HC MR MRA PELVIS WO W CON
|
Facility
|
IP
|
$2,207.90
|
|
Service Code
|
HCPCS C8920
|
Hospital Charge Code |
61800003
|
Hospital Revenue Code
|
618
|
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 PELVIS WO W CON
|
Facility
|
OP
|
$2,207.90
|
|
Service Code
|
HCPCS C8920
|
Hospital Charge Code |
61800003
|
Hospital Revenue Code
|
618
|
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 SPINAL CANAL W CON
|
Facility
|
IP
|
$1,902.60
|
|
Service Code
|
HCPCS C8931
|
Hospital Charge Code |
61000072
|
Hospital Revenue Code
|
610
|
Min. Negotiated Rate |
$837.14 |
Max. Negotiated Rate |
$1,712.34 |
Rate for Payer: Aetna American Axle |
$1,236.69
|
Rate for Payer: Aetna Commercial |
$1,617.21
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.69
|
Rate for Payer: Cash Price |
$1,522.08
|
Rate for Payer: Cofinity Commercial |
$1,331.82
|
Rate for Payer: Cofinity Commercial |
$1,636.24
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.08
|
Rate for Payer: Healthscope Commercial |
$1,712.34
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,331.82
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,426.95
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,617.21
|
Rate for Payer: PHP Commercial |
$1,617.21
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,331.82
|
Rate for Payer: Priority Health SBD |
$1,198.64
|
Rate for Payer: UMR Bronson Commercial |
$837.14
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,426.95
|
|
HC MR MRA SPINAL CANAL W CON
|
Facility
|
OP
|
$1,902.60
|
|
Service Code
|
HCPCS C8931
|
Hospital Charge Code |
61000072
|
Hospital Revenue Code
|
610
|
Min. Negotiated Rate |
$186.99 |
Max. Negotiated Rate |
$1,943.00 |
Rate for Payer: Aetna American Axle |
$1,236.69
|
Rate for Payer: Aetna Commercial |
$1,617.21
|
Rate for Payer: Aetna Medicare |
$355.51
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.69
|
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 |
$1,522.08
|
Rate for Payer: Cash Price |
$1,522.08
|
Rate for Payer: Cofinity Commercial |
$1,636.24
|
Rate for Payer: Cofinity Commercial |
$1,331.82
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.08
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
Rate for Payer: Healthscope Commercial |
$1,712.34
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,331.82
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,426.95
|
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 |
$1,617.21
|
Rate for Payer: PACE Medicare |
$324.75
|
Rate for Payer: PACE SWMI |
$341.84
|
Rate for Payer: PHP Commercial |
$1,617.21
|
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 |
$1,331.82
|
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 |
$1,198.64
|
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 |
$703.96
|
Rate for Payer: VA VA |
$341.84
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,426.95
|
|
HC MR MRA SPINAL CANAL WO CON
|
Facility
|
IP
|
$1,902.60
|
|
Service Code
|
HCPCS C8932
|
Hospital Charge Code |
61000073
|
Hospital Revenue Code
|
610
|
Min. Negotiated Rate |
$837.14 |
Max. Negotiated Rate |
$1,712.34 |
Rate for Payer: Aetna American Axle |
$1,236.69
|
Rate for Payer: Aetna Commercial |
$1,617.21
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.69
|
Rate for Payer: Cash Price |
$1,522.08
|
Rate for Payer: Cofinity Commercial |
$1,331.82
|
Rate for Payer: Cofinity Commercial |
$1,636.24
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.08
|
Rate for Payer: Healthscope Commercial |
$1,712.34
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,331.82
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,426.95
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,617.21
|
Rate for Payer: PHP Commercial |
$1,617.21
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,331.82
|
Rate for Payer: Priority Health SBD |
$1,198.64
|
Rate for Payer: UMR Bronson Commercial |
$837.14
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,426.95
|
|
HC MR MRA SPINAL CANAL WO CON
|
Facility
|
OP
|
$1,902.60
|
|
Service Code
|
HCPCS C8932
|
Hospital Charge Code |
61000073
|
Hospital Revenue Code
|
610
|
Min. Negotiated Rate |
$119.14 |
Max. Negotiated Rate |
$1,943.00 |
Rate for Payer: Aetna American Axle |
$1,236.69
|
Rate for Payer: Aetna Commercial |
$1,617.21
|
Rate for Payer: Aetna Medicare |
$226.52
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.69
|
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 |
$1,522.08
|
Rate for Payer: Cash Price |
$1,522.08
|
Rate for Payer: Cofinity Commercial |
$1,331.82
|
Rate for Payer: Cofinity Commercial |
$1,636.24
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.08
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
Rate for Payer: Healthscope Commercial |
$1,712.34
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,331.82
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,426.95
|
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 |
$1,617.21
|
Rate for Payer: PACE Medicare |
$206.92
|
Rate for Payer: PACE SWMI |
$217.81
|
Rate for Payer: PHP Commercial |
$1,617.21
|
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 |
$1,331.82
|
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 |
$1,198.64
|
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 |
$703.96
|
Rate for Payer: VA VA |
$217.81
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,426.95
|
|
HC MR MRA UPPER EXTREM BIL WO W C
|
Facility
|
IP
|
$2,080.90
|
|
Service Code
|
HCPCS C8936
|
Hospital Charge Code |
61000074
|
Hospital Revenue Code
|
610
|
Min. Negotiated Rate |
$915.60 |
Max. Negotiated Rate |
$1,872.81 |
Rate for Payer: Aetna American Axle |
$1,352.58
|
Rate for Payer: Aetna Commercial |
$1,768.76
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,352.58
|
Rate for Payer: Cash Price |
$1,664.72
|
Rate for Payer: Cofinity Commercial |
$1,456.63
|
Rate for Payer: Cofinity Commercial |
$1,789.57
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.72
|
Rate for Payer: Healthscope Commercial |
$1,872.81
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,456.63
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,560.68
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,768.76
|
Rate for Payer: PHP Commercial |
$1,768.76
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,456.63
|
Rate for Payer: Priority Health SBD |
$1,310.97
|
Rate for Payer: UMR Bronson Commercial |
$915.60
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,560.68
|
|
HC MR MRA UPPER EXTREM BIL WO W C
|
Facility
|
OP
|
$2,080.90
|
|
Service Code
|
HCPCS C8936
|
Hospital Charge Code |
61000074
|
Hospital Revenue Code
|
610
|
Min. Negotiated Rate |
$186.99 |
Max. Negotiated Rate |
$1,943.00 |
Rate for Payer: Aetna American Axle |
$1,352.58
|
Rate for Payer: Aetna Commercial |
$1,768.76
|
Rate for Payer: Aetna Medicare |
$355.51
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,352.58
|
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 |
$1,664.72
|
Rate for Payer: Cash Price |
$1,664.72
|
Rate for Payer: Cofinity Commercial |
$1,789.57
|
Rate for Payer: Cofinity Commercial |
$1,456.63
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.72
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
Rate for Payer: Healthscope Commercial |
$1,872.81
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,456.63
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,560.68
|
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 |
$1,768.76
|
Rate for Payer: PACE Medicare |
$324.75
|
Rate for Payer: PACE SWMI |
$341.84
|
Rate for Payer: PHP Commercial |
$1,768.76
|
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 |
$1,456.63
|
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 |
$1,310.97
|
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 |
$769.93
|
Rate for Payer: VA VA |
$341.84
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,560.68
|
|
HC MR MRA UPPER EXTREMITY BIL W CO
|
Facility
|
IP
|
$2,080.90
|
|
Service Code
|
HCPCS C8934
|
Hospital Charge Code |
61000075
|
Hospital Revenue Code
|
610
|
Min. Negotiated Rate |
$915.60 |
Max. Negotiated Rate |
$1,872.81 |
Rate for Payer: Aetna American Axle |
$1,352.58
|
Rate for Payer: Aetna Commercial |
$1,768.76
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,352.58
|
Rate for Payer: Cash Price |
$1,664.72
|
Rate for Payer: Cofinity Commercial |
$1,456.63
|
Rate for Payer: Cofinity Commercial |
$1,789.57
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.72
|
Rate for Payer: Healthscope Commercial |
$1,872.81
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,456.63
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,560.68
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,768.76
|
Rate for Payer: PHP Commercial |
$1,768.76
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,456.63
|
Rate for Payer: Priority Health SBD |
$1,310.97
|
Rate for Payer: UMR Bronson Commercial |
$915.60
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,560.68
|
|
HC MR MRA UPPER EXTREMITY BIL W CO
|
Facility
|
OP
|
$2,080.90
|
|
Service Code
|
HCPCS C8934
|
Hospital Charge Code |
61000075
|
Hospital Revenue Code
|
610
|
Min. Negotiated Rate |
$186.99 |
Max. Negotiated Rate |
$1,943.00 |
Rate for Payer: Aetna American Axle |
$1,352.58
|
Rate for Payer: Aetna Commercial |
$1,768.76
|
Rate for Payer: Aetna Medicare |
$355.51
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,352.58
|
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 |
$1,664.72
|
Rate for Payer: Cash Price |
$1,664.72
|
Rate for Payer: Cofinity Commercial |
$1,456.63
|
Rate for Payer: Cofinity Commercial |
$1,789.57
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.72
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
Rate for Payer: Healthscope Commercial |
$1,872.81
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,456.63
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,560.68
|
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 |
$1,768.76
|
Rate for Payer: PACE Medicare |
$324.75
|
Rate for Payer: PACE SWMI |
$341.84
|
Rate for Payer: PHP Commercial |
$1,768.76
|
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 |
$1,456.63
|
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 |
$1,310.97
|
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 |
$769.93
|
Rate for Payer: VA VA |
$341.84
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,560.68
|
|
HC MR MRA UPPER EXTREMITY BIL WO C
|
Facility
|
OP
|
$2,080.90
|
|
Service Code
|
HCPCS C8935
|
Hospital Charge Code |
61000076
|
Hospital Revenue Code
|
610
|
Min. Negotiated Rate |
$119.14 |
Max. Negotiated Rate |
$1,943.00 |
Rate for Payer: Aetna American Axle |
$1,352.58
|
Rate for Payer: Aetna Commercial |
$1,768.76
|
Rate for Payer: Aetna Medicare |
$226.52
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,352.58
|
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 |
$1,664.72
|
Rate for Payer: Cash Price |
$1,664.72
|
Rate for Payer: Cofinity Commercial |
$1,456.63
|
Rate for Payer: Cofinity Commercial |
$1,789.57
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.72
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
Rate for Payer: Healthscope Commercial |
$1,872.81
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,456.63
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,560.68
|
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 |
$1,768.76
|
Rate for Payer: PACE Medicare |
$206.92
|
Rate for Payer: PACE SWMI |
$217.81
|
Rate for Payer: PHP Commercial |
$1,768.76
|
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 |
$1,456.63
|
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 |
$1,310.97
|
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 |
$769.93
|
Rate for Payer: VA VA |
$217.81
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,560.68
|
|
HC MR MRA UPPER EXTREMITY BIL WO C
|
Facility
|
IP
|
$2,080.90
|
|
Service Code
|
HCPCS C8935
|
Hospital Charge Code |
61000076
|
Hospital Revenue Code
|
610
|
Min. Negotiated Rate |
$915.60 |
Max. Negotiated Rate |
$1,872.81 |
Rate for Payer: Aetna American Axle |
$1,352.58
|
Rate for Payer: Aetna Commercial |
$1,768.76
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,352.58
|
Rate for Payer: Cash Price |
$1,664.72
|
Rate for Payer: Cofinity Commercial |
$1,456.63
|
Rate for Payer: Cofinity Commercial |
$1,789.57
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.72
|
Rate for Payer: Healthscope Commercial |
$1,872.81
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,456.63
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,560.68
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,768.76
|
Rate for Payer: PHP Commercial |
$1,768.76
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,456.63
|
Rate for Payer: Priority Health SBD |
$1,310.97
|
Rate for Payer: UMR Bronson Commercial |
$915.60
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,560.68
|
|
HC MR MRA UPPER EXTREMITY W CO
|
Facility
|
IP
|
$1,903.11
|
|
Service Code
|
HCPCS C8934
|
Hospital Charge Code |
61000077
|
Hospital Revenue Code
|
610
|
Min. Negotiated Rate |
$837.37 |
Max. Negotiated Rate |
$1,712.80 |
Rate for Payer: Aetna American Axle |
$1,237.02
|
Rate for Payer: Aetna American Axle |
$1,855.54
|
Rate for Payer: Aetna Commercial |
$1,617.64
|
Rate for Payer: Aetna Commercial |
$2,426.47
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,855.54
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,237.02
|
Rate for Payer: Cash Price |
$2,283.74
|
Rate for Payer: Cash Price |
$1,522.49
|
Rate for Payer: Cofinity Commercial |
$2,455.02
|
Rate for Payer: Cofinity Commercial |
$1,998.27
|
Rate for Payer: Cofinity Commercial |
$1,636.67
|
Rate for Payer: Cofinity Commercial |
$1,332.18
|
Rate for Payer: Encore Health Key Benefits Commercial |
$2,283.74
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.49
|
Rate for Payer: Healthscope Commercial |
$2,569.20
|
Rate for Payer: Healthscope Commercial |
$1,712.80
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,998.27
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,332.18
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,427.33
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,141.00
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,426.47
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,617.64
|
Rate for Payer: PHP Commercial |
$1,617.64
|
Rate for Payer: PHP Commercial |
$2,426.47
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,998.27
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,332.18
|
Rate for Payer: Priority Health SBD |
$1,798.44
|
Rate for Payer: Priority Health SBD |
$1,198.96
|
Rate for Payer: UMR Bronson Commercial |
$837.37
|
Rate for Payer: UMR Bronson Commercial |
$1,256.05
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,141.00
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,427.33
|
|
HC MR MRA UPPER EXTREMITY W CO
|
Facility
|
OP
|
$1,903.11
|
|
Service Code
|
HCPCS C8934
|
Hospital Charge Code |
61000077
|
Hospital Revenue Code
|
610
|
Min. Negotiated Rate |
$186.99 |
Max. Negotiated Rate |
$1,943.00 |
Rate for Payer: Aetna American Axle |
$1,237.02
|
Rate for Payer: Aetna American Axle |
$1,855.54
|
Rate for Payer: Aetna Commercial |
$1,617.64
|
Rate for Payer: Aetna Commercial |
$2,426.47
|
Rate for Payer: Aetna Medicare |
$355.51
|
Rate for Payer: Aetna Medicare |
$355.51
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,855.54
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,237.02
|
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: BCN Medicare Advantage |
$341.84
|
Rate for Payer: BCN Medicare Advantage |
$341.84
|
Rate for Payer: Cash Price |
$2,283.74
|
Rate for Payer: Cash Price |
$2,283.74
|
Rate for Payer: Cash Price |
$1,522.49
|
Rate for Payer: Cash Price |
$1,522.49
|
Rate for Payer: Cofinity Commercial |
$2,455.02
|
Rate for Payer: Cofinity Commercial |
$1,636.67
|
Rate for Payer: Cofinity Commercial |
$1,998.27
|
Rate for Payer: Cofinity Commercial |
$1,332.18
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.49
|
Rate for Payer: Encore Health Key Benefits Commercial |
$2,283.74
|
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 |
$1,712.80
|
Rate for Payer: Healthscope Commercial |
$2,569.20
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,998.27
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,332.18
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,427.33
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,141.00
|
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 |
$2,426.47
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,617.64
|
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 |
$1,617.64
|
Rate for Payer: PHP Commercial |
$2,426.47
|
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 |
$1,998.27
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,332.18
|
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 |
$1,198.96
|
Rate for Payer: Priority Health SBD |
$1,798.44
|
Rate for Payer: Railroad Medicare Medicare |
$341.84
|
Rate for Payer: Railroad Medicare Medicare |
$341.84
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$958.42
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$958.42
|
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 |
$653.29
|
Rate for Payer: UHC Exchange |
$653.29
|
Rate for Payer: UHC Medicare Advantage |
$352.10
|
Rate for Payer: UHC Medicare Advantage |
$352.10
|
Rate for Payer: UMR Bronson Commercial |
$704.15
|
Rate for Payer: UMR Bronson Commercial |
$1,056.23
|
Rate for Payer: VA VA |
$341.84
|
Rate for Payer: VA VA |
$341.84
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,427.33
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,141.00
|
|
HC MR MRA UPPER EXTREMITY WO C
|
Facility
|
IP
|
$2,635.11
|
|
Service Code
|
HCPCS C8935
|
Hospital Charge Code |
61000078
|
Hospital Revenue Code
|
610
|
Min. Negotiated Rate |
$1,159.45 |
Max. Negotiated Rate |
$2,371.60 |
Rate for Payer: Aetna American Axle |
$1,712.82
|
Rate for Payer: Aetna American Axle |
$1,141.88
|
Rate for Payer: Aetna Commercial |
$2,239.84
|
Rate for Payer: Aetna Commercial |
$1,493.23
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,712.82
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,141.88
|
Rate for Payer: Cash Price |
$2,108.09
|
Rate for Payer: Cash Price |
$1,405.39
|
Rate for Payer: Cofinity Commercial |
$2,266.19
|
Rate for Payer: Cofinity Commercial |
$1,844.58
|
Rate for Payer: Cofinity Commercial |
$1,510.80
|
Rate for Payer: Cofinity Commercial |
$1,229.72
|
Rate for Payer: Encore Health Key Benefits Commercial |
$2,108.09
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,405.39
|
Rate for Payer: Healthscope Commercial |
$2,371.60
|
Rate for Payer: Healthscope Commercial |
$1,581.07
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,844.58
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,229.72
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,317.56
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,976.33
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,239.84
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,493.23
|
Rate for Payer: PHP Commercial |
$1,493.23
|
Rate for Payer: PHP Commercial |
$2,239.84
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,844.58
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,229.72
|
Rate for Payer: Priority Health SBD |
$1,660.12
|
Rate for Payer: Priority Health SBD |
$1,106.75
|
Rate for Payer: UMR Bronson Commercial |
$772.97
|
Rate for Payer: UMR Bronson Commercial |
$1,159.45
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,317.56
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,976.33
|
|
HC MR MRA UPPER EXTREMITY WO C
|
Facility
|
OP
|
$1,756.74
|
|
Service Code
|
HCPCS C8935
|
Hospital Charge Code |
61000078
|
Hospital Revenue Code
|
610
|
Min. Negotiated Rate |
$119.14 |
Max. Negotiated Rate |
$1,943.00 |
Rate for Payer: Aetna American Axle |
$1,141.88
|
Rate for Payer: Aetna American Axle |
$1,712.82
|
Rate for Payer: Aetna Commercial |
$2,239.84
|
Rate for Payer: Aetna Commercial |
$1,493.23
|
Rate for Payer: Aetna Medicare |
$226.52
|
Rate for Payer: Aetna Medicare |
$226.52
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,141.88
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,712.82
|
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: BCN Medicare Advantage |
$217.81
|
Rate for Payer: BCN Medicare Advantage |
$217.81
|
Rate for Payer: Cash Price |
$2,108.09
|
Rate for Payer: Cash Price |
$2,108.09
|
Rate for Payer: Cash Price |
$1,405.39
|
Rate for Payer: Cash Price |
$1,405.39
|
Rate for Payer: Cofinity Commercial |
$1,229.72
|
Rate for Payer: Cofinity Commercial |
$2,266.19
|
Rate for Payer: Cofinity Commercial |
$1,844.58
|
Rate for Payer: Cofinity Commercial |
$1,510.80
|
Rate for Payer: Encore Health Key Benefits Commercial |
$2,108.09
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,405.39
|
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 |
$1,581.07
|
Rate for Payer: Healthscope Commercial |
$2,371.60
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,229.72
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,844.58
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,976.33
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,317.56
|
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 |
$2,239.84
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,493.23
|
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 |
$1,493.23
|
Rate for Payer: PHP Commercial |
$2,239.84
|
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 |
$1,844.58
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,229.72
|
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 |
$1,660.12
|
Rate for Payer: Priority Health SBD |
$1,106.75
|
Rate for Payer: Railroad Medicare Medicare |
$217.81
|
Rate for Payer: Railroad Medicare Medicare |
$217.81
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$610.67
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$610.67
|
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 |
$416.26
|
Rate for Payer: UHC Exchange |
$416.26
|
Rate for Payer: UHC Medicare Advantage |
$224.34
|
Rate for Payer: UHC Medicare Advantage |
$224.34
|
Rate for Payer: UMR Bronson Commercial |
$974.99
|
Rate for Payer: UMR Bronson Commercial |
$649.99
|
Rate for Payer: VA VA |
$217.81
|
Rate for Payer: VA VA |
$217.81
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,317.56
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,976.33
|
|
HC MR MRA UPPER EXTREMITY WO W
|
Facility
|
OP
|
$3,074.07
|
|
Service Code
|
HCPCS C8936
|
Hospital Charge Code |
61000079
|
Hospital Revenue Code
|
610
|
Min. Negotiated Rate |
$186.99 |
Max. Negotiated Rate |
$2,766.66 |
Rate for Payer: Aetna American Axle |
$1,998.15
|
Rate for Payer: Aetna American Axle |
$1,332.10
|
Rate for Payer: Aetna Commercial |
$1,741.97
|
Rate for Payer: Aetna Commercial |
$2,612.96
|
Rate for Payer: Aetna Medicare |
$355.51
|
Rate for Payer: Aetna Medicare |
$355.51
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,332.10
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,998.15
|
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: BCN Medicare Advantage |
$341.84
|
Rate for Payer: BCN Medicare Advantage |
$341.84
|
Rate for Payer: Cash Price |
$2,459.26
|
Rate for Payer: Cash Price |
$1,639.50
|
Rate for Payer: Cash Price |
$2,459.26
|
Rate for Payer: Cash Price |
$1,639.50
|
Rate for Payer: Cofinity Commercial |
$2,151.85
|
Rate for Payer: Cofinity Commercial |
$1,762.47
|
Rate for Payer: Cofinity Commercial |
$2,643.70
|
Rate for Payer: Cofinity Commercial |
$1,434.57
|
Rate for Payer: Encore Health Key Benefits Commercial |
$2,459.26
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,639.50
|
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 |
$2,766.66
|
Rate for Payer: Healthscope Commercial |
$1,844.44
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,434.57
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,151.85
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,537.04
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,305.55
|
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 |
$1,741.97
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,612.96
|
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 |
$2,612.96
|
Rate for Payer: PHP Commercial |
$1,741.97
|
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 |
$1,434.57
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,151.85
|
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 |
$1,291.11
|
Rate for Payer: Priority Health SBD |
$1,936.66
|
Rate for Payer: Railroad Medicare Medicare |
$341.84
|
Rate for Payer: Railroad Medicare Medicare |
$341.84
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$958.42
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$958.42
|
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 |
$653.29
|
Rate for Payer: UHC Exchange |
$653.29
|
Rate for Payer: UHC Medicare Advantage |
$352.10
|
Rate for Payer: UHC Medicare Advantage |
$352.10
|
Rate for Payer: UMR Bronson Commercial |
$1,137.41
|
Rate for Payer: UMR Bronson Commercial |
$758.27
|
Rate for Payer: VA VA |
$341.84
|
Rate for Payer: VA VA |
$341.84
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,537.04
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,305.55
|
|
HC MR MRA UPPER EXTREMITY WO W
|
Facility
|
IP
|
$3,074.07
|
|
Service Code
|
HCPCS C8936
|
Hospital Charge Code |
61000079
|
Hospital Revenue Code
|
610
|
Min. Negotiated Rate |
$1,352.59 |
Max. Negotiated Rate |
$2,766.66 |
Rate for Payer: Aetna American Axle |
$1,998.15
|
Rate for Payer: Aetna American Axle |
$1,332.10
|
Rate for Payer: Aetna Commercial |
$2,612.96
|
Rate for Payer: Aetna Commercial |
$1,741.97
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,998.15
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,332.10
|
Rate for Payer: Cash Price |
$2,459.26
|
Rate for Payer: Cash Price |
$1,639.50
|
Rate for Payer: Cofinity Commercial |
$2,151.85
|
Rate for Payer: Cofinity Commercial |
$1,434.57
|
Rate for Payer: Cofinity Commercial |
$1,762.47
|
Rate for Payer: Cofinity Commercial |
$2,643.70
|
Rate for Payer: Encore Health Key Benefits Commercial |
$2,459.26
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,639.50
|
Rate for Payer: Healthscope Commercial |
$1,844.44
|
Rate for Payer: Healthscope Commercial |
$2,766.66
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,434.57
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,151.85
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,305.55
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,537.04
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,741.97
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,612.96
|
Rate for Payer: PHP Commercial |
$1,741.97
|
Rate for Payer: PHP Commercial |
$2,612.96
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,151.85
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,434.57
|
Rate for Payer: Priority Health SBD |
$1,936.66
|
Rate for Payer: Priority Health SBD |
$1,291.11
|
Rate for Payer: UMR Bronson Commercial |
$901.73
|
Rate for Payer: UMR Bronson Commercial |
$1,352.59
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,305.55
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,537.04
|
|
HC MR MRCP
|
Facility
|
OP
|
$2,069.07
|
|
Service Code
|
CPT 74181
|
Hospital Charge Code |
61000042
|
Hospital Revenue Code
|
610
|
Min. Negotiated Rate |
$119.14 |
Max. Negotiated Rate |
$1,943.00 |
Rate for Payer: Aetna American Axle |
$1,344.90
|
Rate for Payer: Aetna Commercial |
$1,758.71
|
Rate for Payer: Aetna Medicare |
$226.52
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,344.90
|
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 |
$257.19
|
Rate for Payer: BCN Medicare Advantage |
$217.81
|
Rate for Payer: Cash Price |
$1,655.26
|
Rate for Payer: Cash Price |
$1,655.26
|
Rate for Payer: Cofinity Commercial |
$1,448.35
|
Rate for Payer: Cofinity Commercial |
$1,779.40
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,655.26
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
Rate for Payer: Healthscope Commercial |
$1,862.16
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,448.35
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,551.80
|
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 |
$1,758.71
|
Rate for Payer: PACE Medicare |
$206.92
|
Rate for Payer: PACE SWMI |
$217.81
|
Rate for Payer: PHP Commercial |
$1,758.71
|
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 |
$1,448.35
|
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 |
$1,303.51
|
Rate for Payer: Railroad Medicare Medicare |
$217.81
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$217.55
|
Rate for Payer: UHC Core |
$1,943.00
|
Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
Rate for Payer: UHC Exchange |
$197.77
|
Rate for Payer: UHC Medicare Advantage |
$224.34
|
Rate for Payer: UMR Bronson Commercial |
$765.56
|
Rate for Payer: VA VA |
$217.81
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,551.80
|
|
HC MR MRCP
|
Facility
|
IP
|
$2,069.07
|
|
Service Code
|
CPT 74181
|
Hospital Charge Code |
61000042
|
Hospital Revenue Code
|
610
|
Min. Negotiated Rate |
$910.39 |
Max. Negotiated Rate |
$1,862.16 |
Rate for Payer: Aetna American Axle |
$1,344.90
|
Rate for Payer: Aetna Commercial |
$1,758.71
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,344.90
|
Rate for Payer: Cash Price |
$1,655.26
|
Rate for Payer: Cofinity Commercial |
$1,448.35
|
Rate for Payer: Cofinity Commercial |
$1,779.40
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,655.26
|
Rate for Payer: Healthscope Commercial |
$1,862.16
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,448.35
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,551.80
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,758.71
|
Rate for Payer: PHP Commercial |
$1,758.71
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,448.35
|
Rate for Payer: Priority Health SBD |
$1,303.51
|
Rate for Payer: UMR Bronson Commercial |
$910.39
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,551.80
|
|
HC MR NEEDLE PLACEMENT
|
Facility
|
OP
|
$985.70
|
|
Service Code
|
CPT 77021
|
Hospital Charge Code |
61000081
|
Hospital Revenue Code
|
610
|
Min. Negotiated Rate |
$364.71 |
Max. Negotiated Rate |
$1,943.00 |
Rate for Payer: Aetna American Axle |
$640.70
|
Rate for Payer: Aetna Commercial |
$837.84
|
Rate for Payer: Aetna New Business (MI Preferred) |
$640.70
|
Rate for Payer: BCBS Complete |
$394.28
|
Rate for Payer: BCBS Trust/PPO |
$682.26
|
Rate for Payer: Cash Price |
$788.56
|
Rate for Payer: Cash Price |
$788.56
|
Rate for Payer: Cofinity Commercial |
$847.70
|
Rate for Payer: Cofinity Commercial |
$689.99
|
Rate for Payer: Encore Health Key Benefits Commercial |
$788.56
|
Rate for Payer: Healthscope Commercial |
$887.13
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$689.99
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$739.28
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$837.84
|
Rate for Payer: PHP Commercial |
$837.84
|
Rate for Payer: Priority Health Cigna Priority Health |
$689.99
|
Rate for Payer: Priority Health SBD |
$620.99
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$459.60
|
Rate for Payer: UHC Core |
$1,943.00
|
Rate for Payer: UHC Exchange |
$417.82
|
Rate for Payer: UMR Bronson Commercial |
$364.71
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$739.28
|
|
HC MR NEEDLE PLACEMENT
|
Facility
|
IP
|
$985.70
|
|
Service Code
|
CPT 77021
|
Hospital Charge Code |
61000081
|
Hospital Revenue Code
|
610
|
Min. Negotiated Rate |
$433.71 |
Max. Negotiated Rate |
$887.13 |
Rate for Payer: Aetna American Axle |
$640.70
|
Rate for Payer: Aetna Commercial |
$837.84
|
Rate for Payer: Aetna New Business (MI Preferred) |
$640.70
|
Rate for Payer: Cash Price |
$788.56
|
Rate for Payer: Cofinity Commercial |
$689.99
|
Rate for Payer: Cofinity Commercial |
$847.70
|
Rate for Payer: Encore Health Key Benefits Commercial |
$788.56
|
Rate for Payer: Healthscope Commercial |
$887.13
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$689.99
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$739.28
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$837.84
|
Rate for Payer: PHP Commercial |
$837.84
|
Rate for Payer: Priority Health Cigna Priority Health |
$689.99
|
Rate for Payer: Priority Health SBD |
$620.99
|
Rate for Payer: UMR Bronson Commercial |
$433.71
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$739.28
|
|
HC MR ONLY HEAD W CON
|
Facility
|
OP
|
$2,173.50
|
|
Service Code
|
CPT 70545
|
Hospital Charge Code |
61000005
|
Hospital Revenue Code
|
610
|
Min. Negotiated Rate |
$186.99 |
Max. Negotiated Rate |
$1,956.15 |
Rate for Payer: Aetna American Axle |
$1,412.78
|
Rate for Payer: Aetna Commercial |
$1,847.48
|
Rate for Payer: Aetna Medicare |
$355.51
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,412.78
|
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 |
$342.71
|
Rate for Payer: BCN Medicare Advantage |
$341.84
|
Rate for Payer: Cash Price |
$1,738.80
|
Rate for Payer: Cash Price |
$1,738.80
|
Rate for Payer: Cofinity Commercial |
$1,521.45
|
Rate for Payer: Cofinity Commercial |
$1,869.21
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,738.80
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
Rate for Payer: Healthscope Commercial |
$1,956.15
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,521.45
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,630.12
|
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 |
$1,847.48
|
Rate for Payer: PACE Medicare |
$324.75
|
Rate for Payer: PACE SWMI |
$341.84
|
Rate for Payer: PHP Commercial |
$1,847.48
|
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 |
$1,521.45
|
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 |
$1,369.30
|
Rate for Payer: Railroad Medicare Medicare |
$341.84
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$252.49
|
Rate for Payer: UHC Core |
$1,943.00
|
Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
Rate for Payer: UHC Exchange |
$229.54
|
Rate for Payer: UHC Medicare Advantage |
$352.10
|
Rate for Payer: UMR Bronson Commercial |
$804.20
|
Rate for Payer: VA VA |
$341.84
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,630.12
|
|
HC MR ONLY HEAD W CON
|
Facility
|
IP
|
$2,173.50
|
|
Service Code
|
CPT 70545
|
Hospital Charge Code |
61000005
|
Hospital Revenue Code
|
610
|
Min. Negotiated Rate |
$956.34 |
Max. Negotiated Rate |
$1,956.15 |
Rate for Payer: Aetna American Axle |
$1,412.78
|
Rate for Payer: Aetna Commercial |
$1,847.48
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,412.78
|
Rate for Payer: Cash Price |
$1,738.80
|
Rate for Payer: Cofinity Commercial |
$1,521.45
|
Rate for Payer: Cofinity Commercial |
$1,869.21
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,738.80
|
Rate for Payer: Healthscope Commercial |
$1,956.15
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,521.45
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,630.12
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,847.48
|
Rate for Payer: PHP Commercial |
$1,847.48
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,521.45
|
Rate for Payer: Priority Health SBD |
$1,369.30
|
Rate for Payer: UMR Bronson Commercial |
$956.34
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,630.12
|
|
HC MR ORBITS FACE NECK W CON
|
Facility
|
IP
|
$2,104.40
|
|
Service Code
|
CPT 70542
|
Hospital Charge Code |
61000003
|
Hospital Revenue Code
|
610
|
Min. Negotiated Rate |
$925.94 |
Max. Negotiated Rate |
$1,893.96 |
Rate for Payer: Aetna American Axle |
$1,367.86
|
Rate for Payer: Aetna Commercial |
$1,788.74
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,367.86
|
Rate for Payer: Cash Price |
$1,683.52
|
Rate for Payer: Cofinity Commercial |
$1,809.78
|
Rate for Payer: Cofinity Commercial |
$1,473.08
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.52
|
Rate for Payer: Healthscope Commercial |
$1,893.96
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,473.08
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,578.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.74
|
Rate for Payer: PHP Commercial |
$1,788.74
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,473.08
|
Rate for Payer: Priority Health SBD |
$1,325.77
|
Rate for Payer: UMR Bronson Commercial |
$925.94
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,578.30
|
|