|
HC MR LOWER EXTREM BIL ANY JOINT W CON
|
Facility
|
IP
|
$2,346.00
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000038
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,032.24 |
| Max. Negotiated Rate |
$2,111.40 |
| Rate for Payer: Aetna American Axle |
$1,524.90
|
| Rate for Payer: Aetna Commercial |
$1,994.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,524.90
|
| Rate for Payer: Cash Price |
$1,876.80
|
| Rate for Payer: Cofinity Commercial |
$2,017.56
|
| Rate for Payer: Cofinity Commercial |
$1,642.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,876.80
|
| Rate for Payer: Healthscope Commercial |
$2,111.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,642.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,759.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,994.10
|
| Rate for Payer: PHP Commercial |
$1,994.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,642.20
|
| Rate for Payer: Priority Health SBD |
$1,477.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,032.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,759.50
|
|
|
HC MR LOWER EXTREM BIL ANY JOINT W CON
|
Facility
|
OP
|
$2,346.00
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000038
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$316.96 |
| Max. Negotiated Rate |
$2,240.48 |
| Rate for Payer: Aetna American Axle |
$1,524.90
|
| Rate for Payer: Aetna Commercial |
$1,994.10
|
| Rate for Payer: Aetna Medicare |
$740.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,524.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$889.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$889.64
|
| Rate for Payer: BCBS Complete |
$408.81
|
| Rate for Payer: BCBS MAPPO |
$711.71
|
| Rate for Payer: BCBS Trust/PPO |
$477.65
|
| Rate for Payer: BCN Medicare Advantage |
$711.71
|
| Rate for Payer: Cash Price |
$1,876.80
|
| Rate for Payer: Cash Price |
$1,876.80
|
| Rate for Payer: Cofinity Commercial |
$1,642.20
|
| Rate for Payer: Cofinity Commercial |
$2,017.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,876.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$711.71
|
| Rate for Payer: Healthscope Commercial |
$2,111.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,642.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,759.50
|
| Rate for Payer: Mclaren Medicaid |
$389.31
|
| Rate for Payer: Mclaren Medicare |
$711.71
|
| Rate for Payer: Meridian Medicaid |
$408.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$747.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$818.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,994.10
|
| Rate for Payer: PACE Medicare |
$676.12
|
| Rate for Payer: PACE SWMI |
$711.71
|
| Rate for Payer: PHP Commercial |
$1,994.10
|
| Rate for Payer: PHP Medicare Advantage |
$711.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,642.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,240.48
|
| Rate for Payer: Priority Health Medicare |
$711.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,792.38
|
| Rate for Payer: Priority Health SBD |
$1,477.98
|
| Rate for Payer: Railroad Medicare Medicare |
$711.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.66
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$711.71
|
| Rate for Payer: UHC Exchange |
$316.96
|
| Rate for Payer: UHC Medicare Advantage |
$733.06
|
| Rate for Payer: UMR Bronson Commercial |
$868.02
|
| Rate for Payer: VA VA |
$711.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,759.50
|
|
|
HC MR LOWER EXTREM BILAT ANY JOINT WO CON
|
Facility
|
IP
|
$1,932.90
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000036
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$850.48 |
| Max. Negotiated Rate |
$1,739.61 |
| Rate for Payer: Aetna American Axle |
$1,256.38
|
| Rate for Payer: Aetna Commercial |
$1,642.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,256.38
|
| Rate for Payer: Cash Price |
$1,546.32
|
| Rate for Payer: Cofinity Commercial |
$1,662.29
|
| Rate for Payer: Cofinity Commercial |
$1,353.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,546.32
|
| Rate for Payer: Healthscope Commercial |
$1,739.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,353.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,449.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,642.96
|
| Rate for Payer: PHP Commercial |
$1,642.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,353.03
|
| Rate for Payer: Priority Health SBD |
$1,217.73
|
| Rate for Payer: UMR Bronson Commercial |
$850.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,449.68
|
|
|
HC MR LOWER EXTREM BILAT ANY JOINT WO CON
|
Facility
|
OP
|
$1,932.90
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000036
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$1,256.38
|
| Rate for Payer: Aetna Commercial |
$1,642.96
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,256.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$278.10
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,546.32
|
| Rate for Payer: Cash Price |
$1,546.32
|
| Rate for Payer: Cofinity Commercial |
$1,353.03
|
| Rate for Payer: Cofinity Commercial |
$1,662.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,546.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$1,739.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,353.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,449.68
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,642.96
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$1,642.96
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,353.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.66
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$548.53
|
| Rate for Payer: Priority Health SBD |
$1,217.73
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.12
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$204.65
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$715.17
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,449.68
|
|
|
HC MR LOWER EXTREM BIL NO JOINT W CON
|
Facility
|
IP
|
$2,897.90
|
|
|
Service Code
|
CPT 73719
|
| Hospital Charge Code |
61000032
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,275.08 |
| Max. Negotiated Rate |
$2,608.11 |
| Rate for Payer: Aetna American Axle |
$1,883.64
|
| Rate for Payer: Aetna Commercial |
$2,463.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,883.64
|
| Rate for Payer: Cash Price |
$2,318.32
|
| Rate for Payer: Cofinity Commercial |
$2,028.53
|
| Rate for Payer: Cofinity Commercial |
$2,492.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,318.32
|
| Rate for Payer: Healthscope Commercial |
$2,608.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,028.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,173.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,463.22
|
| Rate for Payer: PHP Commercial |
$2,463.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,028.53
|
| Rate for Payer: Priority Health SBD |
$1,825.68
|
| Rate for Payer: UMR Bronson Commercial |
$1,275.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,173.42
|
|
|
HC MR LOWER EXTREM BIL NO JOINT W CON
|
Facility
|
OP
|
$2,897.90
|
|
|
Service Code
|
CPT 73719
|
| Hospital Charge Code |
61000032
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,608.11 |
| Rate for Payer: Aetna American Axle |
$1,883.64
|
| Rate for Payer: Aetna Commercial |
$2,463.22
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,883.64
|
| 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 |
$375.65
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$2,318.32
|
| Rate for Payer: Cash Price |
$2,318.32
|
| Rate for Payer: Cofinity Commercial |
$2,492.19
|
| Rate for Payer: Cofinity Commercial |
$2,028.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,318.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,608.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,028.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,173.42
|
| 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 |
$2,463.22
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$2,463.22
|
| 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 |
$2,028.53
|
| 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 |
$1,825.68
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$292.47
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$265.88
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,072.22
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,173.42
|
|
|
HC MR LOWER EXTREM BIL NO JOINT WO CON
|
Facility
|
OP
|
$2,252.06
|
|
|
Service Code
|
CPT 73718
|
| Hospital Charge Code |
61000030
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$2,026.85 |
| Rate for Payer: Aetna American Axle |
$1,463.84
|
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,463.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$322.44
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cofinity Commercial |
$1,576.44
|
| Rate for Payer: Cofinity Commercial |
$1,936.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,576.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,689.04
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,914.25
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,576.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.66
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$548.53
|
| Rate for Payer: Priority Health SBD |
$1,418.80
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.17
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$225.61
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$833.26
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.04
|
|
|
HC MR LOWER EXTREM BIL NO JOINT WO CON
|
Facility
|
IP
|
$2,252.06
|
|
|
Service Code
|
CPT 73718
|
| Hospital Charge Code |
61000030
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$990.91 |
| Max. Negotiated Rate |
$2,026.85 |
| Rate for Payer: Aetna American Axle |
$1,463.84
|
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,463.84
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cofinity Commercial |
$1,576.44
|
| Rate for Payer: Cofinity Commercial |
$1,936.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,576.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,689.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,914.25
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,576.44
|
| Rate for Payer: Priority Health SBD |
$1,418.80
|
| Rate for Payer: UMR Bronson Commercial |
$990.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.04
|
|
|
HC MR LOWER EXTREM NO JOINT BIL WO W CON
|
Facility
|
OP
|
$3,096.62
|
|
|
Service Code
|
CPT 73720
|
| Hospital Charge Code |
61000034
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,786.96 |
| Rate for Payer: Aetna American Axle |
$2,012.80
|
| Rate for Payer: Aetna Commercial |
$2,632.13
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,012.80
|
| 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 |
$477.65
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$2,477.30
|
| Rate for Payer: Cash Price |
$2,477.30
|
| Rate for Payer: Cofinity Commercial |
$2,167.63
|
| Rate for Payer: Cofinity Commercial |
$2,663.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,477.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,786.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,167.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,322.46
|
| 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 |
$2,632.13
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$2,632.13
|
| 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 |
$2,167.63
|
| 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 |
$1,950.87
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$374.59
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$340.54
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,145.75
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,322.46
|
|
|
HC MR LOWER EXTREM NO JOINT BIL WO W CON
|
Facility
|
IP
|
$3,096.62
|
|
|
Service Code
|
CPT 73720
|
| Hospital Charge Code |
61000034
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,362.51 |
| Max. Negotiated Rate |
$2,786.96 |
| Rate for Payer: Aetna American Axle |
$2,012.80
|
| Rate for Payer: Aetna Commercial |
$2,632.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,012.80
|
| Rate for Payer: Cash Price |
$2,477.30
|
| Rate for Payer: Cofinity Commercial |
$2,663.09
|
| Rate for Payer: Cofinity Commercial |
$2,167.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,477.30
|
| Rate for Payer: Healthscope Commercial |
$2,786.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,167.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,322.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,632.13
|
| Rate for Payer: PHP Commercial |
$2,632.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,167.63
|
| Rate for Payer: Priority Health SBD |
$1,950.87
|
| Rate for Payer: UMR Bronson Commercial |
$1,362.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,322.46
|
|
|
HC MR LOWER EXTREM NO JOINT W CON
|
Facility
|
IP
|
$3,547.07
|
|
|
Service Code
|
CPT 73719
|
| Hospital Charge Code |
61000031
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,560.71 |
| Max. Negotiated Rate |
$3,192.36 |
| Rate for Payer: Aetna American Axle |
$2,305.60
|
| Rate for Payer: Aetna American Axle |
$1,537.06
|
| Rate for Payer: Aetna Commercial |
$2,010.00
|
| Rate for Payer: Aetna Commercial |
$3,015.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,537.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,305.60
|
| Rate for Payer: Cash Price |
$1,891.77
|
| Rate for Payer: Cash Price |
$2,837.66
|
| Rate for Payer: Cofinity Commercial |
$2,033.65
|
| Rate for Payer: Cofinity Commercial |
$1,655.30
|
| Rate for Payer: Cofinity Commercial |
$3,050.48
|
| Rate for Payer: Cofinity Commercial |
$2,482.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,891.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,837.66
|
| Rate for Payer: Healthscope Commercial |
$3,192.36
|
| Rate for Payer: Healthscope Commercial |
$2,128.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,655.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,482.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,773.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,660.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,010.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,015.01
|
| Rate for Payer: PHP Commercial |
$3,015.01
|
| Rate for Payer: PHP Commercial |
$2,010.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,655.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,482.95
|
| Rate for Payer: Priority Health SBD |
$2,234.65
|
| Rate for Payer: Priority Health SBD |
$1,489.77
|
| Rate for Payer: UMR Bronson Commercial |
$1,040.47
|
| Rate for Payer: UMR Bronson Commercial |
$1,560.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,773.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,660.30
|
|
|
HC MR LOWER EXTREM NO JOINT W CON
|
Facility
|
OP
|
$3,547.07
|
|
|
Service Code
|
CPT 73719
|
| Hospital Charge Code |
61000031
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$3,192.36 |
| Rate for Payer: Aetna American Axle |
$2,305.60
|
| Rate for Payer: Aetna American Axle |
$1,537.06
|
| Rate for Payer: Aetna Commercial |
$2,010.00
|
| Rate for Payer: Aetna Commercial |
$3,015.01
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,537.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,305.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$375.65
|
| Rate for Payer: BCBS Trust/PPO |
$375.65
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$1,891.77
|
| Rate for Payer: Cash Price |
$2,837.66
|
| Rate for Payer: Cash Price |
$1,891.77
|
| Rate for Payer: Cash Price |
$2,837.66
|
| Rate for Payer: Cofinity Commercial |
$3,050.48
|
| Rate for Payer: Cofinity Commercial |
$2,482.95
|
| Rate for Payer: Cofinity Commercial |
$2,033.65
|
| Rate for Payer: Cofinity Commercial |
$1,655.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,837.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,891.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$3,192.36
|
| Rate for Payer: Healthscope Commercial |
$2,128.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,482.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,655.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,773.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,660.30
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,015.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,010.00
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$2,010.00
|
| Rate for Payer: PHP Commercial |
$3,015.01
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,655.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,482.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,076.13
|
| 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 Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$860.90
|
| Rate for Payer: Priority Health Narrow Network |
$860.90
|
| Rate for Payer: Priority Health SBD |
$1,489.77
|
| Rate for Payer: Priority Health SBD |
$2,234.65
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$292.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$292.47
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$265.88
|
| Rate for Payer: UHC Exchange |
$265.88
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$874.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,312.42
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,773.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,660.30
|
|
|
HC MR LOWER EXTREM NO JOINT WO CON
|
Facility
|
OP
|
$2,132.92
|
|
|
Service Code
|
CPT 73718
|
| Hospital Charge Code |
61000029
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$1,386.40
|
| Rate for Payer: Aetna American Axle |
$2,079.60
|
| Rate for Payer: Aetna Commercial |
$1,812.98
|
| Rate for Payer: Aetna Commercial |
$2,719.47
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,079.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,386.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$322.44
|
| Rate for Payer: BCBS Trust/PPO |
$322.44
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$2,559.50
|
| Rate for Payer: Cash Price |
$2,559.50
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cofinity Commercial |
$1,834.31
|
| Rate for Payer: Cofinity Commercial |
$2,239.57
|
| Rate for Payer: Cofinity Commercial |
$2,751.47
|
| Rate for Payer: Cofinity Commercial |
$1,493.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,706.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,559.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$2,879.44
|
| Rate for Payer: Healthscope Commercial |
$1,919.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,239.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,493.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,399.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,599.69
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,812.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,719.47
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$2,719.47
|
| Rate for Payer: PHP Commercial |
$1,812.98
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,493.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,239.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.66
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$548.53
|
| Rate for Payer: Priority Health Narrow Network |
$548.53
|
| Rate for Payer: Priority Health SBD |
$2,015.61
|
| Rate for Payer: Priority Health SBD |
$1,343.74
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.17
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$225.61
|
| Rate for Payer: UHC Exchange |
$225.61
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$789.18
|
| Rate for Payer: UMR Bronson Commercial |
$1,183.77
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,399.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,599.69
|
|
|
HC MR LOWER EXTREM NO JOINT WO CON
|
Facility
|
IP
|
$2,132.92
|
|
|
Service Code
|
CPT 73718
|
| Hospital Charge Code |
61000029
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$938.48 |
| Max. Negotiated Rate |
$1,919.63 |
| Rate for Payer: Aetna American Axle |
$1,386.40
|
| Rate for Payer: Aetna American Axle |
$2,079.60
|
| Rate for Payer: Aetna Commercial |
$2,719.47
|
| Rate for Payer: Aetna Commercial |
$1,812.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,386.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,079.60
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cash Price |
$2,559.50
|
| Rate for Payer: Cofinity Commercial |
$2,751.47
|
| Rate for Payer: Cofinity Commercial |
$2,239.57
|
| Rate for Payer: Cofinity Commercial |
$1,493.04
|
| Rate for Payer: Cofinity Commercial |
$1,834.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,706.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,559.50
|
| Rate for Payer: Healthscope Commercial |
$1,919.63
|
| Rate for Payer: Healthscope Commercial |
$2,879.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,239.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,493.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,599.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,399.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,719.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,812.98
|
| Rate for Payer: PHP Commercial |
$2,719.47
|
| Rate for Payer: PHP Commercial |
$1,812.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,493.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,239.57
|
| Rate for Payer: Priority Health SBD |
$2,015.61
|
| Rate for Payer: Priority Health SBD |
$1,343.74
|
| Rate for Payer: UMR Bronson Commercial |
$938.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,407.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,599.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,399.54
|
|
|
HC MR LOWER EXTREM NO JOINT WO W CON
|
Facility
|
OP
|
$3,029.70
|
|
|
Service Code
|
CPT 73720
|
| Hospital Charge Code |
61000033
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,726.73 |
| Rate for Payer: Aetna American Axle |
$1,969.30
|
| Rate for Payer: Aetna American Axle |
$2,953.96
|
| Rate for Payer: Aetna Commercial |
$2,575.24
|
| Rate for Payer: Aetna Commercial |
$3,862.87
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,953.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,969.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$477.65
|
| Rate for Payer: BCBS Trust/PPO |
$477.65
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$2,423.76
|
| Rate for Payer: Cash Price |
$2,423.76
|
| Rate for Payer: Cash Price |
$3,635.64
|
| Rate for Payer: Cash Price |
$3,635.64
|
| Rate for Payer: Cofinity Commercial |
$3,908.31
|
| Rate for Payer: Cofinity Commercial |
$3,181.18
|
| Rate for Payer: Cofinity Commercial |
$2,605.54
|
| Rate for Payer: Cofinity Commercial |
$2,120.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,635.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,423.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$4,090.10
|
| Rate for Payer: Healthscope Commercial |
$2,726.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,120.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,181.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,272.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,408.41
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,575.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,862.87
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$2,575.24
|
| Rate for Payer: PHP Commercial |
$3,862.87
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,120.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,181.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,076.13
|
| 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 Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$860.90
|
| Rate for Payer: Priority Health Narrow Network |
$860.90
|
| Rate for Payer: Priority Health SBD |
$2,863.07
|
| Rate for Payer: Priority Health SBD |
$1,908.71
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$374.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$374.59
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$340.54
|
| Rate for Payer: UHC Exchange |
$340.54
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,681.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,120.99
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,408.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,272.28
|
|
|
HC MR LOWER EXTREM NO JOINT WO W CON
|
Facility
|
IP
|
$3,029.70
|
|
|
Service Code
|
CPT 73720
|
| Hospital Charge Code |
61000033
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,333.07 |
| Max. Negotiated Rate |
$2,726.73 |
| Rate for Payer: Aetna American Axle |
$1,969.30
|
| Rate for Payer: Aetna American Axle |
$2,953.96
|
| Rate for Payer: Aetna Commercial |
$3,862.87
|
| Rate for Payer: Aetna Commercial |
$2,575.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,969.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,953.96
|
| Rate for Payer: Cash Price |
$2,423.76
|
| Rate for Payer: Cash Price |
$3,635.64
|
| Rate for Payer: Cofinity Commercial |
$3,181.18
|
| Rate for Payer: Cofinity Commercial |
$2,605.54
|
| Rate for Payer: Cofinity Commercial |
$3,908.31
|
| Rate for Payer: Cofinity Commercial |
$2,120.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,635.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,423.76
|
| Rate for Payer: Healthscope Commercial |
$4,090.10
|
| Rate for Payer: Healthscope Commercial |
$2,726.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,120.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,181.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,272.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,408.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,862.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,575.24
|
| Rate for Payer: PHP Commercial |
$2,575.24
|
| Rate for Payer: PHP Commercial |
$3,862.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,181.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,120.79
|
| Rate for Payer: Priority Health SBD |
$1,908.71
|
| Rate for Payer: Priority Health SBD |
$2,863.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,999.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,333.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,272.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,408.41
|
|
|
HC MR MRA ABDOMEN W CON
|
Facility
|
OP
|
$2,207.90
|
|
|
Service Code
|
HCPCS C8900
|
| Hospital Charge Code |
61000060
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$1,987.11 |
| Rate for Payer: Aetna American Axle |
$1,435.14
|
| Rate for Payer: Aetna Commercial |
$1,876.72
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,435.14
|
| 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: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cofinity Commercial |
$1,898.79
|
| Rate for Payer: Cofinity Commercial |
$1,545.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,766.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$1,987.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,545.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,655.92
|
| 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 |
$1,876.72
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$1,876.72
|
| 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 |
$1,545.53
|
| 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 |
$1,390.98
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$958.42
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$653.29
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$816.92
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,655.92
|
|
|
HC MR MRA ABDOMEN W CON
|
Facility
|
IP
|
$2,207.90
|
|
|
Service Code
|
HCPCS C8900
|
| Hospital Charge Code |
61000060
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$971.48 |
| Max. Negotiated Rate |
$1,987.11 |
| Rate for Payer: Aetna American Axle |
$1,435.14
|
| Rate for Payer: Aetna Commercial |
$1,876.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,435.14
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cofinity Commercial |
$1,545.53
|
| Rate for Payer: Cofinity Commercial |
$1,898.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,766.32
|
| Rate for Payer: Healthscope Commercial |
$1,987.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,545.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,655.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,876.72
|
| Rate for Payer: PHP Commercial |
$1,876.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,545.53
|
| Rate for Payer: Priority Health SBD |
$1,390.98
|
| Rate for Payer: UMR Bronson Commercial |
$971.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,655.92
|
|
|
HC MR MRA ABDOMEN WO CON
|
Facility
|
OP
|
$2,070.00
|
|
|
Service Code
|
HCPCS C8901
|
| Hospital Charge Code |
61000061
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$1,345.50
|
| Rate for Payer: Aetna Commercial |
$1,759.50
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,345.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cofinity Commercial |
$1,780.20
|
| Rate for Payer: Cofinity Commercial |
$1,449.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,656.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$1,863.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,449.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,552.50
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,759.50
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$1,759.50
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,449.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.66
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$548.53
|
| Rate for Payer: Priority Health SBD |
$1,304.10
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$610.67
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$416.26
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$765.90
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,552.50
|
|
|
HC MR MRA ABDOMEN WO CON
|
Facility
|
IP
|
$2,070.00
|
|
|
Service Code
|
HCPCS C8901
|
| Hospital Charge Code |
61000061
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$910.80 |
| Max. Negotiated Rate |
$1,863.00 |
| Rate for Payer: Aetna American Axle |
$1,345.50
|
| Rate for Payer: Aetna Commercial |
$1,759.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,345.50
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cofinity Commercial |
$1,449.00
|
| Rate for Payer: Cofinity Commercial |
$1,780.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,656.00
|
| Rate for Payer: Healthscope Commercial |
$1,863.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,449.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,552.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,759.50
|
| Rate for Payer: PHP Commercial |
$1,759.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,449.00
|
| Rate for Payer: Priority Health SBD |
$1,304.10
|
| Rate for Payer: UMR Bronson Commercial |
$910.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,552.50
|
|
|
HC MR MRA ABDOMEN WO W CON
|
Facility
|
IP
|
$2,674.34
|
|
|
Service Code
|
HCPCS C8902
|
| Hospital Charge Code |
61000062
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,176.71 |
| Max. Negotiated Rate |
$2,406.91 |
| Rate for Payer: Aetna American Axle |
$1,738.32
|
| Rate for Payer: Aetna Commercial |
$2,273.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,738.32
|
| Rate for Payer: Cash Price |
$2,139.47
|
| Rate for Payer: Cofinity Commercial |
$1,872.04
|
| Rate for Payer: Cofinity Commercial |
$2,299.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,139.47
|
| Rate for Payer: Healthscope Commercial |
$2,406.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,872.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,005.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,273.19
|
| Rate for Payer: PHP Commercial |
$2,273.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,872.04
|
| Rate for Payer: Priority Health SBD |
$1,684.83
|
| Rate for Payer: UMR Bronson Commercial |
$1,176.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,005.76
|
|
|
HC MR MRA ABDOMEN WO W CON
|
Facility
|
OP
|
$2,674.34
|
|
|
Service Code
|
HCPCS C8902
|
| Hospital Charge Code |
61000062
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,406.91 |
| Rate for Payer: Aetna American Axle |
$1,738.32
|
| Rate for Payer: Aetna Commercial |
$2,273.19
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,738.32
|
| 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: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$2,139.47
|
| Rate for Payer: Cash Price |
$2,139.47
|
| Rate for Payer: Cofinity Commercial |
$1,872.04
|
| Rate for Payer: Cofinity Commercial |
$2,299.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,139.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,406.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,872.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,005.76
|
| 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 |
$2,273.19
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$2,273.19
|
| 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 |
$1,872.04
|
| 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 |
$1,684.83
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$958.42
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$653.29
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$989.51
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,005.76
|
|
|
HC MR MRA CHEST W CON
|
Facility
|
OP
|
$2,207.90
|
|
|
Service Code
|
HCPCS C8909
|
| Hospital Charge Code |
61000063
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$1,987.11 |
| Rate for Payer: Aetna American Axle |
$1,435.14
|
| Rate for Payer: Aetna Commercial |
$1,876.72
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,435.14
|
| 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: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cofinity Commercial |
$1,545.53
|
| Rate for Payer: Cofinity Commercial |
$1,898.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,766.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$1,987.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,545.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,655.92
|
| 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 |
$1,876.72
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$1,876.72
|
| 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 |
$1,545.53
|
| 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 |
$1,390.98
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$958.42
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$653.29
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$816.92
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,655.92
|
|
|
HC MR MRA CHEST W CON
|
Facility
|
IP
|
$2,207.90
|
|
|
Service Code
|
HCPCS C8909
|
| Hospital Charge Code |
61000063
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$971.48 |
| Max. Negotiated Rate |
$1,987.11 |
| Rate for Payer: Aetna American Axle |
$1,435.14
|
| Rate for Payer: Aetna Commercial |
$1,876.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,435.14
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cofinity Commercial |
$1,898.79
|
| Rate for Payer: Cofinity Commercial |
$1,545.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,766.32
|
| Rate for Payer: Healthscope Commercial |
$1,987.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,545.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,655.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,876.72
|
| Rate for Payer: PHP Commercial |
$1,876.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,545.53
|
| Rate for Payer: Priority Health SBD |
$1,390.98
|
| Rate for Payer: UMR Bronson Commercial |
$971.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,655.92
|
|
|
HC MR MRA CHEST WO CON
|
Facility
|
OP
|
$2,070.00
|
|
|
Service Code
|
HCPCS C8910
|
| Hospital Charge Code |
61000064
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$1,345.50
|
| Rate for Payer: Aetna Commercial |
$1,759.50
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,345.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cofinity Commercial |
$1,449.00
|
| Rate for Payer: Cofinity Commercial |
$1,780.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,656.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$1,863.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,449.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,552.50
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,759.50
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$1,759.50
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,449.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.66
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$548.53
|
| Rate for Payer: Priority Health SBD |
$1,304.10
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$610.67
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$416.26
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$765.90
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,552.50
|
|
