|
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 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 |
$259.61 |
| 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 |
$259.61
|
| 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 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 |
$259.61 |
| 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 |
$259.61
|
| 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 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 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 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 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 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
|
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 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 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 |
$66.85
|
| Rate for Payer: BCBS MAPPO |
$37.63
|
| Rate for Payer: BCBS Trust/PPO |
$123.76
|
| Rate for Payer: BCN Commercial |
$117.04
|
| Rate for Payer: BCN Medicare Advantage |
$37.63
|
| 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 |
$37.63
|
| Rate for Payer: Healthscope Commercial |
$135.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.91
|
| Rate for Payer: Mclaren Medicaid |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.52
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| 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 |
$37.63
|
| Rate for Payer: PHP Commercial |
$127.96
|
| Rate for Payer: PHP Medicare Advantage |
$37.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.66
|
| 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 |
$37.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.48
|
| Rate for Payer: UHC Core |
$125.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.63
|
| Rate for Payer: UHC Exchange |
$37.63
|
| Rate for Payer: UHC Medicare Advantage |
$37.63
|
| Rate for Payer: UHCCP Medicaid |
$63.66
|
| Rate for Payer: VA VA |
$37.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.91
|
|
|
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 |
$112.91
|
| 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 |
$112.91
|
|
|
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 |
$76.88 |
| 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 |
$80.73
|
| 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 |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.85
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| 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 |
$76.88
|
| 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 |
$76.88
|
| 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 |
$76.88 |
| 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 |
$80.73
|
| 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 |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.46
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| 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 |
$76.88
|
| 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 |
$76.88
|
| Rate for Payer: VA VA |
$120.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.32
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 4 OR 5 VIEW
|
Facility
|
IP
|
$481.76
|
|
|
Service Code
|
CPT 72083
|
| Hospital Charge Code |
32000307
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$313.14 |
| Max. Negotiated Rate |
$433.58 |
| Rate for Payer: Aetna Commercial |
$409.50
|
| Rate for Payer: BCBS Trust/PPO |
$393.26
|
| Rate for Payer: BCN Commercial |
$372.30
|
| 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: Healthscope Commercial |
$433.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.50
|
| Rate for Payer: Nomi Health Commercial |
$395.04
|
| Rate for Payer: PHP Commercial |
$409.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.14
|
| Rate for Payer: Priority Health HMO/PPO |
$419.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$322.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.95
|
| Rate for Payer: UHC Core |
$402.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.32
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL MIN 6 VIEW
|
Facility
|
IP
|
$602.20
|
|
|
Service Code
|
CPT 72084
|
| Hospital Charge Code |
32000308
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$391.43 |
| Max. Negotiated Rate |
$541.98 |
| Rate for Payer: Aetna Commercial |
$511.87
|
| Rate for Payer: BCBS Trust/PPO |
$491.58
|
| Rate for Payer: BCN Commercial |
$465.38
|
| Rate for Payer: Cash Price |
$481.76
|
| Rate for Payer: Cofinity Commercial |
$517.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$481.76
|
| Rate for Payer: Healthscope Commercial |
$541.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$451.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$511.87
|
| Rate for Payer: Nomi Health Commercial |
$493.80
|
| Rate for Payer: PHP Commercial |
$511.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$391.43
|
| Rate for Payer: Priority Health HMO/PPO |
$523.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$403.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$529.94
|
| Rate for Payer: UHC Core |
$502.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$451.65
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL MIN 6 VIEW
|
Facility
|
OP
|
$602.20
|
|
|
Service Code
|
CPT 72084
|
| Hospital Charge Code |
32000308
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$541.98 |
| Rate for Payer: Aetna Commercial |
$511.87
|
| Rate for Payer: Aetna Medicare |
$156.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$188.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$188.19
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$150.55
|
| Rate for Payer: BCBS Trust/PPO |
$495.07
|
| Rate for Payer: BCN Commercial |
$468.21
|
| Rate for Payer: BCN Medicare Advantage |
$150.55
|
| Rate for Payer: Cash Price |
$481.76
|
| Rate for Payer: Cash Price |
$481.76
|
| Rate for Payer: Cofinity Commercial |
$517.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$481.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.55
|
| Rate for Payer: Healthscope Commercial |
$541.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$451.65
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.08
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$173.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$511.87
|
| Rate for Payer: Nomi Health Commercial |
$493.80
|
| Rate for Payer: PACE Senior Care Partners |
$143.02
|
| Rate for Payer: PACE SWMI |
$150.55
|
| Rate for Payer: PHP Commercial |
$511.87
|
| Rate for Payer: PHP Medicare Advantage |
$150.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$391.43
|
| Rate for Payer: Priority Health HMO/PPO |
$523.91
|
| Rate for Payer: Priority Health Medicare |
$152.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$403.47
|
| Rate for Payer: Railroad Medicare Medicare |
$150.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$529.94
|
| Rate for Payer: UHC Core |
$502.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.55
|
| Rate for Payer: UHC Exchange |
$150.55
|
| Rate for Payer: UHC Medicare Advantage |
$150.55
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$150.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$451.65
|
|
|
HC SPINE THORACIC W CON
|
Facility
|
OP
|
$2,243.18
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200008
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$258.20 |
| Max. Negotiated Rate |
$2,018.86 |
| Rate for Payer: Aetna Commercial |
$1,906.70
|
| Rate for Payer: Aetna Medicare |
$583.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$700.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$700.99
|
| Rate for Payer: BCBS Complete |
$271.13
|
| Rate for Payer: BCBS MAPPO |
$560.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,844.12
|
| Rate for Payer: BCN Commercial |
$1,744.07
|
| Rate for Payer: BCN Medicare Advantage |
$560.79
|
| Rate for Payer: Cash Price |
$1,794.54
|
| Rate for Payer: Cash Price |
$1,794.54
|
| Rate for Payer: Cofinity Commercial |
$1,929.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,794.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$560.79
|
| Rate for Payer: Healthscope Commercial |
$2,018.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,682.38
|
| Rate for Payer: Mclaren Medicaid |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$588.83
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$644.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,906.70
|
| Rate for Payer: Nomi Health Commercial |
$1,839.41
|
| Rate for Payer: PACE Senior Care Partners |
$532.76
|
| Rate for Payer: PACE SWMI |
$560.79
|
| Rate for Payer: PHP Commercial |
$1,906.70
|
| Rate for Payer: PHP Medicare Advantage |
$560.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,458.07
|
| Rate for Payer: Priority Health HMO/PPO |
$1,951.57
|
| Rate for Payer: Priority Health Medicare |
$566.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,502.93
|
| Rate for Payer: Railroad Medicare Medicare |
$560.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,974.00
|
| Rate for Payer: UHC Core |
$1,873.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$560.79
|
| Rate for Payer: UHC Exchange |
$560.79
|
| Rate for Payer: UHC Medicare Advantage |
$560.79
|
| Rate for Payer: UHCCP Medicaid |
$258.20
|
| Rate for Payer: VA VA |
$560.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,682.38
|
|
|
HC SPINE THORACIC W CON
|
Facility
|
IP
|
$2,243.18
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200008
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,458.07 |
| Max. Negotiated Rate |
$2,018.86 |
| Rate for Payer: Aetna Commercial |
$1,906.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,831.11
|
| Rate for Payer: BCN Commercial |
$1,733.53
|
| Rate for Payer: Cash Price |
$1,794.54
|
| Rate for Payer: Cofinity Commercial |
$1,929.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,794.54
|
| Rate for Payer: Healthscope Commercial |
$2,018.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,682.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,906.70
|
| Rate for Payer: Nomi Health Commercial |
$1,839.41
|
| Rate for Payer: PHP Commercial |
$1,906.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,458.07
|
| Rate for Payer: Priority Health HMO/PPO |
$1,951.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,502.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,974.00
|
| Rate for Payer: UHC Core |
$1,873.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,682.38
|
|
|
HC SP INJECTION TENDON SHEATH
|
Facility
|
OP
|
$320.34
|
|
|
Service Code
|
CPT 20550
|
| Hospital Charge Code |
36100320
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$76.08 |
| Max. Negotiated Rate |
$288.31 |
| Rate for Payer: Aetna Commercial |
$272.29
|
| Rate for Payer: Aetna Medicare |
$83.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.11
|
| Rate for Payer: BCBS Complete |
$224.11
|
| Rate for Payer: BCBS MAPPO |
$80.08
|
| Rate for Payer: BCBS Trust/PPO |
$263.35
|
| Rate for Payer: BCN Commercial |
$249.06
|
| Rate for Payer: BCN Medicare Advantage |
$80.08
|
| Rate for Payer: Cash Price |
$256.27
|
| Rate for Payer: Cash Price |
$256.27
|
| Rate for Payer: Cofinity Commercial |
$275.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.08
|
| Rate for Payer: Healthscope Commercial |
$288.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.25
|
| Rate for Payer: Mclaren Medicaid |
$213.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.09
|
| Rate for Payer: Meridian Medicaid |
$224.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.29
|
| Rate for Payer: Nomi Health Commercial |
$262.68
|
| Rate for Payer: PACE Senior Care Partners |
$76.08
|
| Rate for Payer: PACE SWMI |
$80.08
|
| Rate for Payer: PHP Commercial |
$272.29
|
| Rate for Payer: PHP Medicare Advantage |
$80.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.22
|
| Rate for Payer: Priority Health HMO/PPO |
$278.70
|
| Rate for Payer: Priority Health Medicare |
$80.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$214.63
|
| Rate for Payer: Railroad Medicare Medicare |
$80.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$281.90
|
| Rate for Payer: UHC Core |
$267.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.08
|
| Rate for Payer: UHC Exchange |
$80.08
|
| Rate for Payer: UHC Medicare Advantage |
$80.08
|
| Rate for Payer: UHCCP Medicaid |
$213.42
|
| Rate for Payer: VA VA |
$80.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.25
|
|
|
HC SP INJECTION TENDON SHEATH
|
Facility
|
IP
|
$320.34
|
|
|
Service Code
|
CPT 20550
|
| Hospital Charge Code |
36100320
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$208.22 |
| Max. Negotiated Rate |
$288.31 |
| Rate for Payer: Aetna Commercial |
$272.29
|
| Rate for Payer: BCBS Trust/PPO |
$261.49
|
| Rate for Payer: BCN Commercial |
$247.56
|
| Rate for Payer: Cash Price |
$256.27
|
| Rate for Payer: Cofinity Commercial |
$275.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.27
|
| Rate for Payer: Healthscope Commercial |
$288.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.29
|
| Rate for Payer: Nomi Health Commercial |
$262.68
|
| Rate for Payer: PHP Commercial |
$272.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.22
|
| Rate for Payer: Priority Health HMO/PPO |
$278.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$214.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$281.90
|
| Rate for Payer: UHC Core |
$267.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.25
|
|
|
HC SP INSERTION IVC FILTER
|
Facility
|
IP
|
$7,290.10
|
|
|
Service Code
|
CPT 37191
|
| Hospital Charge Code |
36100351
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,738.56 |
| Max. Negotiated Rate |
$6,561.09 |
| Rate for Payer: Aetna Commercial |
$6,196.59
|
| Rate for Payer: BCBS Trust/PPO |
$5,950.91
|
| Rate for Payer: BCN Commercial |
$5,633.79
|
| Rate for Payer: Cash Price |
$5,832.08
|
| Rate for Payer: Cofinity Commercial |
$6,269.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,832.08
|
| Rate for Payer: Healthscope Commercial |
$6,561.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,467.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,196.59
|
| Rate for Payer: Nomi Health Commercial |
$5,977.88
|
| Rate for Payer: PHP Commercial |
$6,196.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,738.56
|
| Rate for Payer: Priority Health HMO/PPO |
$6,342.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,884.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,415.29
|
| Rate for Payer: UHC Core |
$6,087.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,467.57
|
|
|
HC SP INSERTION IVC FILTER
|
Facility
|
OP
|
$7,290.10
|
|
|
Service Code
|
CPT 37191
|
| Hospital Charge Code |
36100351
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,731.40 |
| Max. Negotiated Rate |
$6,561.09 |
| Rate for Payer: Aetna Commercial |
$6,196.59
|
| Rate for Payer: Aetna Medicare |
$1,895.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,278.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,278.16
|
| Rate for Payer: BCBS Complete |
$4,104.01
|
| Rate for Payer: BCBS MAPPO |
$1,822.53
|
| Rate for Payer: BCBS Trust/PPO |
$5,993.19
|
| Rate for Payer: BCN Commercial |
$5,668.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,822.53
|
| Rate for Payer: Cash Price |
$5,832.08
|
| Rate for Payer: Cash Price |
$5,832.08
|
| Rate for Payer: Cofinity Commercial |
$6,269.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,832.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,822.53
|
| Rate for Payer: Healthscope Commercial |
$6,561.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,467.57
|
| Rate for Payer: Mclaren Medicaid |
$3,908.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,913.65
|
| Rate for Payer: Meridian Medicaid |
$4,104.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,095.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,196.59
|
| Rate for Payer: Nomi Health Commercial |
$5,977.88
|
| Rate for Payer: PACE Senior Care Partners |
$1,731.40
|
| Rate for Payer: PACE SWMI |
$1,822.53
|
| Rate for Payer: PHP Commercial |
$6,196.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,822.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,908.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,738.56
|
| Rate for Payer: Priority Health HMO/PPO |
$6,342.39
|
| Rate for Payer: Priority Health Medicare |
$1,840.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,884.37
|
| Rate for Payer: Railroad Medicare Medicare |
$1,822.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,415.29
|
| Rate for Payer: UHC Core |
$6,087.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,822.53
|
| Rate for Payer: UHC Exchange |
$1,822.53
|
| Rate for Payer: UHC Medicare Advantage |
$1,822.53
|
| Rate for Payer: UHCCP Medicaid |
$3,908.32
|
| Rate for Payer: VA VA |
$1,822.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,467.57
|
|
