|
HC MR GUIDANCE FOR NEEDLE PLACEMENT
|
Facility
|
IP
|
$1,045.60
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100004
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$679.64 |
| Max. Negotiated Rate |
$941.04 |
| Rate for Payer: Aetna Commercial |
$888.76
|
| Rate for Payer: BCBS Trust/PPO |
$853.52
|
| Rate for Payer: BCN Commercial |
$808.04
|
| Rate for Payer: Cash Price |
$836.48
|
| Rate for Payer: Cofinity Commercial |
$899.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$836.48
|
| Rate for Payer: Healthscope Commercial |
$941.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$784.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$888.76
|
| Rate for Payer: Nomi Health Commercial |
$857.39
|
| Rate for Payer: PHP Commercial |
$888.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$679.64
|
| Rate for Payer: Priority Health HMO/PPO |
$909.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$700.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$920.13
|
| Rate for Payer: UHC Core |
$873.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$784.20
|
|
|
HC MR GUIDANCE FOR NEEDLE PLACEMENT
|
Facility
|
OP
|
$1,045.60
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100004
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$248.33 |
| Max. Negotiated Rate |
$941.04 |
| Rate for Payer: Aetna Commercial |
$888.76
|
| Rate for Payer: Aetna Medicare |
$271.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$326.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$326.75
|
| Rate for Payer: BCBS Complete |
$418.24
|
| Rate for Payer: BCBS MAPPO |
$261.40
|
| Rate for Payer: BCBS Trust/PPO |
$859.59
|
| Rate for Payer: BCN Commercial |
$812.95
|
| Rate for Payer: BCN Medicare Advantage |
$261.40
|
| Rate for Payer: Cash Price |
$836.48
|
| Rate for Payer: Cofinity Commercial |
$899.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$836.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$261.40
|
| Rate for Payer: Healthscope Commercial |
$941.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$784.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$274.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$300.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$888.76
|
| Rate for Payer: Nomi Health Commercial |
$857.39
|
| Rate for Payer: PACE Senior Care Partners |
$248.33
|
| Rate for Payer: PACE SWMI |
$261.40
|
| Rate for Payer: PHP Commercial |
$888.76
|
| Rate for Payer: PHP Medicare Advantage |
$261.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$679.64
|
| Rate for Payer: Priority Health HMO/PPO |
$909.67
|
| Rate for Payer: Priority Health Medicare |
$264.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$700.55
|
| Rate for Payer: Railroad Medicare Medicare |
$261.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$920.13
|
| Rate for Payer: UHC Core |
$873.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$261.40
|
| Rate for Payer: UHC Exchange |
$261.40
|
| Rate for Payer: UHC Medicare Advantage |
$261.40
|
| Rate for Payer: VA VA |
$261.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$784.20
|
|
|
HC MR LOWER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
IP
|
$3,014.98
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000040
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,959.74 |
| Max. Negotiated Rate |
$2,713.48 |
| Rate for Payer: Aetna Commercial |
$2,562.73
|
| Rate for Payer: BCBS Trust/PPO |
$2,461.13
|
| Rate for Payer: BCN Commercial |
$2,329.98
|
| Rate for Payer: Cash Price |
$2,411.98
|
| Rate for Payer: Cofinity Commercial |
$2,592.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,411.98
|
| Rate for Payer: Healthscope Commercial |
$2,713.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,261.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,562.73
|
| Rate for Payer: Nomi Health Commercial |
$2,472.28
|
| Rate for Payer: PHP Commercial |
$2,562.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,959.74
|
| Rate for Payer: Priority Health HMO/PPO |
$2,623.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,020.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,653.18
|
| Rate for Payer: UHC Core |
$2,517.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,261.24
|
|
|
HC MR LOWER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
OP
|
$3,014.98
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000040
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,713.48 |
| Rate for Payer: Aetna Commercial |
$2,562.73
|
| Rate for Payer: Aetna Medicare |
$783.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$942.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$942.18
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$753.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,478.62
|
| Rate for Payer: BCN Commercial |
$2,344.15
|
| Rate for Payer: BCN Medicare Advantage |
$753.74
|
| Rate for Payer: Cash Price |
$2,411.98
|
| Rate for Payer: Cash Price |
$2,411.98
|
| Rate for Payer: Cofinity Commercial |
$2,592.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,411.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$753.74
|
| Rate for Payer: Healthscope Commercial |
$2,713.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,261.24
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$791.43
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$866.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,562.73
|
| Rate for Payer: Nomi Health Commercial |
$2,472.28
|
| Rate for Payer: PACE Senior Care Partners |
$716.06
|
| Rate for Payer: PACE SWMI |
$753.74
|
| Rate for Payer: PHP Commercial |
$2,562.73
|
| Rate for Payer: PHP Medicare Advantage |
$753.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,959.74
|
| Rate for Payer: Priority Health HMO/PPO |
$2,623.03
|
| Rate for Payer: Priority Health Medicare |
$761.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,020.04
|
| Rate for Payer: Railroad Medicare Medicare |
$753.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,653.18
|
| Rate for Payer: UHC Core |
$2,517.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$753.74
|
| Rate for Payer: UHC Exchange |
$753.74
|
| Rate for Payer: UHC Medicare Advantage |
$753.74
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$753.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,261.24
|
|
|
HC MR LOWER EXTREM ANY JOINT W CON
|
Facility
|
OP
|
$2,252.06
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000037
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$534.86 |
| Max. Negotiated Rate |
$2,026.85 |
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: Aetna Commercial |
$2,871.38
|
| Rate for Payer: Aetna Medicare |
$585.54
|
| Rate for Payer: Aetna Medicare |
$878.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$703.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,055.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$703.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,055.65
|
| Rate for Payer: BCBS Complete |
$587.68
|
| Rate for Payer: BCBS Complete |
$587.68
|
| Rate for Payer: BCBS MAPPO |
$844.52
|
| Rate for Payer: BCBS MAPPO |
$563.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,851.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,777.13
|
| Rate for Payer: BCN Commercial |
$1,750.98
|
| Rate for Payer: BCN Commercial |
$2,626.46
|
| Rate for Payer: BCN Medicare Advantage |
$563.02
|
| Rate for Payer: BCN Medicare Advantage |
$844.52
|
| Rate for Payer: Cash Price |
$2,702.47
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cash Price |
$2,702.47
|
| Rate for Payer: Cofinity Commercial |
$1,936.77
|
| Rate for Payer: Cofinity Commercial |
$2,905.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,702.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$563.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$844.52
|
| Rate for Payer: Healthscope Commercial |
$3,040.28
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,689.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,533.57
|
| Rate for Payer: Mclaren Medicaid |
$559.66
|
| Rate for Payer: Mclaren Medicaid |
$559.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$886.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$591.17
|
| Rate for Payer: Meridian Medicaid |
$587.68
|
| Rate for Payer: Meridian Medicaid |
$587.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$647.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$971.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,871.38
|
| Rate for Payer: Nomi Health Commercial |
$1,846.69
|
| Rate for Payer: Nomi Health Commercial |
$2,770.03
|
| Rate for Payer: PACE Senior Care Partners |
$534.86
|
| Rate for Payer: PACE Senior Care Partners |
$802.30
|
| Rate for Payer: PACE SWMI |
$563.02
|
| Rate for Payer: PACE SWMI |
$844.52
|
| Rate for Payer: PHP Commercial |
$2,871.38
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: PHP Medicare Advantage |
$563.02
|
| Rate for Payer: PHP Medicare Advantage |
$844.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$559.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$559.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,195.76
|
| Rate for Payer: Priority Health HMO/PPO |
$2,938.94
|
| Rate for Payer: Priority Health HMO/PPO |
$1,959.29
|
| Rate for Payer: Priority Health Medicare |
$568.65
|
| Rate for Payer: Priority Health Medicare |
$852.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,508.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,263.32
|
| Rate for Payer: Railroad Medicare Medicare |
$844.52
|
| Rate for Payer: Railroad Medicare Medicare |
$563.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,972.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,981.81
|
| Rate for Payer: UHC Core |
$2,820.71
|
| Rate for Payer: UHC Core |
$1,880.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$563.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$844.52
|
| Rate for Payer: UHC Exchange |
$844.52
|
| Rate for Payer: UHC Exchange |
$563.02
|
| Rate for Payer: UHC Medicare Advantage |
$844.52
|
| Rate for Payer: UHC Medicare Advantage |
$563.02
|
| Rate for Payer: UHCCP Medicaid |
$559.66
|
| Rate for Payer: UHCCP Medicaid |
$559.66
|
| Rate for Payer: VA VA |
$563.02
|
| Rate for Payer: VA VA |
$844.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,533.57
|
|
|
HC MR LOWER EXTREM ANY JOINT W CON
|
Facility
|
IP
|
$2,252.06
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000037
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,463.84 |
| Max. Negotiated Rate |
$2,026.85 |
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: Aetna Commercial |
$2,871.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,838.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,757.53
|
| Rate for Payer: BCN Commercial |
$1,740.39
|
| Rate for Payer: BCN Commercial |
$2,610.59
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cash Price |
$2,702.47
|
| Rate for Payer: Cofinity Commercial |
$2,905.16
|
| Rate for Payer: Cofinity Commercial |
$1,936.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,702.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Healthscope Commercial |
$3,040.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,689.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,533.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,871.38
|
| Rate for Payer: Nomi Health Commercial |
$1,846.69
|
| Rate for Payer: Nomi Health Commercial |
$2,770.03
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: PHP Commercial |
$2,871.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,195.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.84
|
| Rate for Payer: Priority Health HMO/PPO |
$2,938.94
|
| Rate for Payer: Priority Health HMO/PPO |
$1,959.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,508.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,263.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,981.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,972.72
|
| Rate for Payer: UHC Core |
$1,880.47
|
| Rate for Payer: UHC Core |
$2,820.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,533.57
|
|
|
HC MR LOWER EXTREM ANY JOINT WO CON
|
Facility
|
IP
|
$1,932.90
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000035
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,256.38 |
| Max. Negotiated Rate |
$1,739.61 |
| Rate for Payer: Aetna Commercial |
$1,642.96
|
| Rate for Payer: Aetna Commercial |
$2,464.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,577.83
|
| Rate for Payer: BCBS Trust/PPO |
$2,366.74
|
| Rate for Payer: BCN Commercial |
$1,493.75
|
| Rate for Payer: BCN Commercial |
$2,240.62
|
| Rate for Payer: Cash Price |
$1,546.32
|
| Rate for Payer: Cash Price |
$2,319.48
|
| Rate for Payer: Cofinity Commercial |
$2,493.44
|
| Rate for Payer: Cofinity Commercial |
$1,662.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,319.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,546.32
|
| Rate for Payer: Healthscope Commercial |
$1,739.61
|
| Rate for Payer: Healthscope Commercial |
$2,609.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,449.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,174.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,642.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,464.45
|
| Rate for Payer: Nomi Health Commercial |
$1,584.98
|
| Rate for Payer: Nomi Health Commercial |
$2,377.47
|
| Rate for Payer: PHP Commercial |
$1,642.96
|
| Rate for Payer: PHP Commercial |
$2,464.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,884.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,256.38
|
| Rate for Payer: Priority Health HMO/PPO |
$2,522.43
|
| Rate for Payer: Priority Health HMO/PPO |
$1,681.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,295.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,942.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,700.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,551.43
|
| Rate for Payer: UHC Core |
$1,613.97
|
| Rate for Payer: UHC Core |
$2,420.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,449.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,174.51
|
|
|
HC MR LOWER EXTREM ANY JOINT WO CON
|
Facility
|
OP
|
$1,932.90
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000035
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,739.61 |
| Rate for Payer: Aetna Commercial |
$1,642.96
|
| Rate for Payer: Aetna Commercial |
$2,464.45
|
| Rate for Payer: Aetna Medicare |
$502.55
|
| Rate for Payer: Aetna Medicare |
$753.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$604.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$906.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$604.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$906.05
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$724.84
|
| Rate for Payer: BCBS MAPPO |
$483.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,589.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,383.56
|
| Rate for Payer: BCN Commercial |
$1,502.83
|
| Rate for Payer: BCN Commercial |
$2,254.24
|
| Rate for Payer: BCN Medicare Advantage |
$483.22
|
| Rate for Payer: BCN Medicare Advantage |
$724.84
|
| Rate for Payer: Cash Price |
$2,319.48
|
| Rate for Payer: Cash Price |
$1,546.32
|
| Rate for Payer: Cash Price |
$1,546.32
|
| Rate for Payer: Cash Price |
$2,319.48
|
| Rate for Payer: Cofinity Commercial |
$1,662.29
|
| Rate for Payer: Cofinity Commercial |
$2,493.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,319.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,546.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$483.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$724.84
|
| Rate for Payer: Healthscope Commercial |
$2,609.42
|
| Rate for Payer: Healthscope Commercial |
$1,739.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,449.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,174.51
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$761.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$507.39
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$555.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$833.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,642.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,464.45
|
| Rate for Payer: Nomi Health Commercial |
$1,584.98
|
| Rate for Payer: Nomi Health Commercial |
$2,377.47
|
| Rate for Payer: PACE Senior Care Partners |
$459.06
|
| Rate for Payer: PACE Senior Care Partners |
$688.60
|
| Rate for Payer: PACE SWMI |
$483.22
|
| Rate for Payer: PACE SWMI |
$724.84
|
| Rate for Payer: PHP Commercial |
$2,464.45
|
| Rate for Payer: PHP Commercial |
$1,642.96
|
| Rate for Payer: PHP Medicare Advantage |
$483.22
|
| Rate for Payer: PHP Medicare Advantage |
$724.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,256.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,884.58
|
| Rate for Payer: Priority Health HMO/PPO |
$2,522.43
|
| Rate for Payer: Priority Health HMO/PPO |
$1,681.62
|
| Rate for Payer: Priority Health Medicare |
$488.06
|
| Rate for Payer: Priority Health Medicare |
$732.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,295.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,942.56
|
| Rate for Payer: Railroad Medicare Medicare |
$724.84
|
| Rate for Payer: Railroad Medicare Medicare |
$483.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,551.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,700.95
|
| Rate for Payer: UHC Core |
$2,420.96
|
| Rate for Payer: UHC Core |
$1,613.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$483.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$724.84
|
| Rate for Payer: UHC Exchange |
$724.84
|
| Rate for Payer: UHC Exchange |
$483.22
|
| Rate for Payer: UHC Medicare Advantage |
$724.84
|
| Rate for Payer: UHC Medicare Advantage |
$483.22
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$483.22
|
| Rate for Payer: VA VA |
$724.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,449.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,174.51
|
|
|
HC MR LOWER EXTREM ANY JOINT WO W CON
|
Facility
|
IP
|
$2,533.57
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000039
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,646.82 |
| Max. Negotiated Rate |
$2,280.21 |
| Rate for Payer: Aetna Commercial |
$2,153.53
|
| Rate for Payer: Aetna Commercial |
$3,230.31
|
| Rate for Payer: BCBS Trust/PPO |
$2,068.15
|
| Rate for Payer: BCBS Trust/PPO |
$3,102.23
|
| Rate for Payer: BCN Commercial |
$1,957.94
|
| Rate for Payer: BCN Commercial |
$2,936.92
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cofinity Commercial |
$3,268.31
|
| Rate for Payer: Cofinity Commercial |
$2,178.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,040.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,026.86
|
| Rate for Payer: Healthscope Commercial |
$2,280.21
|
| Rate for Payer: Healthscope Commercial |
$3,420.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,900.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,850.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,153.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,230.31
|
| Rate for Payer: Nomi Health Commercial |
$2,077.53
|
| Rate for Payer: Nomi Health Commercial |
$3,116.30
|
| Rate for Payer: PHP Commercial |
$2,153.53
|
| Rate for Payer: PHP Commercial |
$3,230.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,470.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.82
|
| Rate for Payer: Priority Health HMO/PPO |
$3,306.31
|
| Rate for Payer: Priority Health HMO/PPO |
$2,204.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,697.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,546.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,229.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,344.32
|
| Rate for Payer: UHC Core |
$2,115.53
|
| Rate for Payer: UHC Core |
$3,173.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,900.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,850.27
|
|
|
HC MR LOWER EXTREM ANY JOINT WO W CON
|
Facility
|
OP
|
$2,533.57
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000039
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,280.21 |
| Rate for Payer: Aetna Commercial |
$2,153.53
|
| Rate for Payer: Aetna Commercial |
$3,230.31
|
| Rate for Payer: Aetna Medicare |
$658.73
|
| Rate for Payer: Aetna Medicare |
$988.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$791.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,187.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$791.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,187.61
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$950.09
|
| Rate for Payer: BCBS MAPPO |
$633.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,082.85
|
| Rate for Payer: BCBS Trust/PPO |
$3,124.28
|
| Rate for Payer: BCN Commercial |
$1,969.85
|
| Rate for Payer: BCN Commercial |
$2,954.78
|
| Rate for Payer: BCN Medicare Advantage |
$633.39
|
| Rate for Payer: BCN Medicare Advantage |
$950.09
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cofinity Commercial |
$2,178.87
|
| Rate for Payer: Cofinity Commercial |
$3,268.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,040.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,026.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$633.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$950.09
|
| Rate for Payer: Healthscope Commercial |
$3,420.32
|
| Rate for Payer: Healthscope Commercial |
$2,280.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,900.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,850.27
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$997.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$665.06
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$728.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,092.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,153.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,230.31
|
| Rate for Payer: Nomi Health Commercial |
$2,077.53
|
| Rate for Payer: Nomi Health Commercial |
$3,116.30
|
| Rate for Payer: PACE Senior Care Partners |
$601.72
|
| Rate for Payer: PACE Senior Care Partners |
$902.59
|
| Rate for Payer: PACE SWMI |
$633.39
|
| Rate for Payer: PACE SWMI |
$950.09
|
| Rate for Payer: PHP Commercial |
$3,230.31
|
| Rate for Payer: PHP Commercial |
$2,153.53
|
| Rate for Payer: PHP Medicare Advantage |
$633.39
|
| Rate for Payer: PHP Medicare Advantage |
$950.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,470.23
|
| Rate for Payer: Priority Health HMO/PPO |
$3,306.31
|
| Rate for Payer: Priority Health HMO/PPO |
$2,204.21
|
| Rate for Payer: Priority Health Medicare |
$639.73
|
| Rate for Payer: Priority Health Medicare |
$959.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,697.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,546.24
|
| Rate for Payer: Railroad Medicare Medicare |
$950.09
|
| Rate for Payer: Railroad Medicare Medicare |
$633.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,344.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,229.54
|
| Rate for Payer: UHC Core |
$3,173.30
|
| Rate for Payer: UHC Core |
$2,115.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$633.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$950.09
|
| Rate for Payer: UHC Exchange |
$950.09
|
| Rate for Payer: UHC Exchange |
$633.39
|
| Rate for Payer: UHC Medicare Advantage |
$950.09
|
| Rate for Payer: UHC Medicare Advantage |
$633.39
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$633.39
|
| Rate for Payer: VA VA |
$950.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,900.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,850.27
|
|
|
HC MR LOWER EXTREM BIL ANY JOINT W CON
|
Facility
|
IP
|
$2,392.92
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000038
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,555.40 |
| Max. Negotiated Rate |
$2,153.63 |
| Rate for Payer: Aetna Commercial |
$2,033.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,953.34
|
| Rate for Payer: BCN Commercial |
$1,849.25
|
| Rate for Payer: Cash Price |
$1,914.34
|
| Rate for Payer: Cofinity Commercial |
$2,057.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,914.34
|
| Rate for Payer: Healthscope Commercial |
$2,153.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,794.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,033.98
|
| Rate for Payer: Nomi Health Commercial |
$1,962.19
|
| Rate for Payer: PHP Commercial |
$2,033.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,555.40
|
| Rate for Payer: Priority Health HMO/PPO |
$2,081.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,603.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,105.77
|
| Rate for Payer: UHC Core |
$1,998.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,794.69
|
|
|
HC MR LOWER EXTREM BIL ANY JOINT W CON
|
Facility
|
OP
|
$2,392.92
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000038
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$559.66 |
| Max. Negotiated Rate |
$2,153.63 |
| Rate for Payer: Aetna Commercial |
$2,033.98
|
| Rate for Payer: Aetna Medicare |
$622.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$747.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$747.79
|
| Rate for Payer: BCBS Complete |
$587.68
|
| Rate for Payer: BCBS MAPPO |
$598.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,967.22
|
| Rate for Payer: BCN Commercial |
$1,860.50
|
| Rate for Payer: BCN Medicare Advantage |
$598.23
|
| Rate for Payer: Cash Price |
$1,914.34
|
| Rate for Payer: Cash Price |
$1,914.34
|
| Rate for Payer: Cofinity Commercial |
$2,057.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,914.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$598.23
|
| Rate for Payer: Healthscope Commercial |
$2,153.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,794.69
|
| Rate for Payer: Mclaren Medicaid |
$559.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$628.14
|
| Rate for Payer: Meridian Medicaid |
$587.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$687.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,033.98
|
| Rate for Payer: Nomi Health Commercial |
$1,962.19
|
| Rate for Payer: PACE Senior Care Partners |
$568.32
|
| Rate for Payer: PACE SWMI |
$598.23
|
| Rate for Payer: PHP Commercial |
$2,033.98
|
| Rate for Payer: PHP Medicare Advantage |
$598.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$559.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,555.40
|
| Rate for Payer: Priority Health HMO/PPO |
$2,081.84
|
| Rate for Payer: Priority Health Medicare |
$604.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,603.26
|
| Rate for Payer: Railroad Medicare Medicare |
$598.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,105.77
|
| Rate for Payer: UHC Core |
$1,998.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$598.23
|
| Rate for Payer: UHC Exchange |
$598.23
|
| Rate for Payer: UHC Medicare Advantage |
$598.23
|
| Rate for Payer: UHCCP Medicaid |
$559.66
|
| Rate for Payer: VA VA |
$598.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,794.69
|
|
|
HC MR LOWER EXTREM BILAT ANY JOINT WO CON
|
Facility
|
IP
|
$1,971.56
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000036
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,281.51 |
| Max. Negotiated Rate |
$1,774.40 |
| Rate for Payer: Aetna Commercial |
$1,675.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,609.38
|
| Rate for Payer: BCN Commercial |
$1,523.62
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Cofinity Commercial |
$1,695.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,577.25
|
| Rate for Payer: Healthscope Commercial |
$1,774.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,478.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,675.83
|
| Rate for Payer: Nomi Health Commercial |
$1,616.68
|
| Rate for Payer: PHP Commercial |
$1,675.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,281.51
|
| Rate for Payer: Priority Health HMO/PPO |
$1,715.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,320.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,734.97
|
| Rate for Payer: UHC Core |
$1,646.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,478.67
|
|
|
HC MR LOWER EXTREM BILAT ANY JOINT WO CON
|
Facility
|
OP
|
$1,971.56
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000036
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,774.40 |
| Rate for Payer: Aetna Commercial |
$1,675.83
|
| Rate for Payer: Aetna Medicare |
$512.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$616.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$616.11
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$492.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,620.82
|
| Rate for Payer: BCN Commercial |
$1,532.89
|
| Rate for Payer: BCN Medicare Advantage |
$492.89
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Cofinity Commercial |
$1,695.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,577.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$492.89
|
| Rate for Payer: Healthscope Commercial |
$1,774.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,478.67
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$517.53
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$566.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,675.83
|
| Rate for Payer: Nomi Health Commercial |
$1,616.68
|
| Rate for Payer: PACE Senior Care Partners |
$468.25
|
| Rate for Payer: PACE SWMI |
$492.89
|
| Rate for Payer: PHP Commercial |
$1,675.83
|
| Rate for Payer: PHP Medicare Advantage |
$492.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,281.51
|
| Rate for Payer: Priority Health HMO/PPO |
$1,715.26
|
| Rate for Payer: Priority Health Medicare |
$497.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,320.95
|
| Rate for Payer: Railroad Medicare Medicare |
$492.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,734.97
|
| Rate for Payer: UHC Core |
$1,646.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$492.89
|
| Rate for Payer: UHC Exchange |
$492.89
|
| Rate for Payer: UHC Medicare Advantage |
$492.89
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$492.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,478.67
|
|
|
HC MR LOWER EXTREM BIL NO JOINT W CON
|
Facility
|
OP
|
$2,955.86
|
|
|
Service Code
|
CPT 73719
|
| Hospital Charge Code |
61000032
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,660.27 |
| Rate for Payer: Aetna Commercial |
$2,512.48
|
| Rate for Payer: Aetna Medicare |
$768.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$923.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$923.71
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$738.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,430.01
|
| Rate for Payer: BCN Commercial |
$2,298.18
|
| Rate for Payer: BCN Medicare Advantage |
$738.96
|
| Rate for Payer: Cash Price |
$2,364.69
|
| Rate for Payer: Cash Price |
$2,364.69
|
| Rate for Payer: Cofinity Commercial |
$2,542.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,364.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$738.96
|
| Rate for Payer: Healthscope Commercial |
$2,660.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,216.90
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$775.91
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$849.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,512.48
|
| Rate for Payer: Nomi Health Commercial |
$2,423.81
|
| Rate for Payer: PACE Senior Care Partners |
$702.02
|
| Rate for Payer: PACE SWMI |
$738.96
|
| Rate for Payer: PHP Commercial |
$2,512.48
|
| Rate for Payer: PHP Medicare Advantage |
$738.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,921.31
|
| Rate for Payer: Priority Health HMO/PPO |
$2,571.60
|
| Rate for Payer: Priority Health Medicare |
$746.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,980.43
|
| Rate for Payer: Railroad Medicare Medicare |
$738.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,601.16
|
| Rate for Payer: UHC Core |
$2,468.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$738.96
|
| Rate for Payer: UHC Exchange |
$738.96
|
| Rate for Payer: UHC Medicare Advantage |
$738.96
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$738.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,216.90
|
|
|
HC MR LOWER EXTREM BIL NO JOINT W CON
|
Facility
|
IP
|
$2,955.86
|
|
|
Service Code
|
CPT 73719
|
| Hospital Charge Code |
61000032
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,921.31 |
| Max. Negotiated Rate |
$2,660.27 |
| Rate for Payer: Aetna Commercial |
$2,512.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,412.87
|
| Rate for Payer: BCN Commercial |
$2,284.29
|
| Rate for Payer: Cash Price |
$2,364.69
|
| Rate for Payer: Cofinity Commercial |
$2,542.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,364.69
|
| Rate for Payer: Healthscope Commercial |
$2,660.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,216.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,512.48
|
| Rate for Payer: Nomi Health Commercial |
$2,423.81
|
| Rate for Payer: PHP Commercial |
$2,512.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,921.31
|
| Rate for Payer: Priority Health HMO/PPO |
$2,571.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,980.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,601.16
|
| Rate for Payer: UHC Core |
$2,468.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,216.90
|
|
|
HC MR LOWER EXTREM BIL NO JOINT WO CON
|
Facility
|
OP
|
$2,297.10
|
|
|
Service Code
|
CPT 73718
|
| Hospital Charge Code |
61000030
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$2,067.39 |
| Rate for Payer: Aetna Commercial |
$1,952.54
|
| Rate for Payer: Aetna Medicare |
$597.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$717.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$717.84
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$574.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,888.45
|
| Rate for Payer: BCN Commercial |
$1,786.00
|
| Rate for Payer: BCN Medicare Advantage |
$574.28
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Commercial |
$1,975.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$574.28
|
| Rate for Payer: Healthscope Commercial |
$2,067.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,722.82
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$602.99
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$660.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.54
|
| Rate for Payer: Nomi Health Commercial |
$1,883.62
|
| Rate for Payer: PACE Senior Care Partners |
$545.56
|
| Rate for Payer: PACE SWMI |
$574.28
|
| Rate for Payer: PHP Commercial |
$1,952.54
|
| Rate for Payer: PHP Medicare Advantage |
$574.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,493.12
|
| Rate for Payer: Priority Health HMO/PPO |
$1,998.48
|
| Rate for Payer: Priority Health Medicare |
$580.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,539.06
|
| Rate for Payer: Railroad Medicare Medicare |
$574.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,021.45
|
| Rate for Payer: UHC Core |
$1,918.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$574.28
|
| Rate for Payer: UHC Exchange |
$574.28
|
| Rate for Payer: UHC Medicare Advantage |
$574.28
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$574.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,722.82
|
|
|
HC MR LOWER EXTREM BIL NO JOINT WO CON
|
Facility
|
IP
|
$2,297.10
|
|
|
Service Code
|
CPT 73718
|
| Hospital Charge Code |
61000030
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,493.12 |
| Max. Negotiated Rate |
$2,067.39 |
| Rate for Payer: Aetna Commercial |
$1,952.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,875.12
|
| Rate for Payer: BCN Commercial |
$1,775.20
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Commercial |
$1,975.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Healthscope Commercial |
$2,067.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,722.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.54
|
| Rate for Payer: Nomi Health Commercial |
$1,883.62
|
| Rate for Payer: PHP Commercial |
$1,952.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,493.12
|
| Rate for Payer: Priority Health HMO/PPO |
$1,998.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,539.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,021.45
|
| Rate for Payer: UHC Core |
$1,918.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,722.82
|
|
|
HC MR LOWER EXTREM NO JOINT BIL WO W CON
|
Facility
|
OP
|
$3,158.55
|
|
|
Service Code
|
CPT 73720
|
| Hospital Charge Code |
61000034
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,842.70 |
| Rate for Payer: Aetna Commercial |
$2,684.77
|
| Rate for Payer: Aetna Medicare |
$821.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$987.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$987.05
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$789.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,596.64
|
| Rate for Payer: BCN Commercial |
$2,455.77
|
| Rate for Payer: BCN Medicare Advantage |
$789.64
|
| Rate for Payer: Cash Price |
$2,526.84
|
| Rate for Payer: Cash Price |
$2,526.84
|
| Rate for Payer: Cofinity Commercial |
$2,716.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,526.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$789.64
|
| Rate for Payer: Healthscope Commercial |
$2,842.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,368.91
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$829.12
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$908.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,684.77
|
| Rate for Payer: Nomi Health Commercial |
$2,590.01
|
| Rate for Payer: PACE Senior Care Partners |
$750.16
|
| Rate for Payer: PACE SWMI |
$789.64
|
| Rate for Payer: PHP Commercial |
$2,684.77
|
| Rate for Payer: PHP Medicare Advantage |
$789.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,053.06
|
| Rate for Payer: Priority Health HMO/PPO |
$2,747.94
|
| Rate for Payer: Priority Health Medicare |
$797.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,116.23
|
| Rate for Payer: Railroad Medicare Medicare |
$789.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,779.52
|
| Rate for Payer: UHC Core |
$2,637.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$789.64
|
| Rate for Payer: UHC Exchange |
$789.64
|
| Rate for Payer: UHC Medicare Advantage |
$789.64
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$789.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,368.91
|
|
|
HC MR LOWER EXTREM NO JOINT BIL WO W CON
|
Facility
|
IP
|
$3,158.55
|
|
|
Service Code
|
CPT 73720
|
| Hospital Charge Code |
61000034
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,053.06 |
| Max. Negotiated Rate |
$2,842.70 |
| Rate for Payer: Aetna Commercial |
$2,684.77
|
| Rate for Payer: BCBS Trust/PPO |
$2,578.32
|
| Rate for Payer: BCN Commercial |
$2,440.93
|
| Rate for Payer: Cash Price |
$2,526.84
|
| Rate for Payer: Cofinity Commercial |
$2,716.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,526.84
|
| Rate for Payer: Healthscope Commercial |
$2,842.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,368.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,684.77
|
| Rate for Payer: Nomi Health Commercial |
$2,590.01
|
| Rate for Payer: PHP Commercial |
$2,684.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,053.06
|
| Rate for Payer: Priority Health HMO/PPO |
$2,747.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,116.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,779.52
|
| Rate for Payer: UHC Core |
$2,637.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,368.91
|
|
|
HC MR LOWER EXTREM NO JOINT W CON
|
Facility
|
IP
|
$2,364.71
|
|
|
Service Code
|
CPT 73719
|
| Hospital Charge Code |
61000031
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,537.06 |
| Max. Negotiated Rate |
$2,128.24 |
| Rate for Payer: Aetna Commercial |
$2,010.00
|
| Rate for Payer: Aetna Commercial |
$3,015.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,930.31
|
| Rate for Payer: BCBS Trust/PPO |
$2,895.47
|
| Rate for Payer: BCN Commercial |
$1,827.45
|
| Rate for Payer: BCN Commercial |
$2,741.18
|
| Rate for Payer: Cash Price |
$1,891.77
|
| Rate for Payer: Cash Price |
$2,837.66
|
| Rate for Payer: Cofinity Commercial |
$3,050.48
|
| Rate for Payer: Cofinity Commercial |
$2,033.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,837.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,891.77
|
| Rate for Payer: Healthscope Commercial |
$2,128.24
|
| Rate for Payer: Healthscope Commercial |
$3,192.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,773.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,660.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,010.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,015.01
|
| Rate for Payer: Nomi Health Commercial |
$1,939.06
|
| Rate for Payer: Nomi Health Commercial |
$2,908.60
|
| Rate for Payer: PHP Commercial |
$2,010.00
|
| Rate for Payer: PHP Commercial |
$3,015.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,305.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.06
|
| Rate for Payer: Priority Health HMO/PPO |
$3,085.95
|
| Rate for Payer: Priority Health HMO/PPO |
$2,057.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,584.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,376.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,080.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,121.42
|
| Rate for Payer: UHC Core |
$1,974.53
|
| Rate for Payer: UHC Core |
$2,961.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,773.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,660.30
|
|
|
HC MR LOWER EXTREM NO JOINT W CON
|
Facility
|
OP
|
$2,364.71
|
|
|
Service Code
|
CPT 73719
|
| Hospital Charge Code |
61000031
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,128.24 |
| Rate for Payer: Aetna Commercial |
$2,010.00
|
| Rate for Payer: Aetna Commercial |
$3,015.01
|
| Rate for Payer: Aetna Medicare |
$614.82
|
| Rate for Payer: Aetna Medicare |
$922.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$738.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,108.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$738.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,108.46
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$886.77
|
| Rate for Payer: BCBS MAPPO |
$591.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,944.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,916.05
|
| Rate for Payer: BCN Commercial |
$1,838.56
|
| Rate for Payer: BCN Commercial |
$2,757.85
|
| Rate for Payer: BCN Medicare Advantage |
$591.18
|
| Rate for Payer: BCN Medicare Advantage |
$886.77
|
| Rate for Payer: Cash Price |
$2,837.66
|
| Rate for Payer: Cash Price |
$1,891.77
|
| Rate for Payer: Cash Price |
$1,891.77
|
| Rate for Payer: Cash Price |
$2,837.66
|
| Rate for Payer: Cofinity Commercial |
$2,033.65
|
| Rate for Payer: Cofinity Commercial |
$3,050.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,837.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,891.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$591.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$886.77
|
| Rate for Payer: Healthscope Commercial |
$3,192.36
|
| Rate for Payer: Healthscope Commercial |
$2,128.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,773.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,660.30
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$931.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$620.74
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$679.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,019.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,010.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,015.01
|
| Rate for Payer: Nomi Health Commercial |
$1,939.06
|
| Rate for Payer: Nomi Health Commercial |
$2,908.60
|
| Rate for Payer: PACE Senior Care Partners |
$561.62
|
| Rate for Payer: PACE Senior Care Partners |
$842.43
|
| Rate for Payer: PACE SWMI |
$591.18
|
| Rate for Payer: PACE SWMI |
$886.77
|
| Rate for Payer: PHP Commercial |
$3,015.01
|
| Rate for Payer: PHP Commercial |
$2,010.00
|
| Rate for Payer: PHP Medicare Advantage |
$591.18
|
| Rate for Payer: PHP Medicare Advantage |
$886.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,305.60
|
| Rate for Payer: Priority Health HMO/PPO |
$3,085.95
|
| Rate for Payer: Priority Health HMO/PPO |
$2,057.30
|
| Rate for Payer: Priority Health Medicare |
$597.09
|
| Rate for Payer: Priority Health Medicare |
$895.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,584.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,376.54
|
| Rate for Payer: Railroad Medicare Medicare |
$886.77
|
| Rate for Payer: Railroad Medicare Medicare |
$591.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,121.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,080.94
|
| Rate for Payer: UHC Core |
$2,961.80
|
| Rate for Payer: UHC Core |
$1,974.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$591.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$886.77
|
| Rate for Payer: UHC Exchange |
$886.77
|
| Rate for Payer: UHC Exchange |
$591.18
|
| Rate for Payer: UHC Medicare Advantage |
$886.77
|
| Rate for Payer: UHC Medicare Advantage |
$591.18
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$591.18
|
| Rate for Payer: VA VA |
$886.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,773.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,660.30
|
|
|
HC MR LOWER EXTREM NO JOINT WO CON
|
Facility
|
OP
|
$2,132.92
|
|
|
Service Code
|
CPT 73718
|
| Hospital Charge Code |
61000029
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,919.63 |
| Rate for Payer: Aetna Commercial |
$1,812.98
|
| Rate for Payer: Aetna Commercial |
$2,719.47
|
| Rate for Payer: Aetna Medicare |
$554.56
|
| Rate for Payer: Aetna Medicare |
$831.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$666.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$999.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$666.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$999.81
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$799.84
|
| Rate for Payer: BCBS MAPPO |
$533.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,753.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,630.21
|
| Rate for Payer: BCN Commercial |
$1,658.35
|
| Rate for Payer: BCN Commercial |
$2,487.52
|
| Rate for Payer: BCN Medicare Advantage |
$533.23
|
| Rate for Payer: BCN Medicare Advantage |
$799.84
|
| Rate for Payer: Cash Price |
$2,559.50
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cash Price |
$2,559.50
|
| Rate for Payer: Cofinity Commercial |
$1,834.31
|
| Rate for Payer: Cofinity Commercial |
$2,751.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,559.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,706.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$533.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$799.84
|
| Rate for Payer: Healthscope Commercial |
$2,879.44
|
| Rate for Payer: Healthscope Commercial |
$1,919.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,599.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,399.54
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$839.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$559.89
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$613.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$919.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,812.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,719.47
|
| Rate for Payer: Nomi Health Commercial |
$1,748.99
|
| Rate for Payer: Nomi Health Commercial |
$2,623.49
|
| Rate for Payer: PACE Senior Care Partners |
$506.57
|
| Rate for Payer: PACE Senior Care Partners |
$759.85
|
| Rate for Payer: PACE SWMI |
$533.23
|
| Rate for Payer: PACE SWMI |
$799.84
|
| Rate for Payer: PHP Commercial |
$2,719.47
|
| Rate for Payer: PHP Commercial |
$1,812.98
|
| Rate for Payer: PHP Medicare Advantage |
$533.23
|
| Rate for Payer: PHP Medicare Advantage |
$799.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,386.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,079.60
|
| Rate for Payer: Priority Health HMO/PPO |
$2,783.46
|
| Rate for Payer: Priority Health HMO/PPO |
$1,855.64
|
| Rate for Payer: Priority Health Medicare |
$538.56
|
| Rate for Payer: Priority Health Medicare |
$807.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,429.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,143.58
|
| Rate for Payer: Railroad Medicare Medicare |
$799.84
|
| Rate for Payer: Railroad Medicare Medicare |
$533.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,815.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,876.97
|
| Rate for Payer: UHC Core |
$2,671.48
|
| Rate for Payer: UHC Core |
$1,780.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$533.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$799.84
|
| Rate for Payer: UHC Exchange |
$799.84
|
| Rate for Payer: UHC Exchange |
$533.23
|
| Rate for Payer: UHC Medicare Advantage |
$799.84
|
| Rate for Payer: UHC Medicare Advantage |
$533.23
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$533.23
|
| Rate for Payer: VA VA |
$799.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,599.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,399.54
|
|
|
HC MR LOWER EXTREM NO JOINT WO CON
|
Facility
|
IP
|
$2,132.92
|
|
|
Service Code
|
CPT 73718
|
| Hospital Charge Code |
61000029
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,386.40 |
| Max. Negotiated Rate |
$1,919.63 |
| Rate for Payer: Aetna Commercial |
$1,812.98
|
| Rate for Payer: Aetna Commercial |
$2,719.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,741.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,611.65
|
| Rate for Payer: BCN Commercial |
$1,648.32
|
| Rate for Payer: BCN Commercial |
$2,472.48
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cash Price |
$2,559.50
|
| Rate for Payer: Cofinity Commercial |
$2,751.47
|
| Rate for Payer: Cofinity Commercial |
$1,834.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,559.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,706.34
|
| Rate for Payer: Healthscope Commercial |
$1,919.63
|
| Rate for Payer: Healthscope Commercial |
$2,879.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,599.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,399.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,812.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,719.47
|
| Rate for Payer: Nomi Health Commercial |
$1,748.99
|
| Rate for Payer: Nomi Health Commercial |
$2,623.49
|
| Rate for Payer: PHP Commercial |
$1,812.98
|
| Rate for Payer: PHP Commercial |
$2,719.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,079.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,386.40
|
| Rate for Payer: Priority Health HMO/PPO |
$2,783.46
|
| Rate for Payer: Priority Health HMO/PPO |
$1,855.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,429.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,143.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,876.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,815.45
|
| Rate for Payer: UHC Core |
$1,780.99
|
| Rate for Payer: UHC Core |
$2,671.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,599.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,399.54
|
|
|
HC MR LOWER EXTREM NO JOINT WO W CON
|
Facility
|
IP
|
$3,029.70
|
|
|
Service Code
|
CPT 73720
|
| Hospital Charge Code |
61000033
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,969.30 |
| Max. Negotiated Rate |
$2,726.73 |
| Rate for Payer: Aetna Commercial |
$2,575.24
|
| Rate for Payer: Aetna Commercial |
$3,862.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,473.14
|
| Rate for Payer: BCBS Trust/PPO |
$3,709.72
|
| Rate for Payer: BCN Commercial |
$2,341.35
|
| Rate for Payer: BCN Commercial |
$3,512.03
|
| Rate for Payer: Cash Price |
$2,423.76
|
| Rate for Payer: Cash Price |
$3,635.64
|
| Rate for Payer: Cofinity Commercial |
$3,908.31
|
| Rate for Payer: Cofinity Commercial |
$2,605.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,635.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,423.76
|
| Rate for Payer: Healthscope Commercial |
$2,726.73
|
| Rate for Payer: Healthscope Commercial |
$4,090.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,272.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,408.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,575.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,862.87
|
| Rate for Payer: Nomi Health Commercial |
$2,484.35
|
| Rate for Payer: Nomi Health Commercial |
$3,726.53
|
| Rate for Payer: PHP Commercial |
$2,575.24
|
| Rate for Payer: PHP Commercial |
$3,862.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,953.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,969.30
|
| Rate for Payer: Priority Health HMO/PPO |
$3,953.76
|
| Rate for Payer: Priority Health HMO/PPO |
$2,635.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,029.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,044.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,666.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,999.20
|
| Rate for Payer: UHC Core |
$2,529.80
|
| Rate for Payer: UHC Core |
$3,794.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,272.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,408.41
|
|
