|
HC SPEECH FLUENCY EVAL
|
Facility
|
OP
|
$295.57
|
|
|
Service Code
|
CPT 92521
|
| Hospital Charge Code |
44400012
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$70.20 |
| Max. Negotiated Rate |
$266.01 |
| Rate for Payer: Aetna Commercial |
$251.23
|
| Rate for Payer: Aetna Medicare |
$76.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$92.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$92.37
|
| Rate for Payer: BCBS Complete |
$118.23
|
| Rate for Payer: BCBS MAPPO |
$73.89
|
| Rate for Payer: BCBS Trust/PPO |
$242.99
|
| Rate for Payer: BCN Commercial |
$229.81
|
| Rate for Payer: BCN Medicare Advantage |
$73.89
|
| Rate for Payer: Cash Price |
$236.46
|
| Rate for Payer: Cofinity Commercial |
$254.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.89
|
| Rate for Payer: Healthscope Commercial |
$266.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$221.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.23
|
| Rate for Payer: Nomi Health Commercial |
$242.37
|
| Rate for Payer: PACE Senior Care Partners |
$70.20
|
| Rate for Payer: PACE SWMI |
$73.89
|
| Rate for Payer: PHP Commercial |
$251.23
|
| Rate for Payer: PHP Medicare Advantage |
$73.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.12
|
| Rate for Payer: Priority Health HMO/PPO |
$257.15
|
| Rate for Payer: Priority Health Medicare |
$74.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.03
|
| Rate for Payer: Railroad Medicare Medicare |
$73.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$260.10
|
| Rate for Payer: UHC Core |
$246.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.89
|
| Rate for Payer: UHC Exchange |
$73.89
|
| Rate for Payer: UHC Medicare Advantage |
$73.89
|
| Rate for Payer: VA VA |
$73.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$221.68
|
|
|
HC SPEECH FLUENCY EVAL
|
Facility
|
IP
|
$295.57
|
|
|
Service Code
|
CPT 92521
|
| Hospital Charge Code |
44400012
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$192.12 |
| Max. Negotiated Rate |
$266.01 |
| Rate for Payer: Aetna Commercial |
$251.23
|
| Rate for Payer: BCBS Trust/PPO |
$241.27
|
| Rate for Payer: BCN Commercial |
$228.42
|
| Rate for Payer: Cash Price |
$236.46
|
| Rate for Payer: Cofinity Commercial |
$254.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.46
|
| Rate for Payer: Healthscope Commercial |
$266.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$221.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.23
|
| Rate for Payer: Nomi Health Commercial |
$242.37
|
| Rate for Payer: PHP Commercial |
$251.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.12
|
| Rate for Payer: Priority Health HMO/PPO |
$257.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$260.10
|
| Rate for Payer: UHC Core |
$246.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$221.68
|
|
|
HC SPEECH/LANGUAGE/HEARING THERAPY
|
Facility
|
IP
|
$216.40
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
44000001
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$140.66 |
| Max. Negotiated Rate |
$194.76 |
| Rate for Payer: Aetna Commercial |
$183.94
|
| Rate for Payer: BCBS Trust/PPO |
$176.65
|
| Rate for Payer: BCN Commercial |
$167.23
|
| Rate for Payer: Cash Price |
$173.12
|
| Rate for Payer: Cofinity Commercial |
$186.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.12
|
| Rate for Payer: Healthscope Commercial |
$194.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.94
|
| Rate for Payer: Nomi Health Commercial |
$177.45
|
| Rate for Payer: PHP Commercial |
$183.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.66
|
| Rate for Payer: Priority Health HMO/PPO |
$188.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.43
|
| Rate for Payer: UHC Core |
$180.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.30
|
|
|
HC SPEECH/LANGUAGE/HEARING THERAPY
|
Facility
|
OP
|
$216.40
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
44000001
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$51.40 |
| Max. Negotiated Rate |
$194.76 |
| Rate for Payer: Aetna Commercial |
$183.94
|
| Rate for Payer: Aetna Medicare |
$56.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.62
|
| Rate for Payer: BCBS Complete |
$86.56
|
| Rate for Payer: BCBS MAPPO |
$54.10
|
| Rate for Payer: BCBS Trust/PPO |
$177.90
|
| Rate for Payer: BCN Commercial |
$168.25
|
| Rate for Payer: BCN Medicare Advantage |
$54.10
|
| Rate for Payer: Cash Price |
$173.12
|
| Rate for Payer: Cofinity Commercial |
$186.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$194.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.94
|
| Rate for Payer: Nomi Health Commercial |
$177.45
|
| Rate for Payer: PACE Senior Care Partners |
$51.40
|
| Rate for Payer: PACE SWMI |
$54.10
|
| Rate for Payer: PHP Commercial |
$183.94
|
| Rate for Payer: PHP Medicare Advantage |
$54.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.66
|
| Rate for Payer: Priority Health HMO/PPO |
$188.27
|
| Rate for Payer: Priority Health Medicare |
$54.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.99
|
| Rate for Payer: Railroad Medicare Medicare |
$54.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.43
|
| Rate for Payer: UHC Core |
$180.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.10
|
| Rate for Payer: UHC Exchange |
$54.10
|
| Rate for Payer: UHC Medicare Advantage |
$54.10
|
| Rate for Payer: VA VA |
$54.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.30
|
|
|
HC SPEECH SOUND PRODUCTION EVAL
|
Facility
|
OP
|
$259.56
|
|
|
Service Code
|
CPT 92522
|
| Hospital Charge Code |
44400010
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$61.65 |
| Max. Negotiated Rate |
$233.60 |
| Rate for Payer: Aetna Commercial |
$220.63
|
| Rate for Payer: Aetna Medicare |
$67.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.11
|
| Rate for Payer: BCBS Complete |
$103.82
|
| Rate for Payer: BCBS MAPPO |
$64.89
|
| Rate for Payer: BCBS Trust/PPO |
$213.38
|
| Rate for Payer: BCN Commercial |
$201.81
|
| Rate for Payer: BCN Medicare Advantage |
$64.89
|
| Rate for Payer: Cash Price |
$207.65
|
| Rate for Payer: Cofinity Commercial |
$223.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.89
|
| Rate for Payer: Healthscope Commercial |
$233.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.63
|
| Rate for Payer: Nomi Health Commercial |
$212.84
|
| Rate for Payer: PACE Senior Care Partners |
$61.65
|
| Rate for Payer: PACE SWMI |
$64.89
|
| Rate for Payer: PHP Commercial |
$220.63
|
| Rate for Payer: PHP Medicare Advantage |
$64.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.71
|
| Rate for Payer: Priority Health HMO/PPO |
$225.82
|
| Rate for Payer: Priority Health Medicare |
$65.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.91
|
| Rate for Payer: Railroad Medicare Medicare |
$64.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.41
|
| Rate for Payer: UHC Core |
$216.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.89
|
| Rate for Payer: UHC Exchange |
$64.89
|
| Rate for Payer: UHC Medicare Advantage |
$64.89
|
| Rate for Payer: VA VA |
$64.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.67
|
|
|
HC SPEECH SOUND PRODUCTION EVAL
|
Facility
|
IP
|
$259.56
|
|
|
Service Code
|
CPT 92522
|
| Hospital Charge Code |
44400010
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$168.71 |
| Max. Negotiated Rate |
$233.60 |
| Rate for Payer: Aetna Commercial |
$220.63
|
| Rate for Payer: BCBS Trust/PPO |
$211.88
|
| Rate for Payer: BCN Commercial |
$200.59
|
| Rate for Payer: Cash Price |
$207.65
|
| Rate for Payer: Cofinity Commercial |
$223.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.65
|
| Rate for Payer: Healthscope Commercial |
$233.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.63
|
| Rate for Payer: Nomi Health Commercial |
$212.84
|
| Rate for Payer: PHP Commercial |
$220.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.71
|
| Rate for Payer: Priority Health HMO/PPO |
$225.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.41
|
| Rate for Payer: UHC Core |
$216.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.67
|
|
|
HC SPEECH THRESHOLD AUDIOMETRY
|
Facility
|
IP
|
$50.12
|
|
|
Service Code
|
CPT 92555
|
| Hospital Charge Code |
47100011
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$32.58 |
| Max. Negotiated Rate |
$45.11 |
| Rate for Payer: Aetna Commercial |
$42.60
|
| Rate for Payer: BCBS Trust/PPO |
$40.91
|
| Rate for Payer: BCN Commercial |
$38.73
|
| Rate for Payer: Cash Price |
$40.10
|
| Rate for Payer: Cofinity Commercial |
$43.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.10
|
| Rate for Payer: Healthscope Commercial |
$45.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.60
|
| Rate for Payer: Nomi Health Commercial |
$41.10
|
| Rate for Payer: PHP Commercial |
$42.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.58
|
| Rate for Payer: Priority Health HMO/PPO |
$43.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.11
|
| Rate for Payer: UHC Core |
$41.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.59
|
|
|
HC SPEECH THRESHOLD AUDIOMETRY
|
Facility
|
OP
|
$50.12
|
|
|
Service Code
|
CPT 92555
|
| Hospital Charge Code |
47100011
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$11.90 |
| Max. Negotiated Rate |
$45.11 |
| Rate for Payer: Aetna Commercial |
$42.60
|
| Rate for Payer: Aetna Medicare |
$13.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.66
|
| Rate for Payer: BCBS Complete |
$44.19
|
| Rate for Payer: BCBS MAPPO |
$12.53
|
| Rate for Payer: BCBS Trust/PPO |
$41.20
|
| Rate for Payer: BCN Commercial |
$38.97
|
| Rate for Payer: BCN Medicare Advantage |
$12.53
|
| Rate for Payer: Cash Price |
$40.10
|
| Rate for Payer: Cash Price |
$40.10
|
| Rate for Payer: Cofinity Commercial |
$43.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.53
|
| Rate for Payer: Healthscope Commercial |
$45.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.59
|
| Rate for Payer: Mclaren Medicaid |
$42.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.16
|
| Rate for Payer: Meridian Medicaid |
$44.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.60
|
| Rate for Payer: Nomi Health Commercial |
$41.10
|
| Rate for Payer: PACE Senior Care Partners |
$11.90
|
| Rate for Payer: PACE SWMI |
$12.53
|
| Rate for Payer: PHP Commercial |
$42.60
|
| Rate for Payer: PHP Medicare Advantage |
$12.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.58
|
| Rate for Payer: Priority Health HMO/PPO |
$43.60
|
| Rate for Payer: Priority Health Medicare |
$12.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.58
|
| Rate for Payer: Railroad Medicare Medicare |
$12.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.11
|
| Rate for Payer: UHC Core |
$41.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.53
|
| Rate for Payer: UHC Exchange |
$12.53
|
| Rate for Payer: UHC Medicare Advantage |
$12.53
|
| Rate for Payer: UHCCP Medicaid |
$42.08
|
| Rate for Payer: VA VA |
$12.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.59
|
|
|
HC SPEECH VIDEO FLUORO EVAL
|
Facility
|
IP
|
$397.01
|
|
|
Service Code
|
CPT 92611
|
| Hospital Charge Code |
44000004
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$258.06 |
| Max. Negotiated Rate |
$357.31 |
| Rate for Payer: Aetna Commercial |
$337.46
|
| Rate for Payer: BCBS Trust/PPO |
$324.08
|
| Rate for Payer: BCN Commercial |
$306.81
|
| Rate for Payer: Cash Price |
$317.61
|
| Rate for Payer: Cofinity Commercial |
$341.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.61
|
| Rate for Payer: Healthscope Commercial |
$357.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.46
|
| Rate for Payer: Nomi Health Commercial |
$325.55
|
| Rate for Payer: PHP Commercial |
$337.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.06
|
| Rate for Payer: Priority Health HMO/PPO |
$345.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$349.37
|
| Rate for Payer: UHC Core |
$331.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.76
|
|
|
HC SPEECH VIDEO FLUORO EVAL
|
Facility
|
OP
|
$397.01
|
|
|
Service Code
|
CPT 92611
|
| Hospital Charge Code |
44000004
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$94.29 |
| Max. Negotiated Rate |
$357.31 |
| Rate for Payer: Aetna Commercial |
$337.46
|
| Rate for Payer: Aetna Medicare |
$103.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$124.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$124.07
|
| Rate for Payer: BCBS Complete |
$158.80
|
| Rate for Payer: BCBS MAPPO |
$99.25
|
| Rate for Payer: BCBS Trust/PPO |
$326.38
|
| Rate for Payer: BCN Commercial |
$308.68
|
| Rate for Payer: BCN Medicare Advantage |
$99.25
|
| Rate for Payer: Cash Price |
$317.61
|
| Rate for Payer: Cofinity Commercial |
$341.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.25
|
| Rate for Payer: Healthscope Commercial |
$357.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$114.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.46
|
| Rate for Payer: Nomi Health Commercial |
$325.55
|
| Rate for Payer: PACE Senior Care Partners |
$94.29
|
| Rate for Payer: PACE SWMI |
$99.25
|
| Rate for Payer: PHP Commercial |
$337.46
|
| Rate for Payer: PHP Medicare Advantage |
$99.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.06
|
| Rate for Payer: Priority Health HMO/PPO |
$345.40
|
| Rate for Payer: Priority Health Medicare |
$100.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.00
|
| Rate for Payer: Railroad Medicare Medicare |
$99.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$349.37
|
| Rate for Payer: UHC Core |
$331.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.25
|
| Rate for Payer: UHC Exchange |
$99.25
|
| Rate for Payer: UHC Medicare Advantage |
$99.25
|
| Rate for Payer: VA VA |
$99.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.76
|
|
|
HC SPEECH VOICE EVALUATION
|
Facility
|
IP
|
$288.45
|
|
|
Service Code
|
CPT 92524
|
| Hospital Charge Code |
44400011
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$187.49 |
| Max. Negotiated Rate |
$259.60 |
| Rate for Payer: Aetna Commercial |
$245.18
|
| Rate for Payer: BCBS Trust/PPO |
$235.46
|
| Rate for Payer: BCN Commercial |
$222.91
|
| Rate for Payer: Cash Price |
$230.76
|
| Rate for Payer: Cofinity Commercial |
$248.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$230.76
|
| Rate for Payer: Healthscope Commercial |
$259.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$216.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$245.18
|
| Rate for Payer: Nomi Health Commercial |
$236.53
|
| Rate for Payer: PHP Commercial |
$245.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.49
|
| Rate for Payer: Priority Health HMO/PPO |
$250.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$193.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$253.84
|
| Rate for Payer: UHC Core |
$240.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$216.34
|
|
|
HC SPEECH VOICE EVALUATION
|
Facility
|
OP
|
$288.45
|
|
|
Service Code
|
CPT 92524
|
| Hospital Charge Code |
44400011
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$68.51 |
| Max. Negotiated Rate |
$259.60 |
| Rate for Payer: Aetna Commercial |
$245.18
|
| Rate for Payer: Aetna Medicare |
$75.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$90.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$90.14
|
| Rate for Payer: BCBS Complete |
$115.38
|
| Rate for Payer: BCBS MAPPO |
$72.11
|
| Rate for Payer: BCBS Trust/PPO |
$237.13
|
| Rate for Payer: BCN Commercial |
$224.27
|
| Rate for Payer: BCN Medicare Advantage |
$72.11
|
| Rate for Payer: Cash Price |
$230.76
|
| Rate for Payer: Cofinity Commercial |
$248.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$230.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.11
|
| Rate for Payer: Healthscope Commercial |
$259.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$216.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$245.18
|
| Rate for Payer: Nomi Health Commercial |
$236.53
|
| Rate for Payer: PACE Senior Care Partners |
$68.51
|
| Rate for Payer: PACE SWMI |
$72.11
|
| Rate for Payer: PHP Commercial |
$245.18
|
| Rate for Payer: PHP Medicare Advantage |
$72.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.49
|
| Rate for Payer: Priority Health HMO/PPO |
$250.95
|
| Rate for Payer: Priority Health Medicare |
$72.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$193.26
|
| Rate for Payer: Railroad Medicare Medicare |
$72.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$253.84
|
| Rate for Payer: UHC Core |
$240.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.11
|
| Rate for Payer: UHC Exchange |
$72.11
|
| Rate for Payer: UHC Medicare Advantage |
$72.11
|
| Rate for Payer: VA VA |
$72.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$216.34
|
|
|
HC SPIKE BLOOD ACCESS
|
Facility
|
OP
|
$16.07
|
|
| Hospital Charge Code |
27000669
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.82 |
| Max. Negotiated Rate |
$14.46 |
| Rate for Payer: Aetna Commercial |
$13.66
|
| Rate for Payer: Aetna Medicare |
$4.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.02
|
| Rate for Payer: BCBS Complete |
$6.43
|
| Rate for Payer: BCBS MAPPO |
$4.02
|
| Rate for Payer: BCBS Trust/PPO |
$13.21
|
| Rate for Payer: BCN Commercial |
$12.49
|
| Rate for Payer: BCN Medicare Advantage |
$4.02
|
| Rate for Payer: Cash Price |
$12.86
|
| Rate for Payer: Cofinity Commercial |
$13.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.02
|
| Rate for Payer: Healthscope Commercial |
$14.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.66
|
| Rate for Payer: Nomi Health Commercial |
$13.18
|
| Rate for Payer: PACE Senior Care Partners |
$3.82
|
| Rate for Payer: PACE SWMI |
$4.02
|
| Rate for Payer: PHP Commercial |
$13.66
|
| Rate for Payer: PHP Medicare Advantage |
$4.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.45
|
| Rate for Payer: Priority Health HMO/PPO |
$13.98
|
| Rate for Payer: Priority Health Medicare |
$4.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.77
|
| Rate for Payer: Railroad Medicare Medicare |
$4.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.14
|
| Rate for Payer: UHC Core |
$13.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.02
|
| Rate for Payer: UHC Exchange |
$4.02
|
| Rate for Payer: UHC Medicare Advantage |
$4.02
|
| Rate for Payer: VA VA |
$4.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.05
|
|
|
HC SPIKE BLOOD ACCESS
|
Facility
|
IP
|
$16.07
|
|
| Hospital Charge Code |
27000669
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.45 |
| Max. Negotiated Rate |
$14.46 |
| Rate for Payer: Aetna Commercial |
$13.66
|
| Rate for Payer: BCBS Trust/PPO |
$13.12
|
| Rate for Payer: BCN Commercial |
$12.42
|
| Rate for Payer: Cash Price |
$12.86
|
| Rate for Payer: Cofinity Commercial |
$13.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.86
|
| Rate for Payer: Healthscope Commercial |
$14.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.66
|
| Rate for Payer: Nomi Health Commercial |
$13.18
|
| Rate for Payer: PHP Commercial |
$13.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.45
|
| Rate for Payer: Priority Health HMO/PPO |
$13.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.14
|
| Rate for Payer: UHC Core |
$13.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.05
|
|
|
HC SPINAL/EPI ADDL 15 MIN
|
Facility
|
OP
|
$159.71
|
|
| Hospital Charge Code |
37000013
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$37.93 |
| Max. Negotiated Rate |
$143.74 |
| Rate for Payer: Aetna Commercial |
$135.75
|
| Rate for Payer: Aetna Medicare |
$41.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.91
|
| Rate for Payer: BCBS Complete |
$63.88
|
| Rate for Payer: BCBS MAPPO |
$39.93
|
| Rate for Payer: BCBS Trust/PPO |
$131.30
|
| Rate for Payer: BCN Commercial |
$124.17
|
| Rate for Payer: BCN Medicare Advantage |
$39.93
|
| Rate for Payer: Cash Price |
$127.77
|
| Rate for Payer: Cofinity Commercial |
$137.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.93
|
| Rate for Payer: Healthscope Commercial |
$143.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.75
|
| Rate for Payer: Nomi Health Commercial |
$130.96
|
| Rate for Payer: PACE Senior Care Partners |
$37.93
|
| Rate for Payer: PACE SWMI |
$39.93
|
| Rate for Payer: PHP Commercial |
$135.75
|
| Rate for Payer: PHP Medicare Advantage |
$39.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.81
|
| Rate for Payer: Priority Health HMO/PPO |
$138.95
|
| Rate for Payer: Priority Health Medicare |
$40.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.01
|
| Rate for Payer: Railroad Medicare Medicare |
$39.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.54
|
| Rate for Payer: UHC Core |
$133.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.93
|
| Rate for Payer: UHC Exchange |
$39.93
|
| Rate for Payer: UHC Medicare Advantage |
$39.93
|
| Rate for Payer: VA VA |
$39.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.78
|
|
|
HC SPINAL/EPI ADDL 15 MIN
|
Facility
|
IP
|
$159.71
|
|
| Hospital Charge Code |
37000013
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$103.81 |
| Max. Negotiated Rate |
$143.74 |
| Rate for Payer: Aetna Commercial |
$135.75
|
| Rate for Payer: BCBS Trust/PPO |
$130.37
|
| Rate for Payer: BCN Commercial |
$123.42
|
| Rate for Payer: Cash Price |
$127.77
|
| Rate for Payer: Cofinity Commercial |
$137.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.77
|
| Rate for Payer: Healthscope Commercial |
$143.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.75
|
| Rate for Payer: Nomi Health Commercial |
$130.96
|
| Rate for Payer: PHP Commercial |
$135.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.81
|
| Rate for Payer: Priority Health HMO/PPO |
$138.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.54
|
| Rate for Payer: UHC Core |
$133.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.78
|
|
|
HC SPINAL/EPI INIT 30 MIN
|
Facility
|
OP
|
$436.73
|
|
| Hospital Charge Code |
37000014
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$103.72 |
| Max. Negotiated Rate |
$393.06 |
| Rate for Payer: Aetna Commercial |
$371.22
|
| Rate for Payer: Aetna Medicare |
$113.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$136.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$136.48
|
| Rate for Payer: BCBS Complete |
$174.69
|
| Rate for Payer: BCBS MAPPO |
$109.18
|
| Rate for Payer: BCBS Trust/PPO |
$359.04
|
| Rate for Payer: BCN Commercial |
$339.56
|
| Rate for Payer: BCN Medicare Advantage |
$109.18
|
| Rate for Payer: Cash Price |
$349.38
|
| Rate for Payer: Cofinity Commercial |
$375.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.18
|
| Rate for Payer: Healthscope Commercial |
$393.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$327.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$125.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.22
|
| Rate for Payer: Nomi Health Commercial |
$358.12
|
| Rate for Payer: PACE Senior Care Partners |
$103.72
|
| Rate for Payer: PACE SWMI |
$109.18
|
| Rate for Payer: PHP Commercial |
$371.22
|
| Rate for Payer: PHP Medicare Advantage |
$109.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$283.87
|
| Rate for Payer: Priority Health HMO/PPO |
$379.96
|
| Rate for Payer: Priority Health Medicare |
$110.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$292.61
|
| Rate for Payer: Railroad Medicare Medicare |
$109.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$384.32
|
| Rate for Payer: UHC Core |
$364.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.18
|
| Rate for Payer: UHC Exchange |
$109.18
|
| Rate for Payer: UHC Medicare Advantage |
$109.18
|
| Rate for Payer: VA VA |
$109.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$327.55
|
|
|
HC SPINAL/EPI INIT 30 MIN
|
Facility
|
IP
|
$436.73
|
|
| Hospital Charge Code |
37000014
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$283.87 |
| Max. Negotiated Rate |
$393.06 |
| Rate for Payer: Aetna Commercial |
$371.22
|
| Rate for Payer: BCBS Trust/PPO |
$356.50
|
| Rate for Payer: BCN Commercial |
$337.50
|
| Rate for Payer: Cash Price |
$349.38
|
| Rate for Payer: Cofinity Commercial |
$375.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.38
|
| Rate for Payer: Healthscope Commercial |
$393.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$327.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.22
|
| Rate for Payer: Nomi Health Commercial |
$358.12
|
| Rate for Payer: PHP Commercial |
$371.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$283.87
|
| Rate for Payer: Priority Health HMO/PPO |
$379.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$292.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$384.32
|
| Rate for Payer: UHC Core |
$364.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$327.55
|
|
|
HC SPINE JACK
|
Facility
|
IP
|
$14,119.00
|
|
|
Service Code
|
CPT C1062
|
| Hospital Charge Code |
27800148
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,177.35 |
| Max. Negotiated Rate |
$12,707.10 |
| Rate for Payer: Aetna Commercial |
$12,001.15
|
| Rate for Payer: BCBS Trust/PPO |
$11,525.34
|
| Rate for Payer: BCN Commercial |
$10,911.16
|
| Rate for Payer: Cash Price |
$11,295.20
|
| Rate for Payer: Cofinity Commercial |
$12,142.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,295.20
|
| Rate for Payer: Healthscope Commercial |
$12,707.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,589.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,001.15
|
| Rate for Payer: Nomi Health Commercial |
$11,577.58
|
| Rate for Payer: PHP Commercial |
$12,001.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,177.35
|
| Rate for Payer: Priority Health HMO/PPO |
$12,283.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,459.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,424.72
|
| Rate for Payer: UHC Core |
$11,789.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,589.25
|
|
|
HC SPINE JACK
|
Facility
|
OP
|
$14,119.00
|
|
|
Service Code
|
CPT C1062
|
| Hospital Charge Code |
27800148
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,353.26 |
| Max. Negotiated Rate |
$12,707.10 |
| Rate for Payer: Aetna Commercial |
$12,001.15
|
| Rate for Payer: Aetna Medicare |
$3,670.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,412.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,412.19
|
| Rate for Payer: BCBS Complete |
$5,647.60
|
| Rate for Payer: BCBS MAPPO |
$3,529.75
|
| Rate for Payer: BCBS Trust/PPO |
$11,607.23
|
| Rate for Payer: BCN Commercial |
$10,977.52
|
| Rate for Payer: BCN Medicare Advantage |
$3,529.75
|
| Rate for Payer: Cash Price |
$11,295.20
|
| Rate for Payer: Cofinity Commercial |
$12,142.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,295.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,529.75
|
| Rate for Payer: Healthscope Commercial |
$12,707.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,589.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,706.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,059.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,001.15
|
| Rate for Payer: Nomi Health Commercial |
$11,577.58
|
| Rate for Payer: PACE Senior Care Partners |
$3,353.26
|
| Rate for Payer: PACE SWMI |
$3,529.75
|
| Rate for Payer: PHP Commercial |
$12,001.15
|
| Rate for Payer: PHP Medicare Advantage |
$3,529.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,177.35
|
| Rate for Payer: Priority Health HMO/PPO |
$12,283.53
|
| Rate for Payer: Priority Health Medicare |
$3,565.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,459.73
|
| Rate for Payer: Railroad Medicare Medicare |
$3,529.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,424.72
|
| Rate for Payer: UHC Core |
$11,789.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,529.75
|
| Rate for Payer: UHC Exchange |
$3,529.75
|
| Rate for Payer: UHC Medicare Advantage |
$3,529.75
|
| Rate for Payer: VA VA |
$3,529.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,589.25
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 1 VIEW
|
Facility
|
IP
|
$150.54
|
|
|
Service Code
|
CPT 72081
|
| Hospital Charge Code |
32000317
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$97.85 |
| Max. Negotiated Rate |
$135.49 |
| Rate for Payer: Aetna Commercial |
$127.96
|
| Rate for Payer: BCBS Trust/PPO |
$122.89
|
| Rate for Payer: BCN Commercial |
$116.34
|
| Rate for Payer: Cash Price |
$120.43
|
| Rate for Payer: Cofinity Commercial |
$129.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.43
|
| Rate for Payer: Healthscope Commercial |
$135.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.96
|
| Rate for Payer: Nomi Health Commercial |
$123.44
|
| Rate for Payer: PHP Commercial |
$127.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.85
|
| Rate for Payer: Priority Health HMO/PPO |
$130.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.48
|
| Rate for Payer: UHC Core |
$125.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.90
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 1 VIEW
|
Facility
|
OP
|
$150.54
|
|
|
Service Code
|
CPT 72081
|
| Hospital Charge Code |
32000317
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$35.75 |
| Max. Negotiated Rate |
$135.49 |
| Rate for Payer: Aetna Commercial |
$127.96
|
| Rate for Payer: Aetna Medicare |
$39.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.04
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$37.64
|
| Rate for Payer: BCBS Trust/PPO |
$123.76
|
| Rate for Payer: BCN Commercial |
$117.04
|
| Rate for Payer: BCN Medicare Advantage |
$37.64
|
| Rate for Payer: Cash Price |
$120.43
|
| Rate for Payer: Cash Price |
$120.43
|
| Rate for Payer: Cofinity Commercial |
$129.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.64
|
| Rate for Payer: Healthscope Commercial |
$135.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.90
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.52
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.96
|
| Rate for Payer: Nomi Health Commercial |
$123.44
|
| Rate for Payer: PACE Senior Care Partners |
$35.75
|
| Rate for Payer: PACE SWMI |
$37.64
|
| Rate for Payer: PHP Commercial |
$127.96
|
| Rate for Payer: PHP Medicare Advantage |
$37.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.85
|
| Rate for Payer: Priority Health HMO/PPO |
$130.97
|
| Rate for Payer: Priority Health Medicare |
$38.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.86
|
| Rate for Payer: Railroad Medicare Medicare |
$37.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.48
|
| Rate for Payer: UHC Core |
$125.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.64
|
| Rate for Payer: UHC Exchange |
$37.64
|
| Rate for Payer: UHC Medicare Advantage |
$37.64
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$37.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.90
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 2 OR 3 VIEW
|
Facility
|
OP
|
$361.32
|
|
|
Service Code
|
CPT 72082
|
| Hospital Charge Code |
32000306
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$325.19 |
| Rate for Payer: Aetna Commercial |
$307.12
|
| Rate for Payer: Aetna Medicare |
$93.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$112.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$112.91
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$90.33
|
| Rate for Payer: BCBS Trust/PPO |
$297.04
|
| Rate for Payer: BCN Commercial |
$280.93
|
| Rate for Payer: BCN Medicare Advantage |
$90.33
|
| Rate for Payer: Cash Price |
$289.06
|
| Rate for Payer: Cash Price |
$289.06
|
| Rate for Payer: Cofinity Commercial |
$310.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.33
|
| Rate for Payer: Healthscope Commercial |
$325.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$270.99
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.85
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$307.12
|
| Rate for Payer: Nomi Health Commercial |
$296.28
|
| Rate for Payer: PACE Senior Care Partners |
$85.81
|
| Rate for Payer: PACE SWMI |
$90.33
|
| Rate for Payer: PHP Commercial |
$307.12
|
| Rate for Payer: PHP Medicare Advantage |
$90.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.86
|
| Rate for Payer: Priority Health HMO/PPO |
$314.35
|
| Rate for Payer: Priority Health Medicare |
$91.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$242.08
|
| Rate for Payer: Railroad Medicare Medicare |
$90.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$317.96
|
| Rate for Payer: UHC Core |
$301.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.33
|
| Rate for Payer: UHC Exchange |
$90.33
|
| Rate for Payer: UHC Medicare Advantage |
$90.33
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$90.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$270.99
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 2 OR 3 VIEW
|
Facility
|
IP
|
$361.32
|
|
|
Service Code
|
CPT 72082
|
| Hospital Charge Code |
32000306
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$234.86 |
| Max. Negotiated Rate |
$325.19 |
| Rate for Payer: Aetna Commercial |
$307.12
|
| Rate for Payer: BCBS Trust/PPO |
$294.95
|
| Rate for Payer: BCN Commercial |
$279.23
|
| Rate for Payer: Cash Price |
$289.06
|
| Rate for Payer: Cofinity Commercial |
$310.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.06
|
| Rate for Payer: Healthscope Commercial |
$325.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$270.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$307.12
|
| Rate for Payer: Nomi Health Commercial |
$296.28
|
| Rate for Payer: PHP Commercial |
$307.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.86
|
| Rate for Payer: Priority Health HMO/PPO |
$314.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$242.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$317.96
|
| Rate for Payer: UHC Core |
$301.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$270.99
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 4 OR 5 VIEW
|
Facility
|
OP
|
$481.76
|
|
|
Service Code
|
CPT 72083
|
| Hospital Charge Code |
32000307
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$433.58 |
| Rate for Payer: Aetna Commercial |
$409.50
|
| Rate for Payer: Aetna Medicare |
$125.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.55
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$120.44
|
| Rate for Payer: BCBS Trust/PPO |
$396.05
|
| Rate for Payer: BCN Commercial |
$374.57
|
| Rate for Payer: BCN Medicare Advantage |
$120.44
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cofinity Commercial |
$414.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.44
|
| Rate for Payer: Healthscope Commercial |
$433.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.32
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.46
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.50
|
| Rate for Payer: Nomi Health Commercial |
$395.04
|
| Rate for Payer: PACE Senior Care Partners |
$114.42
|
| Rate for Payer: PACE SWMI |
$120.44
|
| Rate for Payer: PHP Commercial |
$409.50
|
| Rate for Payer: PHP Medicare Advantage |
$120.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.14
|
| Rate for Payer: Priority Health HMO/PPO |
$419.13
|
| Rate for Payer: Priority Health Medicare |
$121.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$322.78
|
| Rate for Payer: Railroad Medicare Medicare |
$120.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.95
|
| Rate for Payer: UHC Core |
$402.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.44
|
| Rate for Payer: UHC Exchange |
$120.44
|
| Rate for Payer: UHC Medicare Advantage |
$120.44
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$120.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.32
|
|
