|
HC SPEECH EVAL
|
Facility
|
IP
|
$667.13
|
|
|
Service Code
|
CPT 92523
|
| Hospital Charge Code |
44400009
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$464.32 |
| Max. Negotiated Rate |
$600.42 |
| Rate for Payer: Aetna Commercial |
$567.06
|
| Rate for Payer: BCBS Trust/PPO |
$550.98
|
| Rate for Payer: BCN Commercial |
$550.98
|
| Rate for Payer: Cash Price |
$533.70
|
| Rate for Payer: Cofinity Commercial |
$573.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$533.70
|
| Rate for Payer: Healthscope Commercial |
$600.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$500.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$567.06
|
| Rate for Payer: Nomi Health Commercial |
$547.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$500.35
|
| Rate for Payer: PHP Commercial |
$567.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$580.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$464.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$587.07
|
| Rate for Payer: UHC Core |
$557.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$500.35
|
|
|
HC SPEECH FLUENCY EVAL
|
Facility
|
OP
|
$354.68
|
|
|
Service Code
|
CPT 92521
|
| Hospital Charge Code |
44400012
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$62.53 |
| Max. Negotiated Rate |
$319.21 |
| Rate for Payer: Aetna Commercial |
$301.48
|
| Rate for Payer: Aetna Medicare |
$92.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$110.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$110.84
|
| Rate for Payer: BCBS Complete |
$65.65
|
| Rate for Payer: BCBS MAPPO |
$88.67
|
| Rate for Payer: BCBS Trust/PPO |
$291.58
|
| Rate for Payer: BCN Commercial |
$291.58
|
| Rate for Payer: BCN Medicare Advantage |
$88.67
|
| Rate for Payer: Cash Price |
$283.74
|
| Rate for Payer: Cofinity Commercial |
$305.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.67
|
| Rate for Payer: Healthscope Commercial |
$319.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.01
|
| Rate for Payer: Mclaren Medicaid |
$62.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.10
|
| Rate for Payer: Meridian Medicaid |
$65.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$101.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$97.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$301.48
|
| Rate for Payer: Nomi Health Commercial |
$290.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$266.01
|
| Rate for Payer: PACE Senior Care Partners |
$84.24
|
| Rate for Payer: PACE SWMI |
$88.67
|
| Rate for Payer: PHP Commercial |
$301.48
|
| Rate for Payer: PHP Medicare Advantage |
$88.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$308.57
|
| Rate for Payer: Priority Health Medicare |
$89.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$246.86
|
| Rate for Payer: Railroad Medicare Medicare |
$88.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$312.12
|
| Rate for Payer: UHC Core |
$296.16
|
| Rate for Payer: UHC Exchange |
$88.67
|
| Rate for Payer: UHC Medicaid |
$62.53
|
| Rate for Payer: UHC Medicare Advantage |
$88.67
|
| Rate for Payer: UHCCP Medicaid |
$62.53
|
| Rate for Payer: VA VA |
$88.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.01
|
|
|
HC SPEECH FLUENCY EVAL
|
Facility
|
IP
|
$354.68
|
|
|
Service Code
|
CPT 92521
|
| Hospital Charge Code |
44400012
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$246.86 |
| Max. Negotiated Rate |
$319.21 |
| Rate for Payer: Aetna Commercial |
$301.48
|
| Rate for Payer: BCBS Trust/PPO |
$292.93
|
| Rate for Payer: BCN Commercial |
$292.93
|
| Rate for Payer: Cash Price |
$283.74
|
| Rate for Payer: Cofinity Commercial |
$305.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.74
|
| Rate for Payer: Healthscope Commercial |
$319.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$301.48
|
| Rate for Payer: Nomi Health Commercial |
$290.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$266.01
|
| Rate for Payer: PHP Commercial |
$301.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$308.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$246.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$312.12
|
| Rate for Payer: UHC Core |
$296.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.01
|
|
|
HC SPEECH/LANGUAGE/HEARING THERAPY
|
Facility
|
IP
|
$223.98
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
44000001
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$155.89 |
| Max. Negotiated Rate |
$201.58 |
| Rate for Payer: Aetna Commercial |
$190.38
|
| Rate for Payer: BCBS Trust/PPO |
$184.99
|
| Rate for Payer: BCN Commercial |
$184.99
|
| Rate for Payer: Cash Price |
$179.18
|
| Rate for Payer: Cofinity Commercial |
$192.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.18
|
| Rate for Payer: Healthscope Commercial |
$201.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.38
|
| Rate for Payer: Nomi Health Commercial |
$183.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.99
|
| Rate for Payer: PHP Commercial |
$190.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$194.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.10
|
| Rate for Payer: UHC Core |
$187.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.99
|
|
|
HC SPEECH/LANGUAGE/HEARING THERAPY
|
Facility
|
OP
|
$223.98
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
44000001
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$39.49 |
| Max. Negotiated Rate |
$201.58 |
| Rate for Payer: Aetna Commercial |
$190.38
|
| Rate for Payer: Aetna Medicare |
$58.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.99
|
| Rate for Payer: BCBS Complete |
$41.46
|
| Rate for Payer: BCBS MAPPO |
$55.99
|
| Rate for Payer: BCBS Trust/PPO |
$184.13
|
| Rate for Payer: BCN Commercial |
$184.13
|
| Rate for Payer: BCN Medicare Advantage |
$55.99
|
| Rate for Payer: Cash Price |
$179.18
|
| Rate for Payer: Cofinity Commercial |
$192.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.99
|
| Rate for Payer: Healthscope Commercial |
$201.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.99
|
| Rate for Payer: Mclaren Medicaid |
$39.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.79
|
| Rate for Payer: Meridian Medicaid |
$41.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$61.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.38
|
| Rate for Payer: Nomi Health Commercial |
$183.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.99
|
| Rate for Payer: PACE Senior Care Partners |
$53.20
|
| Rate for Payer: PACE SWMI |
$55.99
|
| Rate for Payer: PHP Commercial |
$190.38
|
| Rate for Payer: PHP Medicare Advantage |
$55.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$194.86
|
| Rate for Payer: Priority Health Medicare |
$56.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.89
|
| Rate for Payer: Railroad Medicare Medicare |
$55.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.10
|
| Rate for Payer: UHC Core |
$187.02
|
| Rate for Payer: UHC Exchange |
$55.99
|
| Rate for Payer: UHC Medicaid |
$39.49
|
| Rate for Payer: UHC Medicare Advantage |
$55.99
|
| Rate for Payer: UHCCP Medicaid |
$39.49
|
| Rate for Payer: VA VA |
$55.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.99
|
|
|
HC SPEECH SOUND PRODUCTION EVAL
|
Facility
|
IP
|
$311.47
|
|
|
Service Code
|
CPT 92522
|
| Hospital Charge Code |
44400010
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$216.78 |
| Max. Negotiated Rate |
$280.32 |
| Rate for Payer: Aetna Commercial |
$264.75
|
| Rate for Payer: BCBS Trust/PPO |
$257.24
|
| Rate for Payer: BCN Commercial |
$257.24
|
| Rate for Payer: Cash Price |
$249.18
|
| Rate for Payer: Cofinity Commercial |
$267.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.18
|
| Rate for Payer: Healthscope Commercial |
$280.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$233.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$264.75
|
| Rate for Payer: Nomi Health Commercial |
$255.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$233.60
|
| Rate for Payer: PHP Commercial |
$264.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$270.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$216.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$274.09
|
| Rate for Payer: UHC Core |
$260.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$233.60
|
|
|
HC SPEECH SOUND PRODUCTION EVAL
|
Facility
|
OP
|
$311.47
|
|
|
Service Code
|
CPT 92522
|
| Hospital Charge Code |
44400010
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$54.91 |
| Max. Negotiated Rate |
$280.32 |
| Rate for Payer: Aetna Commercial |
$264.75
|
| Rate for Payer: Aetna Medicare |
$80.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$97.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$97.33
|
| Rate for Payer: BCBS Complete |
$57.65
|
| Rate for Payer: BCBS MAPPO |
$77.87
|
| Rate for Payer: BCBS Trust/PPO |
$256.06
|
| Rate for Payer: BCN Commercial |
$256.06
|
| Rate for Payer: BCN Medicare Advantage |
$77.87
|
| Rate for Payer: Cash Price |
$249.18
|
| Rate for Payer: Cofinity Commercial |
$267.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.87
|
| Rate for Payer: Healthscope Commercial |
$280.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$233.60
|
| Rate for Payer: Mclaren Medicaid |
$54.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.76
|
| Rate for Payer: Meridian Medicaid |
$57.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$85.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$264.75
|
| Rate for Payer: Nomi Health Commercial |
$255.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$233.60
|
| Rate for Payer: PACE Senior Care Partners |
$73.97
|
| Rate for Payer: PACE SWMI |
$77.87
|
| Rate for Payer: PHP Commercial |
$264.75
|
| Rate for Payer: PHP Medicare Advantage |
$77.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$270.98
|
| Rate for Payer: Priority Health Medicare |
$78.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$216.78
|
| Rate for Payer: Railroad Medicare Medicare |
$77.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$274.09
|
| Rate for Payer: UHC Core |
$260.08
|
| Rate for Payer: UHC Exchange |
$77.87
|
| Rate for Payer: UHC Medicaid |
$54.91
|
| Rate for Payer: UHC Medicare Advantage |
$77.87
|
| Rate for Payer: UHCCP Medicaid |
$54.91
|
| Rate for Payer: VA VA |
$77.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$233.60
|
|
|
HC SPEECH THRESHOLD AUDIOMETRY
|
Facility
|
IP
|
$51.12
|
|
|
Service Code
|
CPT 92555
|
| Hospital Charge Code |
47100011
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$35.58 |
| Max. Negotiated Rate |
$46.01 |
| Rate for Payer: Aetna Commercial |
$43.45
|
| Rate for Payer: BCBS Trust/PPO |
$42.22
|
| Rate for Payer: BCN Commercial |
$42.22
|
| Rate for Payer: Cash Price |
$40.90
|
| Rate for Payer: Cofinity Commercial |
$43.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.90
|
| Rate for Payer: Healthscope Commercial |
$46.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.45
|
| Rate for Payer: Nomi Health Commercial |
$41.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.34
|
| Rate for Payer: PHP Commercial |
$43.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.99
|
| Rate for Payer: UHC Core |
$42.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.34
|
|
|
HC SPEECH THRESHOLD AUDIOMETRY
|
Facility
|
OP
|
$51.12
|
|
|
Service Code
|
CPT 92555
|
| Hospital Charge Code |
47100011
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$9.01 |
| Max. Negotiated Rate |
$46.01 |
| Rate for Payer: Aetna Commercial |
$43.45
|
| Rate for Payer: Aetna Medicare |
$13.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.97
|
| Rate for Payer: BCBS Complete |
$9.46
|
| Rate for Payer: BCBS MAPPO |
$12.78
|
| Rate for Payer: BCBS Trust/PPO |
$42.03
|
| Rate for Payer: BCN Commercial |
$42.03
|
| Rate for Payer: BCN Medicare Advantage |
$12.78
|
| Rate for Payer: Cash Price |
$40.90
|
| Rate for Payer: Cofinity Commercial |
$43.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.78
|
| Rate for Payer: Healthscope Commercial |
$46.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.34
|
| Rate for Payer: Mclaren Medicaid |
$9.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.42
|
| Rate for Payer: Meridian Medicaid |
$9.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.45
|
| Rate for Payer: Nomi Health Commercial |
$41.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.34
|
| Rate for Payer: PACE Senior Care Partners |
$12.14
|
| Rate for Payer: PACE SWMI |
$12.78
|
| Rate for Payer: PHP Commercial |
$43.45
|
| Rate for Payer: PHP Medicare Advantage |
$12.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.47
|
| Rate for Payer: Priority Health Medicare |
$12.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.58
|
| Rate for Payer: Railroad Medicare Medicare |
$12.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.99
|
| Rate for Payer: UHC Core |
$42.69
|
| Rate for Payer: UHC Exchange |
$12.78
|
| Rate for Payer: UHC Medicaid |
$9.01
|
| Rate for Payer: UHC Medicare Advantage |
$12.78
|
| Rate for Payer: UHCCP Medicaid |
$9.01
|
| Rate for Payer: VA VA |
$12.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.34
|
|
|
HC SPEECH VIDEO FLUORO EVAL
|
Facility
|
IP
|
$404.95
|
|
|
Service Code
|
CPT 92611
|
| Hospital Charge Code |
44000004
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$281.85 |
| Max. Negotiated Rate |
$364.45 |
| Rate for Payer: Aetna Commercial |
$344.21
|
| Rate for Payer: BCBS Trust/PPO |
$334.45
|
| Rate for Payer: BCN Commercial |
$334.45
|
| Rate for Payer: Cash Price |
$323.96
|
| Rate for Payer: Cofinity Commercial |
$348.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$323.96
|
| Rate for Payer: Healthscope Commercial |
$364.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$303.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$344.21
|
| Rate for Payer: Nomi Health Commercial |
$332.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.71
|
| Rate for Payer: PHP Commercial |
$344.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$352.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$281.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.36
|
| Rate for Payer: UHC Core |
$338.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$303.71
|
|
|
HC SPEECH VIDEO FLUORO EVAL
|
Facility
|
OP
|
$404.95
|
|
|
Service Code
|
CPT 92611
|
| Hospital Charge Code |
44000004
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$71.39 |
| Max. Negotiated Rate |
$364.45 |
| Rate for Payer: Aetna Commercial |
$344.21
|
| Rate for Payer: Aetna Medicare |
$105.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$126.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$126.55
|
| Rate for Payer: BCBS Complete |
$74.96
|
| Rate for Payer: BCBS MAPPO |
$101.24
|
| Rate for Payer: BCBS Trust/PPO |
$332.91
|
| Rate for Payer: BCN Commercial |
$332.91
|
| Rate for Payer: BCN Medicare Advantage |
$101.24
|
| Rate for Payer: Cash Price |
$323.96
|
| Rate for Payer: Cofinity Commercial |
$348.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$323.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.24
|
| Rate for Payer: Healthscope Commercial |
$364.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$303.71
|
| Rate for Payer: Mclaren Medicaid |
$71.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.30
|
| Rate for Payer: Meridian Medicaid |
$74.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$344.21
|
| Rate for Payer: Nomi Health Commercial |
$332.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.71
|
| Rate for Payer: PACE Senior Care Partners |
$96.18
|
| Rate for Payer: PACE SWMI |
$101.24
|
| Rate for Payer: PHP Commercial |
$344.21
|
| Rate for Payer: PHP Medicare Advantage |
$101.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$352.31
|
| Rate for Payer: Priority Health Medicare |
$102.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$281.85
|
| Rate for Payer: Railroad Medicare Medicare |
$101.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.36
|
| Rate for Payer: UHC Core |
$338.13
|
| Rate for Payer: UHC Exchange |
$101.24
|
| Rate for Payer: UHC Medicaid |
$71.39
|
| Rate for Payer: UHC Medicare Advantage |
$101.24
|
| Rate for Payer: UHCCP Medicaid |
$71.39
|
| Rate for Payer: VA VA |
$101.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$303.71
|
|
|
HC SPEECH VOICE EVALUATION
|
Facility
|
IP
|
$318.60
|
|
|
Service Code
|
CPT 92524
|
| Hospital Charge Code |
44400011
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$221.75 |
| Max. Negotiated Rate |
$286.74 |
| Rate for Payer: Aetna Commercial |
$270.81
|
| Rate for Payer: BCBS Trust/PPO |
$263.13
|
| Rate for Payer: BCN Commercial |
$263.13
|
| Rate for Payer: Cash Price |
$254.88
|
| Rate for Payer: Cofinity Commercial |
$274.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$254.88
|
| Rate for Payer: Healthscope Commercial |
$286.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$238.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$270.81
|
| Rate for Payer: Nomi Health Commercial |
$261.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$238.95
|
| Rate for Payer: PHP Commercial |
$270.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$277.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$221.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$280.37
|
| Rate for Payer: UHC Core |
$266.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$238.95
|
|
|
HC SPEECH VOICE EVALUATION
|
Facility
|
OP
|
$318.60
|
|
|
Service Code
|
CPT 92524
|
| Hospital Charge Code |
44400011
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$56.17 |
| Max. Negotiated Rate |
$286.74 |
| Rate for Payer: Aetna Commercial |
$270.81
|
| Rate for Payer: Aetna Medicare |
$82.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$99.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$99.56
|
| Rate for Payer: BCBS Complete |
$58.97
|
| Rate for Payer: BCBS MAPPO |
$79.65
|
| Rate for Payer: BCBS Trust/PPO |
$261.92
|
| Rate for Payer: BCN Commercial |
$261.92
|
| Rate for Payer: BCN Medicare Advantage |
$79.65
|
| Rate for Payer: Cash Price |
$254.88
|
| Rate for Payer: Cofinity Commercial |
$274.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$254.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.65
|
| Rate for Payer: Healthscope Commercial |
$286.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$238.95
|
| Rate for Payer: Mclaren Medicaid |
$56.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.63
|
| Rate for Payer: Meridian Medicaid |
$58.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$91.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$87.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$270.81
|
| Rate for Payer: Nomi Health Commercial |
$261.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$238.95
|
| Rate for Payer: PACE Senior Care Partners |
$75.67
|
| Rate for Payer: PACE SWMI |
$79.65
|
| Rate for Payer: PHP Commercial |
$270.81
|
| Rate for Payer: PHP Medicare Advantage |
$79.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$277.18
|
| Rate for Payer: Priority Health Medicare |
$80.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$221.75
|
| Rate for Payer: Railroad Medicare Medicare |
$79.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$280.37
|
| Rate for Payer: UHC Core |
$266.03
|
| Rate for Payer: UHC Exchange |
$79.65
|
| Rate for Payer: UHC Medicaid |
$56.17
|
| Rate for Payer: UHC Medicare Advantage |
$79.65
|
| Rate for Payer: UHCCP Medicaid |
$56.17
|
| Rate for Payer: VA VA |
$79.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$238.95
|
|
|
HC SPIKE BLOOD ACCESS
|
Facility
|
IP
|
$16.39
|
|
| Hospital Charge Code |
27000669
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.41 |
| Max. Negotiated Rate |
$14.75 |
| Rate for Payer: Aetna Commercial |
$13.93
|
| Rate for Payer: BCBS Trust/PPO |
$13.54
|
| Rate for Payer: BCN Commercial |
$13.54
|
| Rate for Payer: Cash Price |
$13.11
|
| Rate for Payer: Cofinity Commercial |
$14.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.11
|
| Rate for Payer: Healthscope Commercial |
$14.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.93
|
| Rate for Payer: Nomi Health Commercial |
$13.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.29
|
| Rate for Payer: PHP Commercial |
$13.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.42
|
| Rate for Payer: UHC Core |
$13.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.29
|
|
|
HC SPIKE BLOOD ACCESS
|
Facility
|
OP
|
$16.39
|
|
| Hospital Charge Code |
27000669
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.89 |
| Max. Negotiated Rate |
$14.75 |
| Rate for Payer: Aetna Commercial |
$13.93
|
| Rate for Payer: Aetna Medicare |
$4.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.12
|
| Rate for Payer: BCBS Complete |
$3.03
|
| Rate for Payer: BCBS MAPPO |
$4.10
|
| Rate for Payer: BCBS Trust/PPO |
$13.47
|
| Rate for Payer: BCN Commercial |
$13.47
|
| Rate for Payer: BCN Medicare Advantage |
$4.10
|
| Rate for Payer: Cash Price |
$13.11
|
| Rate for Payer: Cofinity Commercial |
$14.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.10
|
| Rate for Payer: Healthscope Commercial |
$14.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.29
|
| Rate for Payer: Mclaren Medicaid |
$2.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.30
|
| Rate for Payer: Meridian Medicaid |
$3.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.93
|
| Rate for Payer: Nomi Health Commercial |
$13.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.29
|
| Rate for Payer: PACE Senior Care Partners |
$3.89
|
| Rate for Payer: PACE SWMI |
$4.10
|
| Rate for Payer: PHP Commercial |
$13.93
|
| Rate for Payer: PHP Medicare Advantage |
$4.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.26
|
| Rate for Payer: Priority Health Medicare |
$4.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.41
|
| Rate for Payer: Railroad Medicare Medicare |
$4.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.42
|
| Rate for Payer: UHC Core |
$13.69
|
| Rate for Payer: UHC Exchange |
$4.10
|
| Rate for Payer: UHC Medicaid |
$2.89
|
| Rate for Payer: UHC Medicare Advantage |
$4.10
|
| Rate for Payer: UHCCP Medicaid |
$2.89
|
| Rate for Payer: VA VA |
$4.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.29
|
|
|
HC SPINAL/EPI ADDL 15 MIN
|
Facility
|
OP
|
$162.90
|
|
| Hospital Charge Code |
37000013
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$28.72 |
| Max. Negotiated Rate |
$146.61 |
| Rate for Payer: Aetna Commercial |
$138.47
|
| Rate for Payer: Aetna Medicare |
$42.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.91
|
| Rate for Payer: BCBS Complete |
$30.15
|
| Rate for Payer: BCBS MAPPO |
$40.73
|
| Rate for Payer: BCBS Trust/PPO |
$133.92
|
| Rate for Payer: BCN Commercial |
$133.92
|
| Rate for Payer: BCN Medicare Advantage |
$40.73
|
| Rate for Payer: Cash Price |
$130.32
|
| Rate for Payer: Cofinity Commercial |
$140.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.73
|
| Rate for Payer: Healthscope Commercial |
$146.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.17
|
| Rate for Payer: Mclaren Medicaid |
$28.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.76
|
| Rate for Payer: Meridian Medicaid |
$30.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.47
|
| Rate for Payer: Nomi Health Commercial |
$133.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.17
|
| Rate for Payer: PACE Senior Care Partners |
$38.69
|
| Rate for Payer: PACE SWMI |
$40.73
|
| Rate for Payer: PHP Commercial |
$138.47
|
| Rate for Payer: PHP Medicare Advantage |
$40.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$141.72
|
| Rate for Payer: Priority Health Medicare |
$41.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.38
|
| Rate for Payer: Railroad Medicare Medicare |
$40.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.35
|
| Rate for Payer: UHC Core |
$136.02
|
| Rate for Payer: UHC Exchange |
$40.73
|
| Rate for Payer: UHC Medicaid |
$28.72
|
| Rate for Payer: UHC Medicare Advantage |
$40.73
|
| Rate for Payer: UHCCP Medicaid |
$28.72
|
| Rate for Payer: VA VA |
$40.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.17
|
|
|
HC SPINAL/EPI ADDL 15 MIN
|
Facility
|
IP
|
$162.90
|
|
| Hospital Charge Code |
37000013
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$113.38 |
| Max. Negotiated Rate |
$146.61 |
| Rate for Payer: Aetna Commercial |
$138.47
|
| Rate for Payer: BCBS Trust/PPO |
$134.54
|
| Rate for Payer: BCN Commercial |
$134.54
|
| Rate for Payer: Cash Price |
$130.32
|
| Rate for Payer: Cofinity Commercial |
$140.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.32
|
| Rate for Payer: Healthscope Commercial |
$146.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.47
|
| Rate for Payer: Nomi Health Commercial |
$133.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.17
|
| Rate for Payer: PHP Commercial |
$138.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$141.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.35
|
| Rate for Payer: UHC Core |
$136.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.17
|
|
|
HC SPINAL/EPI INIT 30 MIN
|
Facility
|
IP
|
$445.46
|
|
| Hospital Charge Code |
37000014
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$310.04 |
| Max. Negotiated Rate |
$400.91 |
| Rate for Payer: Aetna Commercial |
$378.64
|
| Rate for Payer: BCBS Trust/PPO |
$367.91
|
| Rate for Payer: BCN Commercial |
$367.91
|
| Rate for Payer: Cash Price |
$356.37
|
| Rate for Payer: Cofinity Commercial |
$383.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.37
|
| Rate for Payer: Healthscope Commercial |
$400.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$378.64
|
| Rate for Payer: Nomi Health Commercial |
$365.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.10
|
| Rate for Payer: PHP Commercial |
$378.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$387.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.00
|
| Rate for Payer: UHC Core |
$371.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.10
|
|
|
HC SPINAL/EPI INIT 30 MIN
|
Facility
|
OP
|
$445.46
|
|
| Hospital Charge Code |
37000014
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$78.53 |
| Max. Negotiated Rate |
$400.91 |
| Rate for Payer: Aetna Commercial |
$378.64
|
| Rate for Payer: Aetna Medicare |
$115.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$139.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$139.21
|
| Rate for Payer: BCBS Complete |
$82.45
|
| Rate for Payer: BCBS MAPPO |
$111.36
|
| Rate for Payer: BCBS Trust/PPO |
$366.21
|
| Rate for Payer: BCN Commercial |
$366.21
|
| Rate for Payer: BCN Medicare Advantage |
$111.36
|
| Rate for Payer: Cash Price |
$356.37
|
| Rate for Payer: Cofinity Commercial |
$383.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.36
|
| Rate for Payer: Healthscope Commercial |
$400.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.10
|
| Rate for Payer: Mclaren Medicaid |
$78.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$116.93
|
| Rate for Payer: Meridian Medicaid |
$82.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$122.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$378.64
|
| Rate for Payer: Nomi Health Commercial |
$365.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.10
|
| Rate for Payer: PACE Senior Care Partners |
$105.80
|
| Rate for Payer: PACE SWMI |
$111.36
|
| Rate for Payer: PHP Commercial |
$378.64
|
| Rate for Payer: PHP Medicare Advantage |
$111.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$387.55
|
| Rate for Payer: Priority Health Medicare |
$112.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.04
|
| Rate for Payer: Railroad Medicare Medicare |
$111.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.00
|
| Rate for Payer: UHC Core |
$371.96
|
| Rate for Payer: UHC Exchange |
$111.36
|
| Rate for Payer: UHC Medicaid |
$78.53
|
| Rate for Payer: UHC Medicare Advantage |
$111.36
|
| Rate for Payer: UHCCP Medicaid |
$78.53
|
| Rate for Payer: VA VA |
$111.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.10
|
|
|
HC SPINE JACK
|
Facility
|
IP
|
$14,401.38
|
|
|
Service Code
|
CPT C1062
|
| Hospital Charge Code |
27800148
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,023.36 |
| Max. Negotiated Rate |
$12,961.24 |
| Rate for Payer: Aetna Commercial |
$12,241.17
|
| Rate for Payer: BCBS Trust/PPO |
$11,894.10
|
| Rate for Payer: BCN Commercial |
$11,894.10
|
| Rate for Payer: Cash Price |
$11,521.10
|
| Rate for Payer: Cofinity Commercial |
$12,385.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,521.10
|
| Rate for Payer: Healthscope Commercial |
$12,961.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,801.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,241.17
|
| Rate for Payer: Nomi Health Commercial |
$11,809.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,801.03
|
| Rate for Payer: PHP Commercial |
$12,241.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12,529.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,023.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,673.21
|
| Rate for Payer: UHC Core |
$12,025.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,801.03
|
|
|
HC SPINE JACK
|
Facility
|
OP
|
$14,401.38
|
|
|
Service Code
|
CPT C1062
|
| Hospital Charge Code |
27800148
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,538.96 |
| Max. Negotiated Rate |
$12,961.24 |
| Rate for Payer: Aetna Commercial |
$12,241.17
|
| Rate for Payer: Aetna Medicare |
$3,744.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,500.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,500.43
|
| Rate for Payer: BCBS Complete |
$2,665.70
|
| Rate for Payer: BCBS MAPPO |
$3,600.34
|
| Rate for Payer: BCBS Trust/PPO |
$11,839.37
|
| Rate for Payer: BCN Commercial |
$11,839.37
|
| Rate for Payer: BCN Medicare Advantage |
$3,600.34
|
| Rate for Payer: Cash Price |
$11,521.10
|
| Rate for Payer: Cofinity Commercial |
$12,385.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,521.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,600.34
|
| Rate for Payer: Healthscope Commercial |
$12,961.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,801.03
|
| Rate for Payer: Mclaren Medicaid |
$2,538.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,780.36
|
| Rate for Payer: Meridian Medicaid |
$2,665.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,140.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,960.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,241.17
|
| Rate for Payer: Nomi Health Commercial |
$11,809.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,801.03
|
| Rate for Payer: PACE Senior Care Partners |
$3,420.33
|
| Rate for Payer: PACE SWMI |
$3,600.34
|
| Rate for Payer: PHP Commercial |
$12,241.17
|
| Rate for Payer: PHP Medicare Advantage |
$3,600.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,538.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12,529.20
|
| Rate for Payer: Priority Health Medicare |
$3,636.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,023.36
|
| Rate for Payer: Railroad Medicare Medicare |
$3,600.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,673.21
|
| Rate for Payer: UHC Core |
$12,025.15
|
| Rate for Payer: UHC Exchange |
$3,600.34
|
| Rate for Payer: UHC Medicaid |
$2,538.96
|
| Rate for Payer: UHC Medicare Advantage |
$3,600.34
|
| Rate for Payer: UHCCP Medicaid |
$2,538.96
|
| Rate for Payer: VA VA |
$3,600.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,801.03
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 1 VIEW
|
Facility
|
OP
|
$153.55
|
|
|
Service Code
|
CPT 72081
|
| Hospital Charge Code |
32000317
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$27.07 |
| Max. Negotiated Rate |
$138.19 |
| Rate for Payer: Aetna Commercial |
$130.52
|
| Rate for Payer: Aetna Medicare |
$39.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.98
|
| Rate for Payer: BCBS Complete |
$28.42
|
| Rate for Payer: BCBS MAPPO |
$38.39
|
| Rate for Payer: BCBS Trust/PPO |
$126.23
|
| Rate for Payer: BCN Commercial |
$126.23
|
| Rate for Payer: BCN Medicare Advantage |
$38.39
|
| Rate for Payer: Cash Price |
$122.84
|
| Rate for Payer: Cofinity Commercial |
$132.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.39
|
| Rate for Payer: Healthscope Commercial |
$138.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.16
|
| Rate for Payer: Mclaren Medicaid |
$27.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.31
|
| Rate for Payer: Meridian Medicaid |
$28.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.52
|
| Rate for Payer: Nomi Health Commercial |
$125.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$115.16
|
| Rate for Payer: PACE Senior Care Partners |
$36.47
|
| Rate for Payer: PACE SWMI |
$38.39
|
| Rate for Payer: PHP Commercial |
$130.52
|
| Rate for Payer: PHP Medicare Advantage |
$38.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$133.59
|
| Rate for Payer: Priority Health Medicare |
$38.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.87
|
| Rate for Payer: Railroad Medicare Medicare |
$38.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.12
|
| Rate for Payer: UHC Core |
$128.21
|
| Rate for Payer: UHC Exchange |
$38.39
|
| Rate for Payer: UHC Medicaid |
$27.07
|
| Rate for Payer: UHC Medicare Advantage |
$38.39
|
| Rate for Payer: UHCCP Medicaid |
$27.07
|
| Rate for Payer: VA VA |
$38.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.16
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 1 VIEW
|
Facility
|
IP
|
$153.55
|
|
|
Service Code
|
CPT 72081
|
| Hospital Charge Code |
32000317
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$106.87 |
| Max. Negotiated Rate |
$138.19 |
| Rate for Payer: Aetna Commercial |
$130.52
|
| Rate for Payer: BCBS Trust/PPO |
$126.82
|
| Rate for Payer: BCN Commercial |
$126.82
|
| Rate for Payer: Cash Price |
$122.84
|
| Rate for Payer: Cofinity Commercial |
$132.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.84
|
| Rate for Payer: Healthscope Commercial |
$138.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.52
|
| Rate for Payer: Nomi Health Commercial |
$125.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$115.16
|
| Rate for Payer: PHP Commercial |
$130.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$133.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.12
|
| Rate for Payer: UHC Core |
$128.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.16
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 2 OR 3 VIEW
|
Facility
|
IP
|
$368.55
|
|
|
Service Code
|
CPT 72082
|
| Hospital Charge Code |
32000306
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$256.51 |
| Max. Negotiated Rate |
$331.69 |
| Rate for Payer: Aetna Commercial |
$313.27
|
| Rate for Payer: BCBS Trust/PPO |
$304.39
|
| Rate for Payer: BCN Commercial |
$304.39
|
| Rate for Payer: Cash Price |
$294.84
|
| Rate for Payer: Cofinity Commercial |
$316.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.84
|
| Rate for Payer: Healthscope Commercial |
$331.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.27
|
| Rate for Payer: Nomi Health Commercial |
$302.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.41
|
| Rate for Payer: PHP Commercial |
$313.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$320.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$256.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.32
|
| Rate for Payer: UHC Core |
$307.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.41
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 2 OR 3 VIEW
|
Facility
|
OP
|
$368.55
|
|
|
Service Code
|
CPT 72082
|
| Hospital Charge Code |
32000306
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$64.98 |
| Max. Negotiated Rate |
$331.69 |
| Rate for Payer: Aetna Commercial |
$313.27
|
| Rate for Payer: Aetna Medicare |
$95.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$115.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$115.17
|
| Rate for Payer: BCBS Complete |
$68.22
|
| Rate for Payer: BCBS MAPPO |
$92.14
|
| Rate for Payer: BCBS Trust/PPO |
$302.98
|
| Rate for Payer: BCN Commercial |
$302.98
|
| Rate for Payer: BCN Medicare Advantage |
$92.14
|
| Rate for Payer: Cash Price |
$294.84
|
| Rate for Payer: Cofinity Commercial |
$316.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.14
|
| Rate for Payer: Healthscope Commercial |
$331.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.41
|
| Rate for Payer: Mclaren Medicaid |
$64.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.74
|
| Rate for Payer: Meridian Medicaid |
$68.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$101.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.27
|
| Rate for Payer: Nomi Health Commercial |
$302.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.41
|
| Rate for Payer: PACE Senior Care Partners |
$87.53
|
| Rate for Payer: PACE SWMI |
$92.14
|
| Rate for Payer: PHP Commercial |
$313.27
|
| Rate for Payer: PHP Medicare Advantage |
$92.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$320.64
|
| Rate for Payer: Priority Health Medicare |
$93.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$256.51
|
| Rate for Payer: Railroad Medicare Medicare |
$92.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.32
|
| Rate for Payer: UHC Core |
$307.74
|
| Rate for Payer: UHC Exchange |
$92.14
|
| Rate for Payer: UHC Medicaid |
$64.98
|
| Rate for Payer: UHC Medicare Advantage |
$92.14
|
| Rate for Payer: UHCCP Medicaid |
$64.98
|
| Rate for Payer: VA VA |
$92.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.41
|
|
