|
HC XR SPINE LUMBAR 2 OR 3 VW
|
Facility
|
OP
|
$416.36
|
|
|
Service Code
|
CPT 72100
|
| Hospital Charge Code |
32000044
|
|
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 SPINE LUMBAR BENDING ONLY 4
|
Facility
|
IP
|
$396.48
|
|
|
Service Code
|
CPT 72120
|
| Hospital Charge Code |
32000047
|
|
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 SPINE LUMBAR BENDING ONLY 4
|
Facility
|
OP
|
$396.48
|
|
|
Service Code
|
CPT 72120
|
| Hospital Charge Code |
32000047
|
|
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 SPINE LUMBAR MIN 4 VW
|
Facility
|
IP
|
$446.38
|
|
|
Service Code
|
CPT 72110
|
| Hospital Charge Code |
32000045
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$310.68 |
| Max. Negotiated Rate |
$401.74 |
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: BCBS Trust/PPO |
$368.67
|
| Rate for Payer: BCN Commercial |
$368.67
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$366.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$388.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.81
|
| Rate for Payer: UHC Core |
$372.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC XR SPINE LUMBAR MIN 4 VW
|
Facility
|
OP
|
$446.38
|
|
|
Service Code
|
CPT 72110
|
| Hospital Charge Code |
32000045
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$78.70 |
| Max. Negotiated Rate |
$401.74 |
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: Aetna Medicare |
$116.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$139.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$139.49
|
| Rate for Payer: BCBS Complete |
$82.62
|
| Rate for Payer: BCBS MAPPO |
$111.59
|
| Rate for Payer: BCBS Trust/PPO |
$366.97
|
| Rate for Payer: BCN Commercial |
$366.97
|
| Rate for Payer: BCN Medicare Advantage |
$111.59
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.59
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: Mclaren Medicaid |
$78.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.17
|
| Rate for Payer: Meridian Medicaid |
$82.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$122.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$366.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PACE Senior Care Partners |
$106.02
|
| Rate for Payer: PACE SWMI |
$111.59
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: PHP Medicare Advantage |
$111.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$388.35
|
| Rate for Payer: Priority Health Medicare |
$112.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.68
|
| Rate for Payer: Railroad Medicare Medicare |
$111.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.81
|
| Rate for Payer: UHC Core |
$372.73
|
| Rate for Payer: UHC Exchange |
$111.59
|
| Rate for Payer: UHC Medicaid |
$78.70
|
| Rate for Payer: UHC Medicare Advantage |
$111.59
|
| Rate for Payer: UHCCP Medicaid |
$78.70
|
| Rate for Payer: VA VA |
$111.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC XR SPINE LUMB COMP W BEND MIN 6 VW
|
Facility
|
IP
|
$574.54
|
|
|
Service Code
|
CPT 72114
|
| Hospital Charge Code |
32000046
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$399.88 |
| Max. Negotiated Rate |
$517.09 |
| Rate for Payer: Aetna Commercial |
$488.36
|
| Rate for Payer: BCBS Trust/PPO |
$474.51
|
| Rate for Payer: BCN Commercial |
$474.51
|
| Rate for Payer: Cash Price |
$459.63
|
| Rate for Payer: Cofinity Commercial |
$494.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$459.63
|
| Rate for Payer: Healthscope Commercial |
$517.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$430.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$488.36
|
| Rate for Payer: Nomi Health Commercial |
$471.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$430.90
|
| Rate for Payer: PHP Commercial |
$488.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$499.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$399.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$505.60
|
| Rate for Payer: UHC Core |
$479.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$430.90
|
|
|
HC XR SPINE LUMB COMP W BEND MIN 6 VW
|
Facility
|
OP
|
$574.54
|
|
|
Service Code
|
CPT 72114
|
| Hospital Charge Code |
32000046
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$101.29 |
| Max. Negotiated Rate |
$517.09 |
| Rate for Payer: Aetna Commercial |
$488.36
|
| Rate for Payer: Aetna Medicare |
$149.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$179.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$179.54
|
| Rate for Payer: BCBS Complete |
$106.35
|
| Rate for Payer: BCBS MAPPO |
$143.63
|
| Rate for Payer: BCBS Trust/PPO |
$472.33
|
| Rate for Payer: BCN Commercial |
$472.33
|
| Rate for Payer: BCN Medicare Advantage |
$143.63
|
| Rate for Payer: Cash Price |
$459.63
|
| Rate for Payer: Cofinity Commercial |
$494.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$459.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.63
|
| Rate for Payer: Healthscope Commercial |
$517.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$430.90
|
| Rate for Payer: Mclaren Medicaid |
$101.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.82
|
| Rate for Payer: Meridian Medicaid |
$106.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$165.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$158.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$488.36
|
| Rate for Payer: Nomi Health Commercial |
$471.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$430.90
|
| Rate for Payer: PACE Senior Care Partners |
$136.45
|
| Rate for Payer: PACE SWMI |
$143.63
|
| Rate for Payer: PHP Commercial |
$488.36
|
| Rate for Payer: PHP Medicare Advantage |
$143.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$499.85
|
| Rate for Payer: Priority Health Medicare |
$145.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$399.88
|
| Rate for Payer: Railroad Medicare Medicare |
$143.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$505.60
|
| Rate for Payer: UHC Core |
$479.74
|
| Rate for Payer: UHC Exchange |
$143.63
|
| Rate for Payer: UHC Medicaid |
$101.29
|
| Rate for Payer: UHC Medicare Advantage |
$143.63
|
| Rate for Payer: UHCCP Medicaid |
$101.29
|
| Rate for Payer: VA VA |
$143.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$430.90
|
|
|
HC XR SPINE SINGLE VW
|
Facility
|
IP
|
$191.46
|
|
|
Service Code
|
CPT 72020
|
| Hospital Charge Code |
32000034
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$133.26 |
| Max. Negotiated Rate |
$172.31 |
| Rate for Payer: Aetna Commercial |
$162.74
|
| Rate for Payer: BCBS Trust/PPO |
$158.13
|
| Rate for Payer: BCN Commercial |
$158.13
|
| Rate for Payer: Cash Price |
$153.17
|
| Rate for Payer: Cofinity Commercial |
$164.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.17
|
| Rate for Payer: Healthscope Commercial |
$172.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.74
|
| Rate for Payer: Nomi Health Commercial |
$157.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.59
|
| Rate for Payer: PHP Commercial |
$162.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$166.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.48
|
| Rate for Payer: UHC Core |
$159.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.59
|
|
|
HC XR SPINE SINGLE VW
|
Facility
|
OP
|
$191.46
|
|
|
Service Code
|
CPT 72020
|
| Hospital Charge Code |
32000034
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$33.75 |
| Max. Negotiated Rate |
$172.31 |
| Rate for Payer: Aetna Commercial |
$162.74
|
| Rate for Payer: Aetna Medicare |
$49.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.83
|
| Rate for Payer: BCBS Complete |
$35.44
|
| Rate for Payer: BCBS MAPPO |
$47.87
|
| Rate for Payer: BCBS Trust/PPO |
$157.40
|
| Rate for Payer: BCN Commercial |
$157.40
|
| Rate for Payer: BCN Medicare Advantage |
$47.87
|
| Rate for Payer: Cash Price |
$153.17
|
| Rate for Payer: Cofinity Commercial |
$164.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.87
|
| Rate for Payer: Healthscope Commercial |
$172.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.59
|
| Rate for Payer: Mclaren Medicaid |
$33.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.26
|
| Rate for Payer: Meridian Medicaid |
$35.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$52.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.74
|
| Rate for Payer: Nomi Health Commercial |
$157.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.59
|
| Rate for Payer: PACE Senior Care Partners |
$45.47
|
| Rate for Payer: PACE SWMI |
$47.87
|
| Rate for Payer: PHP Commercial |
$162.74
|
| Rate for Payer: PHP Medicare Advantage |
$47.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$166.57
|
| Rate for Payer: Priority Health Medicare |
$48.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.26
|
| Rate for Payer: Railroad Medicare Medicare |
$47.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.48
|
| Rate for Payer: UHC Core |
$159.87
|
| Rate for Payer: UHC Exchange |
$47.87
|
| Rate for Payer: UHC Medicaid |
$33.75
|
| Rate for Payer: UHC Medicare Advantage |
$47.87
|
| Rate for Payer: UHCCP Medicaid |
$33.75
|
| Rate for Payer: VA VA |
$47.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.59
|
|
|
HC XR SPINE THORACIC 2 VW
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 72070
|
| Hospital Charge Code |
32000039
|
|
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 SPINE THORACIC 2 VW
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 72070
|
| Hospital Charge Code |
32000039
|
|
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 SPINE THORACIC 3 VW
|
Facility
|
IP
|
$416.36
|
|
|
Service Code
|
CPT 72072
|
| Hospital Charge Code |
32000040
|
|
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 SPINE THORACIC 3 VW
|
Facility
|
OP
|
$416.36
|
|
|
Service Code
|
CPT 72072
|
| Hospital Charge Code |
32000040
|
|
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 SPINE THORACIC 4 VW OR MORE
|
Facility
|
IP
|
$520.60
|
|
|
Service Code
|
CPT 72074
|
| Hospital Charge Code |
32000041
|
|
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 THORACIC 4 VW OR MORE
|
Facility
|
OP
|
$520.60
|
|
|
Service Code
|
CPT 72074
|
| Hospital Charge Code |
32000041
|
|
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 THORACOLUMBAR 2 VW
|
Facility
|
IP
|
$390.58
|
|
|
Service Code
|
CPT 72080
|
| Hospital Charge Code |
32000042
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$271.84 |
| Max. Negotiated Rate |
$351.52 |
| Rate for Payer: Aetna Commercial |
$331.99
|
| Rate for Payer: BCBS Trust/PPO |
$322.58
|
| Rate for Payer: BCN Commercial |
$322.58
|
| Rate for Payer: Cash Price |
$312.46
|
| Rate for Payer: Cofinity Commercial |
$335.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.46
|
| Rate for Payer: Healthscope Commercial |
$351.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.99
|
| Rate for Payer: Nomi Health Commercial |
$320.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$292.94
|
| Rate for Payer: PHP Commercial |
$331.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$339.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$271.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.71
|
| Rate for Payer: UHC Core |
$326.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.94
|
|
|
HC XR SPINE THORACOLUMBAR 2 VW
|
Facility
|
OP
|
$390.58
|
|
|
Service Code
|
CPT 72080
|
| Hospital Charge Code |
32000042
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$68.86 |
| Max. Negotiated Rate |
$351.52 |
| Rate for Payer: Aetna Commercial |
$331.99
|
| Rate for Payer: Aetna Medicare |
$101.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.06
|
| Rate for Payer: BCBS Complete |
$72.30
|
| Rate for Payer: BCBS MAPPO |
$97.64
|
| Rate for Payer: BCBS Trust/PPO |
$321.10
|
| Rate for Payer: BCN Commercial |
$321.10
|
| Rate for Payer: BCN Medicare Advantage |
$97.64
|
| Rate for Payer: Cash Price |
$312.46
|
| Rate for Payer: Cofinity Commercial |
$335.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.64
|
| Rate for Payer: Healthscope Commercial |
$351.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.94
|
| Rate for Payer: Mclaren Medicaid |
$68.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.53
|
| Rate for Payer: Meridian Medicaid |
$72.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.99
|
| Rate for Payer: Nomi Health Commercial |
$320.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$292.94
|
| Rate for Payer: PACE Senior Care Partners |
$92.76
|
| Rate for Payer: PACE SWMI |
$97.64
|
| Rate for Payer: PHP Commercial |
$331.99
|
| Rate for Payer: PHP Medicare Advantage |
$97.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$339.80
|
| Rate for Payer: Priority Health Medicare |
$98.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$271.84
|
| Rate for Payer: Railroad Medicare Medicare |
$97.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.71
|
| Rate for Payer: UHC Core |
$326.13
|
| Rate for Payer: UHC Exchange |
$97.64
|
| Rate for Payer: UHC Medicaid |
$68.86
|
| Rate for Payer: UHC Medicare Advantage |
$97.64
|
| Rate for Payer: UHCCP Medicaid |
$68.86
|
| Rate for Payer: VA VA |
$97.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.94
|
|
|
HC XR STERNOCLAV JTS MIN 3 VW
|
Facility
|
OP
|
$312.56
|
|
|
Service Code
|
CPT 71130
|
| Hospital Charge Code |
32000032
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.10 |
| Max. Negotiated Rate |
$281.30 |
| Rate for Payer: Aetna Commercial |
$265.68
|
| Rate for Payer: Aetna Medicare |
$81.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$97.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$97.67
|
| Rate for Payer: BCBS Complete |
$57.85
|
| Rate for Payer: BCBS MAPPO |
$78.14
|
| Rate for Payer: BCBS Trust/PPO |
$256.96
|
| Rate for Payer: BCN Commercial |
$256.96
|
| Rate for Payer: BCN Medicare Advantage |
$78.14
|
| Rate for Payer: Cash Price |
$250.05
|
| Rate for Payer: Cofinity Commercial |
$268.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$250.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.14
|
| Rate for Payer: Healthscope Commercial |
$281.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.42
|
| Rate for Payer: Mclaren Medicaid |
$55.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.05
|
| Rate for Payer: Meridian Medicaid |
$57.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$85.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.68
|
| Rate for Payer: Nomi Health Commercial |
$256.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.42
|
| Rate for Payer: PACE Senior Care Partners |
$74.23
|
| Rate for Payer: PACE SWMI |
$78.14
|
| Rate for Payer: PHP Commercial |
$265.68
|
| Rate for Payer: PHP Medicare Advantage |
$78.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$271.93
|
| Rate for Payer: Priority Health Medicare |
$78.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.54
|
| Rate for Payer: Railroad Medicare Medicare |
$78.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$275.05
|
| Rate for Payer: UHC Core |
$260.99
|
| Rate for Payer: UHC Exchange |
$78.14
|
| Rate for Payer: UHC Medicaid |
$55.10
|
| Rate for Payer: UHC Medicare Advantage |
$78.14
|
| Rate for Payer: UHCCP Medicaid |
$55.10
|
| Rate for Payer: VA VA |
$78.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.42
|
|
|
HC XR STERNOCLAV JTS MIN 3 VW
|
Facility
|
IP
|
$312.56
|
|
|
Service Code
|
CPT 71130
|
| Hospital Charge Code |
32000032
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$217.54 |
| Max. Negotiated Rate |
$281.30 |
| Rate for Payer: Aetna Commercial |
$265.68
|
| Rate for Payer: BCBS Trust/PPO |
$258.14
|
| Rate for Payer: BCN Commercial |
$258.14
|
| Rate for Payer: Cash Price |
$250.05
|
| Rate for Payer: Cofinity Commercial |
$268.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$250.05
|
| Rate for Payer: Healthscope Commercial |
$281.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.68
|
| Rate for Payer: Nomi Health Commercial |
$256.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.42
|
| Rate for Payer: PHP Commercial |
$265.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$271.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$275.05
|
| Rate for Payer: UHC Core |
$260.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.42
|
|
|
HC XR STERNUM MIN 2 VW
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 71120
|
| Hospital Charge Code |
32000031
|
|
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 STERNUM MIN 2 VW
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 71120
|
| Hospital Charge Code |
32000031
|
|
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 SWALLOWING FUNC W CINE VIDE
|
Facility
|
IP
|
$593.63
|
|
|
Service Code
|
CPT 74230
|
| Hospital Charge Code |
32000137
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$413.17 |
| Max. Negotiated Rate |
$534.27 |
| Rate for Payer: Aetna Commercial |
$504.59
|
| Rate for Payer: BCBS Trust/PPO |
$490.28
|
| Rate for Payer: BCN Commercial |
$490.28
|
| Rate for Payer: Cash Price |
$474.90
|
| Rate for Payer: Cofinity Commercial |
$510.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$474.90
|
| Rate for Payer: Healthscope Commercial |
$534.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$445.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$504.59
|
| Rate for Payer: Nomi Health Commercial |
$486.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$445.22
|
| Rate for Payer: PHP Commercial |
$504.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$516.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$413.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$522.39
|
| Rate for Payer: UHC Core |
$495.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$445.22
|
|
|
HC XR SWALLOWING FUNC W CINE VIDE
|
Facility
|
OP
|
$593.63
|
|
|
Service Code
|
CPT 74230
|
| Hospital Charge Code |
32000137
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$104.66 |
| Max. Negotiated Rate |
$534.27 |
| Rate for Payer: Aetna Commercial |
$504.59
|
| Rate for Payer: Aetna Medicare |
$154.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$185.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$185.51
|
| Rate for Payer: BCBS Complete |
$109.88
|
| Rate for Payer: BCBS MAPPO |
$148.41
|
| Rate for Payer: BCBS Trust/PPO |
$488.02
|
| Rate for Payer: BCN Commercial |
$488.02
|
| Rate for Payer: BCN Medicare Advantage |
$148.41
|
| Rate for Payer: Cash Price |
$474.90
|
| Rate for Payer: Cofinity Commercial |
$510.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$474.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.41
|
| Rate for Payer: Healthscope Commercial |
$534.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$445.22
|
| Rate for Payer: Mclaren Medicaid |
$104.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$155.83
|
| Rate for Payer: Meridian Medicaid |
$109.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$170.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$163.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$504.59
|
| Rate for Payer: Nomi Health Commercial |
$486.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$445.22
|
| Rate for Payer: PACE Senior Care Partners |
$140.99
|
| Rate for Payer: PACE SWMI |
$148.41
|
| Rate for Payer: PHP Commercial |
$504.59
|
| Rate for Payer: PHP Medicare Advantage |
$148.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$516.46
|
| Rate for Payer: Priority Health Medicare |
$149.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$413.17
|
| Rate for Payer: Railroad Medicare Medicare |
$148.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$522.39
|
| Rate for Payer: UHC Core |
$495.68
|
| Rate for Payer: UHC Exchange |
$148.41
|
| Rate for Payer: UHC Medicaid |
$104.66
|
| Rate for Payer: UHC Medicare Advantage |
$148.41
|
| Rate for Payer: UHCCP Medicaid |
$104.66
|
| Rate for Payer: VA VA |
$148.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$445.22
|
|
|
HC XR TEETH COMPLETE FULL MOUTH
|
Facility
|
OP
|
$228.33
|
|
|
Service Code
|
CPT 70320
|
| Hospital Charge Code |
32000020
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$40.25 |
| Max. Negotiated Rate |
$205.50 |
| Rate for Payer: Aetna Commercial |
$194.08
|
| Rate for Payer: Aetna Medicare |
$59.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71.35
|
| Rate for Payer: BCBS Complete |
$42.26
|
| Rate for Payer: BCBS MAPPO |
$57.08
|
| Rate for Payer: BCBS Trust/PPO |
$187.71
|
| Rate for Payer: BCN Commercial |
$187.71
|
| Rate for Payer: BCN Medicare Advantage |
$57.08
|
| Rate for Payer: Cash Price |
$182.66
|
| Rate for Payer: Cofinity Commercial |
$196.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.08
|
| Rate for Payer: Healthscope Commercial |
$205.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.25
|
| Rate for Payer: Mclaren Medicaid |
$40.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.94
|
| Rate for Payer: Meridian Medicaid |
$42.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$62.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.08
|
| Rate for Payer: Nomi Health Commercial |
$187.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$171.25
|
| Rate for Payer: PACE Senior Care Partners |
$54.23
|
| Rate for Payer: PACE SWMI |
$57.08
|
| Rate for Payer: PHP Commercial |
$194.08
|
| Rate for Payer: PHP Medicare Advantage |
$57.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$198.65
|
| Rate for Payer: Priority Health Medicare |
$57.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.92
|
| Rate for Payer: Railroad Medicare Medicare |
$57.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$200.93
|
| Rate for Payer: UHC Core |
$190.66
|
| Rate for Payer: UHC Exchange |
$57.08
|
| Rate for Payer: UHC Medicaid |
$40.25
|
| Rate for Payer: UHC Medicare Advantage |
$57.08
|
| Rate for Payer: UHCCP Medicaid |
$40.25
|
| Rate for Payer: VA VA |
$57.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.25
|
|
|
HC XR TEETH COMPLETE FULL MOUTH
|
Facility
|
IP
|
$228.33
|
|
|
Service Code
|
CPT 70320
|
| Hospital Charge Code |
32000020
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$158.92 |
| Max. Negotiated Rate |
$205.50 |
| Rate for Payer: Aetna Commercial |
$194.08
|
| Rate for Payer: BCBS Trust/PPO |
$188.58
|
| Rate for Payer: BCN Commercial |
$188.58
|
| Rate for Payer: Cash Price |
$182.66
|
| Rate for Payer: Cofinity Commercial |
$196.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.66
|
| Rate for Payer: Healthscope Commercial |
$205.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.08
|
| Rate for Payer: Nomi Health Commercial |
$187.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$171.25
|
| Rate for Payer: PHP Commercial |
$194.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$198.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$200.93
|
| Rate for Payer: UHC Core |
$190.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.25
|
|
