|
HC MR BREAST WO CON UNI
|
Facility
|
OP
|
$1,568.76
|
|
|
Service Code
|
CPT 77046
|
| Hospital Charge Code |
61000090
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$174.76 |
| Max. Negotiated Rate |
$1,411.88 |
| Rate for Payer: Aetna Commercial |
$1,333.45
|
| Rate for Payer: Aetna Medicare |
$407.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$490.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$490.24
|
| Rate for Payer: BCBS Complete |
$183.51
|
| Rate for Payer: BCBS MAPPO |
$392.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,289.68
|
| Rate for Payer: BCN Commercial |
$1,219.71
|
| Rate for Payer: BCN Medicare Advantage |
$392.19
|
| Rate for Payer: Cash Price |
$1,255.01
|
| Rate for Payer: Cash Price |
$1,255.01
|
| Rate for Payer: Cofinity Commercial |
$1,349.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.19
|
| Rate for Payer: Healthscope Commercial |
$1,411.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,176.57
|
| Rate for Payer: Mclaren Medicaid |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.80
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$451.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,333.45
|
| Rate for Payer: Nomi Health Commercial |
$1,286.38
|
| Rate for Payer: PACE Senior Care Partners |
$372.58
|
| Rate for Payer: PACE SWMI |
$392.19
|
| Rate for Payer: PHP Commercial |
$1,333.45
|
| Rate for Payer: PHP Medicare Advantage |
$392.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,019.69
|
| Rate for Payer: Priority Health HMO/PPO |
$1,364.82
|
| Rate for Payer: Priority Health Medicare |
$396.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,051.07
|
| Rate for Payer: Railroad Medicare Medicare |
$392.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,380.51
|
| Rate for Payer: UHC Core |
$1,309.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$392.19
|
| Rate for Payer: UHC Exchange |
$392.19
|
| Rate for Payer: UHC Medicare Advantage |
$392.19
|
| Rate for Payer: UHCCP Medicaid |
$174.76
|
| Rate for Payer: VA VA |
$392.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,176.57
|
|
|
HC MR BREAST WO CON UNI
|
Facility
|
IP
|
$1,568.76
|
|
|
Service Code
|
CPT 77046
|
| Hospital Charge Code |
61000090
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,019.69 |
| Max. Negotiated Rate |
$1,411.88 |
| Rate for Payer: Aetna Commercial |
$1,333.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,280.58
|
| Rate for Payer: BCN Commercial |
$1,212.34
|
| Rate for Payer: Cash Price |
$1,255.01
|
| Rate for Payer: Cofinity Commercial |
$1,349.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.01
|
| Rate for Payer: Healthscope Commercial |
$1,411.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,176.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,333.45
|
| Rate for Payer: Nomi Health Commercial |
$1,286.38
|
| Rate for Payer: PHP Commercial |
$1,333.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,019.69
|
| Rate for Payer: Priority Health HMO/PPO |
$1,364.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,051.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,380.51
|
| Rate for Payer: UHC Core |
$1,309.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,176.57
|
|
|
HC MR CARDIAC FOR MORPHOLOGY WO CON
|
Facility
|
IP
|
$2,153.63
|
|
|
Service Code
|
CPT 75557
|
| Hospital Charge Code |
61000046
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,399.86 |
| Max. Negotiated Rate |
$1,938.27 |
| Rate for Payer: Aetna Commercial |
$1,830.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,758.01
|
| Rate for Payer: BCN Commercial |
$1,664.33
|
| Rate for Payer: Cash Price |
$1,722.90
|
| Rate for Payer: Cofinity Commercial |
$1,852.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,722.90
|
| Rate for Payer: Healthscope Commercial |
$1,938.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,615.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,830.59
|
| Rate for Payer: Nomi Health Commercial |
$1,765.98
|
| Rate for Payer: PHP Commercial |
$1,830.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,399.86
|
| Rate for Payer: Priority Health HMO/PPO |
$1,873.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,442.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,895.19
|
| Rate for Payer: UHC Core |
$1,798.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,615.22
|
|
|
HC MR CARDIAC FOR MORPHOLOGY WO CON
|
Facility
|
OP
|
$2,153.63
|
|
|
Service Code
|
CPT 75557
|
| Hospital Charge Code |
61000046
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$174.76 |
| Max. Negotiated Rate |
$1,938.27 |
| Rate for Payer: Aetna Commercial |
$1,830.59
|
| Rate for Payer: Aetna Medicare |
$559.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$673.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$673.01
|
| Rate for Payer: BCBS Complete |
$183.51
|
| Rate for Payer: BCBS MAPPO |
$538.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,770.50
|
| Rate for Payer: BCN Commercial |
$1,674.45
|
| Rate for Payer: BCN Medicare Advantage |
$538.41
|
| Rate for Payer: Cash Price |
$1,722.90
|
| Rate for Payer: Cash Price |
$1,722.90
|
| Rate for Payer: Cofinity Commercial |
$1,852.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,722.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$538.41
|
| Rate for Payer: Healthscope Commercial |
$1,938.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,615.22
|
| Rate for Payer: Mclaren Medicaid |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$565.33
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$619.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,830.59
|
| Rate for Payer: Nomi Health Commercial |
$1,765.98
|
| Rate for Payer: PACE Senior Care Partners |
$511.49
|
| Rate for Payer: PACE SWMI |
$538.41
|
| Rate for Payer: PHP Commercial |
$1,830.59
|
| Rate for Payer: PHP Medicare Advantage |
$538.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,399.86
|
| Rate for Payer: Priority Health HMO/PPO |
$1,873.66
|
| Rate for Payer: Priority Health Medicare |
$543.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,442.93
|
| Rate for Payer: Railroad Medicare Medicare |
$538.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,895.19
|
| Rate for Payer: UHC Core |
$1,798.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$538.41
|
| Rate for Payer: UHC Exchange |
$538.41
|
| Rate for Payer: UHC Medicare Advantage |
$538.41
|
| Rate for Payer: UHCCP Medicaid |
$174.76
|
| Rate for Payer: VA VA |
$538.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,615.22
|
|
|
HC MR CARDIAC MORP AND FUNC WO W CON
|
Facility
|
OP
|
$990.98
|
|
|
Service Code
|
CPT 75561
|
| Hospital Charge Code |
61000047
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$235.36 |
| Max. Negotiated Rate |
$891.88 |
| Rate for Payer: Aetna Commercial |
$842.33
|
| Rate for Payer: Aetna Medicare |
$257.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$309.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$309.68
|
| Rate for Payer: BCBS Complete |
$271.13
|
| Rate for Payer: BCBS MAPPO |
$247.75
|
| Rate for Payer: BCBS Trust/PPO |
$814.68
|
| Rate for Payer: BCN Commercial |
$770.49
|
| Rate for Payer: BCN Medicare Advantage |
$247.75
|
| Rate for Payer: Cash Price |
$792.78
|
| Rate for Payer: Cash Price |
$792.78
|
| Rate for Payer: Cofinity Commercial |
$852.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$792.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.75
|
| Rate for Payer: Healthscope Commercial |
$891.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.24
|
| Rate for Payer: Mclaren Medicaid |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$260.13
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$284.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$842.33
|
| Rate for Payer: Nomi Health Commercial |
$812.60
|
| Rate for Payer: PACE Senior Care Partners |
$235.36
|
| Rate for Payer: PACE SWMI |
$247.75
|
| Rate for Payer: PHP Commercial |
$842.33
|
| Rate for Payer: PHP Medicare Advantage |
$247.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$644.14
|
| Rate for Payer: Priority Health HMO/PPO |
$862.15
|
| Rate for Payer: Priority Health Medicare |
$250.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$663.96
|
| Rate for Payer: Railroad Medicare Medicare |
$247.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$872.06
|
| Rate for Payer: UHC Core |
$827.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$247.75
|
| Rate for Payer: UHC Exchange |
$247.75
|
| Rate for Payer: UHC Medicare Advantage |
$247.75
|
| Rate for Payer: UHCCP Medicaid |
$258.20
|
| Rate for Payer: VA VA |
$247.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.24
|
|
|
HC MR CARDIAC MORP AND FUNC WO W CON
|
Facility
|
IP
|
$990.98
|
|
|
Service Code
|
CPT 75561
|
| Hospital Charge Code |
61000047
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$644.14 |
| Max. Negotiated Rate |
$891.88 |
| Rate for Payer: Aetna Commercial |
$842.33
|
| Rate for Payer: BCBS Trust/PPO |
$808.94
|
| Rate for Payer: BCN Commercial |
$765.83
|
| Rate for Payer: Cash Price |
$792.78
|
| Rate for Payer: Cofinity Commercial |
$852.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$792.78
|
| Rate for Payer: Healthscope Commercial |
$891.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$842.33
|
| Rate for Payer: Nomi Health Commercial |
$812.60
|
| Rate for Payer: PHP Commercial |
$842.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$644.14
|
| Rate for Payer: Priority Health HMO/PPO |
$862.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$663.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$872.06
|
| Rate for Payer: UHC Core |
$827.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.24
|
|
|
HC MR CARDIAC VELOCITY MAPPING
|
Facility
|
IP
|
$1,239.30
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
61000048
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$805.54 |
| Max. Negotiated Rate |
$1,115.37 |
| Rate for Payer: Aetna Commercial |
$1,053.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,011.64
|
| Rate for Payer: BCN Commercial |
$957.73
|
| Rate for Payer: Cash Price |
$991.44
|
| Rate for Payer: Cofinity Commercial |
$1,065.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$991.44
|
| Rate for Payer: Healthscope Commercial |
$1,115.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$929.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,053.40
|
| Rate for Payer: Nomi Health Commercial |
$1,016.23
|
| Rate for Payer: PHP Commercial |
$1,053.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$805.54
|
| Rate for Payer: Priority Health HMO/PPO |
$1,078.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$830.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,090.58
|
| Rate for Payer: UHC Core |
$1,034.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$929.48
|
|
|
HC MR CARDIAC VELOCITY MAPPING
|
Facility
|
OP
|
$1,239.30
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
61000048
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$294.33 |
| Max. Negotiated Rate |
$1,115.37 |
| Rate for Payer: Aetna Commercial |
$1,053.40
|
| Rate for Payer: Aetna Medicare |
$322.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$387.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$387.28
|
| Rate for Payer: BCBS Complete |
$495.72
|
| Rate for Payer: BCBS MAPPO |
$309.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,018.83
|
| Rate for Payer: BCN Commercial |
$963.56
|
| Rate for Payer: BCN Medicare Advantage |
$309.82
|
| Rate for Payer: Cash Price |
$991.44
|
| Rate for Payer: Cofinity Commercial |
$1,065.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$991.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.82
|
| Rate for Payer: Healthscope Commercial |
$1,115.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$929.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$325.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$356.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,053.40
|
| Rate for Payer: Nomi Health Commercial |
$1,016.23
|
| Rate for Payer: PACE Senior Care Partners |
$294.33
|
| Rate for Payer: PACE SWMI |
$309.82
|
| Rate for Payer: PHP Commercial |
$1,053.40
|
| Rate for Payer: PHP Medicare Advantage |
$309.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$805.54
|
| Rate for Payer: Priority Health HMO/PPO |
$1,078.19
|
| Rate for Payer: Priority Health Medicare |
$312.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$830.33
|
| Rate for Payer: Railroad Medicare Medicare |
$309.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,090.58
|
| Rate for Payer: UHC Core |
$1,034.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$309.82
|
| Rate for Payer: UHC Exchange |
$309.82
|
| Rate for Payer: UHC Medicare Advantage |
$309.82
|
| Rate for Payer: VA VA |
$309.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$929.48
|
|
|
HC MR CHEST W CON
|
Facility
|
IP
|
$2,333.00
|
|
|
Service Code
|
CPT 71551
|
| Hospital Charge Code |
61000011
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,516.45 |
| Max. Negotiated Rate |
$2,099.70 |
| Rate for Payer: Aetna Commercial |
$1,983.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,904.43
|
| Rate for Payer: BCN Commercial |
$1,802.94
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cofinity Commercial |
$2,006.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,866.40
|
| Rate for Payer: Healthscope Commercial |
$2,099.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,749.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,983.05
|
| Rate for Payer: Nomi Health Commercial |
$1,913.06
|
| Rate for Payer: PHP Commercial |
$1,983.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,516.45
|
| Rate for Payer: Priority Health HMO/PPO |
$2,029.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,563.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,053.04
|
| Rate for Payer: UHC Core |
$1,948.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,749.75
|
|
|
HC MR CHEST W CON
|
Facility
|
OP
|
$2,333.00
|
|
|
Service Code
|
CPT 71551
|
| Hospital Charge Code |
61000011
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$554.09 |
| Max. Negotiated Rate |
$2,099.70 |
| Rate for Payer: Aetna Commercial |
$1,983.05
|
| Rate for Payer: Aetna Medicare |
$606.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$729.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$729.06
|
| Rate for Payer: BCBS Complete |
$599.81
|
| Rate for Payer: BCBS MAPPO |
$583.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,917.96
|
| Rate for Payer: BCN Commercial |
$1,813.91
|
| Rate for Payer: BCN Medicare Advantage |
$583.25
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cofinity Commercial |
$2,006.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,866.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$583.25
|
| Rate for Payer: Healthscope Commercial |
$2,099.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,749.75
|
| Rate for Payer: Mclaren Medicaid |
$571.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$612.41
|
| Rate for Payer: Meridian Medicaid |
$599.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$670.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,983.05
|
| Rate for Payer: Nomi Health Commercial |
$1,913.06
|
| Rate for Payer: PACE Senior Care Partners |
$554.09
|
| Rate for Payer: PACE SWMI |
$583.25
|
| Rate for Payer: PHP Commercial |
$1,983.05
|
| Rate for Payer: PHP Medicare Advantage |
$583.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$571.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,516.45
|
| Rate for Payer: Priority Health HMO/PPO |
$2,029.71
|
| Rate for Payer: Priority Health Medicare |
$589.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,563.11
|
| Rate for Payer: Railroad Medicare Medicare |
$583.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,053.04
|
| Rate for Payer: UHC Core |
$1,948.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$583.25
|
| Rate for Payer: UHC Exchange |
$583.25
|
| Rate for Payer: UHC Medicare Advantage |
$583.25
|
| Rate for Payer: UHCCP Medicaid |
$571.21
|
| Rate for Payer: VA VA |
$583.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,749.75
|
|
|
HC MR CHEST WO CON
|
Facility
|
IP
|
$2,032.25
|
|
|
Service Code
|
CPT 71550
|
| Hospital Charge Code |
61000010
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,320.96 |
| Max. Negotiated Rate |
$1,829.03 |
| Rate for Payer: Aetna Commercial |
$1,727.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,658.93
|
| Rate for Payer: BCN Commercial |
$1,570.52
|
| Rate for Payer: Cash Price |
$1,625.80
|
| Rate for Payer: Cofinity Commercial |
$1,747.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,625.80
|
| Rate for Payer: Healthscope Commercial |
$1,829.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,524.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,727.41
|
| Rate for Payer: Nomi Health Commercial |
$1,666.44
|
| Rate for Payer: PHP Commercial |
$1,727.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,320.96
|
| Rate for Payer: Priority Health HMO/PPO |
$1,768.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,361.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,788.38
|
| Rate for Payer: UHC Core |
$1,696.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,524.19
|
|
|
HC MR CHEST WO CON
|
Facility
|
OP
|
$2,032.25
|
|
|
Service Code
|
CPT 71550
|
| Hospital Charge Code |
61000010
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$174.76 |
| Max. Negotiated Rate |
$1,829.03 |
| Rate for Payer: Aetna Commercial |
$1,727.41
|
| Rate for Payer: Aetna Medicare |
$528.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$635.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$635.08
|
| Rate for Payer: BCBS Complete |
$183.51
|
| Rate for Payer: BCBS MAPPO |
$508.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,670.71
|
| Rate for Payer: BCN Commercial |
$1,580.07
|
| Rate for Payer: BCN Medicare Advantage |
$508.06
|
| Rate for Payer: Cash Price |
$1,625.80
|
| Rate for Payer: Cash Price |
$1,625.80
|
| Rate for Payer: Cofinity Commercial |
$1,747.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,625.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$508.06
|
| Rate for Payer: Healthscope Commercial |
$1,829.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,524.19
|
| Rate for Payer: Mclaren Medicaid |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$533.47
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$584.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,727.41
|
| Rate for Payer: Nomi Health Commercial |
$1,666.44
|
| Rate for Payer: PACE Senior Care Partners |
$482.66
|
| Rate for Payer: PACE SWMI |
$508.06
|
| Rate for Payer: PHP Commercial |
$1,727.41
|
| Rate for Payer: PHP Medicare Advantage |
$508.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,320.96
|
| Rate for Payer: Priority Health HMO/PPO |
$1,768.06
|
| Rate for Payer: Priority Health Medicare |
$513.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,361.61
|
| Rate for Payer: Railroad Medicare Medicare |
$508.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,788.38
|
| Rate for Payer: UHC Core |
$1,696.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$508.06
|
| Rate for Payer: UHC Exchange |
$508.06
|
| Rate for Payer: UHC Medicare Advantage |
$508.06
|
| Rate for Payer: UHCCP Medicaid |
$174.76
|
| Rate for Payer: VA VA |
$508.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,524.19
|
|
|
HC MR CHEST WO W CON
|
Facility
|
OP
|
$3,052.80
|
|
|
Service Code
|
CPT 71552
|
| Hospital Charge Code |
61000012
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$258.20 |
| Max. Negotiated Rate |
$2,747.52 |
| Rate for Payer: Aetna Commercial |
$2,594.88
|
| Rate for Payer: Aetna Medicare |
$793.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$954.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$954.00
|
| Rate for Payer: BCBS Complete |
$271.13
|
| Rate for Payer: BCBS MAPPO |
$763.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,509.71
|
| Rate for Payer: BCN Commercial |
$2,373.55
|
| Rate for Payer: BCN Medicare Advantage |
$763.20
|
| Rate for Payer: Cash Price |
$2,442.24
|
| Rate for Payer: Cash Price |
$2,442.24
|
| Rate for Payer: Cofinity Commercial |
$2,625.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,442.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$763.20
|
| Rate for Payer: Healthscope Commercial |
$2,747.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,289.60
|
| Rate for Payer: Mclaren Medicaid |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$801.36
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$877.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,594.88
|
| Rate for Payer: Nomi Health Commercial |
$2,503.30
|
| Rate for Payer: PACE Senior Care Partners |
$725.04
|
| Rate for Payer: PACE SWMI |
$763.20
|
| Rate for Payer: PHP Commercial |
$2,594.88
|
| Rate for Payer: PHP Medicare Advantage |
$763.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,984.32
|
| Rate for Payer: Priority Health HMO/PPO |
$2,655.94
|
| Rate for Payer: Priority Health Medicare |
$770.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,045.38
|
| Rate for Payer: Railroad Medicare Medicare |
$763.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,686.46
|
| Rate for Payer: UHC Core |
$2,549.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$763.20
|
| Rate for Payer: UHC Exchange |
$763.20
|
| Rate for Payer: UHC Medicare Advantage |
$763.20
|
| Rate for Payer: UHCCP Medicaid |
$258.20
|
| Rate for Payer: VA VA |
$763.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,289.60
|
|
|
HC MR CHEST WO W CON
|
Facility
|
IP
|
$3,052.80
|
|
|
Service Code
|
CPT 71552
|
| Hospital Charge Code |
61000012
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,984.32 |
| Max. Negotiated Rate |
$2,747.52 |
| Rate for Payer: Aetna Commercial |
$2,594.88
|
| Rate for Payer: BCBS Trust/PPO |
$2,492.00
|
| Rate for Payer: BCN Commercial |
$2,359.20
|
| Rate for Payer: Cash Price |
$2,442.24
|
| Rate for Payer: Cofinity Commercial |
$2,625.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,442.24
|
| Rate for Payer: Healthscope Commercial |
$2,747.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,289.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,594.88
|
| Rate for Payer: Nomi Health Commercial |
$2,503.30
|
| Rate for Payer: PHP Commercial |
$2,594.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,984.32
|
| Rate for Payer: Priority Health HMO/PPO |
$2,655.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,045.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,686.46
|
| Rate for Payer: UHC Core |
$2,549.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,289.60
|
|
|
HC MR ELASTOGRAPHY
|
Facility
|
OP
|
$359.98
|
|
|
Service Code
|
CPT 76391
|
| Hospital Charge Code |
61000089
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$85.50 |
| Max. Negotiated Rate |
$323.98 |
| Rate for Payer: Aetna Commercial |
$305.98
|
| Rate for Payer: Aetna Medicare |
$93.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$112.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$112.49
|
| Rate for Payer: BCBS Complete |
$183.51
|
| Rate for Payer: BCBS MAPPO |
$90.00
|
| Rate for Payer: BCBS Trust/PPO |
$295.94
|
| Rate for Payer: BCN Commercial |
$279.88
|
| Rate for Payer: BCN Medicare Advantage |
$90.00
|
| Rate for Payer: Cash Price |
$287.98
|
| Rate for Payer: Cash Price |
$287.98
|
| Rate for Payer: Cofinity Commercial |
$309.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.00
|
| Rate for Payer: Healthscope Commercial |
$323.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.99
|
| Rate for Payer: Mclaren Medicaid |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.49
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.98
|
| Rate for Payer: Nomi Health Commercial |
$295.18
|
| Rate for Payer: PACE Senior Care Partners |
$85.50
|
| Rate for Payer: PACE SWMI |
$90.00
|
| Rate for Payer: PHP Commercial |
$305.98
|
| Rate for Payer: PHP Medicare Advantage |
$90.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.99
|
| Rate for Payer: Priority Health HMO/PPO |
$313.18
|
| Rate for Payer: Priority Health Medicare |
$90.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.19
|
| Rate for Payer: Railroad Medicare Medicare |
$90.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.78
|
| Rate for Payer: UHC Core |
$300.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.00
|
| Rate for Payer: UHC Exchange |
$90.00
|
| Rate for Payer: UHC Medicare Advantage |
$90.00
|
| Rate for Payer: UHCCP Medicaid |
$174.76
|
| Rate for Payer: VA VA |
$90.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.99
|
|
|
HC MR ELASTOGRAPHY
|
Facility
|
IP
|
$359.98
|
|
|
Service Code
|
CPT 76391
|
| Hospital Charge Code |
61000089
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$233.99 |
| Max. Negotiated Rate |
$323.98 |
| Rate for Payer: Aetna Commercial |
$305.98
|
| Rate for Payer: BCBS Trust/PPO |
$293.85
|
| Rate for Payer: BCN Commercial |
$278.19
|
| Rate for Payer: Cash Price |
$287.98
|
| Rate for Payer: Cofinity Commercial |
$309.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.98
|
| Rate for Payer: Healthscope Commercial |
$323.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.98
|
| Rate for Payer: Nomi Health Commercial |
$295.18
|
| Rate for Payer: PHP Commercial |
$305.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.99
|
| Rate for Payer: Priority Health HMO/PPO |
$313.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.78
|
| Rate for Payer: UHC Core |
$300.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.99
|
|
|
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 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 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 |
$258.20 |
| 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 |
$271.13
|
| Rate for Payer: BCBS MAPPO |
$753.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,478.62
|
| Rate for Payer: BCN Commercial |
$2,344.15
|
| Rate for Payer: BCN Medicare Advantage |
$753.75
|
| 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 |
$753.75
|
| Rate for Payer: Healthscope Commercial |
$2,713.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,261.24
|
| Rate for Payer: Mclaren Medicaid |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$791.43
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| 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 |
$753.75
|
| Rate for Payer: PHP Commercial |
$2,562.73
|
| Rate for Payer: PHP Medicare Advantage |
$753.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.20
|
| 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 |
$753.75
|
| 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 |
$753.75
|
| Rate for Payer: UHC Exchange |
$753.75
|
| Rate for Payer: UHC Medicare Advantage |
$753.75
|
| Rate for Payer: UHCCP Medicaid |
$258.20
|
| Rate for Payer: VA VA |
$753.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,261.24
|
|
|
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 |
$1,689.05
|
| 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 |
$1,689.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,533.57
|
|
|
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 |
$599.81
|
| Rate for Payer: BCBS Complete |
$599.81
|
| Rate for Payer: BCBS MAPPO |
$844.52
|
| Rate for Payer: BCBS MAPPO |
$563.01
|
| 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 |
$563.01
|
| 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 |
$563.01
|
| 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 |
$1,689.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,533.57
|
| Rate for Payer: Mclaren Medicaid |
$571.21
|
| Rate for Payer: Mclaren Medicaid |
$571.21
|
| 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 |
$599.81
|
| Rate for Payer: Meridian Medicaid |
$599.81
|
| 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 |
$563.01
|
| 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 |
$563.01
|
| Rate for Payer: PHP Medicare Advantage |
$844.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$571.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$571.21
|
| 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 |
$563.01
|
| 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 |
$563.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$844.52
|
| Rate for Payer: UHC Exchange |
$844.52
|
| Rate for Payer: UHC Exchange |
$563.01
|
| Rate for Payer: UHC Medicare Advantage |
$844.52
|
| Rate for Payer: UHC Medicare Advantage |
$563.01
|
| Rate for Payer: UHCCP Medicaid |
$571.21
|
| Rate for Payer: UHCCP Medicaid |
$571.21
|
| Rate for Payer: VA VA |
$563.01
|
| Rate for Payer: VA VA |
$844.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,533.57
|
|
|
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 |
$174.76 |
| 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 |
$183.51
|
| Rate for Payer: BCBS Complete |
$183.51
|
| Rate for Payer: BCBS MAPPO |
$724.84
|
| Rate for Payer: BCBS MAPPO |
$483.23
|
| 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 |
$483.23
|
| 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 |
$483.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$724.84
|
| Rate for Payer: Healthscope Commercial |
$2,609.41
|
| Rate for Payer: Healthscope Commercial |
$1,739.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,449.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,174.51
|
| Rate for Payer: Mclaren Medicaid |
$174.76
|
| Rate for Payer: Mclaren Medicaid |
$174.76
|
| 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 |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| 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 |
$483.23
|
| 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 |
$483.23
|
| Rate for Payer: PHP Medicare Advantage |
$724.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.76
|
| 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 |
$483.23
|
| 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 |
$483.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$724.84
|
| Rate for Payer: UHC Exchange |
$724.84
|
| Rate for Payer: UHC Exchange |
$483.23
|
| Rate for Payer: UHC Medicare Advantage |
$724.84
|
| Rate for Payer: UHC Medicare Advantage |
$483.23
|
| Rate for Payer: UHCCP Medicaid |
$174.76
|
| Rate for Payer: UHCCP Medicaid |
$174.76
|
| Rate for Payer: VA VA |
$483.23
|
| Rate for Payer: VA VA |
$724.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,449.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,174.51
|
|
|
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 |
$2,609.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,449.67
|
| 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 |
$1,449.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,174.51
|
|
|
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 |
$258.20 |
| 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 |
$271.13
|
| Rate for Payer: BCBS Complete |
$271.13
|
| 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 |
$258.20
|
| Rate for Payer: Mclaren Medicaid |
$258.20
|
| 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 |
$271.13
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| 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 |
$258.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.20
|
| 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 |
$258.20
|
| Rate for Payer: UHCCP Medicaid |
$258.20
|
| 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
|
|
