|
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
|
|
|
HC MR ORBITS FACE NECK WO CON
|
Facility
|
OP
|
$1,995.22
|
|
|
Service Code
|
CPT 70540
|
| Hospital Charge Code |
61000002
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$1,296.89
|
| Rate for Payer: Aetna Commercial |
$1,695.94
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,296.89
|
| 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 |
$328.15
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cofinity Commercial |
$1,396.65
|
| Rate for Payer: Cofinity Commercial |
$1,715.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$1,795.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,396.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,496.42
|
| 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 |
$1,695.94
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$1,695.94
|
| 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 |
$1,396.65
|
| 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 |
$1,256.99
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.40
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$228.55
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$738.23
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,496.42
|
|
|
HC MR ORBITS FACE NECK WO CON
|
Facility
|
IP
|
$1,995.22
|
|
|
Service Code
|
CPT 70540
|
| Hospital Charge Code |
61000002
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$877.90 |
| Max. Negotiated Rate |
$1,795.70 |
| Rate for Payer: Aetna American Axle |
$1,296.89
|
| Rate for Payer: Aetna Commercial |
$1,695.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,296.89
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cofinity Commercial |
$1,396.65
|
| Rate for Payer: Cofinity Commercial |
$1,715.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.18
|
| Rate for Payer: Healthscope Commercial |
$1,795.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,396.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,496.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,695.94
|
| Rate for Payer: PHP Commercial |
$1,695.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,396.65
|
| Rate for Payer: Priority Health SBD |
$1,256.99
|
| Rate for Payer: UMR Bronson Commercial |
$877.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,496.42
|
|
|
HC MR ORBITS FACE NECK WO/W CON
|
Facility
|
OP
|
$2,734.06
|
|
|
Service Code
|
CPT 70543
|
| Hospital Charge Code |
61000004
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,460.65 |
| Rate for Payer: Aetna American Axle |
$1,777.14
|
| Rate for Payer: Aetna Commercial |
$2,323.95
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,777.14
|
| 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: BCBS Trust/PPO |
$480.82
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$2,187.25
|
| Rate for Payer: Cash Price |
$2,187.25
|
| Rate for Payer: Cofinity Commercial |
$2,351.29
|
| Rate for Payer: Cofinity Commercial |
$1,913.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,187.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,460.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,913.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,050.54
|
| 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 |
$2,323.95
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$2,323.95
|
| 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 |
$1,913.84
|
| 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 |
$1,722.46
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$376.40
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$342.18
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,011.60
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,050.54
|
|
|
HC MR ORBITS FACE NECK WO/W CON
|
Facility
|
IP
|
$2,734.06
|
|
|
Service Code
|
CPT 70543
|
| Hospital Charge Code |
61000004
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,202.99 |
| Max. Negotiated Rate |
$2,460.65 |
| Rate for Payer: Aetna American Axle |
$1,777.14
|
| Rate for Payer: Aetna Commercial |
$2,323.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,777.14
|
| Rate for Payer: Cash Price |
$2,187.25
|
| Rate for Payer: Cofinity Commercial |
$1,913.84
|
| Rate for Payer: Cofinity Commercial |
$2,351.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,187.25
|
| Rate for Payer: Healthscope Commercial |
$2,460.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,913.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,050.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,323.95
|
| Rate for Payer: PHP Commercial |
$2,323.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,913.84
|
| Rate for Payer: Priority Health SBD |
$1,722.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,202.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,050.54
|
|
|
HC MR PELVIS W CON
|
Facility
|
IP
|
$2,199.20
|
|
|
Service Code
|
CPT 72196
|
| Hospital Charge Code |
61000014
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$967.65 |
| Max. Negotiated Rate |
$1,979.28 |
| Rate for Payer: Aetna American Axle |
$1,429.48
|
| Rate for Payer: Aetna Commercial |
$1,869.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,429.48
|
| Rate for Payer: Cash Price |
$1,759.36
|
| Rate for Payer: Cofinity Commercial |
$1,539.44
|
| Rate for Payer: Cofinity Commercial |
$1,891.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,759.36
|
| Rate for Payer: Healthscope Commercial |
$1,979.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,539.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,649.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,869.32
|
| Rate for Payer: PHP Commercial |
$1,869.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,539.44
|
| Rate for Payer: Priority Health SBD |
$1,385.50
|
| Rate for Payer: UMR Bronson Commercial |
$967.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,649.40
|
|
|
HC MR PELVIS W CON
|
Facility
|
OP
|
$2,199.20
|
|
|
Service Code
|
CPT 72196
|
| Hospital Charge Code |
61000014
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$1,979.28 |
| Rate for Payer: Aetna American Axle |
$1,429.48
|
| Rate for Payer: Aetna Commercial |
$1,869.32
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,429.48
|
| 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 |
$377.56
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$1,759.36
|
| Rate for Payer: Cash Price |
$1,759.36
|
| Rate for Payer: Cofinity Commercial |
$1,539.44
|
| Rate for Payer: Cofinity Commercial |
$1,891.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,759.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$1,979.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,539.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,649.40
|
| 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 |
$1,869.32
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$1,869.32
|
| 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 |
$1,539.44
|
| 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 |
$1,385.50
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$298.23
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$271.12
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$813.70
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,649.40
|
|
|
HC MR PELVIS WO CON
|
Facility
|
OP
|
$1,992.88
|
|
|
Service Code
|
CPT 72195
|
| Hospital Charge Code |
61000013
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$1,295.37
|
| Rate for Payer: Aetna Commercial |
$1,693.95
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,295.37
|
| 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 |
$323.07
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,594.30
|
| Rate for Payer: Cash Price |
$1,594.30
|
| Rate for Payer: Cofinity Commercial |
$1,395.02
|
| Rate for Payer: Cofinity Commercial |
$1,713.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,594.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$1,793.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,395.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,494.66
|
| 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 |
$1,693.95
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$1,693.95
|
| 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 |
$1,395.02
|
| 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 |
$1,255.51
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$254.65
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$231.50
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$737.37
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,494.66
|
|
|
HC MR PELVIS WO CON
|
Facility
|
IP
|
$1,992.88
|
|
|
Service Code
|
CPT 72195
|
| Hospital Charge Code |
61000013
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$876.87 |
| Max. Negotiated Rate |
$1,793.59 |
| Rate for Payer: Aetna American Axle |
$1,295.37
|
| Rate for Payer: Aetna Commercial |
$1,693.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,295.37
|
| Rate for Payer: Cash Price |
$1,594.30
|
| Rate for Payer: Cofinity Commercial |
$1,395.02
|
| Rate for Payer: Cofinity Commercial |
$1,713.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,594.30
|
| Rate for Payer: Healthscope Commercial |
$1,793.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,395.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,494.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,693.95
|
| Rate for Payer: PHP Commercial |
$1,693.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,395.02
|
| Rate for Payer: Priority Health SBD |
$1,255.51
|
| Rate for Payer: UMR Bronson Commercial |
$876.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,494.66
|
|
|
HC MR PELVIS WO W CON
|
Facility
|
IP
|
$2,989.37
|
|
|
Service Code
|
CPT 72197
|
| Hospital Charge Code |
61000015
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,315.32 |
| Max. Negotiated Rate |
$2,690.43 |
| Rate for Payer: Aetna American Axle |
$1,943.09
|
| Rate for Payer: Aetna Commercial |
$2,540.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,943.09
|
| Rate for Payer: Cash Price |
$2,391.50
|
| Rate for Payer: Cofinity Commercial |
$2,092.56
|
| Rate for Payer: Cofinity Commercial |
$2,570.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,391.50
|
| Rate for Payer: Healthscope Commercial |
$2,690.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,092.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,242.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,540.96
|
| Rate for Payer: PHP Commercial |
$2,540.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,092.56
|
| Rate for Payer: Priority Health SBD |
$1,883.30
|
| Rate for Payer: UMR Bronson Commercial |
$1,315.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,242.03
|
|
|
HC MR PELVIS WO W CON
|
Facility
|
OP
|
$2,989.37
|
|
|
Service Code
|
CPT 72197
|
| Hospital Charge Code |
61000015
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,690.43 |
| Rate for Payer: Aetna American Axle |
$1,943.09
|
| Rate for Payer: Aetna Commercial |
$2,540.96
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,943.09
|
| 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 |
$473.21
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$2,391.50
|
| Rate for Payer: Cash Price |
$2,391.50
|
| Rate for Payer: Cofinity Commercial |
$2,092.56
|
| Rate for Payer: Cofinity Commercial |
$2,570.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,391.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,690.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,092.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,242.03
|
| 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 |
$2,540.96
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$2,540.96
|
| 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 |
$2,092.56
|
| 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 |
$1,883.30
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$374.23
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$340.21
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,106.07
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,242.03
|
|
|
HC MR SPECTROSCOPY
|
Facility
|
IP
|
$1,862.90
|
|
|
Service Code
|
CPT 76390
|
| Hospital Charge Code |
61000049
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$819.68 |
| Max. Negotiated Rate |
$1,676.61 |
| Rate for Payer: Aetna American Axle |
$1,210.88
|
| Rate for Payer: Aetna Commercial |
$1,583.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,210.88
|
| Rate for Payer: Cash Price |
$1,490.32
|
| Rate for Payer: Cofinity Commercial |
$1,304.03
|
| Rate for Payer: Cofinity Commercial |
$1,602.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,490.32
|
| Rate for Payer: Healthscope Commercial |
$1,676.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,304.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,397.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,583.46
|
| Rate for Payer: PHP Commercial |
$1,583.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,304.03
|
| Rate for Payer: Priority Health SBD |
$1,173.63
|
| Rate for Payer: UMR Bronson Commercial |
$819.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,397.18
|
|
|
HC MR SPECTROSCOPY
|
Facility
|
OP
|
$1,862.90
|
|
|
Service Code
|
CPT 76390
|
| Hospital Charge Code |
61000049
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$1,210.88
|
| Rate for Payer: Aetna Commercial |
$1,583.46
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,210.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$613.51
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$1,490.32
|
| Rate for Payer: Cash Price |
$1,490.32
|
| Rate for Payer: Cofinity Commercial |
$1,602.09
|
| Rate for Payer: Cofinity Commercial |
$1,304.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,490.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$1,676.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,304.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,397.18
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,583.46
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$1,583.46
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,304.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.27
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$203.42
|
| Rate for Payer: Priority Health SBD |
$1,173.63
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$689.27
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,397.18
|
|
|
HC MR SPINE CERVICAL W CON
|
Facility
|
IP
|
$2,276.80
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200004
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,001.79 |
| Max. Negotiated Rate |
$2,049.12 |
| Rate for Payer: Aetna American Axle |
$1,479.92
|
| Rate for Payer: Aetna Commercial |
$1,935.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,479.92
|
| Rate for Payer: Cash Price |
$1,821.44
|
| Rate for Payer: Cofinity Commercial |
$1,958.05
|
| Rate for Payer: Cofinity Commercial |
$1,593.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,821.44
|
| Rate for Payer: Healthscope Commercial |
$2,049.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,593.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,707.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,935.28
|
| Rate for Payer: PHP Commercial |
$1,935.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,593.76
|
| Rate for Payer: Priority Health SBD |
$1,434.38
|
| Rate for Payer: UMR Bronson Commercial |
$1,001.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,707.60
|
|
|
HC MR SPINE CERVICAL W CON
|
Facility
|
OP
|
$2,276.80
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200004
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,049.12 |
| Rate for Payer: Aetna American Axle |
$1,479.92
|
| Rate for Payer: Aetna Commercial |
$1,935.28
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,479.92
|
| 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 |
$384.53
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$1,821.44
|
| Rate for Payer: Cash Price |
$1,821.44
|
| Rate for Payer: Cofinity Commercial |
$1,958.05
|
| Rate for Payer: Cofinity Commercial |
$1,593.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,821.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,049.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,593.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,707.60
|
| 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 |
$1,935.28
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$1,935.28
|
| 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 |
$1,593.76
|
| 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 |
$1,434.38
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.16
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$278.33
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$842.42
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,707.60
|
|
|
HC MR SPINE CERVICAL W CON LTD
|
Facility
|
IP
|
$1,138.00
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200003
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$500.72 |
| Max. Negotiated Rate |
$1,024.20 |
| Rate for Payer: Aetna American Axle |
$739.70
|
| Rate for Payer: Aetna Commercial |
$967.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$739.70
|
| Rate for Payer: Cash Price |
$910.40
|
| Rate for Payer: Cofinity Commercial |
$796.60
|
| Rate for Payer: Cofinity Commercial |
$978.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$910.40
|
| Rate for Payer: Healthscope Commercial |
$1,024.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$796.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$853.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$967.30
|
| Rate for Payer: PHP Commercial |
$967.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.60
|
| Rate for Payer: Priority Health SBD |
$716.94
|
| Rate for Payer: UMR Bronson Commercial |
$500.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$853.50
|
|
|
HC MR SPINE CERVICAL W CON LTD
|
Facility
|
OP
|
$1,138.00
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200003
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$739.70
|
| Rate for Payer: Aetna Commercial |
$967.30
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$739.70
|
| 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 |
$384.53
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$910.40
|
| Rate for Payer: Cash Price |
$910.40
|
| Rate for Payer: Cofinity Commercial |
$796.60
|
| Rate for Payer: Cofinity Commercial |
$978.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$910.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$1,024.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$796.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$853.50
|
| 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 |
$967.30
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$967.30
|
| 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 |
$796.60
|
| 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 |
$716.94
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.16
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$278.33
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$421.06
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$853.50
|
|
|
HC MR SPINE CERVICAL WO CON
|
Facility
|
IP
|
$2,243.18
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200002
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$987.00 |
| Max. Negotiated Rate |
$2,018.86 |
| Rate for Payer: Aetna American Axle |
$1,458.07
|
| Rate for Payer: Aetna Commercial |
$1,906.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,458.07
|
| Rate for Payer: Cash Price |
$1,794.54
|
| Rate for Payer: Cofinity Commercial |
$1,570.23
|
| Rate for Payer: Cofinity Commercial |
$1,929.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,794.54
|
| Rate for Payer: Healthscope Commercial |
$2,018.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,570.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,682.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,906.70
|
| Rate for Payer: PHP Commercial |
$1,906.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,570.23
|
| Rate for Payer: Priority Health SBD |
$1,413.20
|
| Rate for Payer: UMR Bronson Commercial |
$987.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,682.38
|
|
|
HC MR SPINE CERVICAL WO CON
|
Facility
|
OP
|
$2,243.18
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200002
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$2,018.86 |
| Rate for Payer: Aetna American Axle |
$1,458.07
|
| Rate for Payer: Aetna Commercial |
$1,906.70
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,458.07
|
| 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 |
$243.26
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,794.54
|
| Rate for Payer: Cash Price |
$1,794.54
|
| Rate for Payer: Cofinity Commercial |
$1,929.13
|
| Rate for Payer: Cofinity Commercial |
$1,570.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,794.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$2,018.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,570.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,682.38
|
| 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 |
$1,906.70
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$1,906.70
|
| 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 |
$1,570.23
|
| 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 |
$1,413.20
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$211.79
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$192.54
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$829.98
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,682.38
|
|
|
HC MR SPINE CERVICAL WO LIMITED
|
Facility
|
OP
|
$1,122.00
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200001
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$729.30
|
| Rate for Payer: Aetna Commercial |
$953.70
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.30
|
| 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 |
$243.26
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$964.92
|
| Rate for Payer: Cofinity Commercial |
$785.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$1,009.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$785.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$841.50
|
| 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 |
$953.70
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$953.70
|
| 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 |
$785.40
|
| 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 |
$706.86
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$211.79
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$192.54
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$415.14
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$841.50
|
|
|
HC MR SPINE CERVICAL WO LIMITED
|
Facility
|
IP
|
$1,122.00
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200001
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$493.68 |
| Max. Negotiated Rate |
$1,009.80 |
| Rate for Payer: Aetna American Axle |
$729.30
|
| Rate for Payer: Aetna Commercial |
$953.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.30
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$785.40
|
| Rate for Payer: Cofinity Commercial |
$964.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Healthscope Commercial |
$1,009.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$785.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$841.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$953.70
|
| Rate for Payer: PHP Commercial |
$953.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$785.40
|
| Rate for Payer: Priority Health SBD |
$706.86
|
| Rate for Payer: UMR Bronson Commercial |
$493.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$841.50
|
|
|
HC MR SPINE CERVICAL WO W CON
|
Facility
|
OP
|
$2,717.54
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200013
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,445.79 |
| Rate for Payer: Aetna American Axle |
$1,766.40
|
| Rate for Payer: Aetna Commercial |
$2,309.91
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,766.40
|
| 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 |
$428.87
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$2,174.03
|
| Rate for Payer: Cash Price |
$2,174.03
|
| Rate for Payer: Cofinity Commercial |
$1,902.28
|
| Rate for Payer: Cofinity Commercial |
$2,337.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,174.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,445.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,902.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,038.16
|
| 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 |
$2,309.91
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$2,309.91
|
| 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 |
$1,902.28
|
| 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 |
$1,712.05
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$355.51
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$323.19
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,005.49
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,038.16
|
|
|
HC MR SPINE CERVICAL WO W CON
|
Facility
|
IP
|
$2,717.54
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200013
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,195.72 |
| Max. Negotiated Rate |
$2,445.79 |
| Rate for Payer: Aetna American Axle |
$1,766.40
|
| Rate for Payer: Aetna Commercial |
$2,309.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,766.40
|
| Rate for Payer: Cash Price |
$2,174.03
|
| Rate for Payer: Cofinity Commercial |
$1,902.28
|
| Rate for Payer: Cofinity Commercial |
$2,337.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,174.03
|
| Rate for Payer: Healthscope Commercial |
$2,445.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,902.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,038.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,309.91
|
| Rate for Payer: PHP Commercial |
$2,309.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,902.28
|
| Rate for Payer: Priority Health SBD |
$1,712.05
|
| Rate for Payer: UMR Bronson Commercial |
$1,195.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,038.16
|
|
|
HC MR SPINE CERVICAL WO W LTD
|
Facility
|
OP
|
$871.49
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200014
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$566.47
|
| Rate for Payer: Aetna Commercial |
$740.77
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.47
|
| 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 |
$428.87
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$697.19
|
| Rate for Payer: Cash Price |
$697.19
|
| Rate for Payer: Cofinity Commercial |
$749.48
|
| Rate for Payer: Cofinity Commercial |
$610.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$697.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$784.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$610.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$653.62
|
| 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 |
$740.77
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$740.77
|
| 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 |
$610.04
|
| 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 |
$549.04
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$355.51
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$323.19
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$322.45
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$653.62
|
|
|
HC MR SPINE CERVICAL WO W LTD
|
Facility
|
IP
|
$871.49
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200014
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$383.46 |
| Max. Negotiated Rate |
$784.34 |
| Rate for Payer: Aetna American Axle |
$566.47
|
| Rate for Payer: Aetna Commercial |
$740.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.47
|
| Rate for Payer: Cash Price |
$697.19
|
| Rate for Payer: Cofinity Commercial |
$610.04
|
| Rate for Payer: Cofinity Commercial |
$749.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$697.19
|
| Rate for Payer: Healthscope Commercial |
$784.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$610.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$653.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$740.77
|
| Rate for Payer: PHP Commercial |
$740.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$610.04
|
| Rate for Payer: Priority Health SBD |
$549.04
|
| Rate for Payer: UMR Bronson Commercial |
$383.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$653.62
|
|
