|
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 W CON
|
Facility
|
OP
|
$2,252.06
|
|
|
Service Code
|
HCPCS C8920
|
| Hospital Charge Code |
61800003
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$258.20 |
| 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 |
$271.13
|
| Rate for Payer: BCBS MAPPO |
$563.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,851.42
|
| Rate for Payer: BCN Commercial |
$1,750.98
|
| Rate for Payer: BCN Medicare Advantage |
$563.01
|
| 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 |
$563.01
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,689.05
|
| Rate for Payer: Mclaren Medicaid |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$591.17
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| 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 |
$563.01
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: PHP Medicare Advantage |
$563.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.20
|
| 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 |
$563.01
|
| 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 |
$563.01
|
| Rate for Payer: UHC Exchange |
$563.01
|
| Rate for Payer: UHC Medicare Advantage |
$563.01
|
| Rate for Payer: UHCCP Medicaid |
$258.20
|
| Rate for Payer: VA VA |
$563.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.05
|
|
|
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 |
$1,689.05
|
| 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 |
$1,689.05
|
|
|
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 |
$258.20 |
| Max. Negotiated Rate |
$1,746.59 |
| 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 |
$271.13
|
| 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 |
$1,746.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,455.49
|
| Rate for Payer: Mclaren Medicaid |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$509.42
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| 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 |
$258.20
|
| 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 |
$258.20
|
| Rate for Payer: VA VA |
$485.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,455.49
|
|
|
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 |
$1,746.59 |
| 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 |
$1,746.59
|
| 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 |
$174.76 |
| Max. Negotiated Rate |
$1,746.59 |
| 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 |
$183.51
|
| 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 |
$1,746.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,455.49
|
| Rate for Payer: Mclaren Medicaid |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$509.42
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| 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 |
$174.76
|
| 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 |
$174.76
|
| 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 |
$1,746.59 |
| 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 |
$1,746.59
|
| 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 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 |
$258.20 |
| 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 |
$271.13
|
| 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 |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$557.16
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| 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 |
$258.20
|
| 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 |
$258.20
|
| 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
|
OP
|
$2,122.52
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000075
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$258.20 |
| 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 |
$271.13
|
| 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 |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$557.16
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| 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 |
$258.20
|
| 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 |
$258.20
|
| 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 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 WO C
|
Facility
|
OP
|
$2,122.52
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000076
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$174.76 |
| 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 |
$183.51
|
| 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 |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$557.16
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| 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 |
$174.76
|
| 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 |
$174.76
|
| 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 W CO
|
Facility
|
OP
|
$1,903.11
|
|
|
Service Code
|
HCPCS C8934
|
| Hospital Charge Code |
61000077
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$258.20 |
| 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 |
$271.13
|
| Rate for Payer: BCBS Complete |
$271.13
|
| 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 |
$258.20
|
| Rate for Payer: Mclaren Medicaid |
$258.20
|
| 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 |
$271.13
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| 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 |
$258.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.20
|
| 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 |
$258.20
|
| Rate for Payer: UHCCP Medicaid |
$258.20
|
| 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 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 WO C
|
Facility
|
OP
|
$1,756.74
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000078
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$174.76 |
| 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 |
$183.51
|
| Rate for Payer: BCBS Complete |
$183.51
|
| Rate for Payer: BCBS MAPPO |
$658.78
|
| Rate for Payer: BCBS MAPPO |
$439.19
|
| 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 |
$439.19
|
| 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 |
$439.19
|
| 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 |
$174.76
|
| Rate for Payer: Mclaren Medicaid |
$174.76
|
| 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 |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| 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 |
$439.19
|
| 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 |
$439.19
|
| Rate for Payer: PHP Medicare Advantage |
$658.78
|
| 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 |
$1,141.88
|
| 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 |
$439.19
|
| 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 |
$439.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$658.78
|
| Rate for Payer: UHC Exchange |
$658.78
|
| Rate for Payer: UHC Exchange |
$439.19
|
| Rate for Payer: UHC Medicare Advantage |
$658.78
|
| Rate for Payer: UHC Medicare Advantage |
$439.19
|
| Rate for Payer: UHCCP Medicaid |
$174.76
|
| Rate for Payer: UHCCP Medicaid |
$174.76
|
| Rate for Payer: VA VA |
$439.19
|
| 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
|
|
|
HC MR MRA UPPER EXTREMITY WO C
|
Facility
|
IP
|
$1,756.74
|
|
|
Service Code
|
HCPCS C8935
|
| Hospital Charge Code |
61000078
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,141.88 |
| 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: BCBS Trust/PPO |
$1,434.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,151.04
|
| Rate for Payer: BCN Commercial |
$1,357.61
|
| Rate for Payer: BCN Commercial |
$2,036.41
|
| Rate for Payer: Cash Price |
$1,405.39
|
| Rate for Payer: Cash Price |
$2,108.09
|
| Rate for Payer: Cofinity Commercial |
$2,266.19
|
| Rate for Payer: Cofinity Commercial |
$1,510.80
|
| 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: Healthscope Commercial |
$1,581.07
|
| Rate for Payer: Healthscope Commercial |
$2,371.60
|
| 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: 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: PHP Commercial |
$1,493.23
|
| Rate for Payer: PHP Commercial |
$2,239.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,712.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,141.88
|
| 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 Narrow/Tiered Network |
$1,177.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,765.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,545.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,318.90
|
| Rate for Payer: UHC Core |
$1,466.88
|
| Rate for Payer: UHC Core |
$2,200.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,317.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,976.33
|
|
|
HC MR MRA UPPER EXTREMITY WO W
|
Facility
|
IP
|
$2,049.38
|
|
|
Service Code
|
HCPCS C8936
|
| Hospital Charge Code |
61000079
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,332.10 |
| Max. Negotiated Rate |
$1,844.44 |
| Rate for Payer: Aetna Commercial |
$1,741.97
|
| Rate for Payer: Aetna Commercial |
$2,612.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,672.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,509.36
|
| Rate for Payer: BCN Commercial |
$1,583.76
|
| Rate for Payer: BCN Commercial |
$2,375.64
|
| Rate for Payer: Cash Price |
$1,639.50
|
| Rate for Payer: Cash Price |
$2,459.26
|
| Rate for Payer: Cofinity Commercial |
$2,643.70
|
| Rate for Payer: Cofinity Commercial |
$1,762.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,459.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,639.50
|
| Rate for Payer: Healthscope Commercial |
$1,844.44
|
| Rate for Payer: Healthscope Commercial |
$2,766.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,537.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,305.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,741.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,612.96
|
| Rate for Payer: Nomi Health Commercial |
$1,680.49
|
| Rate for Payer: Nomi Health Commercial |
$2,520.74
|
| Rate for Payer: PHP Commercial |
$1,741.97
|
| Rate for Payer: PHP Commercial |
$2,612.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,998.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.10
|
| Rate for Payer: Priority Health HMO/PPO |
$2,674.44
|
| Rate for Payer: Priority Health HMO/PPO |
$1,782.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,373.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,059.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,803.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,705.18
|
| Rate for Payer: UHC Core |
$1,711.23
|
| Rate for Payer: UHC Core |
$2,566.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,537.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,305.55
|
|
|
HC MR MRA UPPER EXTREMITY WO W
|
Facility
|
OP
|
$2,049.38
|
|
|
Service Code
|
HCPCS C8936
|
| Hospital Charge Code |
61000079
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$258.20 |
| Max. Negotiated Rate |
$1,844.44 |
| Rate for Payer: Aetna Commercial |
$1,741.97
|
| Rate for Payer: Aetna Commercial |
$2,612.96
|
| Rate for Payer: Aetna Medicare |
$532.84
|
| Rate for Payer: Aetna Medicare |
$799.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$640.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$960.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$640.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$960.65
|
| Rate for Payer: BCBS Complete |
$271.13
|
| Rate for Payer: BCBS Complete |
$271.13
|
| Rate for Payer: BCBS MAPPO |
$768.52
|
| Rate for Payer: BCBS MAPPO |
$512.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,684.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,527.19
|
| Rate for Payer: BCN Commercial |
$1,593.39
|
| Rate for Payer: BCN Commercial |
$2,390.09
|
| Rate for Payer: BCN Medicare Advantage |
$512.35
|
| Rate for Payer: BCN Medicare Advantage |
$768.52
|
| Rate for Payer: Cash Price |
$2,459.26
|
| Rate for Payer: Cash Price |
$1,639.50
|
| Rate for Payer: Cash Price |
$1,639.50
|
| Rate for Payer: Cash Price |
$2,459.26
|
| Rate for Payer: Cofinity Commercial |
$1,762.47
|
| Rate for Payer: Cofinity Commercial |
$2,643.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,459.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,639.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$512.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$768.52
|
| Rate for Payer: Healthscope Commercial |
$2,766.66
|
| Rate for Payer: Healthscope Commercial |
$1,844.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,537.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,305.55
|
| 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 |
$806.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$537.96
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$589.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$883.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,741.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,612.96
|
| Rate for Payer: Nomi Health Commercial |
$1,680.49
|
| Rate for Payer: Nomi Health Commercial |
$2,520.74
|
| Rate for Payer: PACE Senior Care Partners |
$486.73
|
| Rate for Payer: PACE Senior Care Partners |
$730.09
|
| Rate for Payer: PACE SWMI |
$512.35
|
| Rate for Payer: PACE SWMI |
$768.52
|
| Rate for Payer: PHP Commercial |
$2,612.96
|
| Rate for Payer: PHP Commercial |
$1,741.97
|
| Rate for Payer: PHP Medicare Advantage |
$512.35
|
| Rate for Payer: PHP Medicare Advantage |
$768.52
|
| 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 |
$1,332.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,998.15
|
| Rate for Payer: Priority Health HMO/PPO |
$2,674.44
|
| Rate for Payer: Priority Health HMO/PPO |
$1,782.96
|
| Rate for Payer: Priority Health Medicare |
$517.47
|
| Rate for Payer: Priority Health Medicare |
$776.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,373.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,059.63
|
| Rate for Payer: Railroad Medicare Medicare |
$768.52
|
| Rate for Payer: Railroad Medicare Medicare |
$512.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,705.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,803.45
|
| Rate for Payer: UHC Core |
$2,566.85
|
| Rate for Payer: UHC Core |
$1,711.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$512.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$768.52
|
| Rate for Payer: UHC Exchange |
$768.52
|
| Rate for Payer: UHC Exchange |
$512.35
|
| Rate for Payer: UHC Medicare Advantage |
$768.52
|
| Rate for Payer: UHC Medicare Advantage |
$512.35
|
| Rate for Payer: UHCCP Medicaid |
$258.20
|
| Rate for Payer: UHCCP Medicaid |
$258.20
|
| Rate for Payer: VA VA |
$512.35
|
| Rate for Payer: VA VA |
$768.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,537.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,305.55
|
|
|
HC MR MRCP
|
Facility
|
IP
|
$2,110.45
|
|
|
Service Code
|
CPT 74181
|
| Hospital Charge Code |
61000042
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,371.79 |
| Max. Negotiated Rate |
$1,899.40 |
| Rate for Payer: Aetna Commercial |
$1,793.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,722.76
|
| Rate for Payer: BCN Commercial |
$1,630.96
|
| Rate for Payer: Cash Price |
$1,688.36
|
| Rate for Payer: Cofinity Commercial |
$1,814.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,688.36
|
| Rate for Payer: Healthscope Commercial |
$1,899.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,582.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,793.88
|
| Rate for Payer: Nomi Health Commercial |
$1,730.57
|
| Rate for Payer: PHP Commercial |
$1,793.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,371.79
|
| Rate for Payer: Priority Health HMO/PPO |
$1,836.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,414.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,857.20
|
| Rate for Payer: UHC Core |
$1,762.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,582.84
|
|
|
HC MR MRCP
|
Facility
|
OP
|
$2,110.45
|
|
|
Service Code
|
CPT 74181
|
| Hospital Charge Code |
61000042
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$174.76 |
| Max. Negotiated Rate |
$1,899.40 |
| Rate for Payer: Aetna Commercial |
$1,793.88
|
| Rate for Payer: Aetna Medicare |
$548.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$659.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$659.52
|
| Rate for Payer: BCBS Complete |
$183.51
|
| Rate for Payer: BCBS MAPPO |
$527.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,735.00
|
| Rate for Payer: BCN Commercial |
$1,640.87
|
| Rate for Payer: BCN Medicare Advantage |
$527.61
|
| Rate for Payer: Cash Price |
$1,688.36
|
| Rate for Payer: Cash Price |
$1,688.36
|
| Rate for Payer: Cofinity Commercial |
$1,814.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,688.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.61
|
| Rate for Payer: Healthscope Commercial |
$1,899.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,582.84
|
| Rate for Payer: Mclaren Medicaid |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$553.99
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$606.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,793.88
|
| Rate for Payer: Nomi Health Commercial |
$1,730.57
|
| Rate for Payer: PACE Senior Care Partners |
$501.23
|
| Rate for Payer: PACE SWMI |
$527.61
|
| Rate for Payer: PHP Commercial |
$1,793.88
|
| Rate for Payer: PHP Medicare Advantage |
$527.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,371.79
|
| Rate for Payer: Priority Health HMO/PPO |
$1,836.09
|
| Rate for Payer: Priority Health Medicare |
$532.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,414.00
|
| Rate for Payer: Railroad Medicare Medicare |
$527.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,857.20
|
| Rate for Payer: UHC Core |
$1,762.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.61
|
| Rate for Payer: UHC Exchange |
$527.61
|
| Rate for Payer: UHC Medicare Advantage |
$527.61
|
| Rate for Payer: UHCCP Medicaid |
$174.76
|
| Rate for Payer: VA VA |
$527.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,582.84
|
|
|
HC MR NEEDLE PLACEMENT
|
Facility
|
IP
|
$1,005.41
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61000081
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$653.52 |
| Max. Negotiated Rate |
$904.87 |
| Rate for Payer: Aetna Commercial |
$854.60
|
| Rate for Payer: BCBS Trust/PPO |
$820.72
|
| Rate for Payer: BCN Commercial |
$776.98
|
| Rate for Payer: Cash Price |
$804.33
|
| Rate for Payer: Cofinity Commercial |
$864.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$804.33
|
| Rate for Payer: Healthscope Commercial |
$904.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$754.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$854.60
|
| Rate for Payer: Nomi Health Commercial |
$824.44
|
| Rate for Payer: PHP Commercial |
$854.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.52
|
| Rate for Payer: Priority Health HMO/PPO |
$874.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$673.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$884.76
|
| Rate for Payer: UHC Core |
$839.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$754.06
|
|
|
HC MR NEEDLE PLACEMENT
|
Facility
|
OP
|
$1,005.41
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61000081
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$238.78 |
| Max. Negotiated Rate |
$904.87 |
| Rate for Payer: Aetna Commercial |
$854.60
|
| Rate for Payer: Aetna Medicare |
$261.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$314.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$314.19
|
| Rate for Payer: BCBS Complete |
$402.16
|
| Rate for Payer: BCBS MAPPO |
$251.35
|
| Rate for Payer: BCBS Trust/PPO |
$826.55
|
| Rate for Payer: BCN Commercial |
$781.71
|
| Rate for Payer: BCN Medicare Advantage |
$251.35
|
| Rate for Payer: Cash Price |
$804.33
|
| Rate for Payer: Cofinity Commercial |
$864.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$804.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$251.35
|
| Rate for Payer: Healthscope Commercial |
$904.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$754.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$263.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$289.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$854.60
|
| Rate for Payer: Nomi Health Commercial |
$824.44
|
| Rate for Payer: PACE Senior Care Partners |
$238.78
|
| Rate for Payer: PACE SWMI |
$251.35
|
| Rate for Payer: PHP Commercial |
$854.60
|
| Rate for Payer: PHP Medicare Advantage |
$251.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.52
|
| Rate for Payer: Priority Health HMO/PPO |
$874.71
|
| Rate for Payer: Priority Health Medicare |
$253.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$673.62
|
| Rate for Payer: Railroad Medicare Medicare |
$251.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$884.76
|
| Rate for Payer: UHC Core |
$839.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$251.35
|
| Rate for Payer: UHC Exchange |
$251.35
|
| Rate for Payer: UHC Medicare Advantage |
$251.35
|
| Rate for Payer: VA VA |
$251.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$754.06
|
|
|
HC MR ONLY HEAD W CON
|
Facility
|
IP
|
$2,216.97
|
|
|
Service Code
|
CPT 70545
|
| Hospital Charge Code |
61000005
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,441.03 |
| Max. Negotiated Rate |
$1,995.27 |
| Rate for Payer: Aetna Commercial |
$1,884.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,809.71
|
| Rate for Payer: BCN Commercial |
$1,713.27
|
| Rate for Payer: Cash Price |
$1,773.58
|
| Rate for Payer: Cofinity Commercial |
$1,906.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,773.58
|
| Rate for Payer: Healthscope Commercial |
$1,995.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,662.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,884.42
|
| Rate for Payer: Nomi Health Commercial |
$1,817.92
|
| Rate for Payer: PHP Commercial |
$1,884.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,441.03
|
| Rate for Payer: Priority Health HMO/PPO |
$1,928.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,485.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,950.93
|
| Rate for Payer: UHC Core |
$1,851.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,662.73
|
|
|
HC MR ONLY HEAD W CON
|
Facility
|
OP
|
$2,216.97
|
|
|
Service Code
|
CPT 70545
|
| Hospital Charge Code |
61000005
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$258.20 |
| Max. Negotiated Rate |
$1,995.27 |
| Rate for Payer: Aetna Commercial |
$1,884.42
|
| Rate for Payer: Aetna Medicare |
$576.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$692.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$692.80
|
| Rate for Payer: BCBS Complete |
$271.13
|
| Rate for Payer: BCBS MAPPO |
$554.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,822.57
|
| Rate for Payer: BCN Commercial |
$1,723.69
|
| Rate for Payer: BCN Medicare Advantage |
$554.24
|
| Rate for Payer: Cash Price |
$1,773.58
|
| Rate for Payer: Cash Price |
$1,773.58
|
| Rate for Payer: Cofinity Commercial |
$1,906.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,773.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$554.24
|
| Rate for Payer: Healthscope Commercial |
$1,995.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,662.73
|
| Rate for Payer: Mclaren Medicaid |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$581.95
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$637.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,884.42
|
| Rate for Payer: Nomi Health Commercial |
$1,817.92
|
| Rate for Payer: PACE Senior Care Partners |
$526.53
|
| Rate for Payer: PACE SWMI |
$554.24
|
| Rate for Payer: PHP Commercial |
$1,884.42
|
| Rate for Payer: PHP Medicare Advantage |
$554.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,441.03
|
| Rate for Payer: Priority Health HMO/PPO |
$1,928.76
|
| Rate for Payer: Priority Health Medicare |
$559.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,485.37
|
| Rate for Payer: Railroad Medicare Medicare |
$554.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,950.93
|
| Rate for Payer: UHC Core |
$1,851.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$554.24
|
| Rate for Payer: UHC Exchange |
$554.24
|
| Rate for Payer: UHC Medicare Advantage |
$554.24
|
| Rate for Payer: UHCCP Medicaid |
$258.20
|
| Rate for Payer: VA VA |
$554.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,662.73
|
|
