|
HC CT SOFT TISS NECK WO W CON
|
Facility
|
OP
|
$1,844.57
|
|
|
Service Code
|
CPT 70492
|
| Hospital Charge Code |
35000003
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,660.11 |
| Rate for Payer: Aetna American Axle |
$1,198.97
|
| Rate for Payer: Aetna Commercial |
$1,567.88
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,198.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.15
|
| Rate for Payer: BCBS Complete |
$93.81
|
| Rate for Payer: BCBS MAPPO |
$163.32
|
| Rate for Payer: BCBS Trust/PPO |
$292.66
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$1,475.66
|
| Rate for Payer: Cash Price |
$1,475.66
|
| Rate for Payer: Cofinity Commercial |
$1,586.33
|
| Rate for Payer: Cofinity Commercial |
$1,291.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,475.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$1,660.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,291.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,383.43
|
| Rate for Payer: Mclaren Medicaid |
$89.34
|
| Rate for Payer: Mclaren Medicare |
$163.32
|
| Rate for Payer: Meridian Medicaid |
$93.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,567.88
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$1,567.88
|
| Rate for Payer: PHP Medicare Advantage |
$163.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,291.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$514.13
|
| Rate for Payer: Priority Health Medicare |
$163.32
|
| Rate for Payer: Priority Health Narrow Network |
$411.30
|
| Rate for Payer: Priority Health SBD |
$1,162.08
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.93
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$222.66
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$682.49
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,383.43
|
|
|
HC CT SPINE CERVICAL W CON
|
Facility
|
OP
|
$1,900.60
|
|
|
Service Code
|
CPT 72126
|
| Hospital Charge Code |
35200004
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$169.94 |
| Max. Negotiated Rate |
$1,710.54 |
| Rate for Payer: Aetna American Axle |
$1,235.39
|
| Rate for Payer: Aetna Commercial |
$1,615.51
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,235.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$222.98
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$1,520.48
|
| Rate for Payer: Cash Price |
$1,520.48
|
| Rate for Payer: Cofinity Commercial |
$1,330.42
|
| Rate for Payer: Cofinity Commercial |
$1,634.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,520.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$1,710.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,330.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,425.45
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,615.51
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$1,615.51
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,330.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,076.13
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$860.90
|
| Rate for Payer: Priority Health SBD |
$1,197.38
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.93
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$169.94
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$703.22
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,425.45
|
|
|
HC CT SPINE CERVICAL W CON
|
Facility
|
IP
|
$1,900.60
|
|
|
Service Code
|
CPT 72126
|
| Hospital Charge Code |
35200004
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$836.26 |
| Max. Negotiated Rate |
$1,710.54 |
| Rate for Payer: Aetna American Axle |
$1,235.39
|
| Rate for Payer: Aetna Commercial |
$1,615.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,235.39
|
| Rate for Payer: Cash Price |
$1,520.48
|
| Rate for Payer: Cofinity Commercial |
$1,330.42
|
| Rate for Payer: Cofinity Commercial |
$1,634.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,520.48
|
| Rate for Payer: Healthscope Commercial |
$1,710.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,330.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,425.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,615.51
|
| Rate for Payer: PHP Commercial |
$1,615.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,330.42
|
| Rate for Payer: Priority Health SBD |
$1,197.38
|
| Rate for Payer: UMR Bronson Commercial |
$836.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,425.45
|
|
|
HC CT SPINE CERVICAL WO CON
|
Facility
|
OP
|
$1,586.20
|
|
|
Service Code
|
CPT 72125
|
| Hospital Charge Code |
35200003
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$1,427.58 |
| Rate for Payer: Aetna American Axle |
$1,031.03
|
| Rate for Payer: Aetna Commercial |
$1,348.27
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$165.97
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$1,268.96
|
| Rate for Payer: Cash Price |
$1,268.96
|
| Rate for Payer: Cofinity Commercial |
$1,110.34
|
| Rate for Payer: Cofinity Commercial |
$1,364.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,268.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$1,427.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,110.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,189.65
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,348.27
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$1,348.27
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,110.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$999.31
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.08
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$130.98
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$586.89
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,189.65
|
|
|
HC CT SPINE CERVICAL WO CON
|
Facility
|
IP
|
$1,586.20
|
|
|
Service Code
|
CPT 72125
|
| Hospital Charge Code |
35200003
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$697.93 |
| Max. Negotiated Rate |
$1,427.58 |
| Rate for Payer: Aetna American Axle |
$1,031.03
|
| Rate for Payer: Aetna Commercial |
$1,348.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.03
|
| Rate for Payer: Cash Price |
$1,268.96
|
| Rate for Payer: Cofinity Commercial |
$1,110.34
|
| Rate for Payer: Cofinity Commercial |
$1,364.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,268.96
|
| Rate for Payer: Healthscope Commercial |
$1,427.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,110.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,189.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,348.27
|
| Rate for Payer: PHP Commercial |
$1,348.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,110.34
|
| Rate for Payer: Priority Health SBD |
$999.31
|
| Rate for Payer: UMR Bronson Commercial |
$697.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,189.65
|
|
|
HC CT SPINE CERVICAL WO W CON
|
Facility
|
OP
|
$2,159.90
|
|
|
Service Code
|
CPT 72127
|
| Hospital Charge Code |
35000007
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,943.91 |
| Rate for Payer: Aetna American Axle |
$1,403.94
|
| Rate for Payer: Aetna Commercial |
$1,835.92
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,403.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.15
|
| Rate for Payer: BCBS Complete |
$93.81
|
| Rate for Payer: BCBS MAPPO |
$163.32
|
| Rate for Payer: BCBS Trust/PPO |
$275.57
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$1,727.92
|
| Rate for Payer: Cash Price |
$1,727.92
|
| Rate for Payer: Cofinity Commercial |
$1,511.93
|
| Rate for Payer: Cofinity Commercial |
$1,857.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,727.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$1,943.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,511.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,619.92
|
| Rate for Payer: Mclaren Medicaid |
$89.34
|
| Rate for Payer: Mclaren Medicare |
$163.32
|
| Rate for Payer: Meridian Medicaid |
$93.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,835.92
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$1,835.92
|
| Rate for Payer: PHP Medicare Advantage |
$163.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,511.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$514.13
|
| Rate for Payer: Priority Health Medicare |
$163.32
|
| Rate for Payer: Priority Health Narrow Network |
$411.30
|
| Rate for Payer: Priority Health SBD |
$1,360.74
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.99
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$199.08
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$799.16
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,619.92
|
|
|
HC CT SPINE CERVICAL WO W CON
|
Facility
|
IP
|
$2,159.90
|
|
|
Service Code
|
CPT 72127
|
| Hospital Charge Code |
35000007
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$950.36 |
| Max. Negotiated Rate |
$1,943.91 |
| Rate for Payer: Aetna American Axle |
$1,403.94
|
| Rate for Payer: Aetna Commercial |
$1,835.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,403.94
|
| Rate for Payer: Cash Price |
$1,727.92
|
| Rate for Payer: Cofinity Commercial |
$1,511.93
|
| Rate for Payer: Cofinity Commercial |
$1,857.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,727.92
|
| Rate for Payer: Healthscope Commercial |
$1,943.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,511.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,619.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,835.92
|
| Rate for Payer: PHP Commercial |
$1,835.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,511.93
|
| Rate for Payer: Priority Health SBD |
$1,360.74
|
| Rate for Payer: UMR Bronson Commercial |
$950.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,619.92
|
|
|
HC CT SPINE LUMBAR W CON
|
Facility
|
OP
|
$1,938.61
|
|
|
Service Code
|
CPT 72132
|
| Hospital Charge Code |
35200008
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$170.27 |
| Max. Negotiated Rate |
$1,744.75 |
| Rate for Payer: Aetna American Axle |
$1,260.10
|
| Rate for Payer: Aetna Commercial |
$1,647.82
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,260.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$223.62
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$1,550.89
|
| Rate for Payer: Cash Price |
$1,550.89
|
| Rate for Payer: Cofinity Commercial |
$1,357.03
|
| Rate for Payer: Cofinity Commercial |
$1,667.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,550.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$1,744.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,357.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,453.96
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,647.82
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$1,647.82
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,357.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,076.13
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$860.90
|
| Rate for Payer: Priority Health SBD |
$1,221.32
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.30
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$170.27
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$717.29
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,453.96
|
|
|
HC CT SPINE LUMBAR W CON
|
Facility
|
IP
|
$1,938.61
|
|
|
Service Code
|
CPT 72132
|
| Hospital Charge Code |
35200008
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$852.99 |
| Max. Negotiated Rate |
$1,744.75 |
| Rate for Payer: Aetna American Axle |
$1,260.10
|
| Rate for Payer: Aetna Commercial |
$1,647.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,260.10
|
| Rate for Payer: Cash Price |
$1,550.89
|
| Rate for Payer: Cofinity Commercial |
$1,667.20
|
| Rate for Payer: Cofinity Commercial |
$1,357.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,550.89
|
| Rate for Payer: Healthscope Commercial |
$1,744.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,357.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,453.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,647.82
|
| Rate for Payer: PHP Commercial |
$1,647.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,357.03
|
| Rate for Payer: Priority Health SBD |
$1,221.32
|
| Rate for Payer: UMR Bronson Commercial |
$852.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,453.96
|
|
|
HC CT SPINE LUMBAR WO CON
|
Facility
|
IP
|
$1,586.20
|
|
|
Service Code
|
CPT 72131
|
| Hospital Charge Code |
35200007
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$697.93 |
| Max. Negotiated Rate |
$1,427.58 |
| Rate for Payer: Aetna American Axle |
$1,031.03
|
| Rate for Payer: Aetna Commercial |
$1,348.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.03
|
| Rate for Payer: Cash Price |
$1,268.96
|
| Rate for Payer: Cofinity Commercial |
$1,110.34
|
| Rate for Payer: Cofinity Commercial |
$1,364.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,268.96
|
| Rate for Payer: Healthscope Commercial |
$1,427.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,110.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,189.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,348.27
|
| Rate for Payer: PHP Commercial |
$1,348.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,110.34
|
| Rate for Payer: Priority Health SBD |
$999.31
|
| Rate for Payer: UMR Bronson Commercial |
$697.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,189.65
|
|
|
HC CT SPINE LUMBAR WO CON
|
Facility
|
OP
|
$1,586.20
|
|
|
Service Code
|
CPT 72131
|
| Hospital Charge Code |
35200007
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$1,427.58 |
| Rate for Payer: Aetna American Axle |
$1,031.03
|
| Rate for Payer: Aetna Commercial |
$1,348.27
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$164.71
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$1,268.96
|
| Rate for Payer: Cash Price |
$1,268.96
|
| Rate for Payer: Cofinity Commercial |
$1,110.34
|
| Rate for Payer: Cofinity Commercial |
$1,364.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,268.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$1,427.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,110.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,189.65
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,348.27
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$1,348.27
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,110.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$999.31
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.99
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$129.99
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$586.89
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,189.65
|
|
|
HC CT SPINE LUMBAR WO W CON
|
Facility
|
IP
|
$2,159.90
|
|
|
Service Code
|
CPT 72133
|
| Hospital Charge Code |
35200009
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$950.36 |
| Max. Negotiated Rate |
$1,943.91 |
| Rate for Payer: Aetna American Axle |
$1,403.94
|
| Rate for Payer: Aetna Commercial |
$1,835.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,403.94
|
| Rate for Payer: Cash Price |
$1,727.92
|
| Rate for Payer: Cofinity Commercial |
$1,511.93
|
| Rate for Payer: Cofinity Commercial |
$1,857.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,727.92
|
| Rate for Payer: Healthscope Commercial |
$1,943.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,511.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,619.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,835.92
|
| Rate for Payer: PHP Commercial |
$1,835.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,511.93
|
| Rate for Payer: Priority Health SBD |
$1,360.74
|
| Rate for Payer: UMR Bronson Commercial |
$950.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,619.92
|
|
|
HC CT SPINE LUMBAR WO W CON
|
Facility
|
OP
|
$2,159.90
|
|
|
Service Code
|
CPT 72133
|
| Hospital Charge Code |
35200009
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,943.91 |
| Rate for Payer: Aetna American Axle |
$1,403.94
|
| Rate for Payer: Aetna Commercial |
$1,835.92
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,403.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.15
|
| Rate for Payer: BCBS Complete |
$93.81
|
| Rate for Payer: BCBS MAPPO |
$163.32
|
| Rate for Payer: BCBS Trust/PPO |
$276.20
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$1,727.92
|
| Rate for Payer: Cash Price |
$1,727.92
|
| Rate for Payer: Cofinity Commercial |
$1,857.51
|
| Rate for Payer: Cofinity Commercial |
$1,511.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,727.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$1,943.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,511.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,619.92
|
| Rate for Payer: Mclaren Medicaid |
$89.34
|
| Rate for Payer: Mclaren Medicare |
$163.32
|
| Rate for Payer: Meridian Medicaid |
$93.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,835.92
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$1,835.92
|
| Rate for Payer: PHP Medicare Advantage |
$163.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,511.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$514.13
|
| Rate for Payer: Priority Health Medicare |
$163.32
|
| Rate for Payer: Priority Health Narrow Network |
$411.30
|
| Rate for Payer: Priority Health SBD |
$1,360.74
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.35
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$199.41
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$799.16
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,619.92
|
|
|
HC CT SPINE THORACIC W CON
|
Facility
|
IP
|
$1,938.61
|
|
|
Service Code
|
CPT 72129
|
| Hospital Charge Code |
35200006
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$852.99 |
| Max. Negotiated Rate |
$1,744.75 |
| Rate for Payer: Aetna American Axle |
$1,260.10
|
| Rate for Payer: Aetna Commercial |
$1,647.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,260.10
|
| Rate for Payer: Cash Price |
$1,550.89
|
| Rate for Payer: Cofinity Commercial |
$1,667.20
|
| Rate for Payer: Cofinity Commercial |
$1,357.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,550.89
|
| Rate for Payer: Healthscope Commercial |
$1,744.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,357.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,453.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,647.82
|
| Rate for Payer: PHP Commercial |
$1,647.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,357.03
|
| Rate for Payer: Priority Health SBD |
$1,221.32
|
| Rate for Payer: UMR Bronson Commercial |
$852.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,453.96
|
|
|
HC CT SPINE THORACIC W CON
|
Facility
|
OP
|
$1,938.61
|
|
|
Service Code
|
CPT 72129
|
| Hospital Charge Code |
35200006
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,744.75 |
| Rate for Payer: Aetna American Axle |
$1,260.10
|
| Rate for Payer: Aetna Commercial |
$1,647.82
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,260.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.15
|
| Rate for Payer: BCBS Complete |
$93.81
|
| Rate for Payer: BCBS MAPPO |
$163.32
|
| Rate for Payer: BCBS Trust/PPO |
$224.89
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$1,550.89
|
| Rate for Payer: Cash Price |
$1,550.89
|
| Rate for Payer: Cofinity Commercial |
$1,667.20
|
| Rate for Payer: Cofinity Commercial |
$1,357.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,550.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$1,744.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,357.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,453.96
|
| Rate for Payer: Mclaren Medicaid |
$89.34
|
| Rate for Payer: Mclaren Medicare |
$163.32
|
| Rate for Payer: Meridian Medicaid |
$93.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,647.82
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$1,647.82
|
| Rate for Payer: PHP Medicare Advantage |
$163.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,357.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$514.13
|
| Rate for Payer: Priority Health Medicare |
$163.32
|
| Rate for Payer: Priority Health Narrow Network |
$411.30
|
| Rate for Payer: Priority Health SBD |
$1,221.32
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.38
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$171.25
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$717.29
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,453.96
|
|
|
HC CT SPINE THORACIC WO CON
|
Facility
|
IP
|
$1,586.20
|
|
|
Service Code
|
CPT 72128
|
| Hospital Charge Code |
35200005
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$697.93 |
| Max. Negotiated Rate |
$1,427.58 |
| Rate for Payer: Aetna American Axle |
$1,031.03
|
| Rate for Payer: Aetna Commercial |
$1,348.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.03
|
| Rate for Payer: Cash Price |
$1,268.96
|
| Rate for Payer: Cofinity Commercial |
$1,110.34
|
| Rate for Payer: Cofinity Commercial |
$1,364.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,268.96
|
| Rate for Payer: Healthscope Commercial |
$1,427.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,110.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,189.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,348.27
|
| Rate for Payer: PHP Commercial |
$1,348.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,110.34
|
| Rate for Payer: Priority Health SBD |
$999.31
|
| Rate for Payer: UMR Bronson Commercial |
$697.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,189.65
|
|
|
HC CT SPINE THORACIC WO CON
|
Facility
|
OP
|
$1,586.20
|
|
|
Service Code
|
CPT 72128
|
| Hospital Charge Code |
35200005
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$1,427.58 |
| Rate for Payer: Aetna American Axle |
$1,031.03
|
| Rate for Payer: Aetna Commercial |
$1,348.27
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$165.97
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$1,268.96
|
| Rate for Payer: Cash Price |
$1,268.96
|
| Rate for Payer: Cofinity Commercial |
$1,110.34
|
| Rate for Payer: Cofinity Commercial |
$1,364.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,268.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$1,427.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,110.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,189.65
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,348.27
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$1,348.27
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,110.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$999.31
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.72
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$130.65
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$586.89
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,189.65
|
|
|
HC CT SPINE THORACIC WO W CON
|
Facility
|
OP
|
$2,159.90
|
|
|
Service Code
|
CPT 72130
|
| Hospital Charge Code |
35000008
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,943.91 |
| Rate for Payer: Aetna American Axle |
$1,403.94
|
| Rate for Payer: Aetna Commercial |
$1,835.92
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,403.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.15
|
| Rate for Payer: BCBS Complete |
$93.81
|
| Rate for Payer: BCBS MAPPO |
$163.32
|
| Rate for Payer: BCBS Trust/PPO |
$278.73
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$1,727.92
|
| Rate for Payer: Cash Price |
$1,727.92
|
| Rate for Payer: Cofinity Commercial |
$1,511.93
|
| Rate for Payer: Cofinity Commercial |
$1,857.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,727.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$1,943.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,511.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,619.92
|
| Rate for Payer: Mclaren Medicaid |
$89.34
|
| Rate for Payer: Mclaren Medicare |
$163.32
|
| Rate for Payer: Meridian Medicaid |
$93.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,835.92
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$1,835.92
|
| Rate for Payer: PHP Medicare Advantage |
$163.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,511.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$514.13
|
| Rate for Payer: Priority Health Medicare |
$163.32
|
| Rate for Payer: Priority Health Narrow Network |
$411.30
|
| Rate for Payer: Priority Health SBD |
$1,360.74
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$220.43
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$200.39
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$799.16
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,619.92
|
|
|
HC CT SPINE THORACIC WO W CON
|
Facility
|
IP
|
$2,159.90
|
|
|
Service Code
|
CPT 72130
|
| Hospital Charge Code |
35000008
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$950.36 |
| Max. Negotiated Rate |
$1,943.91 |
| Rate for Payer: Aetna American Axle |
$1,403.94
|
| Rate for Payer: Aetna Commercial |
$1,835.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,403.94
|
| Rate for Payer: Cash Price |
$1,727.92
|
| Rate for Payer: Cofinity Commercial |
$1,511.93
|
| Rate for Payer: Cofinity Commercial |
$1,857.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,727.92
|
| Rate for Payer: Healthscope Commercial |
$1,943.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,511.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,619.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,835.92
|
| Rate for Payer: PHP Commercial |
$1,835.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,511.93
|
| Rate for Payer: Priority Health SBD |
$1,360.74
|
| Rate for Payer: UMR Bronson Commercial |
$950.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,619.92
|
|
|
HC CT UPPER EXTREM ANGIO
|
Facility
|
OP
|
$1,799.28
|
|
|
Service Code
|
CPT 73206
|
| Hospital Charge Code |
35000010
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,619.35 |
| Rate for Payer: Aetna American Axle |
$1,169.53
|
| Rate for Payer: Aetna Commercial |
$1,529.39
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,169.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.15
|
| Rate for Payer: BCBS Complete |
$93.81
|
| Rate for Payer: BCBS MAPPO |
$163.32
|
| Rate for Payer: BCBS Trust/PPO |
$426.96
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$1,439.42
|
| Rate for Payer: Cash Price |
$1,439.42
|
| Rate for Payer: Cofinity Commercial |
$1,547.38
|
| Rate for Payer: Cofinity Commercial |
$1,259.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,439.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$1,619.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,259.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,349.46
|
| Rate for Payer: Mclaren Medicaid |
$89.34
|
| Rate for Payer: Mclaren Medicare |
$163.32
|
| Rate for Payer: Meridian Medicaid |
$93.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,529.39
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$1,529.39
|
| Rate for Payer: PHP Medicare Advantage |
$163.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$514.13
|
| Rate for Payer: Priority Health Medicare |
$163.32
|
| Rate for Payer: Priority Health Narrow Network |
$411.30
|
| Rate for Payer: Priority Health SBD |
$1,133.55
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$329.21
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$299.28
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$665.73
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,349.46
|
|
|
HC CT UPPER EXTREM ANGIO
|
Facility
|
IP
|
$1,799.28
|
|
|
Service Code
|
CPT 73206
|
| Hospital Charge Code |
35000010
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$791.68 |
| Max. Negotiated Rate |
$1,619.35 |
| Rate for Payer: Aetna American Axle |
$1,169.53
|
| Rate for Payer: Aetna Commercial |
$1,529.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,169.53
|
| Rate for Payer: Cash Price |
$1,439.42
|
| Rate for Payer: Cofinity Commercial |
$1,259.50
|
| Rate for Payer: Cofinity Commercial |
$1,547.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,439.42
|
| Rate for Payer: Healthscope Commercial |
$1,619.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,259.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,349.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,529.39
|
| Rate for Payer: PHP Commercial |
$1,529.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.50
|
| Rate for Payer: Priority Health SBD |
$1,133.55
|
| Rate for Payer: UMR Bronson Commercial |
$791.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,349.46
|
|
|
HC CT UPPER EXTREMITY W CON
|
Facility
|
IP
|
$1,421.88
|
|
|
Service Code
|
CPT 73201
|
| Hospital Charge Code |
35200014
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$625.63 |
| Max. Negotiated Rate |
$1,279.69 |
| Rate for Payer: Aetna American Axle |
$924.22
|
| Rate for Payer: Aetna Commercial |
$1,208.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$924.22
|
| Rate for Payer: Cash Price |
$1,137.50
|
| Rate for Payer: Cofinity Commercial |
$1,222.82
|
| Rate for Payer: Cofinity Commercial |
$995.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,137.50
|
| Rate for Payer: Healthscope Commercial |
$1,279.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$995.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,066.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,208.60
|
| Rate for Payer: PHP Commercial |
$1,208.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$995.32
|
| Rate for Payer: Priority Health SBD |
$895.78
|
| Rate for Payer: UMR Bronson Commercial |
$625.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,066.41
|
|
|
HC CT UPPER EXTREMITY W CON
|
Facility
|
OP
|
$1,421.88
|
|
|
Service Code
|
CPT 73201
|
| Hospital Charge Code |
35200014
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$1,279.69 |
| Rate for Payer: Aetna American Axle |
$924.22
|
| Rate for Payer: Aetna Commercial |
$1,208.60
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$924.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$293.94
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$1,137.50
|
| Rate for Payer: Cash Price |
$1,137.50
|
| Rate for Payer: Cofinity Commercial |
$995.32
|
| Rate for Payer: Cofinity Commercial |
$1,222.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,137.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$1,279.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$995.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,066.41
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,208.60
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$1,208.60
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$995.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,076.13
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$860.90
|
| Rate for Payer: Priority Health SBD |
$895.78
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.60
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$202.36
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$526.10
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,066.41
|
|
|
HC CT UPPER EXTREMITY WO CON
|
Facility
|
IP
|
$1,191.36
|
|
|
Service Code
|
CPT 73200
|
| Hospital Charge Code |
35200013
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$524.20 |
| Max. Negotiated Rate |
$1,072.22 |
| Rate for Payer: Aetna American Axle |
$774.38
|
| Rate for Payer: Aetna Commercial |
$1,012.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$774.38
|
| Rate for Payer: Cash Price |
$953.09
|
| Rate for Payer: Cofinity Commercial |
$1,024.57
|
| Rate for Payer: Cofinity Commercial |
$833.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$953.09
|
| Rate for Payer: Healthscope Commercial |
$1,072.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$833.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$893.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,012.66
|
| Rate for Payer: PHP Commercial |
$1,012.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$833.95
|
| Rate for Payer: Priority Health SBD |
$750.56
|
| Rate for Payer: UMR Bronson Commercial |
$524.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$893.52
|
|
|
HC CT UPPER EXTREMITY WO CON
|
Facility
|
OP
|
$1,191.36
|
|
|
Service Code
|
CPT 73200
|
| Hospital Charge Code |
35200013
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$1,072.22 |
| Rate for Payer: Aetna American Axle |
$774.38
|
| Rate for Payer: Aetna Commercial |
$1,012.66
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$774.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$229.95
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$953.09
|
| Rate for Payer: Cash Price |
$953.09
|
| Rate for Payer: Cofinity Commercial |
$1,024.57
|
| Rate for Payer: Cofinity Commercial |
$833.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$953.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$1,072.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$833.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$893.52
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,012.66
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$1,012.66
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$833.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$750.56
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.65
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$162.41
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$440.80
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$893.52
|
|
