|
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
|
|
|
HC MR SPINE THORACIC WO LIMITED
|
Facility
|
OP
|
$711.11
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200005
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$168.89 |
| Max. Negotiated Rate |
$640.00 |
| Rate for Payer: Aetna Commercial |
$604.44
|
| Rate for Payer: Aetna Medicare |
$184.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.22
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$177.78
|
| Rate for Payer: BCBS Trust/PPO |
$584.60
|
| Rate for Payer: BCN Commercial |
$552.89
|
| Rate for Payer: BCN Medicare Advantage |
$177.78
|
| Rate for Payer: Cash Price |
$568.89
|
| Rate for Payer: Cash Price |
$568.89
|
| Rate for Payer: Cofinity Commercial |
$611.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$568.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.78
|
| Rate for Payer: Healthscope Commercial |
$640.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$533.33
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.67
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$604.44
|
| Rate for Payer: Nomi Health Commercial |
$583.11
|
| Rate for Payer: PACE Senior Care Partners |
$168.89
|
| Rate for Payer: PACE SWMI |
$177.78
|
| Rate for Payer: PHP Commercial |
$604.44
|
| Rate for Payer: PHP Medicare Advantage |
$177.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.22
|
| Rate for Payer: Priority Health HMO/PPO |
$618.67
|
| Rate for Payer: Priority Health Medicare |
$179.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$476.44
|
| Rate for Payer: Railroad Medicare Medicare |
$177.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$625.78
|
| Rate for Payer: UHC Core |
$593.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.78
|
| Rate for Payer: UHC Exchange |
$177.78
|
| Rate for Payer: UHC Medicare Advantage |
$177.78
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$177.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$533.33
|
|
|
HC MR SPINE THORACIC WO LIMITED
|
Facility
|
IP
|
$711.11
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200005
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$462.22 |
| Max. Negotiated Rate |
$640.00 |
| Rate for Payer: Aetna Commercial |
$604.44
|
| Rate for Payer: BCBS Trust/PPO |
$580.48
|
| Rate for Payer: BCN Commercial |
$549.55
|
| Rate for Payer: Cash Price |
$568.89
|
| Rate for Payer: Cofinity Commercial |
$611.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$568.89
|
| Rate for Payer: Healthscope Commercial |
$640.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$533.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$604.44
|
| Rate for Payer: Nomi Health Commercial |
$583.11
|
| Rate for Payer: PHP Commercial |
$604.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.22
|
| Rate for Payer: Priority Health HMO/PPO |
$618.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$476.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$625.78
|
| Rate for Payer: UHC Core |
$593.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$533.33
|
|
|
HC MR SPINE THORACIC WO W CON
|
Facility
|
IP
|
$2,639.81
|
|
|
Service Code
|
CPT 72157
|
| Hospital Charge Code |
61200015
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,715.88 |
| Max. Negotiated Rate |
$2,375.83 |
| Rate for Payer: Aetna Commercial |
$2,243.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,154.88
|
| Rate for Payer: BCN Commercial |
$2,040.05
|
| Rate for Payer: Cash Price |
$2,111.85
|
| Rate for Payer: Cofinity Commercial |
$2,270.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,111.85
|
| Rate for Payer: Healthscope Commercial |
$2,375.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,979.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,243.84
|
| Rate for Payer: Nomi Health Commercial |
$2,164.64
|
| Rate for Payer: PHP Commercial |
$2,243.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,715.88
|
| Rate for Payer: Priority Health HMO/PPO |
$2,296.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,768.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,323.03
|
| Rate for Payer: UHC Core |
$2,204.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,979.86
|
|
|
HC MR SPINE THORACIC WO W CON
|
Facility
|
OP
|
$2,639.81
|
|
|
Service Code
|
CPT 72157
|
| Hospital Charge Code |
61200015
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,375.83 |
| Rate for Payer: Aetna Commercial |
$2,243.84
|
| Rate for Payer: Aetna Medicare |
$686.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$824.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$824.94
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$659.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,170.19
|
| Rate for Payer: BCN Commercial |
$2,052.45
|
| Rate for Payer: BCN Medicare Advantage |
$659.95
|
| Rate for Payer: Cash Price |
$2,111.85
|
| Rate for Payer: Cash Price |
$2,111.85
|
| Rate for Payer: Cofinity Commercial |
$2,270.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,111.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$659.95
|
| Rate for Payer: Healthscope Commercial |
$2,375.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,979.86
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$692.95
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$758.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,243.84
|
| Rate for Payer: Nomi Health Commercial |
$2,164.64
|
| Rate for Payer: PACE Senior Care Partners |
$626.95
|
| Rate for Payer: PACE SWMI |
$659.95
|
| Rate for Payer: PHP Commercial |
$2,243.84
|
| Rate for Payer: PHP Medicare Advantage |
$659.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,715.88
|
| Rate for Payer: Priority Health HMO/PPO |
$2,296.63
|
| Rate for Payer: Priority Health Medicare |
$666.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,768.67
|
| Rate for Payer: Railroad Medicare Medicare |
$659.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,323.03
|
| Rate for Payer: UHC Core |
$2,204.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$659.95
|
| Rate for Payer: UHC Exchange |
$659.95
|
| Rate for Payer: UHC Medicare Advantage |
$659.95
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$659.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,979.86
|
|
|
HC MR SPINE THORACIC WO W LTD
|
Facility
|
IP
|
$924.50
|
|
|
Service Code
|
CPT 72157
|
| Hospital Charge Code |
61200016
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$600.92 |
| Max. Negotiated Rate |
$832.05 |
| Rate for Payer: Aetna Commercial |
$785.82
|
| Rate for Payer: BCBS Trust/PPO |
$754.67
|
| Rate for Payer: BCN Commercial |
$714.45
|
| Rate for Payer: Cash Price |
$739.60
|
| Rate for Payer: Cofinity Commercial |
$795.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.60
|
| Rate for Payer: Healthscope Commercial |
$832.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$693.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.82
|
| Rate for Payer: Nomi Health Commercial |
$758.09
|
| Rate for Payer: PHP Commercial |
$785.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.92
|
| Rate for Payer: Priority Health HMO/PPO |
$804.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$619.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$813.56
|
| Rate for Payer: UHC Core |
$771.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$693.38
|
|
|
HC MR SPINE THORACIC WO W LTD
|
Facility
|
OP
|
$924.50
|
|
|
Service Code
|
CPT 72157
|
| Hospital Charge Code |
61200016
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$219.57 |
| Max. Negotiated Rate |
$832.05 |
| Rate for Payer: Aetna Commercial |
$785.82
|
| Rate for Payer: Aetna Medicare |
$240.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$288.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$288.91
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$231.12
|
| Rate for Payer: BCBS Trust/PPO |
$760.03
|
| Rate for Payer: BCN Commercial |
$718.80
|
| Rate for Payer: BCN Medicare Advantage |
$231.12
|
| Rate for Payer: Cash Price |
$739.60
|
| Rate for Payer: Cash Price |
$739.60
|
| Rate for Payer: Cofinity Commercial |
$795.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231.12
|
| Rate for Payer: Healthscope Commercial |
$832.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$693.38
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.68
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$265.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.82
|
| Rate for Payer: Nomi Health Commercial |
$758.09
|
| Rate for Payer: PACE Senior Care Partners |
$219.57
|
| Rate for Payer: PACE SWMI |
$231.12
|
| Rate for Payer: PHP Commercial |
$785.82
|
| Rate for Payer: PHP Medicare Advantage |
$231.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.92
|
| Rate for Payer: Priority Health HMO/PPO |
$804.32
|
| Rate for Payer: Priority Health Medicare |
$233.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$619.42
|
| Rate for Payer: Railroad Medicare Medicare |
$231.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$813.56
|
| Rate for Payer: UHC Core |
$771.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$231.12
|
| Rate for Payer: UHC Exchange |
$231.12
|
| Rate for Payer: UHC Medicare Advantage |
$231.12
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$231.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$693.38
|
|
|
HC MR TEMPOROMANDIBULAR JTS
|
Facility
|
OP
|
$2,072.90
|
|
|
Service Code
|
CPT 70336
|
| Hospital Charge Code |
61000001
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,865.61 |
| Rate for Payer: Aetna Commercial |
$1,761.96
|
| Rate for Payer: Aetna Medicare |
$538.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$647.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$647.78
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$518.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,704.13
|
| Rate for Payer: BCN Commercial |
$1,611.68
|
| Rate for Payer: BCN Medicare Advantage |
$518.22
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cofinity Commercial |
$1,782.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,658.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$518.22
|
| Rate for Payer: Healthscope Commercial |
$1,865.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,554.68
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$544.14
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$595.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,761.96
|
| Rate for Payer: Nomi Health Commercial |
$1,699.78
|
| Rate for Payer: PACE Senior Care Partners |
$492.31
|
| Rate for Payer: PACE SWMI |
$518.22
|
| Rate for Payer: PHP Commercial |
$1,761.96
|
| Rate for Payer: PHP Medicare Advantage |
$518.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,347.38
|
| Rate for Payer: Priority Health HMO/PPO |
$1,803.42
|
| Rate for Payer: Priority Health Medicare |
$523.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,388.84
|
| Rate for Payer: Railroad Medicare Medicare |
$518.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,824.15
|
| Rate for Payer: UHC Core |
$1,730.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$518.22
|
| Rate for Payer: UHC Exchange |
$518.22
|
| Rate for Payer: UHC Medicare Advantage |
$518.22
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$518.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,554.68
|
|
|
HC MR TEMPOROMANDIBULAR JTS
|
Facility
|
IP
|
$2,072.90
|
|
|
Service Code
|
CPT 70336
|
| Hospital Charge Code |
61000001
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,347.38 |
| Max. Negotiated Rate |
$1,865.61 |
| Rate for Payer: Aetna Commercial |
$1,761.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,692.11
|
| Rate for Payer: BCN Commercial |
$1,601.94
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cofinity Commercial |
$1,782.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,658.32
|
| Rate for Payer: Healthscope Commercial |
$1,865.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,554.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,761.96
|
| Rate for Payer: Nomi Health Commercial |
$1,699.78
|
| Rate for Payer: PHP Commercial |
$1,761.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,347.38
|
| Rate for Payer: Priority Health HMO/PPO |
$1,803.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,388.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,824.15
|
| Rate for Payer: UHC Core |
$1,730.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,554.68
|
|
|
HC MR UPPER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
IP
|
$2,584.25
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
61000027
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,679.76 |
| Max. Negotiated Rate |
$2,325.82 |
| Rate for Payer: Aetna Commercial |
$2,196.61
|
| Rate for Payer: BCBS Trust/PPO |
$2,109.52
|
| Rate for Payer: BCN Commercial |
$1,997.11
|
| Rate for Payer: Cash Price |
$2,067.40
|
| Rate for Payer: Cofinity Commercial |
$2,222.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,067.40
|
| Rate for Payer: Healthscope Commercial |
$2,325.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,938.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,196.61
|
| Rate for Payer: Nomi Health Commercial |
$2,119.08
|
| Rate for Payer: PHP Commercial |
$2,196.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,679.76
|
| Rate for Payer: Priority Health HMO/PPO |
$2,248.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,731.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,274.14
|
| Rate for Payer: UHC Core |
$2,157.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,938.19
|
|
|
HC MR UPPER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
OP
|
$2,584.25
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
61000027
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,325.82 |
| Rate for Payer: Aetna Commercial |
$2,196.61
|
| Rate for Payer: Aetna Medicare |
$671.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$807.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$807.58
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$646.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,124.51
|
| Rate for Payer: BCN Commercial |
$2,009.25
|
| Rate for Payer: BCN Medicare Advantage |
$646.06
|
| Rate for Payer: Cash Price |
$2,067.40
|
| Rate for Payer: Cash Price |
$2,067.40
|
| Rate for Payer: Cofinity Commercial |
$2,222.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,067.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$646.06
|
| Rate for Payer: Healthscope Commercial |
$2,325.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,938.19
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$678.37
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$742.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,196.61
|
| Rate for Payer: Nomi Health Commercial |
$2,119.08
|
| Rate for Payer: PACE Senior Care Partners |
$613.76
|
| Rate for Payer: PACE SWMI |
$646.06
|
| Rate for Payer: PHP Commercial |
$2,196.61
|
| Rate for Payer: PHP Medicare Advantage |
$646.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,679.76
|
| Rate for Payer: Priority Health HMO/PPO |
$2,248.30
|
| Rate for Payer: Priority Health Medicare |
$652.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,731.45
|
| Rate for Payer: Railroad Medicare Medicare |
$646.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,274.14
|
| Rate for Payer: UHC Core |
$2,157.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$646.06
|
| Rate for Payer: UHC Exchange |
$646.06
|
| Rate for Payer: UHC Medicare Advantage |
$646.06
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$646.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,938.19
|
|
|
HC MR UPPER EXTREM ANY JOINT W CON
|
Facility
|
IP
|
$2,290.86
|
|
|
Service Code
|
CPT 73222
|
| Hospital Charge Code |
61000024
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,489.06 |
| Max. Negotiated Rate |
$2,061.77 |
| Rate for Payer: Aetna Commercial |
$1,947.23
|
| Rate for Payer: Aetna Commercial |
$2,920.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,870.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,805.05
|
| Rate for Payer: BCN Commercial |
$1,770.38
|
| Rate for Payer: BCN Commercial |
$2,655.57
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cofinity Commercial |
$2,955.22
|
| Rate for Payer: Cofinity Commercial |
$1,970.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,749.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,832.69
|
| Rate for Payer: Healthscope Commercial |
$2,061.77
|
| Rate for Payer: Healthscope Commercial |
$3,092.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,718.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,577.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,947.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,920.86
|
| Rate for Payer: Nomi Health Commercial |
$1,878.51
|
| Rate for Payer: Nomi Health Commercial |
$2,817.77
|
| Rate for Payer: PHP Commercial |
$1,947.23
|
| Rate for Payer: PHP Commercial |
$2,920.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,233.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,489.06
|
| Rate for Payer: Priority Health HMO/PPO |
$2,989.58
|
| Rate for Payer: Priority Health HMO/PPO |
$1,993.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,534.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,302.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,015.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,023.94
|
| Rate for Payer: UHC Core |
$1,912.87
|
| Rate for Payer: UHC Core |
$2,869.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,718.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,577.22
|
|
|
HC MR UPPER EXTREM ANY JOINT W CON
|
Facility
|
OP
|
$2,290.86
|
|
|
Service Code
|
CPT 73222
|
| Hospital Charge Code |
61000024
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$544.08 |
| Max. Negotiated Rate |
$2,061.77 |
| Rate for Payer: Aetna Commercial |
$1,947.23
|
| Rate for Payer: Aetna Commercial |
$2,920.86
|
| Rate for Payer: Aetna Medicare |
$595.62
|
| Rate for Payer: Aetna Medicare |
$893.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$715.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,073.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$715.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,073.84
|
| Rate for Payer: BCBS Complete |
$587.68
|
| Rate for Payer: BCBS Complete |
$587.68
|
| Rate for Payer: BCBS MAPPO |
$859.08
|
| Rate for Payer: BCBS MAPPO |
$572.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,883.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,824.98
|
| Rate for Payer: BCN Commercial |
$1,781.14
|
| Rate for Payer: BCN Commercial |
$2,671.72
|
| Rate for Payer: BCN Medicare Advantage |
$572.72
|
| Rate for Payer: BCN Medicare Advantage |
$859.08
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cofinity Commercial |
$1,970.14
|
| Rate for Payer: Cofinity Commercial |
$2,955.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,749.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,832.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$572.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$859.08
|
| Rate for Payer: Healthscope Commercial |
$3,092.67
|
| Rate for Payer: Healthscope Commercial |
$2,061.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,718.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,577.22
|
| Rate for Payer: Mclaren Medicaid |
$559.66
|
| Rate for Payer: Mclaren Medicaid |
$559.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$902.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$601.35
|
| Rate for Payer: Meridian Medicaid |
$587.68
|
| Rate for Payer: Meridian Medicaid |
$587.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$658.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$987.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,947.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,920.86
|
| Rate for Payer: Nomi Health Commercial |
$1,878.51
|
| Rate for Payer: Nomi Health Commercial |
$2,817.77
|
| Rate for Payer: PACE Senior Care Partners |
$544.08
|
| Rate for Payer: PACE Senior Care Partners |
$816.12
|
| Rate for Payer: PACE SWMI |
$572.72
|
| Rate for Payer: PACE SWMI |
$859.08
|
| Rate for Payer: PHP Commercial |
$2,920.86
|
| Rate for Payer: PHP Commercial |
$1,947.23
|
| Rate for Payer: PHP Medicare Advantage |
$572.72
|
| Rate for Payer: PHP Medicare Advantage |
$859.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$559.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$559.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,489.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,233.60
|
| Rate for Payer: Priority Health HMO/PPO |
$2,989.58
|
| Rate for Payer: Priority Health HMO/PPO |
$1,993.05
|
| Rate for Payer: Priority Health Medicare |
$578.44
|
| Rate for Payer: Priority Health Medicare |
$867.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,534.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,302.32
|
| Rate for Payer: Railroad Medicare Medicare |
$859.08
|
| Rate for Payer: Railroad Medicare Medicare |
$572.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,023.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,015.96
|
| Rate for Payer: UHC Core |
$2,869.31
|
| Rate for Payer: UHC Core |
$1,912.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$572.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$859.08
|
| Rate for Payer: UHC Exchange |
$859.08
|
| Rate for Payer: UHC Exchange |
$572.72
|
| Rate for Payer: UHC Medicare Advantage |
$859.08
|
| Rate for Payer: UHC Medicare Advantage |
$572.72
|
| Rate for Payer: UHCCP Medicaid |
$559.66
|
| Rate for Payer: UHCCP Medicaid |
$559.66
|
| Rate for Payer: VA VA |
$572.72
|
| Rate for Payer: VA VA |
$859.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,718.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,577.22
|
|
|
HC MR UPPER EXTREM ANY JOINT WO CON
|
Facility
|
OP
|
$1,995.22
|
|
|
Service Code
|
CPT 73221
|
| Hospital Charge Code |
61000022
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,795.70 |
| Rate for Payer: Aetna Commercial |
$1,695.94
|
| Rate for Payer: Aetna Commercial |
$2,543.91
|
| Rate for Payer: Aetna Medicare |
$518.76
|
| Rate for Payer: Aetna Medicare |
$778.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$623.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$935.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$623.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$935.26
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$748.21
|
| Rate for Payer: BCBS MAPPO |
$498.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,640.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,460.41
|
| Rate for Payer: BCN Commercial |
$1,551.28
|
| Rate for Payer: BCN Commercial |
$2,326.93
|
| Rate for Payer: BCN Medicare Advantage |
$498.80
|
| Rate for Payer: BCN Medicare Advantage |
$748.21
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cofinity Commercial |
$1,715.89
|
| Rate for Payer: Cofinity Commercial |
$2,573.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,394.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$748.21
|
| Rate for Payer: Healthscope Commercial |
$2,693.55
|
| Rate for Payer: Healthscope Commercial |
$1,795.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,496.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,244.62
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$785.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.75
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$573.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$860.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,695.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,543.91
|
| Rate for Payer: Nomi Health Commercial |
$1,636.08
|
| Rate for Payer: Nomi Health Commercial |
$2,454.12
|
| Rate for Payer: PACE Senior Care Partners |
$473.86
|
| Rate for Payer: PACE Senior Care Partners |
$710.80
|
| Rate for Payer: PACE SWMI |
$498.80
|
| Rate for Payer: PACE SWMI |
$748.21
|
| Rate for Payer: PHP Commercial |
$2,543.91
|
| Rate for Payer: PHP Commercial |
$1,695.94
|
| Rate for Payer: PHP Medicare Advantage |
$498.80
|
| Rate for Payer: PHP Medicare Advantage |
$748.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,296.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,945.34
|
| Rate for Payer: Priority Health HMO/PPO |
$2,603.76
|
| Rate for Payer: Priority Health HMO/PPO |
$1,735.84
|
| Rate for Payer: Priority Health Medicare |
$503.79
|
| Rate for Payer: Priority Health Medicare |
$755.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,336.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,005.20
|
| Rate for Payer: Railroad Medicare Medicare |
$748.21
|
| Rate for Payer: Railroad Medicare Medicare |
$498.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,633.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,755.79
|
| Rate for Payer: UHC Core |
$2,499.01
|
| Rate for Payer: UHC Core |
$1,666.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$498.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$748.21
|
| Rate for Payer: UHC Exchange |
$748.21
|
| Rate for Payer: UHC Exchange |
$498.80
|
| Rate for Payer: UHC Medicare Advantage |
$748.21
|
| Rate for Payer: UHC Medicare Advantage |
$498.80
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$498.80
|
| Rate for Payer: VA VA |
$748.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,496.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,244.62
|
|
|
HC MR UPPER EXTREM ANY JOINT WO CON
|
Facility
|
IP
|
$1,995.22
|
|
|
Service Code
|
CPT 73221
|
| Hospital Charge Code |
61000022
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,296.89 |
| Max. Negotiated Rate |
$1,795.70 |
| Rate for Payer: Aetna Commercial |
$1,695.94
|
| Rate for Payer: Aetna Commercial |
$2,543.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,443.05
|
| Rate for Payer: BCN Commercial |
$1,541.91
|
| Rate for Payer: BCN Commercial |
$2,312.86
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cofinity Commercial |
$2,573.83
|
| Rate for Payer: Cofinity Commercial |
$1,715.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,394.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.18
|
| Rate for Payer: Healthscope Commercial |
$1,795.70
|
| Rate for Payer: Healthscope Commercial |
$2,693.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,496.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,244.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,695.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,543.91
|
| Rate for Payer: Nomi Health Commercial |
$1,636.08
|
| Rate for Payer: Nomi Health Commercial |
$2,454.12
|
| Rate for Payer: PHP Commercial |
$1,695.94
|
| Rate for Payer: PHP Commercial |
$2,543.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,945.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,296.89
|
| Rate for Payer: Priority Health HMO/PPO |
$2,603.76
|
| Rate for Payer: Priority Health HMO/PPO |
$1,735.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,336.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,005.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,755.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,633.69
|
| Rate for Payer: UHC Core |
$1,666.01
|
| Rate for Payer: UHC Core |
$2,499.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,496.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,244.62
|
|
|
HC MR UPPER EXTREM ANY JOINT WO W CON
|
Facility
|
IP
|
$2,459.37
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
61000026
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,598.59 |
| Max. Negotiated Rate |
$2,213.43 |
| Rate for Payer: Aetna Commercial |
$2,090.46
|
| Rate for Payer: Aetna Commercial |
$3,135.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,007.58
|
| Rate for Payer: BCBS Trust/PPO |
$3,011.37
|
| Rate for Payer: BCN Commercial |
$1,900.60
|
| Rate for Payer: BCN Commercial |
$2,850.90
|
| Rate for Payer: Cash Price |
$1,967.50
|
| Rate for Payer: Cash Price |
$2,951.24
|
| Rate for Payer: Cofinity Commercial |
$3,172.58
|
| Rate for Payer: Cofinity Commercial |
$2,115.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,951.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,967.50
|
| Rate for Payer: Healthscope Commercial |
$2,213.43
|
| Rate for Payer: Healthscope Commercial |
$3,320.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,844.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,766.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,090.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,135.69
|
| Rate for Payer: Nomi Health Commercial |
$2,016.68
|
| Rate for Payer: Nomi Health Commercial |
$3,025.02
|
| Rate for Payer: PHP Commercial |
$2,090.46
|
| Rate for Payer: PHP Commercial |
$3,135.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,397.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,598.59
|
| Rate for Payer: Priority Health HMO/PPO |
$3,209.47
|
| Rate for Payer: Priority Health HMO/PPO |
$2,139.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,647.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,471.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,164.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,246.36
|
| Rate for Payer: UHC Core |
$2,053.57
|
| Rate for Payer: UHC Core |
$3,080.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,844.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,766.79
|
|
|
HC MR UPPER EXTREM ANY JOINT WO W CON
|
Facility
|
OP
|
$2,459.37
|
|
|
Service Code
|
CPT 73223
|
| Hospital Charge Code |
61000026
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,213.43 |
| Rate for Payer: Aetna Commercial |
$2,090.46
|
| Rate for Payer: Aetna Commercial |
$3,135.69
|
| Rate for Payer: Aetna Medicare |
$639.44
|
| Rate for Payer: Aetna Medicare |
$959.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,152.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,152.83
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$922.26
|
| Rate for Payer: BCBS MAPPO |
$614.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,021.85
|
| Rate for Payer: BCBS Trust/PPO |
$3,032.77
|
| Rate for Payer: BCN Commercial |
$1,912.16
|
| Rate for Payer: BCN Commercial |
$2,868.24
|
| Rate for Payer: BCN Medicare Advantage |
$614.84
|
| Rate for Payer: BCN Medicare Advantage |
$922.26
|
| Rate for Payer: Cash Price |
$2,951.24
|
| Rate for Payer: Cash Price |
$1,967.50
|
| Rate for Payer: Cash Price |
$1,967.50
|
| Rate for Payer: Cash Price |
$2,951.24
|
| Rate for Payer: Cofinity Commercial |
$2,115.06
|
| Rate for Payer: Cofinity Commercial |
$3,172.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,951.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,967.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$922.26
|
| Rate for Payer: Healthscope Commercial |
$3,320.14
|
| Rate for Payer: Healthscope Commercial |
$2,213.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,844.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,766.79
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$968.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$645.58
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$707.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,060.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,090.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,135.69
|
| Rate for Payer: Nomi Health Commercial |
$2,016.68
|
| Rate for Payer: Nomi Health Commercial |
$3,025.02
|
| Rate for Payer: PACE Senior Care Partners |
$584.10
|
| Rate for Payer: PACE Senior Care Partners |
$876.15
|
| Rate for Payer: PACE SWMI |
$614.84
|
| Rate for Payer: PACE SWMI |
$922.26
|
| Rate for Payer: PHP Commercial |
$3,135.69
|
| Rate for Payer: PHP Commercial |
$2,090.46
|
| Rate for Payer: PHP Medicare Advantage |
$614.84
|
| Rate for Payer: PHP Medicare Advantage |
$922.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,598.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,397.88
|
| Rate for Payer: Priority Health HMO/PPO |
$3,209.47
|
| Rate for Payer: Priority Health HMO/PPO |
$2,139.65
|
| Rate for Payer: Priority Health Medicare |
$620.99
|
| Rate for Payer: Priority Health Medicare |
$931.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,647.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,471.66
|
| Rate for Payer: Railroad Medicare Medicare |
$922.26
|
| Rate for Payer: Railroad Medicare Medicare |
$614.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,246.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,164.25
|
| Rate for Payer: UHC Core |
$3,080.36
|
| Rate for Payer: UHC Core |
$2,053.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$922.26
|
| Rate for Payer: UHC Exchange |
$922.26
|
| Rate for Payer: UHC Exchange |
$614.84
|
| Rate for Payer: UHC Medicare Advantage |
$922.26
|
| Rate for Payer: UHC Medicare Advantage |
$614.84
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$614.84
|
| Rate for Payer: VA VA |
$922.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,844.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,766.79
|
|
|
HC MR UPPER EXTREM BIL ANY JOINT W CON
|
Facility
|
IP
|
$2,512.46
|
|
|
Service Code
|
CPT 73222
|
| Hospital Charge Code |
61000025
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,633.10 |
| Max. Negotiated Rate |
$2,261.21 |
| Rate for Payer: Aetna Commercial |
$2,135.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,050.92
|
| Rate for Payer: BCN Commercial |
$1,941.63
|
| Rate for Payer: Cash Price |
$2,009.97
|
| Rate for Payer: Cofinity Commercial |
$2,160.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,009.97
|
| Rate for Payer: Healthscope Commercial |
$2,261.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,884.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,135.59
|
| Rate for Payer: Nomi Health Commercial |
$2,060.22
|
| Rate for Payer: PHP Commercial |
$2,135.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,633.10
|
| Rate for Payer: Priority Health HMO/PPO |
$2,185.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,683.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,210.96
|
| Rate for Payer: UHC Core |
$2,097.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,884.34
|
|
|
HC MR UPPER EXTREM BIL ANY JOINT W CON
|
Facility
|
OP
|
$2,512.46
|
|
|
Service Code
|
CPT 73222
|
| Hospital Charge Code |
61000025
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$559.66 |
| Max. Negotiated Rate |
$2,261.21 |
| Rate for Payer: Aetna Commercial |
$2,135.59
|
| Rate for Payer: Aetna Medicare |
$653.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$785.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$785.14
|
| Rate for Payer: BCBS Complete |
$587.68
|
| Rate for Payer: BCBS MAPPO |
$628.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,065.49
|
| Rate for Payer: BCN Commercial |
$1,953.44
|
| Rate for Payer: BCN Medicare Advantage |
$628.12
|
| Rate for Payer: Cash Price |
$2,009.97
|
| Rate for Payer: Cash Price |
$2,009.97
|
| Rate for Payer: Cofinity Commercial |
$2,160.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,009.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$628.12
|
| Rate for Payer: Healthscope Commercial |
$2,261.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,884.34
|
| Rate for Payer: Mclaren Medicaid |
$559.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$659.52
|
| Rate for Payer: Meridian Medicaid |
$587.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$722.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,135.59
|
| Rate for Payer: Nomi Health Commercial |
$2,060.22
|
| Rate for Payer: PACE Senior Care Partners |
$596.71
|
| Rate for Payer: PACE SWMI |
$628.12
|
| Rate for Payer: PHP Commercial |
$2,135.59
|
| Rate for Payer: PHP Medicare Advantage |
$628.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$559.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,633.10
|
| Rate for Payer: Priority Health HMO/PPO |
$2,185.84
|
| Rate for Payer: Priority Health Medicare |
$634.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,683.35
|
| Rate for Payer: Railroad Medicare Medicare |
$628.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,210.96
|
| Rate for Payer: UHC Core |
$2,097.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$628.12
|
| Rate for Payer: UHC Exchange |
$628.12
|
| Rate for Payer: UHC Medicare Advantage |
$628.12
|
| Rate for Payer: UHCCP Medicaid |
$559.66
|
| Rate for Payer: VA VA |
$628.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,884.34
|
|
|
HC MR UPPER EXTREM BIL ANY JOINT WO CON
|
Facility
|
IP
|
$2,297.10
|
|
|
Service Code
|
CPT 73221
|
| Hospital Charge Code |
61000023
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,493.12 |
| Max. Negotiated Rate |
$2,067.39 |
| Rate for Payer: Aetna Commercial |
$1,952.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,875.12
|
| Rate for Payer: BCN Commercial |
$1,775.20
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Commercial |
$1,975.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Healthscope Commercial |
$2,067.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,722.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.54
|
| Rate for Payer: Nomi Health Commercial |
$1,883.62
|
| Rate for Payer: PHP Commercial |
$1,952.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,493.12
|
| Rate for Payer: Priority Health HMO/PPO |
$1,998.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,539.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,021.45
|
| Rate for Payer: UHC Core |
$1,918.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,722.82
|
|
|
HC MR UPPER EXTREM BIL ANY JOINT WO CON
|
Facility
|
OP
|
$2,297.10
|
|
|
Service Code
|
CPT 73221
|
| Hospital Charge Code |
61000023
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$2,067.39 |
| Rate for Payer: Aetna Commercial |
$1,952.54
|
| Rate for Payer: Aetna Medicare |
$597.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$717.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$717.84
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$574.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,888.45
|
| Rate for Payer: BCN Commercial |
$1,786.00
|
| Rate for Payer: BCN Medicare Advantage |
$574.28
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Commercial |
$1,975.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$574.28
|
| Rate for Payer: Healthscope Commercial |
$2,067.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,722.82
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$602.99
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$660.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.54
|
| Rate for Payer: Nomi Health Commercial |
$1,883.62
|
| Rate for Payer: PACE Senior Care Partners |
$545.56
|
| Rate for Payer: PACE SWMI |
$574.28
|
| Rate for Payer: PHP Commercial |
$1,952.54
|
| Rate for Payer: PHP Medicare Advantage |
$574.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,493.12
|
| Rate for Payer: Priority Health HMO/PPO |
$1,998.48
|
| Rate for Payer: Priority Health Medicare |
$580.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,539.06
|
| Rate for Payer: Railroad Medicare Medicare |
$574.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,021.45
|
| Rate for Payer: UHC Core |
$1,918.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$574.28
|
| Rate for Payer: UHC Exchange |
$574.28
|
| Rate for Payer: UHC Medicare Advantage |
$574.28
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$574.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,722.82
|
|
|
HC MR UPPER EXTREM BIL NO JOINT W CON
|
Facility
|
OP
|
$2,463.20
|
|
|
Service Code
|
CPT 73219
|
| Hospital Charge Code |
61000019
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,216.88 |
| Rate for Payer: Aetna Commercial |
$2,093.72
|
| Rate for Payer: Aetna Medicare |
$640.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$769.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$769.75
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$615.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,025.00
|
| Rate for Payer: BCN Commercial |
$1,915.14
|
| Rate for Payer: BCN Medicare Advantage |
$615.80
|
| Rate for Payer: Cash Price |
$1,970.56
|
| Rate for Payer: Cash Price |
$1,970.56
|
| Rate for Payer: Cofinity Commercial |
$2,118.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,970.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$615.80
|
| Rate for Payer: Healthscope Commercial |
$2,216.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,847.40
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$646.59
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$708.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,093.72
|
| Rate for Payer: Nomi Health Commercial |
$2,019.82
|
| Rate for Payer: PACE Senior Care Partners |
$585.01
|
| Rate for Payer: PACE SWMI |
$615.80
|
| Rate for Payer: PHP Commercial |
$2,093.72
|
| Rate for Payer: PHP Medicare Advantage |
$615.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,601.08
|
| Rate for Payer: Priority Health HMO/PPO |
$2,142.98
|
| Rate for Payer: Priority Health Medicare |
$621.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,650.34
|
| Rate for Payer: Railroad Medicare Medicare |
$615.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,167.62
|
| Rate for Payer: UHC Core |
$2,056.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$615.80
|
| Rate for Payer: UHC Exchange |
$615.80
|
| Rate for Payer: UHC Medicare Advantage |
$615.80
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$615.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,847.40
|
|
|
HC MR UPPER EXTREM BIL NO JOINT W CON
|
Facility
|
IP
|
$2,463.20
|
|
|
Service Code
|
CPT 73219
|
| Hospital Charge Code |
61000019
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,601.08 |
| Max. Negotiated Rate |
$2,216.88 |
| Rate for Payer: Aetna Commercial |
$2,093.72
|
| Rate for Payer: BCBS Trust/PPO |
$2,010.71
|
| Rate for Payer: BCN Commercial |
$1,903.56
|
| Rate for Payer: Cash Price |
$1,970.56
|
| Rate for Payer: Cofinity Commercial |
$2,118.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,970.56
|
| Rate for Payer: Healthscope Commercial |
$2,216.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,847.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,093.72
|
| Rate for Payer: Nomi Health Commercial |
$2,019.82
|
| Rate for Payer: PHP Commercial |
$2,093.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,601.08
|
| Rate for Payer: Priority Health HMO/PPO |
$2,142.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,650.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,167.62
|
| Rate for Payer: UHC Core |
$2,056.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,847.40
|
|
|
HC MR UPPER EXTREM BIL NO JOINT WO CON
|
Facility
|
IP
|
$2,297.10
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
61000017
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,493.12 |
| Max. Negotiated Rate |
$2,067.39 |
| Rate for Payer: Aetna Commercial |
$1,952.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,875.12
|
| Rate for Payer: BCN Commercial |
$1,775.20
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Commercial |
$1,975.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Healthscope Commercial |
$2,067.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,722.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.54
|
| Rate for Payer: Nomi Health Commercial |
$1,883.62
|
| Rate for Payer: PHP Commercial |
$1,952.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,493.12
|
| Rate for Payer: Priority Health HMO/PPO |
$1,998.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,539.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,021.45
|
| Rate for Payer: UHC Core |
$1,918.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,722.82
|
|
|
HC MR UPPER EXTREM BIL NO JOINT WO CON
|
Facility
|
OP
|
$2,297.10
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
61000017
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$2,067.39 |
| Rate for Payer: Aetna Commercial |
$1,952.54
|
| Rate for Payer: Aetna Medicare |
$597.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$717.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$717.84
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$574.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,888.45
|
| Rate for Payer: BCN Commercial |
$1,786.00
|
| Rate for Payer: BCN Medicare Advantage |
$574.28
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cash Price |
$1,837.68
|
| Rate for Payer: Cofinity Commercial |
$1,975.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,837.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$574.28
|
| Rate for Payer: Healthscope Commercial |
$2,067.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,722.82
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$602.99
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$660.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,952.54
|
| Rate for Payer: Nomi Health Commercial |
$1,883.62
|
| Rate for Payer: PACE Senior Care Partners |
$545.56
|
| Rate for Payer: PACE SWMI |
$574.28
|
| Rate for Payer: PHP Commercial |
$1,952.54
|
| Rate for Payer: PHP Medicare Advantage |
$574.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,493.12
|
| Rate for Payer: Priority Health HMO/PPO |
$1,998.48
|
| Rate for Payer: Priority Health Medicare |
$580.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,539.06
|
| Rate for Payer: Railroad Medicare Medicare |
$574.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,021.45
|
| Rate for Payer: UHC Core |
$1,918.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$574.28
|
| Rate for Payer: UHC Exchange |
$574.28
|
| Rate for Payer: UHC Medicare Advantage |
$574.28
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$574.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,722.82
|
|
