|
HC XR SINUS TRACT FISTULA ABSCESS
|
Facility
|
OP
|
$381.09
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000014
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$90.51 |
| Max. Negotiated Rate |
$379.99 |
| Rate for Payer: Aetna Commercial |
$323.93
|
| Rate for Payer: Aetna Medicare |
$99.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$119.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$119.09
|
| Rate for Payer: BCBS Complete |
$379.99
|
| Rate for Payer: BCBS MAPPO |
$95.27
|
| Rate for Payer: BCBS Trust/PPO |
$296.30
|
| Rate for Payer: BCN Commercial |
$296.30
|
| Rate for Payer: BCN Medicare Advantage |
$95.27
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$327.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.27
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
| Rate for Payer: Mclaren Medicaid |
$361.89
|
| Rate for Payer: Meridian Medicaid |
$379.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$100.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: PACE Senior Care Partners |
$90.51
|
| Rate for Payer: PACE SWMI |
$95.27
|
| Rate for Payer: PHP Commercial |
$323.93
|
| Rate for Payer: PHP Medicare Advantage |
$95.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$361.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$331.55
|
| Rate for Payer: Priority Health Medicare |
$95.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$232.43
|
| Rate for Payer: Railroad Medicare Medicare |
$95.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.36
|
| Rate for Payer: UHC Core |
$318.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.27
|
| Rate for Payer: UHC Medicare Advantage |
$98.13
|
| Rate for Payer: VA VA |
$95.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
|
HC XR SKULL LESS THAN 4 VW
|
Facility
|
OP
|
$350.37
|
|
|
Service Code
|
CPT 70250
|
| Hospital Charge Code |
32000017
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$315.33 |
| Rate for Payer: Aetna Commercial |
$297.81
|
| Rate for Payer: Aetna Medicare |
$91.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.49
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$87.59
|
| Rate for Payer: BCBS Trust/PPO |
$272.41
|
| Rate for Payer: BCN Commercial |
$272.41
|
| Rate for Payer: BCN Medicare Advantage |
$87.59
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cofinity Commercial |
$301.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.59
|
| Rate for Payer: Healthscope Commercial |
$315.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.78
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$91.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.81
|
| Rate for Payer: PACE Senior Care Partners |
$83.21
|
| Rate for Payer: PACE SWMI |
$87.59
|
| Rate for Payer: PHP Commercial |
$297.81
|
| Rate for Payer: PHP Medicare Advantage |
$87.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.82
|
| Rate for Payer: Priority Health Medicare |
$87.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.69
|
| Rate for Payer: Railroad Medicare Medicare |
$87.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.33
|
| Rate for Payer: UHC Core |
$292.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.59
|
| Rate for Payer: UHC Medicare Advantage |
$90.22
|
| Rate for Payer: VA VA |
$87.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.78
|
|
|
HC XR SKULL LESS THAN 4 VW
|
Facility
|
IP
|
$350.37
|
|
|
Service Code
|
CPT 70250
|
| Hospital Charge Code |
32000017
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$213.69 |
| Max. Negotiated Rate |
$315.33 |
| Rate for Payer: Aetna Commercial |
$297.81
|
| Rate for Payer: BCBS Trust/PPO |
$270.77
|
| Rate for Payer: BCN Commercial |
$270.77
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cofinity Commercial |
$301.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.30
|
| Rate for Payer: Healthscope Commercial |
$315.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.81
|
| Rate for Payer: PHP Commercial |
$297.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.33
|
| Rate for Payer: UHC Core |
$292.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.78
|
|
|
HC XR SKULL MIN 4 VW
|
Facility
|
IP
|
$400.20
|
|
|
Service Code
|
CPT 70260
|
| Hospital Charge Code |
32000018
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$244.08 |
| Max. Negotiated Rate |
$360.18 |
| Rate for Payer: Aetna Commercial |
$340.17
|
| Rate for Payer: BCBS Trust/PPO |
$309.27
|
| Rate for Payer: BCN Commercial |
$309.27
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cofinity Commercial |
$344.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.16
|
| Rate for Payer: Healthscope Commercial |
$360.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.17
|
| Rate for Payer: PHP Commercial |
$340.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$348.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.18
|
| Rate for Payer: UHC Core |
$334.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.15
|
|
|
HC XR SKULL MIN 4 VW
|
Facility
|
OP
|
$400.20
|
|
|
Service Code
|
CPT 70260
|
| Hospital Charge Code |
32000018
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$360.18 |
| Rate for Payer: Aetna Commercial |
$340.17
|
| Rate for Payer: Aetna Medicare |
$104.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$125.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$125.06
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$100.05
|
| Rate for Payer: BCBS Trust/PPO |
$311.16
|
| Rate for Payer: BCN Commercial |
$311.16
|
| Rate for Payer: BCN Medicare Advantage |
$100.05
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cofinity Commercial |
$344.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.05
|
| Rate for Payer: Healthscope Commercial |
$360.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.15
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$105.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$115.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.17
|
| Rate for Payer: PACE Senior Care Partners |
$95.05
|
| Rate for Payer: PACE SWMI |
$100.05
|
| Rate for Payer: PHP Commercial |
$340.17
|
| Rate for Payer: PHP Medicare Advantage |
$100.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$348.17
|
| Rate for Payer: Priority Health Medicare |
$100.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.08
|
| Rate for Payer: Railroad Medicare Medicare |
$100.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.18
|
| Rate for Payer: UHC Core |
$334.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.05
|
| Rate for Payer: UHC Medicare Advantage |
$103.05
|
| Rate for Payer: VA VA |
$100.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.15
|
|
|
HC XR SMALL BOWEL
|
Facility
|
OP
|
$600.55
|
|
|
Service Code
|
CPT 74250
|
| Hospital Charge Code |
32000144
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$120.53 |
| Max. Negotiated Rate |
$540.50 |
| Rate for Payer: Aetna Commercial |
$510.47
|
| Rate for Payer: Aetna Medicare |
$156.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$187.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$187.67
|
| Rate for Payer: BCBS Complete |
$126.56
|
| Rate for Payer: BCBS MAPPO |
$150.14
|
| Rate for Payer: BCBS Trust/PPO |
$466.93
|
| Rate for Payer: BCN Commercial |
$466.93
|
| Rate for Payer: BCN Medicare Advantage |
$150.14
|
| Rate for Payer: Cash Price |
$480.44
|
| Rate for Payer: Cash Price |
$480.44
|
| Rate for Payer: Cofinity Commercial |
$516.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.14
|
| Rate for Payer: Healthscope Commercial |
$540.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.41
|
| Rate for Payer: Mclaren Medicaid |
$120.53
|
| Rate for Payer: Meridian Medicaid |
$126.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$157.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$172.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.47
|
| Rate for Payer: PACE Senior Care Partners |
$142.63
|
| Rate for Payer: PACE SWMI |
$150.14
|
| Rate for Payer: PHP Commercial |
$510.47
|
| Rate for Payer: PHP Medicare Advantage |
$150.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$522.48
|
| Rate for Payer: Priority Health Medicare |
$150.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$366.28
|
| Rate for Payer: Railroad Medicare Medicare |
$150.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.48
|
| Rate for Payer: UHC Core |
$501.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.14
|
| Rate for Payer: UHC Medicare Advantage |
$154.64
|
| Rate for Payer: VA VA |
$150.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.41
|
|
|
HC XR SMALL BOWEL
|
Facility
|
IP
|
$600.55
|
|
|
Service Code
|
CPT 74250
|
| Hospital Charge Code |
32000144
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$366.28 |
| Max. Negotiated Rate |
$540.50 |
| Rate for Payer: Aetna Commercial |
$510.47
|
| Rate for Payer: BCBS Trust/PPO |
$464.11
|
| Rate for Payer: BCN Commercial |
$464.11
|
| Rate for Payer: Cash Price |
$480.44
|
| Rate for Payer: Cofinity Commercial |
$516.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.44
|
| Rate for Payer: Healthscope Commercial |
$540.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.47
|
| Rate for Payer: PHP Commercial |
$510.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$522.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$366.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.48
|
| Rate for Payer: UHC Core |
$501.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.41
|
|
|
HC XR SMALL BOWEL.
|
Facility
|
IP
|
$278.77
|
|
|
Service Code
|
CPT 74248
|
| Hospital Charge Code |
32000331
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$170.02 |
| Max. Negotiated Rate |
$250.89 |
| Rate for Payer: Aetna Commercial |
$236.95
|
| Rate for Payer: BCBS Trust/PPO |
$215.43
|
| Rate for Payer: BCN Commercial |
$215.43
|
| Rate for Payer: Cash Price |
$223.02
|
| Rate for Payer: Cofinity Commercial |
$239.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.02
|
| Rate for Payer: Healthscope Commercial |
$250.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$209.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$236.95
|
| Rate for Payer: PHP Commercial |
$236.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$242.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.32
|
| Rate for Payer: UHC Core |
$232.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$209.08
|
|
|
HC XR SMALL BOWEL.
|
Facility
|
OP
|
$278.77
|
|
|
Service Code
|
CPT 74248
|
| Hospital Charge Code |
32000331
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$66.21 |
| Max. Negotiated Rate |
$250.89 |
| Rate for Payer: Aetna Commercial |
$236.95
|
| Rate for Payer: Aetna Medicare |
$72.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.12
|
| Rate for Payer: BCBS Complete |
$111.51
|
| Rate for Payer: BCBS MAPPO |
$69.69
|
| Rate for Payer: BCBS Trust/PPO |
$216.74
|
| Rate for Payer: BCN Commercial |
$216.74
|
| Rate for Payer: BCN Medicare Advantage |
$69.69
|
| Rate for Payer: Cash Price |
$223.02
|
| Rate for Payer: Cofinity Commercial |
$239.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.69
|
| Rate for Payer: Healthscope Commercial |
$250.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$209.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$73.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$236.95
|
| Rate for Payer: PACE Senior Care Partners |
$66.21
|
| Rate for Payer: PACE SWMI |
$69.69
|
| Rate for Payer: PHP Commercial |
$236.95
|
| Rate for Payer: PHP Medicare Advantage |
$69.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$242.53
|
| Rate for Payer: Priority Health Medicare |
$69.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.02
|
| Rate for Payer: Railroad Medicare Medicare |
$69.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.32
|
| Rate for Payer: UHC Core |
$232.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.69
|
| Rate for Payer: UHC Medicare Advantage |
$71.78
|
| Rate for Payer: VA VA |
$69.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$209.08
|
|
|
HC XR SMALL BOWEL ENTEROCLYSIS TU
|
Facility
|
OP
|
$800.53
|
|
|
Service Code
|
CPT 74251
|
| Hospital Charge Code |
32000145
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$120.53 |
| Max. Negotiated Rate |
$720.48 |
| Rate for Payer: Aetna Commercial |
$680.45
|
| Rate for Payer: Aetna Medicare |
$208.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$250.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$250.17
|
| Rate for Payer: BCBS Complete |
$126.56
|
| Rate for Payer: BCBS MAPPO |
$200.13
|
| Rate for Payer: BCBS Trust/PPO |
$622.41
|
| Rate for Payer: BCN Commercial |
$622.41
|
| Rate for Payer: BCN Medicare Advantage |
$200.13
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$688.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.13
|
| Rate for Payer: Healthscope Commercial |
$720.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.40
|
| Rate for Payer: Mclaren Medicaid |
$120.53
|
| Rate for Payer: Meridian Medicaid |
$126.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$210.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$230.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: PACE Senior Care Partners |
$190.13
|
| Rate for Payer: PACE SWMI |
$200.13
|
| Rate for Payer: PHP Commercial |
$680.45
|
| Rate for Payer: PHP Medicare Advantage |
$200.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$696.46
|
| Rate for Payer: Priority Health Medicare |
$200.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.24
|
| Rate for Payer: Railroad Medicare Medicare |
$200.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$704.47
|
| Rate for Payer: UHC Core |
$668.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$200.13
|
| Rate for Payer: UHC Medicare Advantage |
$206.14
|
| Rate for Payer: VA VA |
$200.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.40
|
|
|
HC XR SMALL BOWEL ENTEROCLYSIS TU
|
Facility
|
IP
|
$800.53
|
|
|
Service Code
|
CPT 74251
|
| Hospital Charge Code |
32000145
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$488.24 |
| Max. Negotiated Rate |
$720.48 |
| Rate for Payer: Aetna Commercial |
$680.45
|
| Rate for Payer: BCBS Trust/PPO |
$618.65
|
| Rate for Payer: BCN Commercial |
$618.65
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$688.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Healthscope Commercial |
$720.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: PHP Commercial |
$680.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$696.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$704.47
|
| Rate for Payer: UHC Core |
$668.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.40
|
|
|
HC XR SOFT TISSUE NECK
|
Facility
|
OP
|
$304.45
|
|
|
Service Code
|
CPT 70360
|
| Hospital Charge Code |
32000023
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$274.00 |
| Rate for Payer: Aetna Commercial |
$258.78
|
| Rate for Payer: Aetna Medicare |
$79.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95.14
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$76.11
|
| Rate for Payer: BCBS Trust/PPO |
$236.71
|
| Rate for Payer: BCN Commercial |
$236.71
|
| Rate for Payer: BCN Medicare Advantage |
$76.11
|
| Rate for Payer: Cash Price |
$243.56
|
| Rate for Payer: Cash Price |
$243.56
|
| Rate for Payer: Cofinity Commercial |
$261.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.11
|
| Rate for Payer: Healthscope Commercial |
$274.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.34
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$79.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$258.78
|
| Rate for Payer: PACE Senior Care Partners |
$72.31
|
| Rate for Payer: PACE SWMI |
$76.11
|
| Rate for Payer: PHP Commercial |
$258.78
|
| Rate for Payer: PHP Medicare Advantage |
$76.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$264.87
|
| Rate for Payer: Priority Health Medicare |
$76.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$185.68
|
| Rate for Payer: Railroad Medicare Medicare |
$76.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$267.92
|
| Rate for Payer: UHC Core |
$254.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.11
|
| Rate for Payer: UHC Medicare Advantage |
$78.40
|
| Rate for Payer: VA VA |
$76.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.34
|
|
|
HC XR SOFT TISSUE NECK
|
Facility
|
IP
|
$304.45
|
|
|
Service Code
|
CPT 70360
|
| Hospital Charge Code |
32000023
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$185.68 |
| Max. Negotiated Rate |
$274.00 |
| Rate for Payer: Aetna Commercial |
$258.78
|
| Rate for Payer: BCBS Trust/PPO |
$235.28
|
| Rate for Payer: BCN Commercial |
$235.28
|
| Rate for Payer: Cash Price |
$243.56
|
| Rate for Payer: Cofinity Commercial |
$261.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.56
|
| Rate for Payer: Healthscope Commercial |
$274.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$258.78
|
| Rate for Payer: PHP Commercial |
$258.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$264.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$185.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$267.92
|
| Rate for Payer: UHC Core |
$254.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.34
|
|
|
HC XR SPECIMEN X-RAY
|
Facility
|
OP
|
$206.67
|
|
|
Service Code
|
CPT 76098
|
| Hospital Charge Code |
32000237
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$43.13 |
| Max. Negotiated Rate |
$379.99 |
| Rate for Payer: Aetna Commercial |
$175.67
|
| Rate for Payer: Aetna Medicare |
$53.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.58
|
| Rate for Payer: BCBS Complete |
$379.99
|
| Rate for Payer: BCBS MAPPO |
$51.67
|
| Rate for Payer: BCBS Trust/PPO |
$160.69
|
| Rate for Payer: BCCCP Commercial |
$43.13
|
| Rate for Payer: BCN Commercial |
$160.69
|
| Rate for Payer: BCN Medicare Advantage |
$51.67
|
| Rate for Payer: Cash Price |
$165.34
|
| Rate for Payer: Cash Price |
$165.34
|
| Rate for Payer: Cofinity Commercial |
$177.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.67
|
| Rate for Payer: Healthscope Commercial |
$186.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.00
|
| Rate for Payer: Mclaren Medicaid |
$361.89
|
| Rate for Payer: Meridian Medicaid |
$379.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$54.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$175.67
|
| Rate for Payer: PACE Senior Care Partners |
$49.08
|
| Rate for Payer: PACE SWMI |
$51.67
|
| Rate for Payer: PHP Commercial |
$175.67
|
| Rate for Payer: PHP Medicare Advantage |
$51.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$361.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.80
|
| Rate for Payer: Priority Health Medicare |
$51.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.05
|
| Rate for Payer: Railroad Medicare Medicare |
$51.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.87
|
| Rate for Payer: UHC Core |
$172.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.67
|
| Rate for Payer: UHC Medicare Advantage |
$53.22
|
| Rate for Payer: VA VA |
$51.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.00
|
|
|
HC XR SPECIMEN X-RAY
|
Facility
|
IP
|
$206.67
|
|
|
Service Code
|
CPT 76098
|
| Hospital Charge Code |
32000237
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$126.05 |
| Max. Negotiated Rate |
$186.00 |
| Rate for Payer: Aetna Commercial |
$175.67
|
| Rate for Payer: BCBS Trust/PPO |
$159.71
|
| Rate for Payer: BCN Commercial |
$159.71
|
| Rate for Payer: Cash Price |
$165.34
|
| Rate for Payer: Cofinity Commercial |
$177.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.34
|
| Rate for Payer: Healthscope Commercial |
$186.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$175.67
|
| Rate for Payer: PHP Commercial |
$175.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.87
|
| Rate for Payer: UHC Core |
$172.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.00
|
|
|
HC XR SPINE CERV 6VW OR MORE
|
Facility
|
OP
|
$500.38
|
|
|
Service Code
|
CPT 72052
|
| Hospital Charge Code |
32000037
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$450.34 |
| Rate for Payer: Aetna Commercial |
$425.32
|
| Rate for Payer: Aetna Medicare |
$130.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$156.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$156.37
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$125.10
|
| Rate for Payer: BCBS Trust/PPO |
$389.05
|
| Rate for Payer: BCN Commercial |
$389.05
|
| Rate for Payer: BCN Medicare Advantage |
$125.10
|
| Rate for Payer: Cash Price |
$400.30
|
| Rate for Payer: Cash Price |
$400.30
|
| Rate for Payer: Cofinity Commercial |
$430.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.10
|
| Rate for Payer: Healthscope Commercial |
$450.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.28
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$131.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$143.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$425.32
|
| Rate for Payer: PACE Senior Care Partners |
$118.84
|
| Rate for Payer: PACE SWMI |
$125.10
|
| Rate for Payer: PHP Commercial |
$425.32
|
| Rate for Payer: PHP Medicare Advantage |
$125.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$435.33
|
| Rate for Payer: Priority Health Medicare |
$125.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$305.18
|
| Rate for Payer: Railroad Medicare Medicare |
$125.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.33
|
| Rate for Payer: UHC Core |
$417.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.10
|
| Rate for Payer: UHC Medicare Advantage |
$128.85
|
| Rate for Payer: VA VA |
$125.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.28
|
|
|
HC XR SPINE CERV 6VW OR MORE
|
Facility
|
IP
|
$500.38
|
|
|
Service Code
|
CPT 72052
|
| Hospital Charge Code |
32000037
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$305.18 |
| Max. Negotiated Rate |
$450.34 |
| Rate for Payer: Aetna Commercial |
$425.32
|
| Rate for Payer: BCBS Trust/PPO |
$386.69
|
| Rate for Payer: BCN Commercial |
$386.69
|
| Rate for Payer: Cash Price |
$400.30
|
| Rate for Payer: Cofinity Commercial |
$430.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.30
|
| Rate for Payer: Healthscope Commercial |
$450.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$425.32
|
| Rate for Payer: PHP Commercial |
$425.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$435.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$305.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.33
|
| Rate for Payer: UHC Core |
$417.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.28
|
|
|
HC XR SPINE CERVICAL 3VW OR LESS
|
Facility
|
OP
|
$370.48
|
|
|
Service Code
|
CPT 72040
|
| Hospital Charge Code |
32000035
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$333.43 |
| Rate for Payer: Aetna Commercial |
$314.91
|
| Rate for Payer: Aetna Medicare |
$96.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$115.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$115.78
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$92.62
|
| Rate for Payer: BCBS Trust/PPO |
$288.05
|
| Rate for Payer: BCN Commercial |
$288.05
|
| Rate for Payer: BCN Medicare Advantage |
$92.62
|
| Rate for Payer: Cash Price |
$296.38
|
| Rate for Payer: Cash Price |
$296.38
|
| Rate for Payer: Cofinity Commercial |
$318.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.62
|
| Rate for Payer: Healthscope Commercial |
$333.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.86
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$97.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$106.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$314.91
|
| Rate for Payer: PACE Senior Care Partners |
$87.99
|
| Rate for Payer: PACE SWMI |
$92.62
|
| Rate for Payer: PHP Commercial |
$314.91
|
| Rate for Payer: PHP Medicare Advantage |
$92.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$322.32
|
| Rate for Payer: Priority Health Medicare |
$92.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$225.96
|
| Rate for Payer: Railroad Medicare Medicare |
$92.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.02
|
| Rate for Payer: UHC Core |
$309.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.62
|
| Rate for Payer: UHC Medicare Advantage |
$95.40
|
| Rate for Payer: VA VA |
$92.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.86
|
|
|
HC XR SPINE CERVICAL 3VW OR LESS
|
Facility
|
IP
|
$370.48
|
|
|
Service Code
|
CPT 72040
|
| Hospital Charge Code |
32000035
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$225.96 |
| Max. Negotiated Rate |
$333.43 |
| Rate for Payer: Aetna Commercial |
$314.91
|
| Rate for Payer: BCBS Trust/PPO |
$286.31
|
| Rate for Payer: BCN Commercial |
$286.31
|
| Rate for Payer: Cash Price |
$296.38
|
| Rate for Payer: Cofinity Commercial |
$318.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.38
|
| Rate for Payer: Healthscope Commercial |
$333.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$314.91
|
| Rate for Payer: PHP Commercial |
$314.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$322.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$225.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.02
|
| Rate for Payer: UHC Core |
$309.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.86
|
|
|
HC XR SPINE CERVICAL 4 OR 5 VW
|
Facility
|
IP
|
$460.41
|
|
|
Service Code
|
CPT 72050
|
| Hospital Charge Code |
32000036
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$280.80 |
| Max. Negotiated Rate |
$414.37 |
| Rate for Payer: Aetna Commercial |
$391.35
|
| Rate for Payer: BCBS Trust/PPO |
$355.80
|
| Rate for Payer: BCN Commercial |
$355.80
|
| Rate for Payer: Cash Price |
$368.33
|
| Rate for Payer: Cofinity Commercial |
$395.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.33
|
| Rate for Payer: Healthscope Commercial |
$414.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$345.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$391.35
|
| Rate for Payer: PHP Commercial |
$391.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$322.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$400.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$280.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$405.16
|
| Rate for Payer: UHC Core |
$384.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$345.31
|
|
|
HC XR SPINE CERVICAL 4 OR 5 VW
|
Facility
|
OP
|
$460.41
|
|
|
Service Code
|
CPT 72050
|
| Hospital Charge Code |
32000036
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$414.37 |
| Rate for Payer: Aetna Commercial |
$391.35
|
| Rate for Payer: Aetna Medicare |
$119.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$143.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$143.88
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$115.10
|
| Rate for Payer: BCBS Trust/PPO |
$357.97
|
| Rate for Payer: BCN Commercial |
$357.97
|
| Rate for Payer: BCN Medicare Advantage |
$115.10
|
| Rate for Payer: Cash Price |
$368.33
|
| Rate for Payer: Cash Price |
$368.33
|
| Rate for Payer: Cofinity Commercial |
$395.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.10
|
| Rate for Payer: Healthscope Commercial |
$414.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$345.31
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$120.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$132.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$391.35
|
| Rate for Payer: PACE Senior Care Partners |
$109.35
|
| Rate for Payer: PACE SWMI |
$115.10
|
| Rate for Payer: PHP Commercial |
$391.35
|
| Rate for Payer: PHP Medicare Advantage |
$115.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$322.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$400.56
|
| Rate for Payer: Priority Health Medicare |
$115.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$280.80
|
| Rate for Payer: Railroad Medicare Medicare |
$115.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$405.16
|
| Rate for Payer: UHC Core |
$384.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.10
|
| Rate for Payer: UHC Medicare Advantage |
$118.56
|
| Rate for Payer: VA VA |
$115.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$345.31
|
|
|
HC XR SPINE LUMBAR 2 OR 3 VW
|
Facility
|
OP
|
$400.20
|
|
|
Service Code
|
CPT 72100
|
| Hospital Charge Code |
32000044
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$360.18 |
| Rate for Payer: Aetna Commercial |
$340.17
|
| Rate for Payer: Aetna Medicare |
$104.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$125.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$125.06
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$100.05
|
| Rate for Payer: BCBS Trust/PPO |
$311.16
|
| Rate for Payer: BCN Commercial |
$311.16
|
| Rate for Payer: BCN Medicare Advantage |
$100.05
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cofinity Commercial |
$344.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.05
|
| Rate for Payer: Healthscope Commercial |
$360.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.15
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$105.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$115.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.17
|
| Rate for Payer: PACE Senior Care Partners |
$95.05
|
| Rate for Payer: PACE SWMI |
$100.05
|
| Rate for Payer: PHP Commercial |
$340.17
|
| Rate for Payer: PHP Medicare Advantage |
$100.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$348.17
|
| Rate for Payer: Priority Health Medicare |
$100.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.08
|
| Rate for Payer: Railroad Medicare Medicare |
$100.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.18
|
| Rate for Payer: UHC Core |
$334.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.05
|
| Rate for Payer: UHC Medicare Advantage |
$103.05
|
| Rate for Payer: VA VA |
$100.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.15
|
|
|
HC XR SPINE LUMBAR 2 OR 3 VW
|
Facility
|
IP
|
$400.20
|
|
|
Service Code
|
CPT 72100
|
| Hospital Charge Code |
32000044
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$244.08 |
| Max. Negotiated Rate |
$360.18 |
| Rate for Payer: Aetna Commercial |
$340.17
|
| Rate for Payer: BCBS Trust/PPO |
$309.27
|
| Rate for Payer: BCN Commercial |
$309.27
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cofinity Commercial |
$344.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.16
|
| Rate for Payer: Healthscope Commercial |
$360.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.17
|
| Rate for Payer: PHP Commercial |
$340.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$348.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.18
|
| Rate for Payer: UHC Core |
$334.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.15
|
|
|
HC XR SPINE LUMBAR BENDING ONLY 4
|
Facility
|
IP
|
$381.09
|
|
|
Service Code
|
CPT 72120
|
| Hospital Charge Code |
32000047
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$232.43 |
| Max. Negotiated Rate |
$342.98 |
| Rate for Payer: Aetna Commercial |
$323.93
|
| Rate for Payer: BCBS Trust/PPO |
$294.51
|
| Rate for Payer: BCN Commercial |
$294.51
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$327.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: PHP Commercial |
$323.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$331.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$232.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.36
|
| Rate for Payer: UHC Core |
$318.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
|
HC XR SPINE LUMBAR BENDING ONLY 4
|
Facility
|
OP
|
$381.09
|
|
|
Service Code
|
CPT 72120
|
| Hospital Charge Code |
32000047
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$342.98 |
| Rate for Payer: Aetna Commercial |
$323.93
|
| Rate for Payer: Aetna Medicare |
$99.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$119.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$119.09
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$95.27
|
| Rate for Payer: BCBS Trust/PPO |
$296.30
|
| Rate for Payer: BCN Commercial |
$296.30
|
| Rate for Payer: BCN Medicare Advantage |
$95.27
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$327.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.27
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$100.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: PACE Senior Care Partners |
$90.51
|
| Rate for Payer: PACE SWMI |
$95.27
|
| Rate for Payer: PHP Commercial |
$323.93
|
| Rate for Payer: PHP Medicare Advantage |
$95.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$331.55
|
| Rate for Payer: Priority Health Medicare |
$95.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$232.43
|
| Rate for Payer: Railroad Medicare Medicare |
$95.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.36
|
| Rate for Payer: UHC Core |
$318.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.27
|
| Rate for Payer: UHC Medicare Advantage |
$98.13
|
| Rate for Payer: VA VA |
$95.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
