|
HC XR SINUSES MIN 3 VW
|
Facility
|
IP
|
$364.79
|
|
|
Service Code
|
CPT 70220
|
| Hospital Charge Code |
32000015
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$253.89 |
| Max. Negotiated Rate |
$328.31 |
| Rate for Payer: Aetna Commercial |
$310.07
|
| Rate for Payer: BCBS Trust/PPO |
$301.28
|
| Rate for Payer: BCN Commercial |
$301.28
|
| Rate for Payer: Cash Price |
$291.83
|
| Rate for Payer: Cofinity Commercial |
$313.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.83
|
| Rate for Payer: Healthscope Commercial |
$328.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.07
|
| Rate for Payer: Nomi Health Commercial |
$299.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.59
|
| Rate for Payer: PHP Commercial |
$310.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$317.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.02
|
| Rate for Payer: UHC Core |
$304.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.59
|
|
|
HC XR SINUSES MIN 3 VW
|
Facility
|
OP
|
$364.79
|
|
|
Service Code
|
CPT 70220
|
| Hospital Charge Code |
32000015
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$64.31 |
| Max. Negotiated Rate |
$328.31 |
| Rate for Payer: Aetna Commercial |
$310.07
|
| Rate for Payer: Aetna Medicare |
$94.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.00
|
| Rate for Payer: BCBS Complete |
$67.52
|
| Rate for Payer: BCBS MAPPO |
$91.20
|
| Rate for Payer: BCBS Trust/PPO |
$299.89
|
| Rate for Payer: BCN Commercial |
$299.89
|
| Rate for Payer: BCN Medicare Advantage |
$91.20
|
| Rate for Payer: Cash Price |
$291.83
|
| Rate for Payer: Cofinity Commercial |
$313.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.20
|
| Rate for Payer: Healthscope Commercial |
$328.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.59
|
| Rate for Payer: Mclaren Medicaid |
$64.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.76
|
| Rate for Payer: Meridian Medicaid |
$67.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.07
|
| Rate for Payer: Nomi Health Commercial |
$299.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.59
|
| Rate for Payer: PACE Senior Care Partners |
$86.64
|
| Rate for Payer: PACE SWMI |
$91.20
|
| Rate for Payer: PHP Commercial |
$310.07
|
| Rate for Payer: PHP Medicare Advantage |
$91.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$317.37
|
| Rate for Payer: Priority Health Medicare |
$92.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.89
|
| Rate for Payer: Railroad Medicare Medicare |
$91.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.02
|
| Rate for Payer: UHC Core |
$304.60
|
| Rate for Payer: UHC Exchange |
$91.20
|
| Rate for Payer: UHC Medicaid |
$64.31
|
| Rate for Payer: UHC Medicare Advantage |
$91.20
|
| Rate for Payer: UHCCP Medicaid |
$64.31
|
| Rate for Payer: VA VA |
$91.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.59
|
|
|
HC XR SINUS TRACT FISTULA ABSCESS
|
Facility
|
IP
|
$396.48
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000014
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$275.95 |
| Max. Negotiated Rate |
$356.83 |
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: BCBS Trust/PPO |
$327.45
|
| Rate for Payer: BCN Commercial |
$327.45
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$325.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$344.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.90
|
| Rate for Payer: UHC Core |
$331.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.36
|
|
|
HC XR SINUS TRACT FISTULA ABSCESS
|
Facility
|
OP
|
$396.48
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000014
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$69.90 |
| Max. Negotiated Rate |
$356.83 |
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: Aetna Medicare |
$103.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$123.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$123.90
|
| Rate for Payer: BCBS Complete |
$73.39
|
| Rate for Payer: BCBS MAPPO |
$99.12
|
| Rate for Payer: BCBS Trust/PPO |
$325.95
|
| Rate for Payer: BCN Commercial |
$325.95
|
| Rate for Payer: BCN Medicare Advantage |
$99.12
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.12
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.36
|
| Rate for Payer: Mclaren Medicaid |
$69.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.08
|
| Rate for Payer: Meridian Medicaid |
$73.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$113.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$109.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$325.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PACE Senior Care Partners |
$94.16
|
| Rate for Payer: PACE SWMI |
$99.12
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: PHP Medicare Advantage |
$99.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$344.94
|
| Rate for Payer: Priority Health Medicare |
$100.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.95
|
| Rate for Payer: Railroad Medicare Medicare |
$99.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.90
|
| Rate for Payer: UHC Core |
$331.06
|
| Rate for Payer: UHC Exchange |
$99.12
|
| Rate for Payer: UHC Medicaid |
$69.90
|
| Rate for Payer: UHC Medicare Advantage |
$99.12
|
| Rate for Payer: UHCCP Medicaid |
$69.90
|
| Rate for Payer: VA VA |
$99.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.36
|
|
|
HC XR SKULL LESS THAN 4 VW
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 70250
|
| Hospital Charge Code |
32000017
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$64.27 |
| Max. Negotiated Rate |
$328.08 |
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: Aetna Medicare |
$94.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.92
|
| Rate for Payer: BCBS Complete |
$67.47
|
| Rate for Payer: BCBS MAPPO |
$91.13
|
| Rate for Payer: BCBS Trust/PPO |
$299.68
|
| Rate for Payer: BCN Commercial |
$299.68
|
| Rate for Payer: BCN Medicare Advantage |
$91.13
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.13
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.40
|
| Rate for Payer: Mclaren Medicaid |
$64.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.69
|
| Rate for Payer: Meridian Medicaid |
$67.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$298.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PACE Senior Care Partners |
$86.58
|
| Rate for Payer: PACE SWMI |
$91.13
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: PHP Medicare Advantage |
$91.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$317.14
|
| Rate for Payer: Priority Health Medicare |
$92.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.71
|
| Rate for Payer: Railroad Medicare Medicare |
$91.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.79
|
| Rate for Payer: UHC Core |
$304.38
|
| Rate for Payer: UHC Exchange |
$91.13
|
| Rate for Payer: UHC Medicaid |
$64.27
|
| Rate for Payer: UHC Medicare Advantage |
$91.13
|
| Rate for Payer: UHCCP Medicaid |
$64.27
|
| Rate for Payer: VA VA |
$91.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.40
|
|
|
HC XR SKULL LESS THAN 4 VW
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 70250
|
| Hospital Charge Code |
32000017
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$253.71 |
| Max. Negotiated Rate |
$328.08 |
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: BCBS Trust/PPO |
$301.07
|
| Rate for Payer: BCN Commercial |
$301.07
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$298.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$317.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.79
|
| Rate for Payer: UHC Core |
$304.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.40
|
|
|
HC XR SKULL MIN 4 VW
|
Facility
|
OP
|
$416.36
|
|
|
Service Code
|
CPT 70260
|
| Hospital Charge Code |
32000018
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$73.40 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: Aetna Medicare |
$108.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.11
|
| Rate for Payer: BCBS Complete |
$77.07
|
| Rate for Payer: BCBS MAPPO |
$104.09
|
| Rate for Payer: BCBS Trust/PPO |
$342.29
|
| Rate for Payer: BCN Commercial |
$342.29
|
| Rate for Payer: BCN Medicare Advantage |
$104.09
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.09
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.27
|
| Rate for Payer: Mclaren Medicaid |
$73.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.29
|
| Rate for Payer: Meridian Medicaid |
$77.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Nomi Health Commercial |
$341.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PACE Senior Care Partners |
$98.89
|
| Rate for Payer: PACE SWMI |
$104.09
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: PHP Medicare Advantage |
$104.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.23
|
| Rate for Payer: Priority Health Medicare |
$105.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.79
|
| Rate for Payer: Railroad Medicare Medicare |
$104.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.40
|
| Rate for Payer: UHC Core |
$347.66
|
| Rate for Payer: UHC Exchange |
$104.09
|
| Rate for Payer: UHC Medicaid |
$73.40
|
| Rate for Payer: UHC Medicare Advantage |
$104.09
|
| Rate for Payer: UHCCP Medicaid |
$73.40
|
| Rate for Payer: VA VA |
$104.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.27
|
|
|
HC XR SKULL MIN 4 VW
|
Facility
|
IP
|
$416.36
|
|
|
Service Code
|
CPT 70260
|
| Hospital Charge Code |
32000018
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$289.79 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: BCBS Trust/PPO |
$343.87
|
| Rate for Payer: BCN Commercial |
$343.87
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Nomi Health Commercial |
$341.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.40
|
| Rate for Payer: UHC Core |
$347.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.27
|
|
|
HC XR SMALL BOWEL
|
Facility
|
OP
|
$624.81
|
|
|
Service Code
|
CPT 74250
|
| Hospital Charge Code |
32000144
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$110.15 |
| Max. Negotiated Rate |
$562.33 |
| Rate for Payer: Aetna Commercial |
$531.09
|
| Rate for Payer: Aetna Medicare |
$162.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$195.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$195.25
|
| Rate for Payer: BCBS Complete |
$115.65
|
| Rate for Payer: BCBS MAPPO |
$156.20
|
| Rate for Payer: BCBS Trust/PPO |
$513.66
|
| Rate for Payer: BCN Commercial |
$513.66
|
| Rate for Payer: BCN Medicare Advantage |
$156.20
|
| Rate for Payer: Cash Price |
$499.85
|
| Rate for Payer: Cofinity Commercial |
$537.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.20
|
| Rate for Payer: Healthscope Commercial |
$562.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.61
|
| Rate for Payer: Mclaren Medicaid |
$110.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.01
|
| Rate for Payer: Meridian Medicaid |
$115.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$179.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$171.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$531.09
|
| Rate for Payer: Nomi Health Commercial |
$512.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.61
|
| Rate for Payer: PACE Senior Care Partners |
$148.39
|
| Rate for Payer: PACE SWMI |
$156.20
|
| Rate for Payer: PHP Commercial |
$531.09
|
| Rate for Payer: PHP Medicare Advantage |
$156.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$543.58
|
| Rate for Payer: Priority Health Medicare |
$157.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.87
|
| Rate for Payer: Railroad Medicare Medicare |
$156.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.83
|
| Rate for Payer: UHC Core |
$521.72
|
| Rate for Payer: UHC Exchange |
$156.20
|
| Rate for Payer: UHC Medicaid |
$110.15
|
| Rate for Payer: UHC Medicare Advantage |
$156.20
|
| Rate for Payer: UHCCP Medicaid |
$110.15
|
| Rate for Payer: VA VA |
$156.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.61
|
|
|
HC XR SMALL BOWEL
|
Facility
|
IP
|
$624.81
|
|
|
Service Code
|
CPT 74250
|
| Hospital Charge Code |
32000144
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$434.87 |
| Max. Negotiated Rate |
$562.33 |
| Rate for Payer: Aetna Commercial |
$531.09
|
| Rate for Payer: BCBS Trust/PPO |
$516.03
|
| Rate for Payer: BCN Commercial |
$516.03
|
| Rate for Payer: Cash Price |
$499.85
|
| Rate for Payer: Cofinity Commercial |
$537.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.85
|
| Rate for Payer: Healthscope Commercial |
$562.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$531.09
|
| Rate for Payer: Nomi Health Commercial |
$512.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.61
|
| Rate for Payer: PHP Commercial |
$531.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$543.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.83
|
| Rate for Payer: UHC Core |
$521.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.61
|
|
|
HC XR SMALL BOWEL.
|
Facility
|
IP
|
$290.04
|
|
|
Service Code
|
CPT 74248
|
| Hospital Charge Code |
32000331
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$201.87 |
| Max. Negotiated Rate |
$261.04 |
| Rate for Payer: Aetna Commercial |
$246.53
|
| Rate for Payer: BCBS Trust/PPO |
$239.54
|
| Rate for Payer: BCN Commercial |
$239.54
|
| Rate for Payer: Cash Price |
$232.03
|
| Rate for Payer: Cofinity Commercial |
$249.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.03
|
| Rate for Payer: Healthscope Commercial |
$261.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$217.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$246.53
|
| Rate for Payer: Nomi Health Commercial |
$237.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$217.53
|
| Rate for Payer: PHP Commercial |
$246.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$252.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.24
|
| Rate for Payer: UHC Core |
$242.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$217.53
|
|
|
HC XR SMALL BOWEL.
|
Facility
|
OP
|
$290.04
|
|
|
Service Code
|
CPT 74248
|
| Hospital Charge Code |
32000331
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$51.13 |
| Max. Negotiated Rate |
$261.04 |
| Rate for Payer: Aetna Commercial |
$246.53
|
| Rate for Payer: Aetna Medicare |
$75.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$90.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$90.64
|
| Rate for Payer: BCBS Complete |
$53.69
|
| Rate for Payer: BCBS MAPPO |
$72.51
|
| Rate for Payer: BCBS Trust/PPO |
$238.44
|
| Rate for Payer: BCN Commercial |
$238.44
|
| Rate for Payer: BCN Medicare Advantage |
$72.51
|
| Rate for Payer: Cash Price |
$232.03
|
| Rate for Payer: Cofinity Commercial |
$249.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.51
|
| Rate for Payer: Healthscope Commercial |
$261.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$217.53
|
| Rate for Payer: Mclaren Medicaid |
$51.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.14
|
| Rate for Payer: Meridian Medicaid |
$53.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$79.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$246.53
|
| Rate for Payer: Nomi Health Commercial |
$237.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$217.53
|
| Rate for Payer: PACE Senior Care Partners |
$68.88
|
| Rate for Payer: PACE SWMI |
$72.51
|
| Rate for Payer: PHP Commercial |
$246.53
|
| Rate for Payer: PHP Medicare Advantage |
$72.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$252.33
|
| Rate for Payer: Priority Health Medicare |
$73.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.87
|
| Rate for Payer: Railroad Medicare Medicare |
$72.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.24
|
| Rate for Payer: UHC Core |
$242.18
|
| Rate for Payer: UHC Exchange |
$72.51
|
| Rate for Payer: UHC Medicaid |
$51.13
|
| Rate for Payer: UHC Medicare Advantage |
$72.51
|
| Rate for Payer: UHCCP Medicaid |
$51.13
|
| Rate for Payer: VA VA |
$72.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$217.53
|
|
|
HC XR SMALL BOWEL ENTEROCLYSIS TU
|
Facility
|
IP
|
$832.87
|
|
|
Service Code
|
CPT 74251
|
| Hospital Charge Code |
32000145
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$579.68 |
| Max. Negotiated Rate |
$749.58 |
| Rate for Payer: Aetna Commercial |
$707.94
|
| Rate for Payer: BCBS Trust/PPO |
$687.87
|
| Rate for Payer: BCN Commercial |
$687.87
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Commercial |
$716.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Healthscope Commercial |
$749.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$624.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Nomi Health Commercial |
$682.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: PHP Commercial |
$707.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$724.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$579.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$732.93
|
| Rate for Payer: UHC Core |
$695.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$624.65
|
|
|
HC XR SMALL BOWEL ENTEROCLYSIS TU
|
Facility
|
OP
|
$832.87
|
|
|
Service Code
|
CPT 74251
|
| Hospital Charge Code |
32000145
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$146.83 |
| Max. Negotiated Rate |
$749.58 |
| Rate for Payer: Aetna Commercial |
$707.94
|
| Rate for Payer: Aetna Medicare |
$216.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$260.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$260.27
|
| Rate for Payer: BCBS Complete |
$154.16
|
| Rate for Payer: BCBS MAPPO |
$208.22
|
| Rate for Payer: BCBS Trust/PPO |
$684.70
|
| Rate for Payer: BCN Commercial |
$684.70
|
| Rate for Payer: BCN Medicare Advantage |
$208.22
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Commercial |
$716.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.22
|
| Rate for Payer: Healthscope Commercial |
$749.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$624.65
|
| Rate for Payer: Mclaren Medicaid |
$146.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$218.63
|
| Rate for Payer: Meridian Medicaid |
$154.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$239.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$229.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Nomi Health Commercial |
$682.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: PACE Senior Care Partners |
$197.81
|
| Rate for Payer: PACE SWMI |
$208.22
|
| Rate for Payer: PHP Commercial |
$707.94
|
| Rate for Payer: PHP Medicare Advantage |
$208.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$724.60
|
| Rate for Payer: Priority Health Medicare |
$210.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$579.68
|
| Rate for Payer: Railroad Medicare Medicare |
$208.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$732.93
|
| Rate for Payer: UHC Core |
$695.45
|
| Rate for Payer: UHC Exchange |
$208.22
|
| Rate for Payer: UHC Medicaid |
$146.83
|
| Rate for Payer: UHC Medicare Advantage |
$208.22
|
| Rate for Payer: UHCCP Medicaid |
$146.83
|
| Rate for Payer: VA VA |
$208.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$624.65
|
|
|
HC XR SOFT TISSUE NECK
|
Facility
|
OP
|
$316.75
|
|
|
Service Code
|
CPT 70360
|
| Hospital Charge Code |
32000023
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.84 |
| Max. Negotiated Rate |
$285.07 |
| Rate for Payer: Aetna Commercial |
$269.24
|
| Rate for Payer: Aetna Medicare |
$82.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.98
|
| Rate for Payer: BCBS Complete |
$58.63
|
| Rate for Payer: BCBS MAPPO |
$79.19
|
| Rate for Payer: BCBS Trust/PPO |
$260.40
|
| Rate for Payer: BCN Commercial |
$260.40
|
| Rate for Payer: BCN Medicare Advantage |
$79.19
|
| Rate for Payer: Cash Price |
$253.40
|
| Rate for Payer: Cofinity Commercial |
$272.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$253.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.19
|
| Rate for Payer: Healthscope Commercial |
$285.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$237.56
|
| Rate for Payer: Mclaren Medicaid |
$55.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.15
|
| Rate for Payer: Meridian Medicaid |
$58.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$91.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$87.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$269.24
|
| Rate for Payer: Nomi Health Commercial |
$259.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.56
|
| Rate for Payer: PACE Senior Care Partners |
$75.23
|
| Rate for Payer: PACE SWMI |
$79.19
|
| Rate for Payer: PHP Commercial |
$269.24
|
| Rate for Payer: PHP Medicare Advantage |
$79.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$275.57
|
| Rate for Payer: Priority Health Medicare |
$79.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$220.46
|
| Rate for Payer: Railroad Medicare Medicare |
$79.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$278.74
|
| Rate for Payer: UHC Core |
$264.49
|
| Rate for Payer: UHC Exchange |
$79.19
|
| Rate for Payer: UHC Medicaid |
$55.84
|
| Rate for Payer: UHC Medicare Advantage |
$79.19
|
| Rate for Payer: UHCCP Medicaid |
$55.84
|
| Rate for Payer: VA VA |
$79.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$237.56
|
|
|
HC XR SOFT TISSUE NECK
|
Facility
|
IP
|
$316.75
|
|
|
Service Code
|
CPT 70360
|
| Hospital Charge Code |
32000023
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$220.46 |
| Max. Negotiated Rate |
$285.07 |
| Rate for Payer: Aetna Commercial |
$269.24
|
| Rate for Payer: BCBS Trust/PPO |
$261.60
|
| Rate for Payer: BCN Commercial |
$261.60
|
| Rate for Payer: Cash Price |
$253.40
|
| Rate for Payer: Cofinity Commercial |
$272.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$253.40
|
| Rate for Payer: Healthscope Commercial |
$285.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$237.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$269.24
|
| Rate for Payer: Nomi Health Commercial |
$259.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.56
|
| Rate for Payer: PHP Commercial |
$269.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$275.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$220.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$278.74
|
| Rate for Payer: UHC Core |
$264.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$237.56
|
|
|
HC XR SPECIMEN X-RAY
|
Facility
|
IP
|
$215.02
|
|
|
Service Code
|
CPT 76098
|
| Hospital Charge Code |
32000237
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$149.65 |
| Max. Negotiated Rate |
$193.52 |
| Rate for Payer: Aetna Commercial |
$182.77
|
| Rate for Payer: BCBS Trust/PPO |
$177.59
|
| Rate for Payer: BCN Commercial |
$177.59
|
| Rate for Payer: Cash Price |
$172.02
|
| Rate for Payer: Cofinity Commercial |
$184.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.02
|
| Rate for Payer: Healthscope Commercial |
$193.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.77
|
| Rate for Payer: Nomi Health Commercial |
$176.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.26
|
| Rate for Payer: PHP Commercial |
$182.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$187.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.22
|
| Rate for Payer: UHC Core |
$179.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.26
|
|
|
HC XR SPECIMEN X-RAY
|
Facility
|
OP
|
$215.02
|
|
|
Service Code
|
CPT 76098
|
| Hospital Charge Code |
32000237
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$37.91 |
| Max. Negotiated Rate |
$193.52 |
| Rate for Payer: Aetna Commercial |
$182.77
|
| Rate for Payer: Aetna Medicare |
$55.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.19
|
| Rate for Payer: BCBS Complete |
$39.80
|
| Rate for Payer: BCBS MAPPO |
$53.76
|
| Rate for Payer: BCBS Trust/PPO |
$176.77
|
| Rate for Payer: BCCCP Commercial |
$40.47
|
| Rate for Payer: BCN Commercial |
$176.77
|
| Rate for Payer: BCN Medicare Advantage |
$53.76
|
| Rate for Payer: Cash Price |
$172.02
|
| Rate for Payer: Cash Price |
$172.02
|
| Rate for Payer: Cofinity Commercial |
$184.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.76
|
| Rate for Payer: Healthscope Commercial |
$193.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.26
|
| Rate for Payer: Mclaren Medicaid |
$37.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.44
|
| Rate for Payer: Meridian Medicaid |
$39.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$59.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.77
|
| Rate for Payer: Nomi Health Commercial |
$176.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.26
|
| Rate for Payer: PACE Senior Care Partners |
$51.07
|
| Rate for Payer: PACE SWMI |
$53.76
|
| Rate for Payer: PHP Commercial |
$182.77
|
| Rate for Payer: PHP Medicare Advantage |
$53.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$187.07
|
| Rate for Payer: Priority Health Medicare |
$54.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.65
|
| Rate for Payer: Railroad Medicare Medicare |
$53.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.22
|
| Rate for Payer: UHC Core |
$179.54
|
| Rate for Payer: UHC Exchange |
$53.76
|
| Rate for Payer: UHC Medicaid |
$37.91
|
| Rate for Payer: UHC Medicare Advantage |
$53.76
|
| Rate for Payer: UHCCP Medicaid |
$37.91
|
| Rate for Payer: VA VA |
$53.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.26
|
|
|
HC XR SPINE CERV 6VW OR MORE
|
Facility
|
IP
|
$520.60
|
|
|
Service Code
|
CPT 72052
|
| Hospital Charge Code |
32000037
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$362.34 |
| Max. Negotiated Rate |
$468.54 |
| Rate for Payer: Aetna Commercial |
$442.51
|
| Rate for Payer: BCBS Trust/PPO |
$429.96
|
| Rate for Payer: BCN Commercial |
$429.96
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cofinity Commercial |
$447.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.48
|
| Rate for Payer: Healthscope Commercial |
$468.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.51
|
| Rate for Payer: Nomi Health Commercial |
$426.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.45
|
| Rate for Payer: PHP Commercial |
$442.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$452.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$362.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$458.13
|
| Rate for Payer: UHC Core |
$434.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.45
|
|
|
HC XR SPINE CERV 6VW OR MORE
|
Facility
|
OP
|
$520.60
|
|
|
Service Code
|
CPT 72052
|
| Hospital Charge Code |
32000037
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$91.78 |
| Max. Negotiated Rate |
$468.54 |
| Rate for Payer: Aetna Commercial |
$442.51
|
| Rate for Payer: Aetna Medicare |
$135.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$162.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$162.69
|
| Rate for Payer: BCBS Complete |
$96.36
|
| Rate for Payer: BCBS MAPPO |
$130.15
|
| Rate for Payer: BCBS Trust/PPO |
$427.99
|
| Rate for Payer: BCN Commercial |
$427.99
|
| Rate for Payer: BCN Medicare Advantage |
$130.15
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cofinity Commercial |
$447.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.15
|
| Rate for Payer: Healthscope Commercial |
$468.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.45
|
| Rate for Payer: Mclaren Medicaid |
$91.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.66
|
| Rate for Payer: Meridian Medicaid |
$96.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$149.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$143.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.51
|
| Rate for Payer: Nomi Health Commercial |
$426.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.45
|
| Rate for Payer: PACE Senior Care Partners |
$123.64
|
| Rate for Payer: PACE SWMI |
$130.15
|
| Rate for Payer: PHP Commercial |
$442.51
|
| Rate for Payer: PHP Medicare Advantage |
$130.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$452.92
|
| Rate for Payer: Priority Health Medicare |
$131.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$362.34
|
| Rate for Payer: Railroad Medicare Medicare |
$130.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$458.13
|
| Rate for Payer: UHC Core |
$434.70
|
| Rate for Payer: UHC Exchange |
$130.15
|
| Rate for Payer: UHC Medicaid |
$91.78
|
| Rate for Payer: UHC Medicare Advantage |
$130.15
|
| Rate for Payer: UHCCP Medicaid |
$91.78
|
| Rate for Payer: VA VA |
$130.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.45
|
|
|
HC XR SPINE CERVICAL 3VW OR LESS
|
Facility
|
OP
|
$385.45
|
|
|
Service Code
|
CPT 72040
|
| Hospital Charge Code |
32000035
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$67.95 |
| Max. Negotiated Rate |
$346.90 |
| Rate for Payer: Aetna Commercial |
$327.63
|
| Rate for Payer: Aetna Medicare |
$100.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$120.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$120.45
|
| Rate for Payer: BCBS Complete |
$71.35
|
| Rate for Payer: BCBS MAPPO |
$96.36
|
| Rate for Payer: BCBS Trust/PPO |
$316.88
|
| Rate for Payer: BCN Commercial |
$316.88
|
| Rate for Payer: BCN Medicare Advantage |
$96.36
|
| Rate for Payer: Cash Price |
$308.36
|
| Rate for Payer: Cofinity Commercial |
$331.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.36
|
| Rate for Payer: Healthscope Commercial |
$346.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.09
|
| Rate for Payer: Mclaren Medicaid |
$67.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.18
|
| Rate for Payer: Meridian Medicaid |
$71.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$106.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.63
|
| Rate for Payer: Nomi Health Commercial |
$316.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.09
|
| Rate for Payer: PACE Senior Care Partners |
$91.54
|
| Rate for Payer: PACE SWMI |
$96.36
|
| Rate for Payer: PHP Commercial |
$327.63
|
| Rate for Payer: PHP Medicare Advantage |
$96.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$335.34
|
| Rate for Payer: Priority Health Medicare |
$97.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$268.27
|
| Rate for Payer: Railroad Medicare Medicare |
$96.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.20
|
| Rate for Payer: UHC Core |
$321.85
|
| Rate for Payer: UHC Exchange |
$96.36
|
| Rate for Payer: UHC Medicaid |
$67.95
|
| Rate for Payer: UHC Medicare Advantage |
$96.36
|
| Rate for Payer: UHCCP Medicaid |
$67.95
|
| Rate for Payer: VA VA |
$96.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.09
|
|
|
HC XR SPINE CERVICAL 3VW OR LESS
|
Facility
|
IP
|
$385.45
|
|
|
Service Code
|
CPT 72040
|
| Hospital Charge Code |
32000035
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$268.27 |
| Max. Negotiated Rate |
$346.90 |
| Rate for Payer: Aetna Commercial |
$327.63
|
| Rate for Payer: BCBS Trust/PPO |
$318.34
|
| Rate for Payer: BCN Commercial |
$318.34
|
| Rate for Payer: Cash Price |
$308.36
|
| Rate for Payer: Cofinity Commercial |
$331.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.36
|
| Rate for Payer: Healthscope Commercial |
$346.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.63
|
| Rate for Payer: Nomi Health Commercial |
$316.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.09
|
| Rate for Payer: PHP Commercial |
$327.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$335.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$268.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.20
|
| Rate for Payer: UHC Core |
$321.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.09
|
|
|
HC XR SPINE CERVICAL 4 OR 5 VW
|
Facility
|
OP
|
$479.01
|
|
|
Service Code
|
CPT 72050
|
| Hospital Charge Code |
32000036
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$84.45 |
| Max. Negotiated Rate |
$431.11 |
| Rate for Payer: Aetna Commercial |
$407.16
|
| Rate for Payer: Aetna Medicare |
$124.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$149.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$149.69
|
| Rate for Payer: BCBS Complete |
$88.66
|
| Rate for Payer: BCBS MAPPO |
$119.75
|
| Rate for Payer: BCBS Trust/PPO |
$393.79
|
| Rate for Payer: BCN Commercial |
$393.79
|
| Rate for Payer: BCN Medicare Advantage |
$119.75
|
| Rate for Payer: Cash Price |
$383.21
|
| Rate for Payer: Cofinity Commercial |
$411.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$383.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.75
|
| Rate for Payer: Healthscope Commercial |
$431.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$359.26
|
| Rate for Payer: Mclaren Medicaid |
$84.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.74
|
| Rate for Payer: Meridian Medicaid |
$88.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$137.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$131.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$407.16
|
| Rate for Payer: Nomi Health Commercial |
$392.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$359.26
|
| Rate for Payer: PACE Senior Care Partners |
$113.76
|
| Rate for Payer: PACE SWMI |
$119.75
|
| Rate for Payer: PHP Commercial |
$407.16
|
| Rate for Payer: PHP Medicare Advantage |
$119.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$416.74
|
| Rate for Payer: Priority Health Medicare |
$120.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$333.39
|
| Rate for Payer: Railroad Medicare Medicare |
$119.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$421.53
|
| Rate for Payer: UHC Core |
$399.97
|
| Rate for Payer: UHC Exchange |
$119.75
|
| Rate for Payer: UHC Medicaid |
$84.45
|
| Rate for Payer: UHC Medicare Advantage |
$119.75
|
| Rate for Payer: UHCCP Medicaid |
$84.45
|
| Rate for Payer: VA VA |
$119.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$359.26
|
|
|
HC XR SPINE CERVICAL 4 OR 5 VW
|
Facility
|
IP
|
$479.01
|
|
|
Service Code
|
CPT 72050
|
| Hospital Charge Code |
32000036
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$333.39 |
| Max. Negotiated Rate |
$431.11 |
| Rate for Payer: Aetna Commercial |
$407.16
|
| Rate for Payer: BCBS Trust/PPO |
$395.61
|
| Rate for Payer: BCN Commercial |
$395.61
|
| Rate for Payer: Cash Price |
$383.21
|
| Rate for Payer: Cofinity Commercial |
$411.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$383.21
|
| Rate for Payer: Healthscope Commercial |
$431.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$359.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$407.16
|
| Rate for Payer: Nomi Health Commercial |
$392.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$359.26
|
| Rate for Payer: PHP Commercial |
$407.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$416.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$333.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$421.53
|
| Rate for Payer: UHC Core |
$399.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$359.26
|
|
|
HC XR SPINE LUMBAR 2 OR 3 VW
|
Facility
|
IP
|
$416.36
|
|
|
Service Code
|
CPT 72100
|
| Hospital Charge Code |
32000044
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$289.79 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: BCBS Trust/PPO |
$343.87
|
| Rate for Payer: BCN Commercial |
$343.87
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Nomi Health Commercial |
$341.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.40
|
| Rate for Payer: UHC Core |
$347.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.27
|
|
