payer: Aetna Medicare |
$303.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$364.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$364.79
|
| Rate for Payer: BCBS Complete |
$216.07
|
| Rate for Payer: BCBS MAPPO |
$291.83
|
| Rate for Payer: BCBS Trust/PPO |
$959.66
|
| Rate for Payer: BCN Commercial |
$959.66
|
| Rate for Payer: BCN Medicare Advantage |
$291.83
|
| Rate for Payer: Cash Price |
$933.86
|
| Rate for Payer: Cofinity Commercial |
$1,003.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$933.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$291.83
|
| Rate for Payer: Healthscope Commercial |
$1,050.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$875.50
|
| Rate for Payer: Mclaren Medicaid |
$205.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$306.42
|
| Rate for Payer: Meridian Medicaid |
$216.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$335.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$321.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$992.23
|
| Rate for Payer: Nomi Health Commercial |
$957.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$875.50
|
| Rate for Payer: PACE Senior Care Partners |
$277.24
|
| Rate for Payer: PACE SWMI |
$291.83
|
| Rate for Payer: PHP Commercial |
$992.23
|
| Rate for Payer: PHP Medicare Advantage |
$291.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,015.58
|
| Rate for Payer: Priority Health Medicare |
$294.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$812.46
|
| Rate for Payer: Railroad Medicare Medicare |
$291.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,027.25
|
| Rate for Payer: UHC Core |
$974.72
|
| Rate for Payer: UHC Exchange |
$291.83
|
| Rate for Payer: UHC Medicaid |
$205.80
|
| Rate for Payer: UHC Medicare Advantage |
$291.83
|
| Rate for Payer: UHCCP Medicaid |
$205.80
|
| Rate for Payer: VA VA |
$291.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$875.50
|
|
|
HC MR SPINE CERVICAL WO LIMITED
|
Facility
|
IP
|
$1,167.33
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200001
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$812.46 |
| Max. Negotiated Rate |
$1,050.60 |
| Rate for Payer: Aetna Commercial |
$992.23
|
| Rate for Payer: BCBS Trust/PPO |
$964.10
|
| Rate for Payer: BCN Commercial |
$964.10
|
| Rate for Payer: Cash Price |
$933.86
|
| Rate for Payer: Cofinity Commercial |
$1,003.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$933.86
|
| Rate for Payer: Healthscope Commercial |
$1,050.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$875.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$992.23
|
| Rate for Payer: Nomi Health Commercial |
$957.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$875.50
|
| Rate for Payer: PHP Commercial |
$992.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,015.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$812.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,027.25
|
| Rate for Payer: UHC Core |
$974.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$875.50
|
|
|
HC MR SPINE CERVICAL WO W CON
|
Facility
|
OP
|
$2,827.33
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200013
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$498.46 |
| Max. Negotiated Rate |
$2,544.60 |
| Rate for Payer: Aetna Commercial |
$2,403.23
|
| Rate for Payer: Aetna Medicare |
$735.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$883.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$883.54
|
| Rate for Payer: BCBS Complete |
$523.34
|
| Rate for Payer: BCBS MAPPO |
$706.83
|
| Rate for Payer: BCBS Trust/PPO |
$2,324.35
|
| Rate for Payer: BCN Commercial |
$2,324.35
|
| Rate for Payer: BCN Medicare Advantage |
$706.83
|
| Rate for Payer: Cash Price |
$2,261.86
|
| Rate for Payer: Cofinity Commercial |
$2,431.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,261.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$706.83
|
| Rate for Payer: Healthscope Commercial |
$2,544.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,120.50
|
| Rate for Payer: Mclaren Medicaid |
$498.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$742.17
|
| Rate for Payer: Meridian Medicaid |
$523.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$812.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$777.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,403.23
|
| Rate for Payer: Nomi Health Commercial |
$2,318.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,120.50
|
| Rate for Payer: PACE Senior Care Partners |
$671.49
|
| Rate for Payer: PACE SWMI |
$706.83
|
| Rate for Payer: PHP Commercial |
$2,403.23
|
| Rate for Payer: PHP Medicare Advantage |
$706.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,459.78
|
| Rate for Payer: Priority Health Medicare |
$713.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,967.82
|
| Rate for Payer: Railroad Medicare Medicare |
$706.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,488.05
|
| Rate for Payer: UHC Core |
$2,360.82
|
| Rate for Payer: UHC Exchange |
$706.83
|
| Rate for Payer: UHC Medicaid |
$498.46
|
| Rate for Payer: UHC Medicare Advantage |
$706.83
|
| Rate for Payer: UHCCP Medicaid |
$498.46
|
| Rate for Payer: VA VA |
$706.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,120.50
|
|
|
HC MR SPINE CERVICAL WO W CON
|
Facility
|
IP
|
$2,827.33
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200013
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,967.82 |
| Max. Negotiated Rate |
$2,544.60 |
| Rate for Payer: Aetna Commercial |
$2,403.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,335.09
|
| Rate for Payer: BCN Commercial |
$2,335.09
|
| Rate for Payer: Cash Price |
$2,261.86
|
| Rate for Payer: Cofinity Commercial |
$2,431.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,261.86
|
| Rate for Payer: Healthscope Commercial |
$2,544.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,120.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,403.23
|
| Rate for Payer: Nomi Health Commercial |
$2,318.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,120.50
|
| Rate for Payer: PHP Commercial |
$2,403.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,459.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,967.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,488.05
|
| Rate for Payer: UHC Core |
$2,360.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,120.50
|
|
|
HC MR SPINE CERVICAL WO W LTD
|
Facility
|
IP
|
$906.70
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200014
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$631.06 |
| Max. Negotiated Rate |
$816.03 |
| Rate for Payer: Aetna Commercial |
$770.70
|
| Rate for Payer: BCBS Trust/PPO |
$748.84
|
| Rate for Payer: BCN Commercial |
$748.84
|
| Rate for Payer: Cash Price |
$725.36
|
| Rate for Payer: Cofinity Commercial |
$779.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$725.36
|
| Rate for Payer: Healthscope Commercial |
$816.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$680.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$770.70
|
| Rate for Payer: Nomi Health Commercial |
$743.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$680.02
|
| Rate for Payer: PHP Commercial |
$770.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$788.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$631.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$797.90
|
| Rate for Payer: UHC Core |
$757.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$680.02
|
|
|
HC MR SPINE CERVICAL WO W LTD
|
Facility
|
OP
|
$906.70
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200014
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$159.85 |
| Max. Negotiated Rate |
$816.03 |
| Rate for Payer: Aetna Commercial |
$770.70
|
| Rate for Payer: Aetna Medicare |
$235.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$283.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$283.34
|
| Rate for Payer: BCBS Complete |
$167.83
|
| Rate for Payer: BCBS MAPPO |
$226.68
|
| Rate for Payer: BCBS Trust/PPO |
$745.40
|
| Rate for Payer: BCN Commercial |
$745.40
|
| Rate for Payer: BCN Medicare Advantage |
$226.68
|
| Rate for Payer: Cash Price |
$725.36
|
| Rate for Payer: Cofinity Commercial |
$779.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$725.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.68
|
| Rate for Payer: Healthscope Commercial |
$816.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$680.02
|
| Rate for Payer: Mclaren Medicaid |
$159.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.01
|
| Rate for Payer: Meridian Medicaid |
$167.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$260.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$249.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$770.70
|
| Rate for Payer: Nomi Health Commercial |
$743.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$680.02
|
| Rate for Payer: PACE Senior Care Partners |
$215.34
|
| Rate for Payer: PACE SWMI |
$226.68
|
| Rate for Payer: PHP Commercial |
$770.70
|
| Rate for Payer: PHP Medicare Advantage |
$226.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$788.83
|
| Rate for Payer: Priority Health Medicare |
$228.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$631.06
|
| Rate for Payer: Railroad Medicare Medicare |
$226.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$797.90
|
| Rate for Payer: UHC Core |
$757.09
|
| Rate for Payer: UHC Exchange |
$226.68
|
| Rate for Payer: UHC Medicaid |
$159.85
|
| Rate for Payer: UHC Medicare Advantage |
$226.68
|
| Rate for Payer: UHCCP Medicaid |
$159.85
|
| Rate for Payer: VA VA |
$226.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$680.02
|
|
|
HC MR SPINE LUMBAR W CON
|
Facility
|
IP
|
$2,288.04
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200012
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,592.48 |
| Max. Negotiated Rate |
$2,059.24 |
| Rate for Payer: Aetna Commercial |
$1,944.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,889.69
|
| Rate for Payer: BCN Commercial |
$1,889.69
|
| Rate for Payer: Cash Price |
$1,830.43
|
| Rate for Payer: Cofinity Commercial |
$1,967.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,830.43
|
| Rate for Payer: Healthscope Commercial |
$2,059.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,716.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,944.83
|
| Rate for Payer: Nomi Health Commercial |
$1,876.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,716.03
|
| Rate for Payer: PHP Commercial |
$1,944.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,990.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,592.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,013.48
|
| Rate for Payer: UHC Core |
$1,910.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,716.03
|
|
|
HC MR SPINE LUMBAR W CON
|
Facility
|
OP
|
$2,288.04
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200012
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$403.38 |
| Max. Negotiated Rate |
$2,059.24 |
| Rate for Payer: Aetna Commercial |
$1,944.83
|
| Rate for Payer: Aetna Medicare |
$594.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$715.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$715.01
|
| Rate for Payer: BCBS Complete |
$423.52
|
| Rate for Payer: BCBS MAPPO |
$572.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,881.00
|
| Rate for Payer: BCN Commercial |
$1,881.00
|
| Rate for Payer: BCN Medicare Advantage |
$572.01
|
| Rate for Payer: Cash Price |
$1,830.43
|
| Rate for Payer: Cofinity Commercial |
$1,967.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,830.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$572.01
|
| Rate for Payer: Healthscope Commercial |
$2,059.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,716.03
|
| Rate for Payer: Mclaren Medicaid |
$403.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$600.61
|
| Rate for Payer: Meridian Medicaid |
$423.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$657.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$629.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,944.83
|
| Rate for Payer: Nomi Health Commercial |
$1,876.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,716.03
|
| Rate for Payer: PACE Senior Care Partners |
$543.41
|
| Rate for Payer: PACE SWMI |
$572.01
|
| Rate for Payer: PHP Commercial |
$1,944.83
|
| Rate for Payer: PHP Medicare Advantage |
$572.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$403.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,990.59
|
| Rate for Payer: Priority Health Medicare |
$577.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,592.48
|
| Rate for Payer: Railroad Medicare Medicare |
$572.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,013.48
|
| Rate for Payer: UHC Core |
$1,910.51
|
| Rate for Payer: UHC Exchange |
$572.01
|
| Rate for Payer: UHC Medicaid |
$403.38
|
| Rate for Payer: UHC Medicare Advantage |
$572.01
|
| Rate for Payer: UHCCP Medicaid |
$403.38
|
| Rate for Payer: VA VA |
$572.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,716.03
|
|
|
HC MR SPINE LUMBAR W LTD
|
Facility
|
IP
|
$834.11
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200011
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$580.54 |
| Max. Negotiated Rate |
$750.70 |
| Rate for Payer: Aetna Commercial |
$708.99
|
| Rate for Payer: BCBS Trust/PPO |
$688.89
|
| Rate for Payer: BCN Commercial |
$688.89
|
| Rate for Payer: Cash Price |
$667.29
|
| Rate for Payer: Cofinity Commercial |
$717.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$667.29
|
| Rate for Payer: Healthscope Commercial |
$750.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$625.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$708.99
|
| Rate for Payer: Nomi Health Commercial |
$683.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$625.58
|
| Rate for Payer: PHP Commercial |
$708.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$725.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$580.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$734.02
|
| Rate for Payer: UHC Core |
$696.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$625.58
|
|
|
HC MR SPINE LUMBAR W LTD
|
Facility
|
OP
|
$834.11
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200011
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$147.05 |
| Max. Negotiated Rate |
$750.70 |
| Rate for Payer: Aetna Commercial |
$708.99
|
| Rate for Payer: Aetna Medicare |
$216.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$260.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$260.66
|
| Rate for Payer: BCBS Complete |
$154.39
|
| Rate for Payer: BCBS MAPPO |
$208.53
|
| Rate for Payer: BCBS Trust/PPO |
$685.72
|
| Rate for Payer: BCN Commercial |
$685.72
|
| Rate for Payer: BCN Medicare Advantage |
$208.53
|
| Rate for Payer: Cash Price |
$667.29
|
| Rate for Payer: Cofinity Commercial |
$717.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$667.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.53
|
| Rate for Payer: Healthscope Commercial |
$750.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$625.58
|
| Rate for Payer: Mclaren Medicaid |
$147.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$218.95
|
| Rate for Payer: Meridian Medicaid |
$154.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$239.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$229.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$708.99
|
| Rate for Payer: Nomi Health Commercial |
$683.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$625.58
|
| Rate for Payer: PACE Senior Care Partners |
$198.10
|
| Rate for Payer: PACE SWMI |
$208.53
|
| Rate for Payer: PHP Commercial |
$708.99
|
| Rate for Payer: PHP Medicare Advantage |
$208.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$147.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$725.68
|
| Rate for Payer: Priority Health Medicare |
$210.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$580.54
|
| Rate for Payer: Railroad Medicare Medicare |
$208.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$734.02
|
| Rate for Payer: UHC Core |
$696.48
|
| Rate for Payer: UHC Exchange |
$208.53
|
| Rate for Payer: UHC Medicaid |
$147.05
|
| Rate for Payer: UHC Medicare Advantage |
$208.53
|
| Rate for Payer: UHCCP Medicaid |
$147.05
|
| Rate for Payer: VA VA |
$208.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$625.58
|
|
|
HC MR SPINE LUMBAR WO CON
|
Facility
|
IP
|
$2,325.84
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200009
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,618.78 |
| Max. Negotiated Rate |
$2,093.26 |
| Rate for Payer: Aetna Commercial |
$1,976.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,920.91
|
| Rate for Payer: BCN Commercial |
$1,920.91
|
| Rate for Payer: Cash Price |
$1,860.67
|
| Rate for Payer: Cofinity Commercial |
$2,000.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,860.67
|
| Rate for Payer: Healthscope Commercial |
$2,093.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,744.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,976.96
|
| Rate for Payer: Nomi Health Commercial |
$1,907.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,744.38
|
| Rate for Payer: PHP Commercial |
$1,976.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,023.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,618.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,046.74
|
| Rate for Payer: UHC Core |
$1,942.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,744.38
|
|
|
HC MR SPINE LUMBAR WO CON
|
Facility
|
OP
|
$2,325.84
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200009
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$410.05 |
| Max. Negotiated Rate |
$2,093.26 |
| Rate for Payer: Aetna Commercial |
$1,976.96
|
| Rate for Payer: Aetna Medicare |
$604.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$726.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$726.83
|
| Rate for Payer: BCBS Complete |
$430.51
|
| Rate for Payer: BCBS MAPPO |
$581.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,912.07
|
| Rate for Payer: BCN Commercial |
$1,912.07
|
| Rate for Payer: BCN Medicare Advantage |
$581.46
|
| Rate for Payer: Cash Price |
$1,860.67
|
| Rate for Payer: Cofinity Commercial |
$2,000.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,860.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$581.46
|
| Rate for Payer: Healthscope Commercial |
$2,093.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,744.38
|
| Rate for Payer: Mclaren Medicaid |
$410.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$610.53
|
| Rate for Payer: Meridian Medicaid |
$430.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$668.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$639.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,976.96
|
| Rate for Payer: Nomi Health Commercial |
$1,907.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,744.38
|
| Rate for Payer: PACE Senior Care Partners |
$552.39
|
| Rate for Payer: PACE SWMI |
$581.46
|
| Rate for Payer: PHP Commercial |
$1,976.96
|
| Rate for Payer: PHP Medicare Advantage |
$581.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,023.48
|
| Rate for Payer: Priority Health Medicare |
$587.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,618.78
|
| Rate for Payer: Railroad Medicare Medicare |
$581.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,046.74
|
| Rate for Payer: UHC Core |
$1,942.08
|
| Rate for Payer: UHC Exchange |
$581.46
|
| Rate for Payer: UHC Medicaid |
$410.05
|
| Rate for Payer: UHC Medicare Advantage |
$581.46
|
| Rate for Payer: UHCCP Medicaid |
$410.05
|
| Rate for Payer: VA VA |
$581.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,744.38
|
|
|
HC MR SPINE LUMBAR WO LTD
|
Facility
|
IP
|
$2,129.84
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200010
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,482.37 |
| Max. Negotiated Rate |
$1,916.86 |
| Rate for Payer: Aetna Commercial |
$1,810.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,759.03
|
| Rate for Payer: BCN Commercial |
$1,759.03
|
| Rate for Payer: Cash Price |
$1,703.87
|
| Rate for Payer: Cofinity Commercial |
$1,831.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,703.87
|
| Rate for Payer: Healthscope Commercial |
$1,916.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,597.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,810.36
|
| Rate for Payer: Nomi Health Commercial |
$1,746.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,597.38
|
| Rate for Payer: PHP Commercial |
$1,810.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,852.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,482.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,874.26
|
| Rate for Payer: UHC Core |
$1,778.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,597.38
|
|
|
HC MR SPINE LUMBAR WO LTD
|
Facility
|
OP
|
$2,129.84
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200010
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$375.49 |
| Max. Negotiated Rate |
$1,916.86 |
| Rate for Payer: Aetna Commercial |
$1,810.36
|
| Rate for Payer: Aetna Medicare |
$553.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$665.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$665.58
|
| Rate for Payer: BCBS Complete |
$394.23
|
| Rate for Payer: BCBS MAPPO |
$532.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,750.94
|
| Rate for Payer: BCN Commercial |
$1,750.94
|
| Rate for Payer: BCN Medicare Advantage |
$532.46
|
| Rate for Payer: Cash Price |
$1,703.87
|
| Rate for Payer: Cofinity Commercial |
$1,831.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,703.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$532.46
|
| Rate for Payer: Healthscope Commercial |
$1,916.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,597.38
|
| Rate for Payer: Mclaren Medicaid |
$375.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$559.08
|
| Rate for Payer: Meridian Medicaid |
$394.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$612.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$585.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,810.36
|
| Rate for Payer: Nomi Health Commercial |
$1,746.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,597.38
|
| Rate for Payer: PACE Senior Care Partners |
$505.84
|
| Rate for Payer: PACE SWMI |
$532.46
|
| Rate for Payer: PHP Commercial |
$1,810.36
|
| Rate for Payer: PHP Medicare Advantage |
$532.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$375.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,852.96
|
| Rate for Payer: Priority Health Medicare |
$537.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,482.37
|
| Rate for Payer: Railroad Medicare Medicare |
$532.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,874.26
|
| Rate for Payer: UHC Core |
$1,778.42
|
| Rate for Payer: UHC Exchange |
$532.46
|
| Rate for Payer: UHC Medicaid |
$375.49
|
| Rate for Payer: UHC Medicare Advantage |
$532.46
|
| Rate for Payer: UHCCP Medicaid |
$375.49
|
| Rate for Payer: VA VA |
$532.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,597.38
|
|
|
HC MR SPINE LUMBAR WO W CON
|
Facility
|
IP
|
$3,247.14
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200017
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$2,260.01 |
| Max. Negotiated Rate |
$2,922.43 |
| Rate for Payer: Aetna Commercial |
$2,760.07
|
| Rate for Payer: BCBS Trust/PPO |
$2,681.81
|
| Rate for Payer: BCN Commercial |
$2,681.81
|
| Rate for Payer: Cash Price |
$2,597.71
|
| Rate for Payer: Cofinity Commercial |
$2,792.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,597.71
|
| Rate for Payer: Healthscope Commercial |
$2,922.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,435.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,760.07
|
| Rate for Payer: Nomi Health Commercial |
$2,662.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,435.36
|
| Rate for Payer: PHP Commercial |
$2,760.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,825.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,260.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,857.48
|
| Rate for Payer: UHC Core |
$2,711.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,435.36
|
|
|
HC MR SPINE LUMBAR WO W CON
|
Facility
|
OP
|
$3,247.14
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200017
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$572.47 |
| Max. Negotiated Rate |
$2,922.43 |
| Rate for Payer: Aetna Commercial |
$2,760.07
|
| Rate for Payer: Aetna Medicare |
$844.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,014.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,014.73
|
| Rate for Payer: BCBS Complete |
$601.05
|
| Rate for Payer: BCBS MAPPO |
$811.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,669.47
|
| Rate for Payer: BCN Commercial |
$2,669.47
|
| Rate for Payer: BCN Medicare Advantage |
$811.78
|
| Rate for Payer: Cash Price |
$2,597.71
|
| Rate for Payer: Cofinity Commercial |
$2,792.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,597.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$811.78
|
| Rate for Payer: Healthscope Commercial |
$2,922.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,435.36
|
| Rate for Payer: Mclaren Medicaid |
$572.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$852.37
|
| Rate for Payer: Meridian Medicaid |
$601.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$933.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$892.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,760.07
|
| Rate for Payer: Nomi Health Commercial |
$2,662.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,435.36
|
| Rate for Payer: PACE Senior Care Partners |
$771.20
|
| Rate for Payer: PACE SWMI |
$811.78
|
| Rate for Payer: PHP Commercial |
$2,760.07
|
| Rate for Payer: PHP Medicare Advantage |
$811.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$572.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,825.01
|
| Rate for Payer: Priority Health Medicare |
$819.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,260.01
|
| Rate for Payer: Railroad Medicare Medicare |
$811.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,857.48
|
| Rate for Payer: UHC Core |
$2,711.36
|
| Rate for Payer: UHC Exchange |
$811.78
|
| Rate for Payer: UHC Medicaid |
$572.47
|
| Rate for Payer: UHC Medicare Advantage |
$811.78
|
| Rate for Payer: UHCCP Medicaid |
$572.47
|
| Rate for Payer: VA VA |
$811.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,435.36
|
|
|
HC MR SPINE LUMBAR WO W LTD
|
Facility
|
IP
|
$2,973.50
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200018
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$2,069.56 |
| Max. Negotiated Rate |
$2,676.15 |
| Rate for Payer: Aetna Commercial |
$2,527.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,455.81
|
| Rate for Payer: BCN Commercial |
$2,455.81
|
| Rate for Payer: Cash Price |
$2,378.80
|
| Rate for Payer: Cofinity Commercial |
$2,557.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,378.80
|
| Rate for Payer: Healthscope Commercial |
$2,676.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,230.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,527.47
|
| Rate for Payer: Nomi Health Commercial |
$2,438.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,230.12
|
| Rate for Payer: PHP Commercial |
$2,527.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,586.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,069.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,616.68
|
| Rate for Payer: UHC Core |
$2,482.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,230.12
|
|
|
HC MR SPINE LUMBAR WO W LTD
|
Facility
|
OP
|
$2,973.50
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200018
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$524.23 |
| Max. Negotiated Rate |
$2,676.15 |
| Rate for Payer: Aetna Commercial |
$2,527.47
|
| Rate for Payer: Aetna Medicare |
$773.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$929.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$929.22
|
| Rate for Payer: BCBS Complete |
$550.39
|
| Rate for Payer: BCBS MAPPO |
$743.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,444.51
|
| Rate for Payer: BCN Commercial |
$2,444.51
|
| Rate for Payer: BCN Medicare Advantage |
$743.38
|
| Rate for Payer: Cash Price |
$2,378.80
|
| Rate for Payer: Cofinity Commercial |
$2,557.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,378.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$743.38
|
| Rate for Payer: Healthscope Commercial |
$2,676.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,230.12
|
| Rate for Payer: Mclaren Medicaid |
$524.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$780.54
|
| Rate for Payer: Meridian Medicaid |
$550.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$854.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$817.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,527.47
|
| Rate for Payer: Nomi Health Commercial |
$2,438.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,230.12
|
| Rate for Payer: PACE Senior Care Partners |
$706.21
|
| Rate for Payer: PACE SWMI |
$743.38
|
| Rate for Payer: PHP Commercial |
$2,527.47
|
| Rate for Payer: PHP Medicare Advantage |
$743.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$524.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,586.95
|
| Rate for Payer: Priority Health Medicare |
$750.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,069.56
|
| Rate for Payer: Railroad Medicare Medicare |
$743.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,616.68
|
| Rate for Payer: UHC Core |
$2,482.87
|
| Rate for Payer: UHC Exchange |
$743.38
|
| Rate for Payer: UHC Medicaid |
$524.23
|
| Rate for Payer: UHC Medicare Advantage |
$743.38
|
| Rate for Payer: UHCCP Medicaid |
$524.23
|
| Rate for Payer: VA VA |
$743.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,230.12
|
|
|
HC MR SPINE THORACIC W LIMITED
|
Facility
|
IP
|
$1,167.33
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200007
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$812.46 |
| Max. Negotiated Rate |
$1,050.60 |
| Rate for Payer: Aetna Commercial |
$992.23
|
| Rate for Payer: BCBS Trust/PPO |
$964.10
|
| Rate for Payer: BCN Commercial |
$964.10
|
| Rate for Payer: Cash Price |
$933.86
|
| Rate for Payer: Cofinity Commercial |
$1,003.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$933.86
|
| Rate for Payer: Healthscope Commercial |
$1,050.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$875.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$992.23
|
| Rate for Payer: Nomi Health Commercial |
$957.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$875.50
|
| Rate for Payer: PHP Commercial |
$992.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,015.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$812.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,027.25
|
| Rate for Payer: UHC Core |
$974.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$875.50
|
|
|
HC MR SPINE THORACIC W LIMITED
|
Facility
|
OP
|
$1,167.33
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200007
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$205.80 |
| Max. Negotiated Rate |
$1,050.60 |
| Rate for Payer: Aetna Commercial |
$992.23
|
| Rate for Payer: Aetna Medicare |
$303.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$364.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$364.79
|
| Rate for Payer: BCBS Complete |
$216.07
|
| Rate for Payer: BCBS MAPPO |
$291.83
|
| Rate for Payer: BCBS Trust/PPO |
$959.66
|
| Rate for Payer: BCN Commercial |
$959.66
|
| Rate for Payer: BCN Medicare Advantage |
$291.83
|
| Rate for Payer: Cash Price |
$933.86
|
| Rate for Payer: Cofinity Commercial |
$1,003.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$933.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$291.83
|
| Rate for Payer: Healthscope Commercial |
$1,050.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$875.50
|
| Rate for Payer: Mclaren Medicaid |
$205.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$306.42
|
| Rate for Payer: Meridian Medicaid |
$216.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$335.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$321.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$992.23
|
| Rate for Payer: Nomi Health Commercial |
$957.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$875.50
|
| Rate for Payer: PACE Senior Care Partners |
$277.24
|
| Rate for Payer: PACE SWMI |
$291.83
|
| Rate for Payer: PHP Commercial |
$992.23
|
| Rate for Payer: PHP Medicare Advantage |
$291.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,015.58
|
| Rate for Payer: Priority Health Medicare |
$294.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$812.46
|
| Rate for Payer: Railroad Medicare Medicare |
$291.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,027.25
|
| Rate for Payer: UHC Core |
$974.72
|
| Rate for Payer: UHC Exchange |
$291.83
|
| Rate for Payer: UHC Medicaid |
$205.80
|
| Rate for Payer: UHC Medicare Advantage |
$291.83
|
| Rate for Payer: UHCCP Medicaid |
$205.80
|
| Rate for Payer: VA VA |
$291.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$875.50
|
|
|
HC MR SPINE THORACIC WO CON
|
Facility
|
IP
|
$1,974.59
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200006
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,374.31 |
| Max. Negotiated Rate |
$1,777.13 |
| Rate for Payer: Aetna Commercial |
$1,678.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,630.81
|
| Rate for Payer: BCN Commercial |
$1,630.81
|
| Rate for Payer: Cash Price |
$1,579.67
|
| Rate for Payer: Cofinity Commercial |
$1,698.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,579.67
|
| Rate for Payer: Healthscope Commercial |
$1,777.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,480.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,678.40
|
| Rate for Payer: Nomi Health Commercial |
$1,619.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,480.94
|
| Rate for Payer: PHP Commercial |
$1,678.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,717.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,374.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,737.64
|
| Rate for Payer: UHC Core |
$1,648.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,480.94
|
|
|
HC MR SPINE THORACIC WO CON
|
Facility
|
OP
|
$1,974.59
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200006
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$348.12 |
| Max. Negotiated Rate |
$1,777.13 |
| Rate for Payer: Aetna Commercial |
$1,678.40
|
| Rate for Payer: Aetna Medicare |
$513.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$617.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$617.06
|
| Rate for Payer: BCBS Complete |
$365.50
|
| Rate for Payer: BCBS MAPPO |
$493.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,623.31
|
| Rate for Payer: BCN Commercial |
$1,623.31
|
| Rate for Payer: BCN Medicare Advantage |
$493.65
|
| Rate for Payer: Cash Price |
$1,579.67
|
| Rate for Payer: Cofinity Commercial |
$1,698.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,579.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$493.65
|
| Rate for Payer: Healthscope Commercial |
$1,777.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,480.94
|
| Rate for Payer: Mclaren Medicaid |
$348.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$518.33
|
| Rate for Payer: Meridian Medicaid |
$365.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$567.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$543.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,678.40
|
| Rate for Payer: Nomi Health Commercial |
$1,619.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,480.94
|
| Rate for Payer: PACE Senior Care Partners |
$468.97
|
| Rate for Payer: PACE SWMI |
$493.65
|
| Rate for Payer: PHP Commercial |
$1,678.40
|
| Rate for Payer: PHP Medicare Advantage |
$493.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,717.89
|
| Rate for Payer: Priority Health Medicare |
$498.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,374.31
|
| Rate for Payer: Railroad Medicare Medicare |
$493.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,737.64
|
| Rate for Payer: UHC Core |
$1,648.78
|
| Rate for Payer: UHC Exchange |
$493.65
|
| Rate for Payer: UHC Medicaid |
$348.12
|
| Rate for Payer: UHC Medicare Advantage |
$493.65
|
| Rate for Payer: UHCCP Medicaid |
$348.12
|
| Rate for Payer: VA VA |
$493.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,480.94
|
|
