|
HC MR MRA NECK W CON
|
Facility
|
OP
|
$2,404.63
|
|
|
Service Code
|
CPT 70548
|
| Hospital Charge Code |
61000008
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,164.17 |
| Rate for Payer: Aetna Commercial |
$2,043.94
|
| Rate for Payer: Aetna Medicare |
$625.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$751.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$751.45
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$601.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,976.85
|
| Rate for Payer: BCN Commercial |
$1,869.60
|
| Rate for Payer: BCN Medicare Advantage |
$601.16
|
| Rate for Payer: Cash Price |
$1,923.70
|
| Rate for Payer: Cash Price |
$1,923.70
|
| Rate for Payer: Cofinity Commercial |
$2,067.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,923.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$601.16
|
| Rate for Payer: Healthscope Commercial |
$2,164.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,803.47
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$631.22
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$691.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,043.94
|
| Rate for Payer: Nomi Health Commercial |
$1,971.80
|
| Rate for Payer: PACE Senior Care Partners |
$571.10
|
| Rate for Payer: PACE SWMI |
$601.16
|
| Rate for Payer: PHP Commercial |
$2,043.94
|
| Rate for Payer: PHP Medicare Advantage |
$601.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,563.01
|
| Rate for Payer: Priority Health HMO/PPO |
$2,092.03
|
| Rate for Payer: Priority Health Medicare |
$607.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,611.10
|
| Rate for Payer: Railroad Medicare Medicare |
$601.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,116.07
|
| Rate for Payer: UHC Core |
$2,007.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$601.16
|
| Rate for Payer: UHC Exchange |
$601.16
|
| Rate for Payer: UHC Medicare Advantage |
$601.16
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$601.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,803.47
|
|
|
HC MR MRA NECK W CON
|
Facility
|
IP
|
$2,404.63
|
|
|
Service Code
|
CPT 70548
|
| Hospital Charge Code |
61000008
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,563.01 |
| Max. Negotiated Rate |
$2,164.17 |
| Rate for Payer: Aetna Commercial |
$2,043.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,962.90
|
| Rate for Payer: BCN Commercial |
$1,858.30
|
| Rate for Payer: Cash Price |
$1,923.70
|
| Rate for Payer: Cofinity Commercial |
$2,067.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,923.70
|
| Rate for Payer: Healthscope Commercial |
$2,164.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,803.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,043.94
|
| Rate for Payer: Nomi Health Commercial |
$1,971.80
|
| Rate for Payer: PHP Commercial |
$2,043.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,563.01
|
| Rate for Payer: Priority Health HMO/PPO |
$2,092.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,611.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,116.07
|
| Rate for Payer: UHC Core |
$2,007.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,803.47
|
|
|
HC MR MRA NECK WO CON
|
Facility
|
OP
|
$2,004.85
|
|
|
Service Code
|
CPT 70547
|
| Hospital Charge Code |
61000007
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,804.36 |
| Rate for Payer: Aetna Commercial |
$1,704.12
|
| Rate for Payer: Aetna Medicare |
$521.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$626.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$626.52
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$501.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,648.19
|
| Rate for Payer: BCN Commercial |
$1,558.77
|
| Rate for Payer: BCN Medicare Advantage |
$501.21
|
| Rate for Payer: Cash Price |
$1,603.88
|
| Rate for Payer: Cash Price |
$1,603.88
|
| Rate for Payer: Cofinity Commercial |
$1,724.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,603.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$501.21
|
| Rate for Payer: Healthscope Commercial |
$1,804.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,503.64
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$526.27
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$576.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,704.12
|
| Rate for Payer: Nomi Health Commercial |
$1,643.98
|
| Rate for Payer: PACE Senior Care Partners |
$476.15
|
| Rate for Payer: PACE SWMI |
$501.21
|
| Rate for Payer: PHP Commercial |
$1,704.12
|
| Rate for Payer: PHP Medicare Advantage |
$501.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,303.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,744.22
|
| Rate for Payer: Priority Health Medicare |
$506.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,343.25
|
| Rate for Payer: Railroad Medicare Medicare |
$501.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,764.27
|
| Rate for Payer: UHC Core |
$1,674.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$501.21
|
| Rate for Payer: UHC Exchange |
$501.21
|
| Rate for Payer: UHC Medicare Advantage |
$501.21
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$501.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,503.64
|
|
|
HC MR MRA NECK WO CON
|
Facility
|
IP
|
$2,004.85
|
|
|
Service Code
|
CPT 70547
|
| Hospital Charge Code |
61000007
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,303.15 |
| Max. Negotiated Rate |
$1,804.36 |
| Rate for Payer: Aetna Commercial |
$1,704.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,636.56
|
| Rate for Payer: BCN Commercial |
$1,549.35
|
| Rate for Payer: Cash Price |
$1,603.88
|
| Rate for Payer: Cofinity Commercial |
$1,724.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,603.88
|
| Rate for Payer: Healthscope Commercial |
$1,804.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,503.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,704.12
|
| Rate for Payer: Nomi Health Commercial |
$1,643.98
|
| Rate for Payer: PHP Commercial |
$1,704.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,303.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,744.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,343.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,764.27
|
| Rate for Payer: UHC Core |
$1,674.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,503.64
|
|
|
HC MR MRA NECK WO W CON
|
Facility
|
OP
|
$2,826.51
|
|
|
Service Code
|
CPT 70549
|
| Hospital Charge Code |
61000009
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,543.86 |
| Rate for Payer: Aetna Commercial |
$2,402.53
|
| Rate for Payer: Aetna Medicare |
$734.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$883.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$883.28
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$706.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,323.67
|
| Rate for Payer: BCN Commercial |
$2,197.61
|
| Rate for Payer: BCN Medicare Advantage |
$706.63
|
| Rate for Payer: Cash Price |
$2,261.21
|
| Rate for Payer: Cash Price |
$2,261.21
|
| Rate for Payer: Cofinity Commercial |
$2,430.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,261.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$706.63
|
| Rate for Payer: Healthscope Commercial |
$2,543.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,119.88
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$741.96
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$812.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,402.53
|
| Rate for Payer: Nomi Health Commercial |
$2,317.74
|
| Rate for Payer: PACE Senior Care Partners |
$671.30
|
| Rate for Payer: PACE SWMI |
$706.63
|
| Rate for Payer: PHP Commercial |
$2,402.53
|
| Rate for Payer: PHP Medicare Advantage |
$706.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,837.23
|
| Rate for Payer: Priority Health HMO/PPO |
$2,459.06
|
| Rate for Payer: Priority Health Medicare |
$713.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,893.76
|
| Rate for Payer: Railroad Medicare Medicare |
$706.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,487.33
|
| Rate for Payer: UHC Core |
$2,360.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$706.63
|
| Rate for Payer: UHC Exchange |
$706.63
|
| Rate for Payer: UHC Medicare Advantage |
$706.63
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$706.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,119.88
|
|
|
HC MR MRA NECK WO W CON
|
Facility
|
IP
|
$2,826.51
|
|
|
Service Code
|
CPT 70549
|
| Hospital Charge Code |
61000009
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$1,837.23 |
| Max. Negotiated Rate |
$2,543.86 |
| Rate for Payer: Aetna Commercial |
$2,402.53
|
| Rate for Payer: BCBS Trust/PPO |
$2,307.28
|
| Rate for Payer: BCN Commercial |
$2,184.33
|
| Rate for Payer: Cash Price |
$2,261.21
|
| Rate for Payer: Cofinity Commercial |
$2,430.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,261.21
|
| Rate for Payer: Healthscope Commercial |
$2,543.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,119.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,402.53
|
| Rate for Payer: Nomi Health Commercial |
$2,317.74
|
| Rate for Payer: PHP Commercial |
$2,402.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,837.23
|
| Rate for Payer: Priority Health HMO/PPO |
$2,459.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,893.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,487.33
|
| Rate for Payer: UHC Core |
$2,360.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,119.88
|
|
|
HC MR MRA PELVIS W CON
|
Facility
|
OP
|
$2,040.92
|
|
|
Service Code
|
HCPCS C8918
|
| Hospital Charge Code |
61800001
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$1,836.83 |
| Rate for Payer: Aetna Commercial |
$1,734.78
|
| Rate for Payer: Aetna Medicare |
$530.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$637.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$637.79
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$510.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,677.84
|
| Rate for Payer: BCN Commercial |
$1,586.82
|
| Rate for Payer: BCN Medicare Advantage |
$510.23
|
| Rate for Payer: Cash Price |
$1,632.74
|
| Rate for Payer: Cash Price |
$1,632.74
|
| Rate for Payer: Cofinity Commercial |
$1,755.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,632.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$510.23
|
| Rate for Payer: Healthscope Commercial |
$1,836.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,530.69
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$535.74
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$586.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,734.78
|
| Rate for Payer: Nomi Health Commercial |
$1,673.55
|
| Rate for Payer: PACE Senior Care Partners |
$484.72
|
| Rate for Payer: PACE SWMI |
$510.23
|
| Rate for Payer: PHP Commercial |
$1,734.78
|
| Rate for Payer: PHP Medicare Advantage |
$510.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,326.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,775.60
|
| Rate for Payer: Priority Health Medicare |
$515.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,367.42
|
| Rate for Payer: Railroad Medicare Medicare |
$510.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,796.01
|
| Rate for Payer: UHC Core |
$1,704.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$510.23
|
| Rate for Payer: UHC Exchange |
$510.23
|
| Rate for Payer: UHC Medicare Advantage |
$510.23
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$510.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,530.69
|
|
|
HC MR MRA PELVIS W CON
|
Facility
|
IP
|
$2,040.92
|
|
|
Service Code
|
HCPCS C8918
|
| Hospital Charge Code |
61800001
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,326.60 |
| Max. Negotiated Rate |
$1,836.83 |
| Rate for Payer: Aetna Commercial |
$1,734.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,666.00
|
| Rate for Payer: BCN Commercial |
$1,577.22
|
| Rate for Payer: Cash Price |
$1,632.74
|
| Rate for Payer: Cofinity Commercial |
$1,755.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,632.74
|
| Rate for Payer: Healthscope Commercial |
$1,836.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,530.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,734.78
|
| Rate for Payer: Nomi Health Commercial |
$1,673.55
|
| Rate for Payer: PHP Commercial |
$1,734.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,326.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,775.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,367.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,796.01
|
| Rate for Payer: UHC Core |
$1,704.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,530.69
|
|
|
HC MR MRA PELVIS WO CON
|
Facility
|
IP
|
$1,900.16
|
|
|
Service Code
|
HCPCS C8919
|
| Hospital Charge Code |
61800002
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,235.10 |
| Max. Negotiated Rate |
$1,710.14 |
| Rate for Payer: Aetna Commercial |
$1,615.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,551.10
|
| Rate for Payer: BCN Commercial |
$1,468.44
|
| Rate for Payer: Cash Price |
$1,520.13
|
| Rate for Payer: Cofinity Commercial |
$1,634.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,520.13
|
| Rate for Payer: Healthscope Commercial |
$1,710.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,425.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,615.14
|
| Rate for Payer: Nomi Health Commercial |
$1,558.13
|
| Rate for Payer: PHP Commercial |
$1,615.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,235.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,653.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,273.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,672.14
|
| Rate for Payer: UHC Core |
$1,586.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,425.12
|
|
|
HC MR MRA PELVIS WO CON
|
Facility
|
OP
|
$1,900.16
|
|
|
Service Code
|
HCPCS C8919
|
| Hospital Charge Code |
61800002
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,710.14 |
| Rate for Payer: Aetna Commercial |
$1,615.14
|
| Rate for Payer: Aetna Medicare |
$494.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$593.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$593.80
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$475.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,562.12
|
| Rate for Payer: BCN Commercial |
$1,477.37
|
| Rate for Payer: BCN Medicare Advantage |
$475.04
|
| Rate for Payer: Cash Price |
$1,520.13
|
| Rate for Payer: Cash Price |
$1,520.13
|
| Rate for Payer: Cofinity Commercial |
$1,634.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,520.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$475.04
|
| Rate for Payer: Healthscope Commercial |
$1,710.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,425.12
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$498.79
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$546.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,615.14
|
| Rate for Payer: Nomi Health Commercial |
$1,558.13
|
| Rate for Payer: PACE Senior Care Partners |
$451.29
|
| Rate for Payer: PACE SWMI |
$475.04
|
| Rate for Payer: PHP Commercial |
$1,615.14
|
| Rate for Payer: PHP Medicare Advantage |
$475.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,235.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,653.14
|
| Rate for Payer: Priority Health Medicare |
$479.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,273.11
|
| Rate for Payer: Railroad Medicare Medicare |
$475.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,672.14
|
| Rate for Payer: UHC Core |
$1,586.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$475.04
|
| Rate for Payer: UHC Exchange |
$475.04
|
| Rate for Payer: UHC Medicare Advantage |
$475.04
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$475.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,425.12
|
|
|
HC MR MRA PELVIS WO W CON
|
Facility
|
IP
|
$2,252.06
|
|
|
Service Code
|
HCPCS C8920
|
| Hospital Charge Code |
61800003
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,463.84 |
| Max. Negotiated Rate |
$2,026.85 |
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,838.36
|
| Rate for Payer: BCN Commercial |
$1,740.39
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cofinity Commercial |
$1,936.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,689.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.25
|
| Rate for Payer: Nomi Health Commercial |
$1,846.69
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.84
|
| Rate for Payer: Priority Health HMO/PPO |
$1,959.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,508.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,981.81
|
| Rate for Payer: UHC Core |
$1,880.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.04
|
|
|
HC MR MRA PELVIS WO W CON
|
Facility
|
OP
|
$2,252.06
|
|
|
Service Code
|
HCPCS C8920
|
| Hospital Charge Code |
61800003
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,026.85 |
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: Aetna Medicare |
$585.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$703.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$703.77
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$563.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,851.42
|
| Rate for Payer: BCN Commercial |
$1,750.98
|
| Rate for Payer: BCN Medicare Advantage |
$563.02
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cofinity Commercial |
$1,936.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$563.02
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,689.04
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$591.17
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$647.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.25
|
| Rate for Payer: Nomi Health Commercial |
$1,846.69
|
| Rate for Payer: PACE Senior Care Partners |
$534.86
|
| Rate for Payer: PACE SWMI |
$563.02
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: PHP Medicare Advantage |
$563.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.84
|
| Rate for Payer: Priority Health HMO/PPO |
$1,959.29
|
| Rate for Payer: Priority Health Medicare |
$568.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,508.88
|
| Rate for Payer: Railroad Medicare Medicare |
$563.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,981.81
|
| Rate for Payer: UHC Core |
$1,880.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$563.02
|
| Rate for Payer: UHC Exchange |
$563.02
|
| Rate for Payer: UHC Medicare Advantage |
$563.02
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$563.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.04
|
|
|
HC MR MRA SPINAL CANAL W CON
|
Facility
|
IP
|
$1,940.65
|
|
|
Service Code
|
HCPCS C8931
|
| Hospital Charge Code |
61000072
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,261.42 |
| Max. Negotiated Rate |
$1,746.58 |
| Rate for Payer: Aetna Commercial |
$1,649.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,584.15
|
| Rate for Payer: BCN Commercial |
$1,499.73
|
| Rate for Payer: Cash Price |
$1,552.52
|
| Rate for Payer: Cofinity Commercial |
$1,668.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,552.52
|
| Rate for Payer: Healthscope Commercial |
$1,746.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,455.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,649.55
|
| Rate for Payer: Nomi Health Commercial |
$1,591.33
|
| Rate for Payer: PHP Commercial |
$1,649.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,261.42
|
| Rate for Payer: Priority Health HMO/PPO |
$1,688.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,300.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,707.77
|
| Rate for Payer: UHC Core |
$1,620.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,455.49
|
|
|
HC MR MRA SPINAL CANAL W CON
|
Facility
|
OP
|
$1,940.65
|
|
|
Service Code
|
HCPCS C8931
|
| Hospital Charge Code |
61000072
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$1,746.58 |
| Rate for Payer: Aetna Commercial |
$1,649.55
|
| Rate for Payer: Aetna Medicare |
$504.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$606.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$606.45
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$485.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,595.41
|
| Rate for Payer: BCN Commercial |
$1,508.86
|
| Rate for Payer: BCN Medicare Advantage |
$485.16
|
| Rate for Payer: Cash Price |
$1,552.52
|
| Rate for Payer: Cash Price |
$1,552.52
|
| Rate for Payer: Cofinity Commercial |
$1,668.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,552.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$485.16
|
| Rate for Payer: Healthscope Commercial |
$1,746.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,455.49
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$509.42
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$557.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,649.55
|
| Rate for Payer: Nomi Health Commercial |
$1,591.33
|
| Rate for Payer: PACE Senior Care Partners |
$460.90
|
| Rate for Payer: PACE SWMI |
$485.16
|
| Rate for Payer: PHP Commercial |
$1,649.55
|
| Rate for Payer: PHP Medicare Advantage |
$485.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,261.42
|
| Rate for Payer: Priority Health HMO/PPO |
$1,688.37
|
| Rate for Payer: Priority Health Medicare |
$490.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,300.24
|
| Rate for Payer: Railroad Medicare Medicare |
$485.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,707.77
|
| Rate for Payer: UHC Core |
$1,620.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$485.16
|
| Rate for Payer: UHC Exchange |
$485.16
|
| Rate for Payer: UHC Medicare Advantage |
$485.16
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$485.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,455.49
|
|
|
HC MR MRA SPINAL CANAL WO CON
|
Facility
|
IP
|
$1,940.65
|
|
|
Service Code
|
HCPCS C8932
|
| Hospital Charge Code |
61000073
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,261.42 |
| Max. Negotiated Rate |
$1,746.58 |
| Rate for Payer: Aetna Commercial |
$1,649.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,584.15
|
| Rate for Payer: BCN Commercial |
$1,499.73
|
| Rate for Payer: Cash Price |
$1,552.52
|
| Rate for Payer: Cofinity Commercial |
$1,668.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,552.52
|
| Rate for Payer: Healthscope Commercial |
$1,746.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,455.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,649.55
|
| Rate for Payer: Nomi Health Commercial |
$1,591.33
|
| Rate for Payer: PHP Commercial |
$1,649.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,261.42
|
| Rate for Payer: Priority Health HMO/PPO |
$1,688.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,300.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,707.77
|
| Rate for Payer: UHC Core |
$1,620.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,455.49
|
|
|
HC MR MRA SPINAL CANAL WO CON
|
Facility
|
OP
|
$1,940.65
|
|
|
Service Code
|
HCPCS C8932
|
| Hospital Charge Code |
61000073
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,746.58 |
| Rate for Payer: Aetna Commercial |
$1,649.55
|
| Rate for Payer: Aetna Medicare |
$504.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$606.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$606.45
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$485.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,595.41
|
| Rate for Payer: BCN Commercial |
$1,508.86
|
| Rate for Payer: BCN Medicare Advantage |
$485.16
|
| Rate for Payer: Cash Price |
$1,552.52
|
| Rate for Payer: Cash Price |
$1,552.52
|
| Rate for Payer: Cofinity Commercial |
$1,668.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,552.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$485.16
|
| Rate for Payer: Healthscope Commercial |
$1,746.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,455.49
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$509.42
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$557.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,649.55
|
| Rate for Payer: Nomi Health Commercial |
$1,591.33
|
| Rate for Payer: PACE Senior Care Partners |
$460.90
|
| Rate for Payer: PACE SWMI |
$485.16
|
| Rate for Payer: PHP Commercial |
$1,649.55
|
| Rate for Payer: PHP Medicare Advantage |
$485.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,261.42
|
| Rate for Payer: Priority Health HMO/PPO |
$1,688.37
|
| Rate for Payer: Priority Health Medicare |
$490.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,300.24
|
| Rate for Payer: Railroad Medicare Medicare |
$485.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,707.77
|
| Rate for Payer: UHC Core |
$1,620.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$485.16
|
| Rate for Payer: UHC Exchange |
$485.16
|
| Rate for Payer: UHC Medicare Advantage |
$485.16
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$485.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,455.49
|
|
|
HC MR MRA UPPER EXTREM BIL WO W C
|
Facility
|
OP
|
$2,122.52
|
|
|
Service Code
|
HCPCS C8936
|
| Hospital Charge Code |
61000074
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$1,910.27 |
| Rate for Payer: Aetna Commercial |
$1,804.14
|
| Rate for Payer: Aetna Medicare |
$551.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$663.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$663.29
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$530.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,744.92
|
| Rate for Payer: BCN Commercial |
$1,650.26
|
| Rate for Payer: BCN Medicare Advantage |
$530.63
|
| Rate for Payer: Cash Price |
$1,698.02
|
| Rate for Payer: Cash Price |
$1,698.02
|
| Rate for Payer: Cofinity Commercial |
$1,825.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,698.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$530.63
|
| Rate for Payer: Healthscope Commercial |
$1,910.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,591.89
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$557.16
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$610.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,804.14
|
| Rate for Payer: Nomi Health Commercial |
$1,740.47
|
| Rate for Payer: PACE Senior Care Partners |
$504.10
|
| Rate for Payer: PACE SWMI |
$530.63
|
| Rate for Payer: PHP Commercial |
$1,804.14
|
| Rate for Payer: PHP Medicare Advantage |
$530.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,379.64
|
| Rate for Payer: Priority Health HMO/PPO |
$1,846.59
|
| Rate for Payer: Priority Health Medicare |
$535.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,422.09
|
| Rate for Payer: Railroad Medicare Medicare |
$530.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,867.82
|
| Rate for Payer: UHC Core |
$1,772.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$530.63
|
| Rate for Payer: UHC Exchange |
$530.63
|
| Rate for Payer: UHC Medicare Advantage |
$530.63
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$530.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,591.89
|
|
|
HC MR MRA UPPER EXTREM BIL WO W C
|
Facility
|
IP
|
$2,122.52
|
|
|
Service Code
|
HCPCS C8936
|
| Hospital Charge Code |
61000074
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,379.64 |
| Max. Negotiated Rate |
$1,910.27 |
| Rate for Payer: Aetna Commercial |
$1,804.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,732.61
|
| Rate for Payer: BCN Commercial |
$1,640.28
|
| Rate for Payer: Cash Price |
$1,698.02
|
| Rate for Payer: Cofinity Commercial |
$1,825.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,698.02
|
| Rate for Payer: Healthscope Commercial |
$1,910.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,591.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,804.14
|
| Rate for Payer: Nomi Health Commercial |
$1,740.47
|
| Rate for Payer: PHP Commercial |
$1,804.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,379.64
|
| Rate for Payer: Priority Health HMO/PPO |
$1,846.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,422.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,867.82
|
| Rate for Payer: UHC Core |
$1,772.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,591.89
|
|
|
HC MR MRA UPPER EXTREMITY BIL W CO
|
Facility
|
IP
|
$2,122.52
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000075
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,379.64 |
| Max. Negotiated Rate |
$1,910.27 |
| Rate for Payer: Aetna Commercial |
$1,804.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,732.61
|
| Rate for Payer: BCN Commercial |
$1,640.28
|
| Rate for Payer: Cash Price |
$1,698.02
|
| Rate for Payer: Cofinity Commercial |
$1,825.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,698.02
|
| Rate for Payer: Healthscope Commercial |
$1,910.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,591.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,804.14
|
| Rate for Payer: Nomi Health Commercial |
$1,740.47
|
| Rate for Payer: PHP Commercial |
$1,804.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,379.64
|
| Rate for Payer: Priority Health HMO/PPO |
$1,846.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,422.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,867.82
|
| Rate for Payer: UHC Core |
$1,772.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,591.89
|
|
|
HC MR MRA UPPER EXTREMITY BIL W CO
|
Facility
|
OP
|
$2,122.52
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000075
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$1,910.27 |
| Rate for Payer: Aetna Commercial |
$1,804.14
|
| Rate for Payer: Aetna Medicare |
$551.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$663.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$663.29
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$530.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,744.92
|
| Rate for Payer: BCN Commercial |
$1,650.26
|
| Rate for Payer: BCN Medicare Advantage |
$530.63
|
| Rate for Payer: Cash Price |
$1,698.02
|
| Rate for Payer: Cash Price |
$1,698.02
|
| Rate for Payer: Cofinity Commercial |
$1,825.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,698.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$530.63
|
| Rate for Payer: Healthscope Commercial |
$1,910.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,591.89
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$557.16
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$610.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,804.14
|
| Rate for Payer: Nomi Health Commercial |
$1,740.47
|
| Rate for Payer: PACE Senior Care Partners |
$504.10
|
| Rate for Payer: PACE SWMI |
$530.63
|
| Rate for Payer: PHP Commercial |
$1,804.14
|
| Rate for Payer: PHP Medicare Advantage |
$530.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,379.64
|
| Rate for Payer: Priority Health HMO/PPO |
$1,846.59
|
| Rate for Payer: Priority Health Medicare |
$535.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,422.09
|
| Rate for Payer: Railroad Medicare Medicare |
$530.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,867.82
|
| Rate for Payer: UHC Core |
$1,772.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$530.63
|
| Rate for Payer: UHC Exchange |
$530.63
|
| Rate for Payer: UHC Medicare Advantage |
$530.63
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$530.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,591.89
|
|
|
HC MR MRA UPPER EXTREMITY BIL WO C
|
Facility
|
IP
|
$2,122.52
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000076
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,379.64 |
| Max. Negotiated Rate |
$1,910.27 |
| Rate for Payer: Aetna Commercial |
$1,804.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,732.61
|
| Rate for Payer: BCN Commercial |
$1,640.28
|
| Rate for Payer: Cash Price |
$1,698.02
|
| Rate for Payer: Cofinity Commercial |
$1,825.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,698.02
|
| Rate for Payer: Healthscope Commercial |
$1,910.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,591.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,804.14
|
| Rate for Payer: Nomi Health Commercial |
$1,740.47
|
| Rate for Payer: PHP Commercial |
$1,804.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,379.64
|
| Rate for Payer: Priority Health HMO/PPO |
$1,846.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,422.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,867.82
|
| Rate for Payer: UHC Core |
$1,772.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,591.89
|
|
|
HC MR MRA UPPER EXTREMITY BIL WO C
|
Facility
|
OP
|
$2,122.52
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000076
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,910.27 |
| Rate for Payer: Aetna Commercial |
$1,804.14
|
| Rate for Payer: Aetna Medicare |
$551.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$663.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$663.29
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$530.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,744.92
|
| Rate for Payer: BCN Commercial |
$1,650.26
|
| Rate for Payer: BCN Medicare Advantage |
$530.63
|
| Rate for Payer: Cash Price |
$1,698.02
|
| Rate for Payer: Cash Price |
$1,698.02
|
| Rate for Payer: Cofinity Commercial |
$1,825.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,698.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$530.63
|
| Rate for Payer: Healthscope Commercial |
$1,910.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,591.89
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$557.16
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$610.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,804.14
|
| Rate for Payer: Nomi Health Commercial |
$1,740.47
|
| Rate for Payer: PACE Senior Care Partners |
$504.10
|
| Rate for Payer: PACE SWMI |
$530.63
|
| Rate for Payer: PHP Commercial |
$1,804.14
|
| Rate for Payer: PHP Medicare Advantage |
$530.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,379.64
|
| Rate for Payer: Priority Health HMO/PPO |
$1,846.59
|
| Rate for Payer: Priority Health Medicare |
$535.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,422.09
|
| Rate for Payer: Railroad Medicare Medicare |
$530.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,867.82
|
| Rate for Payer: UHC Core |
$1,772.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$530.63
|
| Rate for Payer: UHC Exchange |
$530.63
|
| Rate for Payer: UHC Medicare Advantage |
$530.63
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$530.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,591.89
|
|
|
HC MR MRA UPPER EXTREMITY W CO
|
Facility
|
IP
|
$1,903.11
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000077
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,237.02 |
| Max. Negotiated Rate |
$1,712.80 |
| Rate for Payer: Aetna Commercial |
$1,617.64
|
| Rate for Payer: Aetna Commercial |
$2,426.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,553.51
|
| Rate for Payer: BCBS Trust/PPO |
$2,330.27
|
| Rate for Payer: BCN Commercial |
$1,470.72
|
| Rate for Payer: BCN Commercial |
$2,206.09
|
| Rate for Payer: Cash Price |
$1,522.49
|
| Rate for Payer: Cash Price |
$2,283.74
|
| Rate for Payer: Cofinity Commercial |
$2,455.02
|
| Rate for Payer: Cofinity Commercial |
$1,636.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,283.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.49
|
| Rate for Payer: Healthscope Commercial |
$1,712.80
|
| Rate for Payer: Healthscope Commercial |
$2,569.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,427.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,141.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,617.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,426.47
|
| Rate for Payer: Nomi Health Commercial |
$1,560.55
|
| Rate for Payer: Nomi Health Commercial |
$2,340.83
|
| Rate for Payer: PHP Commercial |
$1,617.64
|
| Rate for Payer: PHP Commercial |
$2,426.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,855.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,237.02
|
| Rate for Payer: Priority Health HMO/PPO |
$2,483.56
|
| Rate for Payer: Priority Health HMO/PPO |
$1,655.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,275.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,912.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,674.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,512.11
|
| Rate for Payer: UHC Core |
$1,589.10
|
| Rate for Payer: UHC Core |
$2,383.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,427.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,141.00
|
|
|
HC MR MRA UPPER EXTREMITY W CO
|
Facility
|
OP
|
$1,903.11
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000077
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$1,712.80 |
| Rate for Payer: Aetna Commercial |
$1,617.64
|
| Rate for Payer: Aetna Commercial |
$2,426.47
|
| Rate for Payer: Aetna Medicare |
$494.81
|
| Rate for Payer: Aetna Medicare |
$742.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$594.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$892.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$594.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$892.08
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$713.67
|
| Rate for Payer: BCBS MAPPO |
$475.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,564.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,346.82
|
| Rate for Payer: BCN Commercial |
$1,479.67
|
| Rate for Payer: BCN Commercial |
$2,219.51
|
| Rate for Payer: BCN Medicare Advantage |
$475.78
|
| Rate for Payer: BCN Medicare Advantage |
$713.67
|
| Rate for Payer: Cash Price |
$2,283.74
|
| Rate for Payer: Cash Price |
$1,522.49
|
| Rate for Payer: Cash Price |
$1,522.49
|
| Rate for Payer: Cash Price |
$2,283.74
|
| Rate for Payer: Cofinity Commercial |
$1,636.67
|
| Rate for Payer: Cofinity Commercial |
$2,455.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,283.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$475.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$713.67
|
| Rate for Payer: Healthscope Commercial |
$2,569.20
|
| Rate for Payer: Healthscope Commercial |
$1,712.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,427.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,141.00
|
| 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 |
$749.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$499.57
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$547.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$820.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,617.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,426.47
|
| Rate for Payer: Nomi Health Commercial |
$1,560.55
|
| Rate for Payer: Nomi Health Commercial |
$2,340.83
|
| Rate for Payer: PACE Senior Care Partners |
$451.99
|
| Rate for Payer: PACE Senior Care Partners |
$677.98
|
| Rate for Payer: PACE SWMI |
$475.78
|
| Rate for Payer: PACE SWMI |
$713.67
|
| Rate for Payer: PHP Commercial |
$2,426.47
|
| Rate for Payer: PHP Commercial |
$1,617.64
|
| Rate for Payer: PHP Medicare Advantage |
$475.78
|
| Rate for Payer: PHP Medicare Advantage |
$713.67
|
| 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 |
$1,237.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,855.54
|
| Rate for Payer: Priority Health HMO/PPO |
$2,483.56
|
| Rate for Payer: Priority Health HMO/PPO |
$1,655.71
|
| Rate for Payer: Priority Health Medicare |
$480.54
|
| Rate for Payer: Priority Health Medicare |
$720.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,275.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,912.63
|
| Rate for Payer: Railroad Medicare Medicare |
$713.67
|
| Rate for Payer: Railroad Medicare Medicare |
$475.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,512.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,674.74
|
| Rate for Payer: UHC Core |
$2,383.65
|
| Rate for Payer: UHC Core |
$1,589.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$475.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$713.67
|
| Rate for Payer: UHC Exchange |
$713.67
|
| Rate for Payer: UHC Exchange |
$475.78
|
| Rate for Payer: UHC Medicare Advantage |
$713.67
|
| Rate for Payer: UHC Medicare Advantage |
$475.78
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$475.78
|
| Rate for Payer: VA VA |
$713.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,427.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,141.00
|
|
|
HC MR MRA UPPER EXTREMITY WO C
|
Facility
|
OP
|
$1,756.74
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000078
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,581.07 |
| Rate for Payer: Aetna Commercial |
$1,493.23
|
| Rate for Payer: Aetna Commercial |
$2,239.84
|
| Rate for Payer: Aetna Medicare |
$456.75
|
| Rate for Payer: Aetna Medicare |
$685.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$548.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$823.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$548.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$823.47
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$658.78
|
| Rate for Payer: BCBS MAPPO |
$439.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,444.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,166.32
|
| Rate for Payer: BCN Commercial |
$1,365.87
|
| Rate for Payer: BCN Commercial |
$2,048.80
|
| Rate for Payer: BCN Medicare Advantage |
$439.18
|
| Rate for Payer: BCN Medicare Advantage |
$658.78
|
| Rate for Payer: Cash Price |
$2,108.09
|
| Rate for Payer: Cash Price |
$1,405.39
|
| Rate for Payer: Cash Price |
$1,405.39
|
| Rate for Payer: Cash Price |
$2,108.09
|
| Rate for Payer: Cofinity Commercial |
$1,510.80
|
| Rate for Payer: Cofinity Commercial |
$2,266.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,108.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,405.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$439.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$658.78
|
| Rate for Payer: Healthscope Commercial |
$2,371.60
|
| Rate for Payer: Healthscope Commercial |
$1,581.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,317.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,976.33
|
| 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 |
$691.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$461.14
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$505.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$757.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,493.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,239.84
|
| Rate for Payer: Nomi Health Commercial |
$1,440.53
|
| Rate for Payer: Nomi Health Commercial |
$2,160.79
|
| Rate for Payer: PACE Senior Care Partners |
$417.23
|
| Rate for Payer: PACE Senior Care Partners |
$625.84
|
| Rate for Payer: PACE SWMI |
$439.18
|
| Rate for Payer: PACE SWMI |
$658.78
|
| Rate for Payer: PHP Commercial |
$2,239.84
|
| Rate for Payer: PHP Commercial |
$1,493.23
|
| Rate for Payer: PHP Medicare Advantage |
$439.18
|
| Rate for Payer: PHP Medicare Advantage |
$658.78
|
| 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 |
$1,141.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,712.82
|
| Rate for Payer: Priority Health HMO/PPO |
$2,292.55
|
| Rate for Payer: Priority Health HMO/PPO |
$1,528.36
|
| Rate for Payer: Priority Health Medicare |
$443.58
|
| Rate for Payer: Priority Health Medicare |
$665.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,177.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,765.52
|
| Rate for Payer: Railroad Medicare Medicare |
$658.78
|
| Rate for Payer: Railroad Medicare Medicare |
$439.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,318.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,545.93
|
| Rate for Payer: UHC Core |
$2,200.32
|
| Rate for Payer: UHC Core |
$1,466.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$439.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$658.78
|
| Rate for Payer: UHC Exchange |
$658.78
|
| Rate for Payer: UHC Exchange |
$439.18
|
| Rate for Payer: UHC Medicare Advantage |
$658.78
|
| Rate for Payer: UHC Medicare Advantage |
$439.18
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$439.18
|
| Rate for Payer: VA VA |
$658.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,317.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,976.33
|
|
