|
HC MR SPINE CERVICAL W CON LTD
|
Facility
|
IP
|
$1,160.76
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200003
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$754.49 |
| Max. Negotiated Rate |
$1,044.68 |
| Rate for Payer: Aetna Commercial |
$986.65
|
| Rate for Payer: BCBS Trust/PPO |
$947.53
|
| Rate for Payer: BCN Commercial |
$897.04
|
| Rate for Payer: Cash Price |
$928.61
|
| Rate for Payer: Cofinity Commercial |
$998.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.61
|
| Rate for Payer: Healthscope Commercial |
$1,044.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$870.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$986.65
|
| Rate for Payer: Nomi Health Commercial |
$951.82
|
| Rate for Payer: PHP Commercial |
$986.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$754.49
|
| Rate for Payer: Priority Health HMO/PPO |
$1,009.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$777.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,021.47
|
| Rate for Payer: UHC Core |
$969.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$870.57
|
|
|
HC MR SPINE CERVICAL W CON LTD
|
Facility
|
OP
|
$1,160.76
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200003
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$1,044.68 |
| Rate for Payer: Aetna Commercial |
$986.65
|
| Rate for Payer: Aetna Medicare |
$301.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$362.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$362.74
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$290.19
|
| Rate for Payer: BCBS Trust/PPO |
$954.26
|
| Rate for Payer: BCN Commercial |
$902.49
|
| Rate for Payer: BCN Medicare Advantage |
$290.19
|
| Rate for Payer: Cash Price |
$928.61
|
| Rate for Payer: Cash Price |
$928.61
|
| Rate for Payer: Cofinity Commercial |
$998.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$290.19
|
| Rate for Payer: Healthscope Commercial |
$1,044.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$870.57
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$304.70
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$333.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$986.65
|
| Rate for Payer: Nomi Health Commercial |
$951.82
|
| Rate for Payer: PACE Senior Care Partners |
$275.68
|
| Rate for Payer: PACE SWMI |
$290.19
|
| Rate for Payer: PHP Commercial |
$986.65
|
| Rate for Payer: PHP Medicare Advantage |
$290.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$754.49
|
| Rate for Payer: Priority Health HMO/PPO |
$1,009.86
|
| Rate for Payer: Priority Health Medicare |
$293.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$777.71
|
| Rate for Payer: Railroad Medicare Medicare |
$290.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,021.47
|
| Rate for Payer: UHC Core |
$969.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$290.19
|
| Rate for Payer: UHC Exchange |
$290.19
|
| Rate for Payer: UHC Medicare Advantage |
$290.19
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$290.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$870.57
|
|
|
HC MR SPINE CERVICAL WO CON
|
Facility
|
OP
|
$2,288.04
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200002
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$2,059.24 |
| Rate for Payer: Aetna Commercial |
$1,944.83
|
| Rate for Payer: Aetna Medicare |
$594.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$715.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$715.01
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$572.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,881.00
|
| Rate for Payer: BCN Commercial |
$1,778.95
|
| Rate for Payer: BCN Medicare Advantage |
$572.01
|
| Rate for Payer: Cash Price |
$1,830.43
|
| Rate for Payer: Cash Price |
$1,830.43
|
| Rate for Payer: Cofinity Commercial |
$1,967.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,830.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$572.01
|
| Rate for Payer: Healthscope Commercial |
$2,059.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,716.03
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$600.61
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$657.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,944.83
|
| Rate for Payer: Nomi Health Commercial |
$1,876.19
|
| Rate for Payer: PACE Senior Care Partners |
$543.41
|
| Rate for Payer: PACE SWMI |
$572.01
|
| Rate for Payer: PHP Commercial |
$1,944.83
|
| Rate for Payer: PHP Medicare Advantage |
$572.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,487.23
|
| Rate for Payer: Priority Health HMO/PPO |
$1,990.59
|
| Rate for Payer: Priority Health Medicare |
$577.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,532.99
|
| Rate for Payer: Railroad Medicare Medicare |
$572.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,013.48
|
| Rate for Payer: UHC Core |
$1,910.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$572.01
|
| Rate for Payer: UHC Exchange |
$572.01
|
| Rate for Payer: UHC Medicare Advantage |
$572.01
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$572.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,716.03
|
|
|
HC MR SPINE CERVICAL WO CON
|
Facility
|
IP
|
$2,288.04
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200002
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,487.23 |
| Max. Negotiated Rate |
$2,059.24 |
| Rate for Payer: Aetna Commercial |
$1,944.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,867.73
|
| Rate for Payer: BCN Commercial |
$1,768.20
|
| Rate for Payer: Cash Price |
$1,830.43
|
| Rate for Payer: Cofinity Commercial |
$1,967.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,830.43
|
| Rate for Payer: Healthscope Commercial |
$2,059.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,716.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,944.83
|
| Rate for Payer: Nomi Health Commercial |
$1,876.19
|
| Rate for Payer: PHP Commercial |
$1,944.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,487.23
|
| Rate for Payer: Priority Health HMO/PPO |
$1,990.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,532.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,013.48
|
| Rate for Payer: UHC Core |
$1,910.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,716.03
|
|
|
HC MR SPINE CERVICAL WO LIMITED
|
Facility
|
OP
|
$1,144.44
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200001
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,030.00 |
| Rate for Payer: Aetna Commercial |
$972.77
|
| Rate for Payer: Aetna Medicare |
$297.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$357.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$357.64
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$286.11
|
| Rate for Payer: BCBS Trust/PPO |
$940.84
|
| Rate for Payer: BCN Commercial |
$889.80
|
| Rate for Payer: BCN Medicare Advantage |
$286.11
|
| Rate for Payer: Cash Price |
$915.55
|
| Rate for Payer: Cash Price |
$915.55
|
| Rate for Payer: Cofinity Commercial |
$984.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$915.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$286.11
|
| Rate for Payer: Healthscope Commercial |
$1,030.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.33
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$300.42
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$329.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$972.77
|
| Rate for Payer: Nomi Health Commercial |
$938.44
|
| Rate for Payer: PACE Senior Care Partners |
$271.80
|
| Rate for Payer: PACE SWMI |
$286.11
|
| Rate for Payer: PHP Commercial |
$972.77
|
| Rate for Payer: PHP Medicare Advantage |
$286.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$743.89
|
| Rate for Payer: Priority Health HMO/PPO |
$995.66
|
| Rate for Payer: Priority Health Medicare |
$288.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$766.77
|
| Rate for Payer: Railroad Medicare Medicare |
$286.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.11
|
| Rate for Payer: UHC Core |
$955.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$286.11
|
| Rate for Payer: UHC Exchange |
$286.11
|
| Rate for Payer: UHC Medicare Advantage |
$286.11
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$286.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.33
|
|
|
HC MR SPINE CERVICAL WO LIMITED
|
Facility
|
IP
|
$1,144.44
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200001
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$743.89 |
| Max. Negotiated Rate |
$1,030.00 |
| Rate for Payer: Aetna Commercial |
$972.77
|
| Rate for Payer: BCBS Trust/PPO |
$934.21
|
| Rate for Payer: BCN Commercial |
$884.42
|
| Rate for Payer: Cash Price |
$915.55
|
| Rate for Payer: Cofinity Commercial |
$984.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$915.55
|
| Rate for Payer: Healthscope Commercial |
$1,030.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$972.77
|
| Rate for Payer: Nomi Health Commercial |
$938.44
|
| Rate for Payer: PHP Commercial |
$972.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$743.89
|
| Rate for Payer: Priority Health HMO/PPO |
$995.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$766.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.11
|
| Rate for Payer: UHC Core |
$955.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.33
|
|
|
HC MR SPINE CERVICAL WO W CON
|
Facility
|
IP
|
$2,771.89
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200013
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,801.73 |
| Max. Negotiated Rate |
$2,494.70 |
| Rate for Payer: Aetna Commercial |
$2,356.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,262.69
|
| Rate for Payer: BCN Commercial |
$2,142.12
|
| Rate for Payer: Cash Price |
$2,217.51
|
| Rate for Payer: Cofinity Commercial |
$2,383.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,217.51
|
| Rate for Payer: Healthscope Commercial |
$2,494.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,078.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,356.11
|
| Rate for Payer: Nomi Health Commercial |
$2,272.95
|
| Rate for Payer: PHP Commercial |
$2,356.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,801.73
|
| Rate for Payer: Priority Health HMO/PPO |
$2,411.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,857.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,439.26
|
| Rate for Payer: UHC Core |
$2,314.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,078.92
|
|
|
HC MR SPINE CERVICAL WO W CON
|
Facility
|
OP
|
$2,771.89
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200013
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,494.70 |
| Rate for Payer: Aetna Commercial |
$2,356.11
|
| Rate for Payer: Aetna Medicare |
$720.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$866.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$866.22
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$692.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,278.77
|
| Rate for Payer: BCN Commercial |
$2,155.14
|
| Rate for Payer: BCN Medicare Advantage |
$692.97
|
| Rate for Payer: Cash Price |
$2,217.51
|
| Rate for Payer: Cash Price |
$2,217.51
|
| Rate for Payer: Cofinity Commercial |
$2,383.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,217.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$692.97
|
| Rate for Payer: Healthscope Commercial |
$2,494.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,078.92
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$727.62
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$796.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,356.11
|
| Rate for Payer: Nomi Health Commercial |
$2,272.95
|
| Rate for Payer: PACE Senior Care Partners |
$658.32
|
| Rate for Payer: PACE SWMI |
$692.97
|
| Rate for Payer: PHP Commercial |
$2,356.11
|
| Rate for Payer: PHP Medicare Advantage |
$692.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,801.73
|
| Rate for Payer: Priority Health HMO/PPO |
$2,411.54
|
| Rate for Payer: Priority Health Medicare |
$699.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,857.17
|
| Rate for Payer: Railroad Medicare Medicare |
$692.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,439.26
|
| Rate for Payer: UHC Core |
$2,314.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$692.97
|
| Rate for Payer: UHC Exchange |
$692.97
|
| Rate for Payer: UHC Medicare Advantage |
$692.97
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$692.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,078.92
|
|
|
HC MR SPINE CERVICAL WO W LTD
|
Facility
|
OP
|
$888.92
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200014
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$211.12 |
| Max. Negotiated Rate |
$800.03 |
| Rate for Payer: Aetna Commercial |
$755.58
|
| Rate for Payer: Aetna Medicare |
$231.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$277.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$277.79
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$222.23
|
| Rate for Payer: BCBS Trust/PPO |
$730.78
|
| Rate for Payer: BCN Commercial |
$691.14
|
| Rate for Payer: BCN Medicare Advantage |
$222.23
|
| Rate for Payer: Cash Price |
$711.14
|
| Rate for Payer: Cash Price |
$711.14
|
| Rate for Payer: Cofinity Commercial |
$764.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$711.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$222.23
|
| Rate for Payer: Healthscope Commercial |
$800.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$666.69
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$233.34
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$255.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$755.58
|
| Rate for Payer: Nomi Health Commercial |
$728.91
|
| Rate for Payer: PACE Senior Care Partners |
$211.12
|
| Rate for Payer: PACE SWMI |
$222.23
|
| Rate for Payer: PHP Commercial |
$755.58
|
| Rate for Payer: PHP Medicare Advantage |
$222.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$577.80
|
| Rate for Payer: Priority Health HMO/PPO |
$773.36
|
| Rate for Payer: Priority Health Medicare |
$224.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$595.58
|
| Rate for Payer: Railroad Medicare Medicare |
$222.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$782.25
|
| Rate for Payer: UHC Core |
$742.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$222.23
|
| Rate for Payer: UHC Exchange |
$222.23
|
| Rate for Payer: UHC Medicare Advantage |
$222.23
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$222.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$666.69
|
|
|
HC MR SPINE CERVICAL WO W LTD
|
Facility
|
IP
|
$888.92
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200014
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$577.80 |
| Max. Negotiated Rate |
$800.03 |
| Rate for Payer: Aetna Commercial |
$755.58
|
| Rate for Payer: BCBS Trust/PPO |
$725.63
|
| Rate for Payer: BCN Commercial |
$686.96
|
| Rate for Payer: Cash Price |
$711.14
|
| Rate for Payer: Cofinity Commercial |
$764.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$711.14
|
| Rate for Payer: Healthscope Commercial |
$800.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$666.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$755.58
|
| Rate for Payer: Nomi Health Commercial |
$728.91
|
| Rate for Payer: PHP Commercial |
$755.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$577.80
|
| Rate for Payer: Priority Health HMO/PPO |
$773.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$595.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$782.25
|
| Rate for Payer: UHC Core |
$742.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$666.69
|
|
|
HC MR SPINE LUMBAR W CON
|
Facility
|
IP
|
$2,243.18
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200012
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,458.07 |
| Max. Negotiated Rate |
$2,018.86 |
| Rate for Payer: Aetna Commercial |
$1,906.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,831.11
|
| Rate for Payer: BCN Commercial |
$1,733.53
|
| Rate for Payer: Cash Price |
$1,794.54
|
| Rate for Payer: Cofinity Commercial |
$1,929.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,794.54
|
| Rate for Payer: Healthscope Commercial |
$2,018.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,682.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,906.70
|
| Rate for Payer: Nomi Health Commercial |
$1,839.41
|
| Rate for Payer: PHP Commercial |
$1,906.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,458.07
|
| Rate for Payer: Priority Health HMO/PPO |
$1,951.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,502.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,974.00
|
| Rate for Payer: UHC Core |
$1,873.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,682.38
|
|
|
HC MR SPINE LUMBAR W CON
|
Facility
|
OP
|
$2,243.18
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200012
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,018.86 |
| Rate for Payer: Aetna Commercial |
$1,906.70
|
| Rate for Payer: Aetna Medicare |
$583.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$700.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$700.99
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$560.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,844.12
|
| Rate for Payer: BCN Commercial |
$1,744.07
|
| Rate for Payer: BCN Medicare Advantage |
$560.80
|
| Rate for Payer: Cash Price |
$1,794.54
|
| Rate for Payer: Cash Price |
$1,794.54
|
| Rate for Payer: Cofinity Commercial |
$1,929.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,794.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$560.80
|
| Rate for Payer: Healthscope Commercial |
$2,018.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,682.38
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$588.83
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$644.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,906.70
|
| Rate for Payer: Nomi Health Commercial |
$1,839.41
|
| Rate for Payer: PACE Senior Care Partners |
$532.76
|
| Rate for Payer: PACE SWMI |
$560.80
|
| Rate for Payer: PHP Commercial |
$1,906.70
|
| Rate for Payer: PHP Medicare Advantage |
$560.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,458.07
|
| Rate for Payer: Priority Health HMO/PPO |
$1,951.57
|
| Rate for Payer: Priority Health Medicare |
$566.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,502.93
|
| Rate for Payer: Railroad Medicare Medicare |
$560.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,974.00
|
| Rate for Payer: UHC Core |
$1,873.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$560.80
|
| Rate for Payer: UHC Exchange |
$560.80
|
| Rate for Payer: UHC Medicare Advantage |
$560.80
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$560.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,682.38
|
|
|
HC MR SPINE LUMBAR W LTD
|
Facility
|
IP
|
$817.75
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200011
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$531.54 |
| Max. Negotiated Rate |
$735.98 |
| Rate for Payer: Aetna Commercial |
$695.09
|
| Rate for Payer: BCBS Trust/PPO |
$667.53
|
| Rate for Payer: BCN Commercial |
$631.96
|
| Rate for Payer: Cash Price |
$654.20
|
| Rate for Payer: Cofinity Commercial |
$703.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$654.20
|
| Rate for Payer: Healthscope Commercial |
$735.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$613.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$695.09
|
| Rate for Payer: Nomi Health Commercial |
$670.56
|
| Rate for Payer: PHP Commercial |
$695.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$531.54
|
| Rate for Payer: Priority Health HMO/PPO |
$711.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$719.62
|
| Rate for Payer: UHC Core |
$682.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$613.31
|
|
|
HC MR SPINE LUMBAR W LTD
|
Facility
|
OP
|
$817.75
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200011
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$194.22 |
| Max. Negotiated Rate |
$735.98 |
| Rate for Payer: Aetna Commercial |
$695.09
|
| Rate for Payer: Aetna Medicare |
$212.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$255.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$255.55
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$204.44
|
| Rate for Payer: BCBS Trust/PPO |
$672.27
|
| Rate for Payer: BCN Commercial |
$635.80
|
| Rate for Payer: BCN Medicare Advantage |
$204.44
|
| Rate for Payer: Cash Price |
$654.20
|
| Rate for Payer: Cash Price |
$654.20
|
| Rate for Payer: Cofinity Commercial |
$703.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$654.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.44
|
| Rate for Payer: Healthscope Commercial |
$735.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$613.31
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.66
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$235.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$695.09
|
| Rate for Payer: Nomi Health Commercial |
$670.56
|
| Rate for Payer: PACE Senior Care Partners |
$194.22
|
| Rate for Payer: PACE SWMI |
$204.44
|
| Rate for Payer: PHP Commercial |
$695.09
|
| Rate for Payer: PHP Medicare Advantage |
$204.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$531.54
|
| Rate for Payer: Priority Health HMO/PPO |
$711.44
|
| Rate for Payer: Priority Health Medicare |
$206.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.89
|
| Rate for Payer: Railroad Medicare Medicare |
$204.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$719.62
|
| Rate for Payer: UHC Core |
$682.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.44
|
| Rate for Payer: UHC Exchange |
$204.44
|
| Rate for Payer: UHC Medicare Advantage |
$204.44
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$204.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$613.31
|
|
|
HC MR SPINE LUMBAR WO CON
|
Facility
|
IP
|
$2,280.24
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200009
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,482.16 |
| Max. Negotiated Rate |
$2,052.22 |
| Rate for Payer: Aetna Commercial |
$1,938.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,861.36
|
| Rate for Payer: BCN Commercial |
$1,762.17
|
| Rate for Payer: Cash Price |
$1,824.19
|
| Rate for Payer: Cofinity Commercial |
$1,961.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,824.19
|
| Rate for Payer: Healthscope Commercial |
$2,052.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,710.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,938.20
|
| Rate for Payer: Nomi Health Commercial |
$1,869.80
|
| Rate for Payer: PHP Commercial |
$1,938.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,482.16
|
| Rate for Payer: Priority Health HMO/PPO |
$1,983.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,527.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,006.61
|
| Rate for Payer: UHC Core |
$1,904.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,710.18
|
|
|
HC MR SPINE LUMBAR WO CON
|
Facility
|
OP
|
$2,280.24
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200009
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$2,052.22 |
| Rate for Payer: Aetna Commercial |
$1,938.20
|
| Rate for Payer: Aetna Medicare |
$592.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$712.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$712.58
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$570.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,874.59
|
| Rate for Payer: BCN Commercial |
$1,772.89
|
| Rate for Payer: BCN Medicare Advantage |
$570.06
|
| Rate for Payer: Cash Price |
$1,824.19
|
| Rate for Payer: Cash Price |
$1,824.19
|
| Rate for Payer: Cofinity Commercial |
$1,961.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,824.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$570.06
|
| Rate for Payer: Healthscope Commercial |
$2,052.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,710.18
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$598.56
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$655.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,938.20
|
| Rate for Payer: Nomi Health Commercial |
$1,869.80
|
| Rate for Payer: PACE Senior Care Partners |
$541.56
|
| Rate for Payer: PACE SWMI |
$570.06
|
| Rate for Payer: PHP Commercial |
$1,938.20
|
| Rate for Payer: PHP Medicare Advantage |
$570.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,482.16
|
| Rate for Payer: Priority Health HMO/PPO |
$1,983.81
|
| Rate for Payer: Priority Health Medicare |
$575.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,527.76
|
| Rate for Payer: Railroad Medicare Medicare |
$570.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,006.61
|
| Rate for Payer: UHC Core |
$1,904.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$570.06
|
| Rate for Payer: UHC Exchange |
$570.06
|
| Rate for Payer: UHC Medicare Advantage |
$570.06
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$570.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,710.18
|
|
|
HC MR SPINE LUMBAR WO LTD
|
Facility
|
IP
|
$2,088.08
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200010
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,357.25 |
| Max. Negotiated Rate |
$1,879.27 |
| Rate for Payer: Aetna Commercial |
$1,774.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,704.50
|
| Rate for Payer: BCN Commercial |
$1,613.67
|
| Rate for Payer: Cash Price |
$1,670.46
|
| Rate for Payer: Cofinity Commercial |
$1,795.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,670.46
|
| Rate for Payer: Healthscope Commercial |
$1,879.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,566.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,774.87
|
| Rate for Payer: Nomi Health Commercial |
$1,712.23
|
| Rate for Payer: PHP Commercial |
$1,774.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,357.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,816.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,399.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,837.51
|
| Rate for Payer: UHC Core |
$1,743.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,566.06
|
|
|
HC MR SPINE LUMBAR WO LTD
|
Facility
|
OP
|
$2,088.08
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200010
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,879.27 |
| Rate for Payer: Aetna Commercial |
$1,774.87
|
| Rate for Payer: Aetna Medicare |
$542.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$652.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$652.52
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$522.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,716.61
|
| Rate for Payer: BCN Commercial |
$1,623.48
|
| Rate for Payer: BCN Medicare Advantage |
$522.02
|
| Rate for Payer: Cash Price |
$1,670.46
|
| Rate for Payer: Cash Price |
$1,670.46
|
| Rate for Payer: Cofinity Commercial |
$1,795.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,670.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$522.02
|
| Rate for Payer: Healthscope Commercial |
$1,879.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,566.06
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$548.12
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$600.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,774.87
|
| Rate for Payer: Nomi Health Commercial |
$1,712.23
|
| Rate for Payer: PACE Senior Care Partners |
$495.92
|
| Rate for Payer: PACE SWMI |
$522.02
|
| Rate for Payer: PHP Commercial |
$1,774.87
|
| Rate for Payer: PHP Medicare Advantage |
$522.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,357.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,816.63
|
| Rate for Payer: Priority Health Medicare |
$527.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,399.01
|
| Rate for Payer: Railroad Medicare Medicare |
$522.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,837.51
|
| Rate for Payer: UHC Core |
$1,743.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$522.02
|
| Rate for Payer: UHC Exchange |
$522.02
|
| Rate for Payer: UHC Medicare Advantage |
$522.02
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$522.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,566.06
|
|
|
HC MR SPINE LUMBAR WO W CON
|
Facility
|
IP
|
$3,183.47
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200017
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$2,069.26 |
| Max. Negotiated Rate |
$2,865.12 |
| Rate for Payer: Aetna Commercial |
$2,705.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,598.67
|
| Rate for Payer: BCN Commercial |
$2,460.19
|
| Rate for Payer: Cash Price |
$2,546.78
|
| Rate for Payer: Cofinity Commercial |
$2,737.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,546.78
|
| Rate for Payer: Healthscope Commercial |
$2,865.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,387.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,705.95
|
| Rate for Payer: Nomi Health Commercial |
$2,610.45
|
| Rate for Payer: PHP Commercial |
$2,705.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,069.26
|
| Rate for Payer: Priority Health HMO/PPO |
$2,769.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,132.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,801.45
|
| Rate for Payer: UHC Core |
$2,658.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,387.60
|
|
|
HC MR SPINE LUMBAR WO W CON
|
Facility
|
OP
|
$3,183.47
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200017
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,865.12 |
| Rate for Payer: Aetna Commercial |
$2,705.95
|
| Rate for Payer: Aetna Medicare |
$827.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$994.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$994.83
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$795.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,617.13
|
| Rate for Payer: BCN Commercial |
$2,475.15
|
| Rate for Payer: BCN Medicare Advantage |
$795.87
|
| Rate for Payer: Cash Price |
$2,546.78
|
| Rate for Payer: Cash Price |
$2,546.78
|
| Rate for Payer: Cofinity Commercial |
$2,737.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,546.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$795.87
|
| Rate for Payer: Healthscope Commercial |
$2,865.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,387.60
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$835.66
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$915.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,705.95
|
| Rate for Payer: Nomi Health Commercial |
$2,610.45
|
| Rate for Payer: PACE Senior Care Partners |
$756.07
|
| Rate for Payer: PACE SWMI |
$795.87
|
| Rate for Payer: PHP Commercial |
$2,705.95
|
| Rate for Payer: PHP Medicare Advantage |
$795.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,069.26
|
| Rate for Payer: Priority Health HMO/PPO |
$2,769.62
|
| Rate for Payer: Priority Health Medicare |
$803.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,132.92
|
| Rate for Payer: Railroad Medicare Medicare |
$795.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,801.45
|
| Rate for Payer: UHC Core |
$2,658.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$795.87
|
| Rate for Payer: UHC Exchange |
$795.87
|
| Rate for Payer: UHC Medicare Advantage |
$795.87
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$795.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,387.60
|
|
|
HC MR SPINE LUMBAR WO W LTD
|
Facility
|
IP
|
$2,915.20
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200018
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,894.88 |
| Max. Negotiated Rate |
$2,623.68 |
| Rate for Payer: Aetna Commercial |
$2,477.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,379.68
|
| Rate for Payer: BCN Commercial |
$2,252.87
|
| Rate for Payer: Cash Price |
$2,332.16
|
| Rate for Payer: Cofinity Commercial |
$2,507.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,332.16
|
| Rate for Payer: Healthscope Commercial |
$2,623.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,186.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,477.92
|
| Rate for Payer: Nomi Health Commercial |
$2,390.46
|
| Rate for Payer: PHP Commercial |
$2,477.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,894.88
|
| Rate for Payer: Priority Health HMO/PPO |
$2,536.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,953.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,565.38
|
| Rate for Payer: UHC Core |
$2,434.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,186.40
|
|
|
HC MR SPINE LUMBAR WO W LTD
|
Facility
|
OP
|
$2,915.20
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200018
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,623.68 |
| Rate for Payer: Aetna Commercial |
$2,477.92
|
| Rate for Payer: Aetna Medicare |
$757.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$911.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$911.00
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$728.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,396.59
|
| Rate for Payer: BCN Commercial |
$2,266.57
|
| Rate for Payer: BCN Medicare Advantage |
$728.80
|
| Rate for Payer: Cash Price |
$2,332.16
|
| Rate for Payer: Cash Price |
$2,332.16
|
| Rate for Payer: Cofinity Commercial |
$2,507.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,332.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$728.80
|
| Rate for Payer: Healthscope Commercial |
$2,623.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,186.40
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$765.24
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$838.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,477.92
|
| Rate for Payer: Nomi Health Commercial |
$2,390.46
|
| Rate for Payer: PACE Senior Care Partners |
$692.36
|
| Rate for Payer: PACE SWMI |
$728.80
|
| Rate for Payer: PHP Commercial |
$2,477.92
|
| Rate for Payer: PHP Medicare Advantage |
$728.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,894.88
|
| Rate for Payer: Priority Health HMO/PPO |
$2,536.22
|
| Rate for Payer: Priority Health Medicare |
$736.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,953.18
|
| Rate for Payer: Railroad Medicare Medicare |
$728.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,565.38
|
| Rate for Payer: UHC Core |
$2,434.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$728.80
|
| Rate for Payer: UHC Exchange |
$728.80
|
| Rate for Payer: UHC Medicare Advantage |
$728.80
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$728.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,186.40
|
|
|
HC MR SPINE THORACIC W LIMITED
|
Facility
|
OP
|
$1,144.44
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200007
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$1,030.00 |
| Rate for Payer: Aetna Commercial |
$972.77
|
| Rate for Payer: Aetna Medicare |
$297.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$357.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$357.64
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$286.11
|
| Rate for Payer: BCBS Trust/PPO |
$940.84
|
| Rate for Payer: BCN Commercial |
$889.80
|
| Rate for Payer: BCN Medicare Advantage |
$286.11
|
| Rate for Payer: Cash Price |
$915.55
|
| Rate for Payer: Cash Price |
$915.55
|
| Rate for Payer: Cofinity Commercial |
$984.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$915.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$286.11
|
| Rate for Payer: Healthscope Commercial |
$1,030.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.33
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$300.42
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$329.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$972.77
|
| Rate for Payer: Nomi Health Commercial |
$938.44
|
| Rate for Payer: PACE Senior Care Partners |
$271.80
|
| Rate for Payer: PACE SWMI |
$286.11
|
| Rate for Payer: PHP Commercial |
$972.77
|
| Rate for Payer: PHP Medicare Advantage |
$286.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$743.89
|
| Rate for Payer: Priority Health HMO/PPO |
$995.66
|
| Rate for Payer: Priority Health Medicare |
$288.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$766.77
|
| Rate for Payer: Railroad Medicare Medicare |
$286.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.11
|
| Rate for Payer: UHC Core |
$955.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$286.11
|
| Rate for Payer: UHC Exchange |
$286.11
|
| Rate for Payer: UHC Medicare Advantage |
$286.11
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$286.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.33
|
|
|
HC MR SPINE THORACIC W LIMITED
|
Facility
|
IP
|
$1,144.44
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200007
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$743.89 |
| Max. Negotiated Rate |
$1,030.00 |
| Rate for Payer: Aetna Commercial |
$972.77
|
| Rate for Payer: BCBS Trust/PPO |
$934.21
|
| Rate for Payer: BCN Commercial |
$884.42
|
| Rate for Payer: Cash Price |
$915.55
|
| Rate for Payer: Cofinity Commercial |
$984.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$915.55
|
| Rate for Payer: Healthscope Commercial |
$1,030.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$972.77
|
| Rate for Payer: Nomi Health Commercial |
$938.44
|
| Rate for Payer: PHP Commercial |
$972.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$743.89
|
| Rate for Payer: Priority Health HMO/PPO |
$995.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$766.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.11
|
| Rate for Payer: UHC Core |
$955.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.33
|
|
|
HC MR SPINE THORACIC WO CON
|
Facility
|
IP
|
$1,935.87
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200006
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,258.32 |
| Max. Negotiated Rate |
$1,742.28 |
| Rate for Payer: Aetna Commercial |
$1,645.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,580.25
|
| Rate for Payer: BCN Commercial |
$1,496.04
|
| Rate for Payer: Cash Price |
$1,548.70
|
| Rate for Payer: Cofinity Commercial |
$1,664.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,548.70
|
| Rate for Payer: Healthscope Commercial |
$1,742.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,451.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,645.49
|
| Rate for Payer: Nomi Health Commercial |
$1,587.41
|
| Rate for Payer: PHP Commercial |
$1,645.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,258.32
|
| Rate for Payer: Priority Health HMO/PPO |
$1,684.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,297.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,703.57
|
| Rate for Payer: UHC Core |
$1,616.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,451.90
|
|
