|
HC SPEECH/LANGUAGE/HEARING THERAPY
|
Facility
|
OP
|
$212.16
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
44000001
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$50.39 |
| Max. Negotiated Rate |
$190.94 |
| Rate for Payer: Aetna Commercial |
$180.34
|
| Rate for Payer: Aetna Medicare |
$55.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.30
|
| Rate for Payer: BCBS Complete |
$84.86
|
| Rate for Payer: BCBS MAPPO |
$53.04
|
| Rate for Payer: BCBS Trust/PPO |
$164.95
|
| Rate for Payer: BCN Commercial |
$164.95
|
| Rate for Payer: BCN Medicare Advantage |
$53.04
|
| Rate for Payer: Cash Price |
$169.73
|
| Rate for Payer: Cofinity Commercial |
$182.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$190.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$55.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$180.34
|
| Rate for Payer: PACE Senior Care Partners |
$50.39
|
| Rate for Payer: PACE SWMI |
$53.04
|
| Rate for Payer: PHP Commercial |
$180.34
|
| Rate for Payer: PHP Medicare Advantage |
$53.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.58
|
| Rate for Payer: Priority Health Medicare |
$53.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.40
|
| Rate for Payer: Railroad Medicare Medicare |
$53.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.70
|
| Rate for Payer: UHC Core |
$177.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.04
|
| Rate for Payer: UHC Medicare Advantage |
$54.63
|
| Rate for Payer: VA VA |
$53.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.12
|
|
|
HC SPEECH/LANGUAGE/HEARING THERAPY
|
Facility
|
IP
|
$212.16
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
44000001
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$129.40 |
| Max. Negotiated Rate |
$190.94 |
| Rate for Payer: Aetna Commercial |
$180.34
|
| Rate for Payer: BCBS Trust/PPO |
$163.96
|
| Rate for Payer: BCN Commercial |
$163.96
|
| Rate for Payer: Cash Price |
$169.73
|
| Rate for Payer: Cofinity Commercial |
$182.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.73
|
| Rate for Payer: Healthscope Commercial |
$190.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$180.34
|
| Rate for Payer: PHP Commercial |
$180.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.70
|
| Rate for Payer: UHC Core |
$177.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.12
|
|
|
HC SPEECH SOUND PRODUCTION EVAL
|
Facility
|
OP
|
$254.47
|
|
|
Service Code
|
CPT 92522
|
| Hospital Charge Code |
44400010
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$60.44 |
| Max. Negotiated Rate |
$229.02 |
| Rate for Payer: Aetna Commercial |
$216.30
|
| Rate for Payer: Aetna Medicare |
$66.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.52
|
| Rate for Payer: BCBS Complete |
$101.79
|
| Rate for Payer: BCBS MAPPO |
$63.62
|
| Rate for Payer: BCBS Trust/PPO |
$197.85
|
| Rate for Payer: BCN Commercial |
$197.85
|
| Rate for Payer: BCN Medicare Advantage |
$63.62
|
| Rate for Payer: Cash Price |
$203.58
|
| Rate for Payer: Cofinity Commercial |
$218.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.62
|
| Rate for Payer: Healthscope Commercial |
$229.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$66.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.30
|
| Rate for Payer: PACE Senior Care Partners |
$60.44
|
| Rate for Payer: PACE SWMI |
$63.62
|
| Rate for Payer: PHP Commercial |
$216.30
|
| Rate for Payer: PHP Medicare Advantage |
$63.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.39
|
| Rate for Payer: Priority Health Medicare |
$63.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.20
|
| Rate for Payer: Railroad Medicare Medicare |
$63.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.93
|
| Rate for Payer: UHC Core |
$212.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.62
|
| Rate for Payer: UHC Medicare Advantage |
$65.53
|
| Rate for Payer: VA VA |
$63.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.85
|
|
|
HC SPEECH SOUND PRODUCTION EVAL
|
Facility
|
IP
|
$254.47
|
|
|
Service Code
|
CPT 92522
|
| Hospital Charge Code |
44400010
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$155.20 |
| Max. Negotiated Rate |
$229.02 |
| Rate for Payer: Aetna Commercial |
$216.30
|
| Rate for Payer: BCBS Trust/PPO |
$196.65
|
| Rate for Payer: BCN Commercial |
$196.65
|
| Rate for Payer: Cash Price |
$203.58
|
| Rate for Payer: Cofinity Commercial |
$218.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.58
|
| Rate for Payer: Healthscope Commercial |
$229.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.30
|
| Rate for Payer: PHP Commercial |
$216.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.93
|
| Rate for Payer: UHC Core |
$212.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.85
|
|
|
HC SPEECH THRESHOLD AUDIOMETRY
|
Facility
|
IP
|
$49.14
|
|
|
Service Code
|
CPT 92555
|
| Hospital Charge Code |
47100011
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$29.97 |
| Max. Negotiated Rate |
$44.23 |
| Rate for Payer: Aetna Commercial |
$41.77
|
| Rate for Payer: BCBS Trust/PPO |
$37.98
|
| Rate for Payer: BCN Commercial |
$37.98
|
| Rate for Payer: Cash Price |
$39.31
|
| Rate for Payer: Cofinity Commercial |
$42.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.31
|
| Rate for Payer: Healthscope Commercial |
$44.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.77
|
| Rate for Payer: PHP Commercial |
$41.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.24
|
| Rate for Payer: UHC Core |
$41.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.86
|
|
|
HC SPEECH THRESHOLD AUDIOMETRY
|
Facility
|
OP
|
$49.14
|
|
|
Service Code
|
CPT 92555
|
| Hospital Charge Code |
47100011
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$44.23 |
| Rate for Payer: Aetna Commercial |
$41.77
|
| Rate for Payer: Aetna Medicare |
$12.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.36
|
| Rate for Payer: BCBS Complete |
$42.13
|
| Rate for Payer: BCBS MAPPO |
$12.28
|
| Rate for Payer: BCBS Trust/PPO |
$38.21
|
| Rate for Payer: BCN Commercial |
$38.21
|
| Rate for Payer: BCN Medicare Advantage |
$12.28
|
| Rate for Payer: Cash Price |
$39.31
|
| Rate for Payer: Cash Price |
$39.31
|
| Rate for Payer: Cofinity Commercial |
$42.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.28
|
| Rate for Payer: Healthscope Commercial |
$44.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.86
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Meridian Medicaid |
$42.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.77
|
| Rate for Payer: PACE Senior Care Partners |
$11.67
|
| Rate for Payer: PACE SWMI |
$12.28
|
| Rate for Payer: PHP Commercial |
$41.77
|
| Rate for Payer: PHP Medicare Advantage |
$12.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.75
|
| Rate for Payer: Priority Health Medicare |
$12.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.97
|
| Rate for Payer: Railroad Medicare Medicare |
$12.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.24
|
| Rate for Payer: UHC Core |
$41.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.28
|
| Rate for Payer: UHC Medicare Advantage |
$12.65
|
| Rate for Payer: VA VA |
$12.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.86
|
|
|
HC SPEECH VIDEO FLUORO EVAL
|
Facility
|
OP
|
$389.23
|
|
|
Service Code
|
CPT 92611
|
| Hospital Charge Code |
44000004
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$92.44 |
| Max. Negotiated Rate |
$350.31 |
| Rate for Payer: Aetna Commercial |
$330.85
|
| Rate for Payer: Aetna Medicare |
$101.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$121.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$121.63
|
| Rate for Payer: BCBS Complete |
$155.69
|
| Rate for Payer: BCBS MAPPO |
$97.31
|
| Rate for Payer: BCBS Trust/PPO |
$302.63
|
| Rate for Payer: BCN Commercial |
$302.63
|
| Rate for Payer: BCN Medicare Advantage |
$97.31
|
| Rate for Payer: Cash Price |
$311.38
|
| Rate for Payer: Cofinity Commercial |
$334.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$311.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.31
|
| Rate for Payer: Healthscope Commercial |
$350.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$330.85
|
| Rate for Payer: PACE Senior Care Partners |
$92.44
|
| Rate for Payer: PACE SWMI |
$97.31
|
| Rate for Payer: PHP Commercial |
$330.85
|
| Rate for Payer: PHP Medicare Advantage |
$97.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$272.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$338.63
|
| Rate for Payer: Priority Health Medicare |
$97.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$237.39
|
| Rate for Payer: Railroad Medicare Medicare |
$97.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.52
|
| Rate for Payer: UHC Core |
$325.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.31
|
| Rate for Payer: UHC Medicare Advantage |
$100.23
|
| Rate for Payer: VA VA |
$97.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.92
|
|
|
HC SPEECH VIDEO FLUORO EVAL
|
Facility
|
IP
|
$389.23
|
|
|
Service Code
|
CPT 92611
|
| Hospital Charge Code |
44000004
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$237.39 |
| Max. Negotiated Rate |
$350.31 |
| Rate for Payer: Aetna Commercial |
$330.85
|
| Rate for Payer: BCBS Trust/PPO |
$300.80
|
| Rate for Payer: BCN Commercial |
$300.80
|
| Rate for Payer: Cash Price |
$311.38
|
| Rate for Payer: Cofinity Commercial |
$334.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$311.38
|
| Rate for Payer: Healthscope Commercial |
$350.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$330.85
|
| Rate for Payer: PHP Commercial |
$330.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$272.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$338.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$237.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.52
|
| Rate for Payer: UHC Core |
$325.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.92
|
|
|
HC SPEECH VOICE EVALUATION
|
Facility
|
IP
|
$280.23
|
|
|
Service Code
|
CPT 92524
|
| Hospital Charge Code |
44400011
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$170.91 |
| Max. Negotiated Rate |
$252.21 |
| Rate for Payer: Aetna Commercial |
$238.20
|
| Rate for Payer: BCBS Trust/PPO |
$216.56
|
| Rate for Payer: BCN Commercial |
$216.56
|
| Rate for Payer: Cash Price |
$224.18
|
| Rate for Payer: Cofinity Commercial |
$241.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.18
|
| Rate for Payer: Healthscope Commercial |
$252.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$238.20
|
| Rate for Payer: PHP Commercial |
$238.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$243.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.60
|
| Rate for Payer: UHC Core |
$233.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.17
|
|
|
HC SPEECH VOICE EVALUATION
|
Facility
|
OP
|
$280.23
|
|
|
Service Code
|
CPT 92524
|
| Hospital Charge Code |
44400011
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$66.55 |
| Max. Negotiated Rate |
$252.21 |
| Rate for Payer: Aetna Commercial |
$238.20
|
| Rate for Payer: Aetna Medicare |
$72.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.57
|
| Rate for Payer: BCBS Complete |
$112.09
|
| Rate for Payer: BCBS MAPPO |
$70.06
|
| Rate for Payer: BCBS Trust/PPO |
$217.88
|
| Rate for Payer: BCN Commercial |
$217.88
|
| Rate for Payer: BCN Medicare Advantage |
$70.06
|
| Rate for Payer: Cash Price |
$224.18
|
| Rate for Payer: Cofinity Commercial |
$241.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.06
|
| Rate for Payer: Healthscope Commercial |
$252.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$73.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$238.20
|
| Rate for Payer: PACE Senior Care Partners |
$66.55
|
| Rate for Payer: PACE SWMI |
$70.06
|
| Rate for Payer: PHP Commercial |
$238.20
|
| Rate for Payer: PHP Medicare Advantage |
$70.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$243.80
|
| Rate for Payer: Priority Health Medicare |
$70.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.91
|
| Rate for Payer: Railroad Medicare Medicare |
$70.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.60
|
| Rate for Payer: UHC Core |
$233.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.06
|
| Rate for Payer: UHC Medicare Advantage |
$72.16
|
| Rate for Payer: VA VA |
$70.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.17
|
|
|
HC SPIKE BLOOD ACCESS
|
Facility
|
IP
|
$15.75
|
|
| Hospital Charge Code |
27000669
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$14.18 |
| Rate for Payer: Aetna Commercial |
$13.39
|
| Rate for Payer: BCBS Trust/PPO |
$12.17
|
| Rate for Payer: BCN Commercial |
$12.17
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cofinity Commercial |
$13.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$14.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.39
|
| Rate for Payer: PHP Commercial |
$13.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.86
|
| Rate for Payer: UHC Core |
$13.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.81
|
|
|
HC SPIKE BLOOD ACCESS
|
Facility
|
OP
|
$15.75
|
|
| Hospital Charge Code |
27000669
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$14.18 |
| Rate for Payer: Aetna Commercial |
$13.39
|
| Rate for Payer: Aetna Medicare |
$4.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.92
|
| Rate for Payer: BCBS Complete |
$6.30
|
| Rate for Payer: BCBS MAPPO |
$3.94
|
| Rate for Payer: BCBS Trust/PPO |
$12.25
|
| Rate for Payer: BCN Commercial |
$12.25
|
| Rate for Payer: BCN Medicare Advantage |
$3.94
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cofinity Commercial |
$13.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.94
|
| Rate for Payer: Healthscope Commercial |
$14.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.39
|
| Rate for Payer: PACE Senior Care Partners |
$3.74
|
| Rate for Payer: PACE SWMI |
$3.94
|
| Rate for Payer: PHP Commercial |
$13.39
|
| Rate for Payer: PHP Medicare Advantage |
$3.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.70
|
| Rate for Payer: Priority Health Medicare |
$3.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.61
|
| Rate for Payer: Railroad Medicare Medicare |
$3.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.86
|
| Rate for Payer: UHC Core |
$13.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.94
|
| Rate for Payer: UHC Medicare Advantage |
$4.06
|
| Rate for Payer: VA VA |
$3.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.81
|
|
|
HC SPINAL/EPI ADDL 15 MIN
|
Facility
|
OP
|
$156.58
|
|
| Hospital Charge Code |
37000013
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$37.19 |
| Max. Negotiated Rate |
$140.92 |
| Rate for Payer: Aetna Commercial |
$133.09
|
| Rate for Payer: Aetna Medicare |
$40.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.93
|
| Rate for Payer: BCBS Complete |
$62.63
|
| Rate for Payer: BCBS MAPPO |
$39.14
|
| Rate for Payer: BCBS Trust/PPO |
$121.74
|
| Rate for Payer: BCN Commercial |
$121.74
|
| Rate for Payer: BCN Medicare Advantage |
$39.14
|
| Rate for Payer: Cash Price |
$125.26
|
| Rate for Payer: Cofinity Commercial |
$134.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.14
|
| Rate for Payer: Healthscope Commercial |
$140.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$133.09
|
| Rate for Payer: PACE Senior Care Partners |
$37.19
|
| Rate for Payer: PACE SWMI |
$39.14
|
| Rate for Payer: PHP Commercial |
$133.09
|
| Rate for Payer: PHP Medicare Advantage |
$39.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$136.22
|
| Rate for Payer: Priority Health Medicare |
$39.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.50
|
| Rate for Payer: Railroad Medicare Medicare |
$39.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.79
|
| Rate for Payer: UHC Core |
$130.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.14
|
| Rate for Payer: UHC Medicare Advantage |
$40.32
|
| Rate for Payer: VA VA |
$39.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.44
|
|
|
HC SPINAL/EPI ADDL 15 MIN
|
Facility
|
IP
|
$156.58
|
|
| Hospital Charge Code |
37000013
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$95.50 |
| Max. Negotiated Rate |
$140.92 |
| Rate for Payer: Aetna Commercial |
$133.09
|
| Rate for Payer: BCBS Trust/PPO |
$121.01
|
| Rate for Payer: BCN Commercial |
$121.01
|
| Rate for Payer: Cash Price |
$125.26
|
| Rate for Payer: Cofinity Commercial |
$134.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.26
|
| Rate for Payer: Healthscope Commercial |
$140.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$133.09
|
| Rate for Payer: PHP Commercial |
$133.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$136.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.79
|
| Rate for Payer: UHC Core |
$130.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.44
|
|
|
HC SPINAL/EPI INIT 30 MIN
|
Facility
|
OP
|
$428.17
|
|
| Hospital Charge Code |
37000014
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$101.69 |
| Max. Negotiated Rate |
$385.35 |
| Rate for Payer: Aetna Commercial |
$363.94
|
| Rate for Payer: Aetna Medicare |
$111.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$133.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$133.80
|
| Rate for Payer: BCBS Complete |
$171.27
|
| Rate for Payer: BCBS MAPPO |
$107.04
|
| Rate for Payer: BCBS Trust/PPO |
$332.90
|
| Rate for Payer: BCN Commercial |
$332.90
|
| Rate for Payer: BCN Medicare Advantage |
$107.04
|
| Rate for Payer: Cash Price |
$342.54
|
| Rate for Payer: Cofinity Commercial |
$368.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.04
|
| Rate for Payer: Healthscope Commercial |
$385.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$363.94
|
| Rate for Payer: PACE Senior Care Partners |
$101.69
|
| Rate for Payer: PACE SWMI |
$107.04
|
| Rate for Payer: PHP Commercial |
$363.94
|
| Rate for Payer: PHP Medicare Advantage |
$107.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$299.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$372.51
|
| Rate for Payer: Priority Health Medicare |
$107.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.14
|
| Rate for Payer: Railroad Medicare Medicare |
$107.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$376.79
|
| Rate for Payer: UHC Core |
$357.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.04
|
| Rate for Payer: UHC Medicare Advantage |
$110.25
|
| Rate for Payer: VA VA |
$107.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.13
|
|
|
HC SPINAL/EPI INIT 30 MIN
|
Facility
|
IP
|
$428.17
|
|
| Hospital Charge Code |
37000014
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$261.14 |
| Max. Negotiated Rate |
$385.35 |
| Rate for Payer: Aetna Commercial |
$363.94
|
| Rate for Payer: BCBS Trust/PPO |
$330.89
|
| Rate for Payer: BCN Commercial |
$330.89
|
| Rate for Payer: Cash Price |
$342.54
|
| Rate for Payer: Cofinity Commercial |
$368.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.54
|
| Rate for Payer: Healthscope Commercial |
$385.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$363.94
|
| Rate for Payer: PHP Commercial |
$363.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$299.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$372.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$376.79
|
| Rate for Payer: UHC Core |
$357.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.13
|
|
|
HC SPINE JACK
|
Facility
|
OP
|
$14,119.00
|
|
|
Service Code
|
CPT C1062
|
| Hospital Charge Code |
27800148
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,353.26 |
| Max. Negotiated Rate |
$12,707.10 |
| Rate for Payer: Aetna Commercial |
$12,001.15
|
| Rate for Payer: Aetna Medicare |
$3,670.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,412.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,412.19
|
| Rate for Payer: BCBS Complete |
$5,647.60
|
| Rate for Payer: BCBS MAPPO |
$3,529.75
|
| Rate for Payer: BCBS Trust/PPO |
$10,977.52
|
| Rate for Payer: BCN Commercial |
$10,977.52
|
| Rate for Payer: BCN Medicare Advantage |
$3,529.75
|
| Rate for Payer: Cash Price |
$11,295.20
|
| Rate for Payer: Cofinity Commercial |
$12,142.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,295.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,529.75
|
| Rate for Payer: Healthscope Commercial |
$12,707.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,589.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,706.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,059.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12,001.15
|
| Rate for Payer: PACE Senior Care Partners |
$3,353.26
|
| Rate for Payer: PACE SWMI |
$3,529.75
|
| Rate for Payer: PHP Commercial |
$12,001.15
|
| Rate for Payer: PHP Medicare Advantage |
$3,529.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,883.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12,283.53
|
| Rate for Payer: Priority Health Medicare |
$3,529.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,611.18
|
| Rate for Payer: Railroad Medicare Medicare |
$3,529.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,424.72
|
| Rate for Payer: UHC Core |
$11,789.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,529.75
|
| Rate for Payer: UHC Medicare Advantage |
$3,635.64
|
| Rate for Payer: VA VA |
$3,529.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,589.25
|
|
|
HC SPINE JACK
|
Facility
|
IP
|
$14,119.00
|
|
|
Service Code
|
CPT C1062
|
| Hospital Charge Code |
27800148
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,611.18 |
| Max. Negotiated Rate |
$12,707.10 |
| Rate for Payer: Aetna Commercial |
$12,001.15
|
| Rate for Payer: BCBS Trust/PPO |
$10,911.16
|
| Rate for Payer: BCN Commercial |
$10,911.16
|
| Rate for Payer: Cash Price |
$11,295.20
|
| Rate for Payer: Cofinity Commercial |
$12,142.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,295.20
|
| Rate for Payer: Healthscope Commercial |
$12,707.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,589.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12,001.15
|
| Rate for Payer: PHP Commercial |
$12,001.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,883.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12,283.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,611.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,424.72
|
| Rate for Payer: UHC Core |
$11,789.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,589.25
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 1 VIEW
|
Facility
|
IP
|
$147.59
|
|
|
Service Code
|
CPT 72081
|
| Hospital Charge Code |
32000317
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$90.02 |
| Max. Negotiated Rate |
$132.83 |
| Rate for Payer: Aetna Commercial |
$125.45
|
| Rate for Payer: BCBS Trust/PPO |
$114.06
|
| Rate for Payer: BCN Commercial |
$114.06
|
| Rate for Payer: Cash Price |
$118.07
|
| Rate for Payer: Cofinity Commercial |
$126.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.07
|
| Rate for Payer: Healthscope Commercial |
$132.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.45
|
| Rate for Payer: PHP Commercial |
$125.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.88
|
| Rate for Payer: UHC Core |
$123.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.69
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 1 VIEW
|
Facility
|
OP
|
$147.59
|
|
|
Service Code
|
CPT 72081
|
| Hospital Charge Code |
32000317
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$35.05 |
| Max. Negotiated Rate |
$132.83 |
| Rate for Payer: Aetna Commercial |
$125.45
|
| Rate for Payer: Aetna Medicare |
$38.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.12
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$36.90
|
| Rate for Payer: BCBS Trust/PPO |
$114.75
|
| Rate for Payer: BCN Commercial |
$114.75
|
| Rate for Payer: BCN Medicare Advantage |
$36.90
|
| Rate for Payer: Cash Price |
$118.07
|
| Rate for Payer: Cash Price |
$118.07
|
| Rate for Payer: Cofinity Commercial |
$126.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.90
|
| Rate for Payer: Healthscope Commercial |
$132.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.69
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.45
|
| Rate for Payer: PACE Senior Care Partners |
$35.05
|
| Rate for Payer: PACE SWMI |
$36.90
|
| Rate for Payer: PHP Commercial |
$125.45
|
| Rate for Payer: PHP Medicare Advantage |
$36.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.40
|
| Rate for Payer: Priority Health Medicare |
$36.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.02
|
| Rate for Payer: Railroad Medicare Medicare |
$36.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.88
|
| Rate for Payer: UHC Core |
$123.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.90
|
| Rate for Payer: UHC Medicare Advantage |
$38.00
|
| Rate for Payer: VA VA |
$36.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.69
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 2 OR 3 VIEW
|
Facility
|
IP
|
$354.24
|
|
|
Service Code
|
CPT 72082
|
| Hospital Charge Code |
32000306
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$216.05 |
| Max. Negotiated Rate |
$318.82 |
| Rate for Payer: Aetna Commercial |
$301.10
|
| Rate for Payer: BCBS Trust/PPO |
$273.76
|
| Rate for Payer: BCN Commercial |
$273.76
|
| Rate for Payer: Cash Price |
$283.39
|
| Rate for Payer: Cofinity Commercial |
$304.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.39
|
| Rate for Payer: Healthscope Commercial |
$318.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$301.10
|
| Rate for Payer: PHP Commercial |
$301.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$308.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$216.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.73
|
| Rate for Payer: UHC Core |
$295.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.68
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 2 OR 3 VIEW
|
Facility
|
OP
|
$354.24
|
|
|
Service Code
|
CPT 72082
|
| Hospital Charge Code |
32000306
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$318.82 |
| Rate for Payer: Aetna Commercial |
$301.10
|
| Rate for Payer: Aetna Medicare |
$92.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$110.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$110.70
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$88.56
|
| Rate for Payer: BCBS Trust/PPO |
$275.42
|
| Rate for Payer: BCN Commercial |
$275.42
|
| Rate for Payer: BCN Medicare Advantage |
$88.56
|
| Rate for Payer: Cash Price |
$283.39
|
| Rate for Payer: Cash Price |
$283.39
|
| Rate for Payer: Cofinity Commercial |
$304.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.56
|
| Rate for Payer: Healthscope Commercial |
$318.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.68
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$92.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$101.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$301.10
|
| Rate for Payer: PACE Senior Care Partners |
$84.13
|
| Rate for Payer: PACE SWMI |
$88.56
|
| Rate for Payer: PHP Commercial |
$301.10
|
| Rate for Payer: PHP Medicare Advantage |
$88.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$308.19
|
| Rate for Payer: Priority Health Medicare |
$88.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$216.05
|
| Rate for Payer: Railroad Medicare Medicare |
$88.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.73
|
| Rate for Payer: UHC Core |
$295.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.56
|
| Rate for Payer: UHC Medicare Advantage |
$91.22
|
| Rate for Payer: VA VA |
$88.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.68
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 4 OR 5 VIEW
|
Facility
|
OP
|
$472.31
|
|
|
Service Code
|
CPT 72083
|
| Hospital Charge Code |
32000307
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$425.08 |
| Rate for Payer: Aetna Commercial |
$401.46
|
| Rate for Payer: Aetna Medicare |
$122.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$147.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$147.60
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$118.08
|
| Rate for Payer: BCBS Trust/PPO |
$367.22
|
| Rate for Payer: BCN Commercial |
$367.22
|
| Rate for Payer: BCN Medicare Advantage |
$118.08
|
| Rate for Payer: Cash Price |
$377.85
|
| Rate for Payer: Cash Price |
$377.85
|
| Rate for Payer: Cofinity Commercial |
$406.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$377.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.08
|
| Rate for Payer: Healthscope Commercial |
$425.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.23
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$123.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$401.46
|
| Rate for Payer: PACE Senior Care Partners |
$112.17
|
| Rate for Payer: PACE SWMI |
$118.08
|
| Rate for Payer: PHP Commercial |
$401.46
|
| Rate for Payer: PHP Medicare Advantage |
$118.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$410.91
|
| Rate for Payer: Priority Health Medicare |
$118.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$288.06
|
| Rate for Payer: Railroad Medicare Medicare |
$118.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$415.63
|
| Rate for Payer: UHC Core |
$394.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.08
|
| Rate for Payer: UHC Medicare Advantage |
$121.62
|
| Rate for Payer: VA VA |
$118.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.23
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 4 OR 5 VIEW
|
Facility
|
IP
|
$472.31
|
|
|
Service Code
|
CPT 72083
|
| Hospital Charge Code |
32000307
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$288.06 |
| Max. Negotiated Rate |
$425.08 |
| Rate for Payer: Aetna Commercial |
$401.46
|
| Rate for Payer: BCBS Trust/PPO |
$365.00
|
| Rate for Payer: BCN Commercial |
$365.00
|
| Rate for Payer: Cash Price |
$377.85
|
| Rate for Payer: Cofinity Commercial |
$406.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$377.85
|
| Rate for Payer: Healthscope Commercial |
$425.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$401.46
|
| Rate for Payer: PHP Commercial |
$401.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$410.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$288.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$415.63
|
| Rate for Payer: UHC Core |
$394.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.23
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL MIN 6 VIEW
|
Facility
|
OP
|
$590.39
|
|
|
Service Code
|
CPT 72084
|
| Hospital Charge Code |
32000308
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$531.35 |
| Rate for Payer: Aetna Commercial |
$501.83
|
| Rate for Payer: Aetna Medicare |
$153.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$184.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$184.50
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$147.60
|
| Rate for Payer: BCBS Trust/PPO |
$459.03
|
| Rate for Payer: BCN Commercial |
$459.03
|
| Rate for Payer: BCN Medicare Advantage |
$147.60
|
| Rate for Payer: Cash Price |
$472.31
|
| Rate for Payer: Cash Price |
$472.31
|
| Rate for Payer: Cofinity Commercial |
$507.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$472.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.60
|
| Rate for Payer: Healthscope Commercial |
$531.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$442.79
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$154.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$169.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$501.83
|
| Rate for Payer: PACE Senior Care Partners |
$140.22
|
| Rate for Payer: PACE SWMI |
$147.60
|
| Rate for Payer: PHP Commercial |
$501.83
|
| Rate for Payer: PHP Medicare Advantage |
$147.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$413.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$513.64
|
| Rate for Payer: Priority Health Medicare |
$147.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$360.08
|
| Rate for Payer: Railroad Medicare Medicare |
$147.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.54
|
| Rate for Payer: UHC Core |
$492.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.60
|
| Rate for Payer: UHC Medicare Advantage |
$152.03
|
| Rate for Payer: VA VA |
$147.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$442.79
|
|
