|
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 |
$271.13
|
| 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 |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$233.34
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| 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 |
$258.20
|
| 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 |
$258.20
|
| Rate for Payer: VA VA |
$222.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$666.69
|
|
|
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 |
$258.20 |
| 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 |
$271.13
|
| Rate for Payer: BCBS MAPPO |
$560.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,844.12
|
| Rate for Payer: BCN Commercial |
$1,744.07
|
| Rate for Payer: BCN Medicare Advantage |
$560.79
|
| 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 |
$560.79
|
| Rate for Payer: Healthscope Commercial |
$2,018.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,682.38
|
| Rate for Payer: Mclaren Medicaid |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$588.83
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| 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 |
$560.79
|
| Rate for Payer: PHP Commercial |
$1,906.70
|
| Rate for Payer: PHP Medicare Advantage |
$560.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.20
|
| 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 |
$560.79
|
| 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 |
$560.79
|
| Rate for Payer: UHC Exchange |
$560.79
|
| Rate for Payer: UHC Medicare Advantage |
$560.79
|
| Rate for Payer: UHCCP Medicaid |
$258.20
|
| Rate for Payer: VA VA |
$560.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,682.38
|
|
|
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 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 |
$670.55
|
| 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 |
$271.13
|
| 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 |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.66
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| 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 |
$670.55
|
| 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 |
$258.20
|
| 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 |
$258.20
|
| 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
|
OP
|
$2,280.24
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200009
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$174.76 |
| 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 |
$183.51
|
| 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 |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$598.56
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| 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 |
$174.76
|
| 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 |
$174.76
|
| Rate for Payer: VA VA |
$570.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,710.18
|
|
|
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 LTD
|
Facility
|
OP
|
$2,088.08
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200010
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$174.76 |
| 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 |
$183.51
|
| 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 |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$548.12
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| 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 |
$174.76
|
| 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 |
$174.76
|
| Rate for Payer: VA VA |
$522.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,566.06
|
|
|
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 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 |
$258.20 |
| 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 |
$271.13
|
| 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 |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$835.66
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| 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 |
$258.20
|
| 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 |
$258.20
|
| 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 |
$258.20 |
| 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 |
$271.13
|
| 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 |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$765.24
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| 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 |
$258.20
|
| 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 |
$258.20
|
| 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 |
$258.20 |
| 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 |
$271.13
|
| 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 |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$300.42
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| 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 |
$258.20
|
| 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 |
$258.20
|
| 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
|
OP
|
$1,935.87
|
|
|
Service Code
|
CPT 72146
|
| Hospital Charge Code |
61200006
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$174.76 |
| Max. Negotiated Rate |
$1,742.28 |
| Rate for Payer: Aetna Commercial |
$1,645.49
|
| Rate for Payer: Aetna Medicare |
$503.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$604.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$604.96
|
| Rate for Payer: BCBS Complete |
$183.51
|
| Rate for Payer: BCBS MAPPO |
$483.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,591.48
|
| Rate for Payer: BCN Commercial |
$1,505.14
|
| Rate for Payer: BCN Medicare Advantage |
$483.97
|
| Rate for Payer: Cash Price |
$1,548.70
|
| 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: Health Alliance Plan Medicare Advantage |
$483.97
|
| Rate for Payer: Healthscope Commercial |
$1,742.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,451.90
|
| Rate for Payer: Mclaren Medicaid |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$508.17
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$556.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,645.49
|
| Rate for Payer: Nomi Health Commercial |
$1,587.41
|
| Rate for Payer: PACE Senior Care Partners |
$459.77
|
| Rate for Payer: PACE SWMI |
$483.97
|
| Rate for Payer: PHP Commercial |
$1,645.49
|
| Rate for Payer: PHP Medicare Advantage |
$483.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.76
|
| 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 Medicare |
$488.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,297.03
|
| Rate for Payer: Railroad Medicare Medicare |
$483.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,703.57
|
| Rate for Payer: UHC Core |
$1,616.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$483.97
|
| Rate for Payer: UHC Exchange |
$483.97
|
| Rate for Payer: UHC Medicare Advantage |
$483.97
|
| Rate for Payer: UHCCP Medicaid |
$174.76
|
| Rate for Payer: VA VA |
$483.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,451.90
|
|
|
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 |
$183.51
|
| 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 |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.67
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| 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 |
$174.76
|
| 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 |
$174.76
|
| 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 |
$258.20 |
| 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 |
$271.13
|
| 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 |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$692.95
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| 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 |
$258.20
|
| 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 |
$258.20
|
| 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
|
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 |
$785.83
|
| 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 |
$271.13
|
| 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 |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.68
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$265.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.83
|
| 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 |
$785.83
|
| Rate for Payer: PHP Medicare Advantage |
$231.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.20
|
| 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 |
$619.41
|
| 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 |
$258.20
|
| Rate for Payer: VA VA |
$231.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$693.38
|
|
|
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 |
$785.83
|
| 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 |
$785.83
|
| Rate for Payer: Nomi Health Commercial |
$758.09
|
| Rate for Payer: PHP Commercial |
$785.83
|
| 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 |
$619.41
|
| 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 TEMPOROMANDIBULAR JTS
|
Facility
|
OP
|
$2,072.90
|
|
|
Service Code
|
CPT 70336
|
| Hospital Charge Code |
61000001
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$174.76 |
| 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 |
$183.51
|
| Rate for Payer: BCBS MAPPO |
$518.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,704.13
|
| Rate for Payer: BCN Commercial |
$1,611.68
|
| Rate for Payer: BCN Medicare Advantage |
$518.23
|
| 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 |
$518.23
|
| Rate for Payer: Healthscope Commercial |
$1,865.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,554.67
|
| Rate for Payer: Mclaren Medicaid |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$544.14
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| 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 |
$518.23
|
| Rate for Payer: PHP Commercial |
$1,761.96
|
| Rate for Payer: PHP Medicare Advantage |
$518.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.76
|
| 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 |
$518.23
|
| 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 |
$518.23
|
| Rate for Payer: UHC Exchange |
$518.23
|
| Rate for Payer: UHC Medicare Advantage |
$518.23
|
| Rate for Payer: UHCCP Medicaid |
$174.76
|
| Rate for Payer: VA VA |
$518.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,554.67
|
|
|
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 |
$1,554.67
|
| 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 |
$1,554.67
|
|
