|
HC XR SMALL BOWEL
|
Facility
|
OP
|
$612.56
|
|
|
Service Code
|
CPT 74250
|
| Hospital Charge Code |
32000144
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$128.71 |
| Max. Negotiated Rate |
$551.30 |
| Rate for Payer: Aetna Commercial |
$520.68
|
| Rate for Payer: Aetna Medicare |
$159.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.43
|
| Rate for Payer: BCBS Complete |
$135.15
|
| Rate for Payer: BCBS MAPPO |
$153.14
|
| Rate for Payer: BCBS Trust/PPO |
$503.59
|
| Rate for Payer: BCN Commercial |
$476.27
|
| Rate for Payer: BCN Medicare Advantage |
$153.14
|
| Rate for Payer: Cash Price |
$490.05
|
| Rate for Payer: Cash Price |
$490.05
|
| Rate for Payer: Cofinity Commercial |
$526.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$490.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.14
|
| Rate for Payer: Healthscope Commercial |
$551.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.42
|
| Rate for Payer: Mclaren Medicaid |
$128.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.80
|
| Rate for Payer: Meridian Medicaid |
$135.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.68
|
| Rate for Payer: Nomi Health Commercial |
$502.30
|
| Rate for Payer: PACE Senior Care Partners |
$145.48
|
| Rate for Payer: PACE SWMI |
$153.14
|
| Rate for Payer: PHP Commercial |
$520.68
|
| Rate for Payer: PHP Medicare Advantage |
$153.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$398.16
|
| Rate for Payer: Priority Health HMO/PPO |
$532.93
|
| Rate for Payer: Priority Health Medicare |
$154.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$410.42
|
| Rate for Payer: Railroad Medicare Medicare |
$153.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$539.05
|
| Rate for Payer: UHC Core |
$511.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.14
|
| Rate for Payer: UHC Exchange |
$153.14
|
| Rate for Payer: UHC Medicare Advantage |
$153.14
|
| Rate for Payer: UHCCP Medicaid |
$128.71
|
| Rate for Payer: VA VA |
$153.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.42
|
|
|
HC XR SMALL BOWEL
|
Facility
|
IP
|
$612.56
|
|
|
Service Code
|
CPT 74250
|
| Hospital Charge Code |
32000144
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$398.16 |
| Max. Negotiated Rate |
$551.30 |
| Rate for Payer: Aetna Commercial |
$520.68
|
| Rate for Payer: BCBS Trust/PPO |
$500.03
|
| Rate for Payer: BCN Commercial |
$473.39
|
| Rate for Payer: Cash Price |
$490.05
|
| Rate for Payer: Cofinity Commercial |
$526.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$490.05
|
| Rate for Payer: Healthscope Commercial |
$551.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.68
|
| Rate for Payer: Nomi Health Commercial |
$502.30
|
| Rate for Payer: PHP Commercial |
$520.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$398.16
|
| Rate for Payer: Priority Health HMO/PPO |
$532.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$410.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$539.05
|
| Rate for Payer: UHC Core |
$511.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.42
|
|
|
HC XR SMALL BOWEL.
|
Facility
|
IP
|
$284.35
|
|
|
Service Code
|
CPT 74248
|
| Hospital Charge Code |
32000331
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$184.83 |
| Max. Negotiated Rate |
$255.91 |
| Rate for Payer: Aetna Commercial |
$241.70
|
| Rate for Payer: BCBS Trust/PPO |
$232.11
|
| Rate for Payer: BCN Commercial |
$219.75
|
| Rate for Payer: Cash Price |
$227.48
|
| Rate for Payer: Cofinity Commercial |
$244.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.48
|
| Rate for Payer: Healthscope Commercial |
$255.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.70
|
| Rate for Payer: Nomi Health Commercial |
$233.17
|
| Rate for Payer: PHP Commercial |
$241.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.83
|
| Rate for Payer: Priority Health HMO/PPO |
$247.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$190.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.23
|
| Rate for Payer: UHC Core |
$237.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.26
|
|
|
HC XR SMALL BOWEL.
|
Facility
|
OP
|
$284.35
|
|
|
Service Code
|
CPT 74248
|
| Hospital Charge Code |
32000331
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$67.53 |
| Max. Negotiated Rate |
$255.91 |
| Rate for Payer: Aetna Commercial |
$241.70
|
| Rate for Payer: Aetna Medicare |
$73.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$88.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$88.86
|
| Rate for Payer: BCBS Complete |
$113.74
|
| Rate for Payer: BCBS MAPPO |
$71.09
|
| Rate for Payer: BCBS Trust/PPO |
$233.76
|
| Rate for Payer: BCN Commercial |
$221.08
|
| Rate for Payer: BCN Medicare Advantage |
$71.09
|
| Rate for Payer: Cash Price |
$227.48
|
| Rate for Payer: Cofinity Commercial |
$244.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.09
|
| Rate for Payer: Healthscope Commercial |
$255.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.70
|
| Rate for Payer: Nomi Health Commercial |
$233.17
|
| Rate for Payer: PACE Senior Care Partners |
$67.53
|
| Rate for Payer: PACE SWMI |
$71.09
|
| Rate for Payer: PHP Commercial |
$241.70
|
| Rate for Payer: PHP Medicare Advantage |
$71.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.83
|
| Rate for Payer: Priority Health HMO/PPO |
$247.38
|
| Rate for Payer: Priority Health Medicare |
$71.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$190.51
|
| Rate for Payer: Railroad Medicare Medicare |
$71.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.23
|
| Rate for Payer: UHC Core |
$237.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.09
|
| Rate for Payer: UHC Exchange |
$71.09
|
| Rate for Payer: UHC Medicare Advantage |
$71.09
|
| Rate for Payer: VA VA |
$71.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.26
|
|
|
HC XR SMALL BOWEL ENTEROCLYSIS TU
|
Facility
|
IP
|
$816.54
|
|
|
Service Code
|
CPT 74251
|
| Hospital Charge Code |
32000145
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$530.75 |
| Max. Negotiated Rate |
$734.89 |
| Rate for Payer: Aetna Commercial |
$694.06
|
| Rate for Payer: BCBS Trust/PPO |
$666.54
|
| Rate for Payer: BCN Commercial |
$631.02
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$702.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Healthscope Commercial |
$734.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$612.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: Nomi Health Commercial |
$669.56
|
| Rate for Payer: PHP Commercial |
$694.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health HMO/PPO |
$710.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$718.56
|
| Rate for Payer: UHC Core |
$681.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$612.40
|
|
|
HC XR SMALL BOWEL ENTEROCLYSIS TU
|
Facility
|
OP
|
$816.54
|
|
|
Service Code
|
CPT 74251
|
| Hospital Charge Code |
32000145
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$128.71 |
| Max. Negotiated Rate |
$734.89 |
| Rate for Payer: Aetna Commercial |
$694.06
|
| Rate for Payer: Aetna Medicare |
$212.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$255.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$255.17
|
| Rate for Payer: BCBS Complete |
$135.15
|
| Rate for Payer: BCBS MAPPO |
$204.13
|
| Rate for Payer: BCBS Trust/PPO |
$671.28
|
| Rate for Payer: BCN Commercial |
$634.86
|
| Rate for Payer: BCN Medicare Advantage |
$204.13
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$702.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.13
|
| Rate for Payer: Healthscope Commercial |
$734.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$612.40
|
| Rate for Payer: Mclaren Medicaid |
$128.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.34
|
| Rate for Payer: Meridian Medicaid |
$135.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$234.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: Nomi Health Commercial |
$669.56
|
| Rate for Payer: PACE Senior Care Partners |
$193.93
|
| Rate for Payer: PACE SWMI |
$204.13
|
| Rate for Payer: PHP Commercial |
$694.06
|
| Rate for Payer: PHP Medicare Advantage |
$204.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health HMO/PPO |
$710.39
|
| Rate for Payer: Priority Health Medicare |
$206.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.08
|
| Rate for Payer: Railroad Medicare Medicare |
$204.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$718.56
|
| Rate for Payer: UHC Core |
$681.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.13
|
| Rate for Payer: UHC Exchange |
$204.13
|
| Rate for Payer: UHC Medicare Advantage |
$204.13
|
| Rate for Payer: UHCCP Medicaid |
$128.71
|
| Rate for Payer: VA VA |
$204.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$612.40
|
|
|
HC XR SOFT TISSUE NECK
|
Facility
|
IP
|
$310.54
|
|
|
Service Code
|
CPT 70360
|
| Hospital Charge Code |
32000023
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$201.85 |
| Max. Negotiated Rate |
$279.49 |
| Rate for Payer: Aetna Commercial |
$263.96
|
| Rate for Payer: BCBS Trust/PPO |
$253.49
|
| Rate for Payer: BCN Commercial |
$239.99
|
| Rate for Payer: Cash Price |
$248.43
|
| Rate for Payer: Cofinity Commercial |
$267.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.43
|
| Rate for Payer: Healthscope Commercial |
$279.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.96
|
| Rate for Payer: Nomi Health Commercial |
$254.64
|
| Rate for Payer: PHP Commercial |
$263.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.85
|
| Rate for Payer: Priority Health HMO/PPO |
$270.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$208.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.28
|
| Rate for Payer: UHC Core |
$259.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.91
|
|
|
HC XR SOFT TISSUE NECK
|
Facility
|
OP
|
$310.54
|
|
|
Service Code
|
CPT 70360
|
| Hospital Charge Code |
32000023
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$63.66 |
| Max. Negotiated Rate |
$279.49 |
| Rate for Payer: Aetna Commercial |
$263.96
|
| Rate for Payer: Aetna Medicare |
$80.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$97.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$97.04
|
| Rate for Payer: BCBS Complete |
$66.85
|
| Rate for Payer: BCBS MAPPO |
$77.64
|
| Rate for Payer: BCBS Trust/PPO |
$255.29
|
| Rate for Payer: BCN Commercial |
$241.44
|
| Rate for Payer: BCN Medicare Advantage |
$77.64
|
| Rate for Payer: Cash Price |
$248.43
|
| Rate for Payer: Cash Price |
$248.43
|
| Rate for Payer: Cofinity Commercial |
$267.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.64
|
| Rate for Payer: Healthscope Commercial |
$279.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.91
|
| Rate for Payer: Mclaren Medicaid |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.52
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.96
|
| Rate for Payer: Nomi Health Commercial |
$254.64
|
| Rate for Payer: PACE Senior Care Partners |
$73.75
|
| Rate for Payer: PACE SWMI |
$77.64
|
| Rate for Payer: PHP Commercial |
$263.96
|
| Rate for Payer: PHP Medicare Advantage |
$77.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.85
|
| Rate for Payer: Priority Health HMO/PPO |
$270.17
|
| Rate for Payer: Priority Health Medicare |
$78.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$208.06
|
| Rate for Payer: Railroad Medicare Medicare |
$77.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.28
|
| Rate for Payer: UHC Core |
$259.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$77.64
|
| Rate for Payer: UHC Exchange |
$77.64
|
| Rate for Payer: UHC Medicare Advantage |
$77.64
|
| Rate for Payer: UHCCP Medicaid |
$63.66
|
| Rate for Payer: VA VA |
$77.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.91
|
|
|
HC XR SPECIMEN X-RAY
|
Facility
|
OP
|
$210.80
|
|
|
Service Code
|
CPT 76098
|
| Hospital Charge Code |
32000237
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$50.06 |
| Max. Negotiated Rate |
$416.27 |
| Rate for Payer: Aetna Commercial |
$179.18
|
| Rate for Payer: Aetna Medicare |
$54.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.88
|
| Rate for Payer: BCBS Complete |
$416.27
|
| Rate for Payer: BCBS MAPPO |
$52.70
|
| Rate for Payer: BCBS Trust/PPO |
$173.30
|
| Rate for Payer: BCN Commercial |
$163.90
|
| Rate for Payer: BCN Medicare Advantage |
$52.70
|
| Rate for Payer: Cash Price |
$168.64
|
| Rate for Payer: Cash Price |
$168.64
|
| Rate for Payer: Cofinity Commercial |
$181.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.70
|
| Rate for Payer: Healthscope Commercial |
$189.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.10
|
| Rate for Payer: Mclaren Medicaid |
$396.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.34
|
| Rate for Payer: Meridian Medicaid |
$416.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179.18
|
| Rate for Payer: Nomi Health Commercial |
$172.86
|
| Rate for Payer: PACE Senior Care Partners |
$50.06
|
| Rate for Payer: PACE SWMI |
$52.70
|
| Rate for Payer: PHP Commercial |
$179.18
|
| Rate for Payer: PHP Medicare Advantage |
$52.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.02
|
| Rate for Payer: Priority Health HMO/PPO |
$183.40
|
| Rate for Payer: Priority Health Medicare |
$53.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.24
|
| Rate for Payer: Railroad Medicare Medicare |
$52.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.50
|
| Rate for Payer: UHC Core |
$176.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.70
|
| Rate for Payer: UHC Exchange |
$52.70
|
| Rate for Payer: UHC Medicare Advantage |
$52.70
|
| Rate for Payer: UHCCP Medicaid |
$396.42
|
| Rate for Payer: VA VA |
$52.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.10
|
|
|
HC XR SPECIMEN X-RAY
|
Facility
|
IP
|
$210.80
|
|
|
Service Code
|
CPT 76098
|
| Hospital Charge Code |
32000237
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$137.02 |
| Max. Negotiated Rate |
$189.72 |
| Rate for Payer: Aetna Commercial |
$179.18
|
| Rate for Payer: BCBS Trust/PPO |
$172.08
|
| Rate for Payer: BCN Commercial |
$162.91
|
| Rate for Payer: Cash Price |
$168.64
|
| Rate for Payer: Cofinity Commercial |
$181.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.64
|
| Rate for Payer: Healthscope Commercial |
$189.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179.18
|
| Rate for Payer: Nomi Health Commercial |
$172.86
|
| Rate for Payer: PHP Commercial |
$179.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.02
|
| Rate for Payer: Priority Health HMO/PPO |
$183.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.50
|
| Rate for Payer: UHC Core |
$176.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.10
|
|
|
HC XR SPINE CERV 6VW OR MORE
|
Facility
|
IP
|
$510.39
|
|
|
Service Code
|
CPT 72052
|
| Hospital Charge Code |
32000037
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$331.75 |
| Max. Negotiated Rate |
$459.35 |
| Rate for Payer: Aetna Commercial |
$433.83
|
| Rate for Payer: BCBS Trust/PPO |
$416.63
|
| Rate for Payer: BCN Commercial |
$394.43
|
| Rate for Payer: Cash Price |
$408.31
|
| Rate for Payer: Cofinity Commercial |
$438.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.31
|
| Rate for Payer: Healthscope Commercial |
$459.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.83
|
| Rate for Payer: Nomi Health Commercial |
$418.52
|
| Rate for Payer: PHP Commercial |
$433.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.75
|
| Rate for Payer: Priority Health HMO/PPO |
$444.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$341.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$449.14
|
| Rate for Payer: UHC Core |
$426.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.79
|
|
|
HC XR SPINE CERV 6VW OR MORE
|
Facility
|
OP
|
$510.39
|
|
|
Service Code
|
CPT 72052
|
| Hospital Charge Code |
32000037
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$459.35 |
| Rate for Payer: Aetna Commercial |
$433.83
|
| Rate for Payer: Aetna Medicare |
$132.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$159.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$159.50
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$127.60
|
| Rate for Payer: BCBS Trust/PPO |
$419.59
|
| Rate for Payer: BCN Commercial |
$396.83
|
| Rate for Payer: BCN Medicare Advantage |
$127.60
|
| Rate for Payer: Cash Price |
$408.31
|
| Rate for Payer: Cash Price |
$408.31
|
| Rate for Payer: Cofinity Commercial |
$438.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.60
|
| Rate for Payer: Healthscope Commercial |
$459.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.79
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.98
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$146.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.83
|
| Rate for Payer: Nomi Health Commercial |
$418.52
|
| Rate for Payer: PACE Senior Care Partners |
$121.22
|
| Rate for Payer: PACE SWMI |
$127.60
|
| Rate for Payer: PHP Commercial |
$433.83
|
| Rate for Payer: PHP Medicare Advantage |
$127.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.75
|
| Rate for Payer: Priority Health HMO/PPO |
$444.04
|
| Rate for Payer: Priority Health Medicare |
$128.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$341.96
|
| Rate for Payer: Railroad Medicare Medicare |
$127.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$449.14
|
| Rate for Payer: UHC Core |
$426.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.60
|
| Rate for Payer: UHC Exchange |
$127.60
|
| Rate for Payer: UHC Medicare Advantage |
$127.60
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$127.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.79
|
|
|
HC XR SPINE CERVICAL 3VW OR LESS
|
Facility
|
IP
|
$377.89
|
|
|
Service Code
|
CPT 72040
|
| Hospital Charge Code |
32000035
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$245.63 |
| Max. Negotiated Rate |
$340.10 |
| Rate for Payer: Aetna Commercial |
$321.21
|
| Rate for Payer: BCBS Trust/PPO |
$308.47
|
| Rate for Payer: BCN Commercial |
$292.03
|
| Rate for Payer: Cash Price |
$302.31
|
| Rate for Payer: Cofinity Commercial |
$324.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.31
|
| Rate for Payer: Healthscope Commercial |
$340.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$283.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.21
|
| Rate for Payer: Nomi Health Commercial |
$309.87
|
| Rate for Payer: PHP Commercial |
$321.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.63
|
| Rate for Payer: Priority Health HMO/PPO |
$328.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$332.54
|
| Rate for Payer: UHC Core |
$315.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$283.42
|
|
|
HC XR SPINE CERVICAL 3VW OR LESS
|
Facility
|
OP
|
$377.89
|
|
|
Service Code
|
CPT 72040
|
| Hospital Charge Code |
32000035
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$63.66 |
| Max. Negotiated Rate |
$340.10 |
| Rate for Payer: Aetna Commercial |
$321.21
|
| Rate for Payer: Aetna Medicare |
$98.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$118.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$118.09
|
| Rate for Payer: BCBS Complete |
$66.85
|
| Rate for Payer: BCBS MAPPO |
$94.47
|
| Rate for Payer: BCBS Trust/PPO |
$310.66
|
| Rate for Payer: BCN Commercial |
$293.81
|
| Rate for Payer: BCN Medicare Advantage |
$94.47
|
| Rate for Payer: Cash Price |
$302.31
|
| Rate for Payer: Cash Price |
$302.31
|
| Rate for Payer: Cofinity Commercial |
$324.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.47
|
| Rate for Payer: Healthscope Commercial |
$340.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$283.42
|
| Rate for Payer: Mclaren Medicaid |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.20
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$108.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.21
|
| Rate for Payer: Nomi Health Commercial |
$309.87
|
| Rate for Payer: PACE Senior Care Partners |
$89.75
|
| Rate for Payer: PACE SWMI |
$94.47
|
| Rate for Payer: PHP Commercial |
$321.21
|
| Rate for Payer: PHP Medicare Advantage |
$94.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.63
|
| Rate for Payer: Priority Health HMO/PPO |
$328.76
|
| Rate for Payer: Priority Health Medicare |
$95.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.19
|
| Rate for Payer: Railroad Medicare Medicare |
$94.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$332.54
|
| Rate for Payer: UHC Core |
$315.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$94.47
|
| Rate for Payer: UHC Exchange |
$94.47
|
| Rate for Payer: UHC Medicare Advantage |
$94.47
|
| Rate for Payer: UHCCP Medicaid |
$63.66
|
| Rate for Payer: VA VA |
$94.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$283.42
|
|
|
HC XR SPINE CERVICAL 4 OR 5 VW
|
Facility
|
IP
|
$469.62
|
|
|
Service Code
|
CPT 72050
|
| Hospital Charge Code |
32000036
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$305.25 |
| Max. Negotiated Rate |
$422.66 |
| Rate for Payer: Aetna Commercial |
$399.18
|
| Rate for Payer: BCBS Trust/PPO |
$383.35
|
| Rate for Payer: BCN Commercial |
$362.92
|
| Rate for Payer: Cash Price |
$375.70
|
| Rate for Payer: Cofinity Commercial |
$403.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.70
|
| Rate for Payer: Healthscope Commercial |
$422.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$352.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$399.18
|
| Rate for Payer: Nomi Health Commercial |
$385.09
|
| Rate for Payer: PHP Commercial |
$399.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.25
|
| Rate for Payer: Priority Health HMO/PPO |
$408.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$314.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$413.27
|
| Rate for Payer: UHC Core |
$392.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$352.21
|
|
|
HC XR SPINE CERVICAL 4 OR 5 VW
|
Facility
|
OP
|
$469.62
|
|
|
Service Code
|
CPT 72050
|
| Hospital Charge Code |
32000036
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$422.66 |
| Rate for Payer: Aetna Commercial |
$399.18
|
| Rate for Payer: Aetna Medicare |
$122.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$146.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$146.76
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$117.41
|
| Rate for Payer: BCBS Trust/PPO |
$386.07
|
| Rate for Payer: BCN Commercial |
$365.13
|
| Rate for Payer: BCN Medicare Advantage |
$117.41
|
| Rate for Payer: Cash Price |
$375.70
|
| Rate for Payer: Cash Price |
$375.70
|
| Rate for Payer: Cofinity Commercial |
$403.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.41
|
| Rate for Payer: Healthscope Commercial |
$422.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$352.21
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.28
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$399.18
|
| Rate for Payer: Nomi Health Commercial |
$385.09
|
| Rate for Payer: PACE Senior Care Partners |
$111.53
|
| Rate for Payer: PACE SWMI |
$117.41
|
| Rate for Payer: PHP Commercial |
$399.18
|
| Rate for Payer: PHP Medicare Advantage |
$117.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.25
|
| Rate for Payer: Priority Health HMO/PPO |
$408.57
|
| Rate for Payer: Priority Health Medicare |
$118.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$314.65
|
| Rate for Payer: Railroad Medicare Medicare |
$117.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$413.27
|
| Rate for Payer: UHC Core |
$392.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$117.41
|
| Rate for Payer: UHC Exchange |
$117.41
|
| Rate for Payer: UHC Medicare Advantage |
$117.41
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$117.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$352.21
|
|
|
HC XR SPINE LUMBAR 2 OR 3 VW
|
Facility
|
OP
|
$408.20
|
|
|
Service Code
|
CPT 72100
|
| Hospital Charge Code |
32000044
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$367.38 |
| Rate for Payer: Aetna Commercial |
$346.97
|
| Rate for Payer: Aetna Medicare |
$106.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$127.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$127.56
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$102.05
|
| Rate for Payer: BCBS Trust/PPO |
$335.58
|
| Rate for Payer: BCN Commercial |
$317.38
|
| Rate for Payer: BCN Medicare Advantage |
$102.05
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cofinity Commercial |
$351.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.05
|
| Rate for Payer: Healthscope Commercial |
$367.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.15
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.15
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$117.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.97
|
| Rate for Payer: Nomi Health Commercial |
$334.72
|
| Rate for Payer: PACE Senior Care Partners |
$96.95
|
| Rate for Payer: PACE SWMI |
$102.05
|
| Rate for Payer: PHP Commercial |
$346.97
|
| Rate for Payer: PHP Medicare Advantage |
$102.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.33
|
| Rate for Payer: Priority Health HMO/PPO |
$355.13
|
| Rate for Payer: Priority Health Medicare |
$103.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.49
|
| Rate for Payer: Railroad Medicare Medicare |
$102.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.22
|
| Rate for Payer: UHC Core |
$340.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.05
|
| Rate for Payer: UHC Exchange |
$102.05
|
| Rate for Payer: UHC Medicare Advantage |
$102.05
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$102.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.15
|
|
|
HC XR SPINE LUMBAR 2 OR 3 VW
|
Facility
|
IP
|
$408.20
|
|
|
Service Code
|
CPT 72100
|
| Hospital Charge Code |
32000044
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$265.33 |
| Max. Negotiated Rate |
$367.38 |
| Rate for Payer: Aetna Commercial |
$346.97
|
| Rate for Payer: BCBS Trust/PPO |
$333.21
|
| Rate for Payer: BCN Commercial |
$315.46
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cofinity Commercial |
$351.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.56
|
| Rate for Payer: Healthscope Commercial |
$367.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.97
|
| Rate for Payer: Nomi Health Commercial |
$334.72
|
| Rate for Payer: PHP Commercial |
$346.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.33
|
| Rate for Payer: Priority Health HMO/PPO |
$355.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.22
|
| Rate for Payer: UHC Core |
$340.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.15
|
|
|
HC XR SPINE LUMBAR BENDING ONLY 4
|
Facility
|
OP
|
$388.71
|
|
|
Service Code
|
CPT 72120
|
| Hospital Charge Code |
32000047
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: Aetna Medicare |
$101.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$121.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$121.47
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$97.18
|
| Rate for Payer: BCBS Trust/PPO |
$319.56
|
| Rate for Payer: BCN Commercial |
$302.22
|
| Rate for Payer: BCN Medicare Advantage |
$97.18
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.18
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.04
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: Nomi Health Commercial |
$318.74
|
| Rate for Payer: PACE Senior Care Partners |
$92.32
|
| Rate for Payer: PACE SWMI |
$97.18
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: PHP Medicare Advantage |
$97.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health HMO/PPO |
$338.18
|
| Rate for Payer: Priority Health Medicare |
$98.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.44
|
| Rate for Payer: Railroad Medicare Medicare |
$97.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.06
|
| Rate for Payer: UHC Core |
$324.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.18
|
| Rate for Payer: UHC Exchange |
$97.18
|
| Rate for Payer: UHC Medicare Advantage |
$97.18
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$97.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC XR SPINE LUMBAR BENDING ONLY 4
|
Facility
|
IP
|
$388.71
|
|
|
Service Code
|
CPT 72120
|
| Hospital Charge Code |
32000047
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$252.66 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: BCBS Trust/PPO |
$317.30
|
| Rate for Payer: BCN Commercial |
$300.40
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: Nomi Health Commercial |
$318.74
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health HMO/PPO |
$338.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.06
|
| Rate for Payer: UHC Core |
$324.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC XR SPINE LUMBAR MIN 4 VW
|
Facility
|
OP
|
$437.63
|
|
|
Service Code
|
CPT 72110
|
| Hospital Charge Code |
32000045
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$393.87 |
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: Aetna Medicare |
$113.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$136.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$136.76
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$109.41
|
| Rate for Payer: BCBS Trust/PPO |
$359.78
|
| Rate for Payer: BCN Commercial |
$340.26
|
| Rate for Payer: BCN Medicare Advantage |
$109.41
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$376.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.41
|
| Rate for Payer: Healthscope Commercial |
$393.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.22
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.88
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$125.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: Nomi Health Commercial |
$358.86
|
| Rate for Payer: PACE Senior Care Partners |
$103.94
|
| Rate for Payer: PACE SWMI |
$109.41
|
| Rate for Payer: PHP Commercial |
$371.99
|
| Rate for Payer: PHP Medicare Advantage |
$109.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health HMO/PPO |
$380.74
|
| Rate for Payer: Priority Health Medicare |
$110.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.21
|
| Rate for Payer: Railroad Medicare Medicare |
$109.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.11
|
| Rate for Payer: UHC Core |
$365.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.41
|
| Rate for Payer: UHC Exchange |
$109.41
|
| Rate for Payer: UHC Medicare Advantage |
$109.41
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$109.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.22
|
|
|
HC XR SPINE LUMBAR MIN 4 VW
|
Facility
|
IP
|
$437.63
|
|
|
Service Code
|
CPT 72110
|
| Hospital Charge Code |
32000045
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$284.46 |
| Max. Negotiated Rate |
$393.87 |
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: BCBS Trust/PPO |
$357.24
|
| Rate for Payer: BCN Commercial |
$338.20
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$376.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Healthscope Commercial |
$393.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: Nomi Health Commercial |
$358.86
|
| Rate for Payer: PHP Commercial |
$371.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health HMO/PPO |
$380.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.11
|
| Rate for Payer: UHC Core |
$365.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.22
|
|
|
HC XR SPINE LUMB COMP W BEND MIN 6 VW
|
Facility
|
IP
|
$563.27
|
|
|
Service Code
|
CPT 72114
|
| Hospital Charge Code |
32000046
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$366.13 |
| Max. Negotiated Rate |
$506.94 |
| Rate for Payer: Aetna Commercial |
$478.78
|
| Rate for Payer: BCBS Trust/PPO |
$459.80
|
| Rate for Payer: BCN Commercial |
$435.30
|
| Rate for Payer: Cash Price |
$450.62
|
| Rate for Payer: Cofinity Commercial |
$484.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$450.62
|
| Rate for Payer: Healthscope Commercial |
$506.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$422.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$478.78
|
| Rate for Payer: Nomi Health Commercial |
$461.88
|
| Rate for Payer: PHP Commercial |
$478.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$366.13
|
| Rate for Payer: Priority Health HMO/PPO |
$490.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$377.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$495.68
|
| Rate for Payer: UHC Core |
$470.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$422.45
|
|
|
HC XR SPINE LUMB COMP W BEND MIN 6 VW
|
Facility
|
OP
|
$563.27
|
|
|
Service Code
|
CPT 72114
|
| Hospital Charge Code |
32000046
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$506.94 |
| Rate for Payer: Aetna Commercial |
$478.78
|
| Rate for Payer: Aetna Medicare |
$146.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$176.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$176.02
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$140.82
|
| Rate for Payer: BCBS Trust/PPO |
$463.06
|
| Rate for Payer: BCN Commercial |
$437.94
|
| Rate for Payer: BCN Medicare Advantage |
$140.82
|
| Rate for Payer: Cash Price |
$450.62
|
| Rate for Payer: Cash Price |
$450.62
|
| Rate for Payer: Cofinity Commercial |
$484.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$450.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.82
|
| Rate for Payer: Healthscope Commercial |
$506.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$422.45
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.86
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$478.78
|
| Rate for Payer: Nomi Health Commercial |
$461.88
|
| Rate for Payer: PACE Senior Care Partners |
$133.78
|
| Rate for Payer: PACE SWMI |
$140.82
|
| Rate for Payer: PHP Commercial |
$478.78
|
| Rate for Payer: PHP Medicare Advantage |
$140.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$366.13
|
| Rate for Payer: Priority Health HMO/PPO |
$490.04
|
| Rate for Payer: Priority Health Medicare |
$142.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$377.39
|
| Rate for Payer: Railroad Medicare Medicare |
$140.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$495.68
|
| Rate for Payer: UHC Core |
$470.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.82
|
| Rate for Payer: UHC Exchange |
$140.82
|
| Rate for Payer: UHC Medicare Advantage |
$140.82
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$140.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$422.45
|
|
|
HC XR SPINE SINGLE VW
|
Facility
|
OP
|
$187.71
|
|
|
Service Code
|
CPT 72020
|
| Hospital Charge Code |
32000034
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.58 |
| Max. Negotiated Rate |
$168.94 |
| Rate for Payer: Aetna Commercial |
$159.55
|
| Rate for Payer: Aetna Medicare |
$48.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.66
|
| Rate for Payer: BCBS Complete |
$66.85
|
| Rate for Payer: BCBS MAPPO |
$46.93
|
| Rate for Payer: BCBS Trust/PPO |
$154.32
|
| Rate for Payer: BCN Commercial |
$145.94
|
| Rate for Payer: BCN Medicare Advantage |
$46.93
|
| Rate for Payer: Cash Price |
$150.17
|
| Rate for Payer: Cash Price |
$150.17
|
| Rate for Payer: Cofinity Commercial |
$161.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.93
|
| Rate for Payer: Healthscope Commercial |
$168.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.78
|
| Rate for Payer: Mclaren Medicaid |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.27
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.55
|
| Rate for Payer: Nomi Health Commercial |
$153.92
|
| Rate for Payer: PACE Senior Care Partners |
$44.58
|
| Rate for Payer: PACE SWMI |
$46.93
|
| Rate for Payer: PHP Commercial |
$159.55
|
| Rate for Payer: PHP Medicare Advantage |
$46.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.01
|
| Rate for Payer: Priority Health HMO/PPO |
$163.31
|
| Rate for Payer: Priority Health Medicare |
$47.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.77
|
| Rate for Payer: Railroad Medicare Medicare |
$46.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.18
|
| Rate for Payer: UHC Core |
$156.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.93
|
| Rate for Payer: UHC Exchange |
$46.93
|
| Rate for Payer: UHC Medicare Advantage |
$46.93
|
| Rate for Payer: UHCCP Medicaid |
$63.66
|
| Rate for Payer: VA VA |
$46.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.78
|
|
