|
HC CT RF/MICROWAVE ABLATION
|
Facility
|
IP
|
$1,096.58
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000042
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$482.50 |
| Max. Negotiated Rate |
$986.92 |
| Rate for Payer: Aetna American Axle |
$712.78
|
| Rate for Payer: Aetna Commercial |
$932.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$712.78
|
| Rate for Payer: Cash Price |
$877.26
|
| Rate for Payer: Cofinity Commercial |
$767.61
|
| Rate for Payer: Cofinity Commercial |
$943.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$767.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.26
|
| Rate for Payer: Healthscope Commercial |
$986.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$767.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$822.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.09
|
| Rate for Payer: PHP Commercial |
$932.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.78
|
| Rate for Payer: Priority Health SBD |
$690.85
|
| Rate for Payer: UMR Bronson Commercial |
$482.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$822.43
|
|
|
HC CT RF/MICROWAVE ABLATION
|
Facility
|
OP
|
$1,096.58
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000042
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$405.73 |
| Max. Negotiated Rate |
$1,048.00 |
| Rate for Payer: Aetna American Axle |
$712.78
|
| Rate for Payer: Aetna Commercial |
$932.09
|
| Rate for Payer: Aetna Medicare |
$548.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$712.78
|
| Rate for Payer: BCBS Complete |
$438.63
|
| Rate for Payer: Cash Price |
$877.26
|
| Rate for Payer: Cash Price |
$877.26
|
| Rate for Payer: Cofinity Commercial |
$943.06
|
| Rate for Payer: Cofinity Commercial |
$767.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$767.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.26
|
| Rate for Payer: Healthscope Commercial |
$986.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$767.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$822.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.09
|
| Rate for Payer: PHP Commercial |
$932.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.78
|
| Rate for Payer: Priority Health SBD |
$690.85
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UMR Bronson Commercial |
$405.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$822.43
|
|
|
HC CTRL NASAL HEMRRG ANT COMPLEX
|
Facility
|
IP
|
$440.64
|
|
|
Service Code
|
CPT 30903
|
| Hospital Charge Code |
76100414
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$193.88 |
| Max. Negotiated Rate |
$396.58 |
| Rate for Payer: Aetna American Axle |
$286.42
|
| Rate for Payer: Aetna Commercial |
$374.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.42
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cofinity Commercial |
$308.45
|
| Rate for Payer: Cofinity Commercial |
$378.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$308.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.51
|
| Rate for Payer: Healthscope Commercial |
$396.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$308.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.54
|
| Rate for Payer: PHP Commercial |
$374.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.42
|
| Rate for Payer: Priority Health SBD |
$277.60
|
| Rate for Payer: UMR Bronson Commercial |
$193.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.48
|
|
|
HC CTRL NASAL HEMRRG ANT COMPLEX
|
Facility
|
OP
|
$440.64
|
|
|
Service Code
|
CPT 30903
|
| Hospital Charge Code |
76100414
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$396.58 |
| Rate for Payer: Aetna American Axle |
$286.42
|
| Rate for Payer: Aetna Commercial |
$374.54
|
| Rate for Payer: Aetna Medicare |
$130.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cofinity Commercial |
$378.95
|
| Rate for Payer: Cofinity Commercial |
$308.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$308.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$396.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$308.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.48
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.54
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$374.54
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.42
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health SBD |
$277.60
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$240.24
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: UMR Bronson Commercial |
$163.04
|
| Rate for Payer: VA VA |
$125.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.48
|
|
|
HC CTRL NASAL HEMRRG POSTERIOR PACKS/CAUTERY SUBSQ
|
Facility
|
IP
|
$596.70
|
|
|
Service Code
|
CPT 30906
|
| Hospital Charge Code |
76100394
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$262.55 |
| Max. Negotiated Rate |
$537.03 |
| Rate for Payer: Aetna American Axle |
$387.86
|
| Rate for Payer: Aetna Commercial |
$507.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.86
|
| Rate for Payer: Cash Price |
$477.36
|
| Rate for Payer: Cofinity Commercial |
$417.69
|
| Rate for Payer: Cofinity Commercial |
$513.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$417.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.36
|
| Rate for Payer: Healthscope Commercial |
$537.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$417.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.19
|
| Rate for Payer: PHP Commercial |
$507.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.86
|
| Rate for Payer: Priority Health SBD |
$375.92
|
| Rate for Payer: UMR Bronson Commercial |
$262.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.52
|
|
|
HC CTRL NASAL HEMRRG POSTERIOR PACKS/CAUTERY SUBSQ
|
Facility
|
OP
|
$596.70
|
|
|
Service Code
|
CPT 30906
|
| Hospital Charge Code |
76100394
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.39 |
| Max. Negotiated Rate |
$637.52 |
| Rate for Payer: Aetna American Axle |
$387.86
|
| Rate for Payer: Aetna Commercial |
$507.19
|
| Rate for Payer: Aetna Medicare |
$235.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$283.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$283.10
|
| Rate for Payer: BCBS Complete |
$127.46
|
| Rate for Payer: BCBS MAPPO |
$226.48
|
| Rate for Payer: BCN Medicare Advantage |
$226.48
|
| Rate for Payer: Cash Price |
$477.36
|
| Rate for Payer: Cash Price |
$477.36
|
| Rate for Payer: Cofinity Commercial |
$513.16
|
| Rate for Payer: Cofinity Commercial |
$417.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$417.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.48
|
| Rate for Payer: Healthscope Commercial |
$537.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$417.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.52
|
| Rate for Payer: Mclaren Medicaid |
$121.39
|
| Rate for Payer: Mclaren Medicare |
$226.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.80
|
| Rate for Payer: Meridian Medicaid |
$127.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$260.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.19
|
| Rate for Payer: PACE Medicare |
$215.16
|
| Rate for Payer: PACE SWMI |
$226.48
|
| Rate for Payer: PHP Commercial |
$507.19
|
| Rate for Payer: PHP Medicare Advantage |
$226.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.86
|
| Rate for Payer: Priority Health Medicare |
$226.48
|
| Rate for Payer: Priority Health SBD |
$375.92
|
| Rate for Payer: Railroad Medicare Medicare |
$226.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$637.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.48
|
| Rate for Payer: UHC Exchange |
$432.83
|
| Rate for Payer: UHC Medicare Advantage |
$226.48
|
| Rate for Payer: UHCCP Medicaid |
$121.39
|
| Rate for Payer: UMR Bronson Commercial |
$220.78
|
| Rate for Payer: VA VA |
$226.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.52
|
|
|
HC CT SI JTS W CON
|
Facility
|
IP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000025
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$310.42 |
| Max. Negotiated Rate |
$634.94 |
| Rate for Payer: Aetna American Axle |
$458.57
|
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.57
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$493.84
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$493.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health SBD |
$444.46
|
| Rate for Payer: UMR Bronson Commercial |
$310.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.12
|
|
|
HC CT SI JTS W CON
|
Facility
|
OP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000025
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$1,048.00 |
| Rate for Payer: Aetna American Axle |
$458.57
|
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Cofinity Commercial |
$493.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$493.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.12
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$444.46
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$164.11
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: UMR Bronson Commercial |
$261.03
|
| Rate for Payer: VA VA |
$85.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.12
|
|
|
HC CT SI JTS WO CON
|
Facility
|
OP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000023
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$1,048.00 |
| Rate for Payer: Aetna American Axle |
$458.57
|
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Cofinity Commercial |
$493.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$493.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.12
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$444.46
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$164.11
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: UMR Bronson Commercial |
$261.03
|
| Rate for Payer: VA VA |
$85.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.12
|
|
|
HC CT SI JTS WO CON
|
Facility
|
IP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000023
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$310.42 |
| Max. Negotiated Rate |
$634.94 |
| Rate for Payer: Aetna American Axle |
$458.57
|
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.57
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$493.84
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$493.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health SBD |
$444.46
|
| Rate for Payer: UMR Bronson Commercial |
$310.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.12
|
|
|
HC CT SI JTS WO W CON
|
Facility
|
OP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000026
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$1,048.00 |
| Rate for Payer: Aetna American Axle |
$458.57
|
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Cofinity Commercial |
$493.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$493.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.12
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$444.46
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$164.11
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: UMR Bronson Commercial |
$261.03
|
| Rate for Payer: VA VA |
$85.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.12
|
|
|
HC CT SI JTS WO W CON
|
Facility
|
IP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000026
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$310.42 |
| Max. Negotiated Rate |
$634.94 |
| Rate for Payer: Aetna American Axle |
$458.57
|
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.57
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$493.84
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$493.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health SBD |
$444.46
|
| Rate for Payer: UMR Bronson Commercial |
$310.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.12
|
|
|
HC CT SOFT TISS NECK W CON
|
Facility
|
IP
|
$1,634.26
|
|
|
Service Code
|
CPT 70491
|
| Hospital Charge Code |
35000002
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$719.07 |
| Max. Negotiated Rate |
$1,470.83 |
| Rate for Payer: Aetna American Axle |
$1,062.27
|
| Rate for Payer: Aetna Commercial |
$1,389.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,062.27
|
| Rate for Payer: Cash Price |
$1,307.41
|
| Rate for Payer: Cofinity Commercial |
$1,143.98
|
| Rate for Payer: Cofinity Commercial |
$1,405.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,143.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,307.41
|
| Rate for Payer: Healthscope Commercial |
$1,470.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,143.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,225.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,389.12
|
| Rate for Payer: PHP Commercial |
$1,389.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,062.27
|
| Rate for Payer: Priority Health SBD |
$1,029.58
|
| Rate for Payer: UMR Bronson Commercial |
$719.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,225.69
|
|
|
HC CT SOFT TISS NECK W CON
|
Facility
|
OP
|
$1,634.26
|
|
|
Service Code
|
CPT 70491
|
| Hospital Charge Code |
35000002
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,470.83 |
| Rate for Payer: Aetna American Axle |
$1,062.27
|
| Rate for Payer: Aetna Commercial |
$1,389.12
|
| Rate for Payer: Aetna Medicare |
$180.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,062.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,307.41
|
| Rate for Payer: Cash Price |
$1,307.41
|
| Rate for Payer: Cofinity Commercial |
$1,405.46
|
| Rate for Payer: Cofinity Commercial |
$1,143.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,143.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,307.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,470.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,143.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,225.69
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,389.12
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$1,389.12
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,062.27
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health SBD |
$1,029.58
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.72
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$331.81
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$93.06
|
| Rate for Payer: UMR Bronson Commercial |
$604.68
|
| Rate for Payer: VA VA |
$173.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,225.69
|
|
|
HC CT SOFT TISS NECK WO CON
|
Facility
|
IP
|
$1,383.22
|
|
|
Service Code
|
CPT 70490
|
| Hospital Charge Code |
35000001
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$608.62 |
| Max. Negotiated Rate |
$1,244.90 |
| Rate for Payer: Aetna American Axle |
$899.09
|
| Rate for Payer: Aetna Commercial |
$1,175.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$899.09
|
| Rate for Payer: Cash Price |
$1,106.58
|
| Rate for Payer: Cofinity Commercial |
$1,189.57
|
| Rate for Payer: Cofinity Commercial |
$968.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$968.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,106.58
|
| Rate for Payer: Healthscope Commercial |
$1,244.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$968.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,037.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,175.74
|
| Rate for Payer: PHP Commercial |
$1,175.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$899.09
|
| Rate for Payer: Priority Health SBD |
$871.43
|
| Rate for Payer: UMR Bronson Commercial |
$608.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,037.41
|
|
|
HC CT SOFT TISS NECK WO CON
|
Facility
|
OP
|
$1,383.22
|
|
|
Service Code
|
CPT 70490
|
| Hospital Charge Code |
35000001
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$1,244.90 |
| Rate for Payer: Aetna American Axle |
$899.09
|
| Rate for Payer: Aetna Commercial |
$1,175.74
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$899.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$1,106.58
|
| Rate for Payer: Cash Price |
$1,106.58
|
| Rate for Payer: Cofinity Commercial |
$968.25
|
| Rate for Payer: Cofinity Commercial |
$1,189.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$968.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,106.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$1,244.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$968.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,037.41
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,175.74
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$1,175.74
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$899.09
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$871.43
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$511.79
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,037.41
|
|
|
HC CT SOFT TISS NECK WO W CON
|
Facility
|
OP
|
$1,881.46
|
|
|
Service Code
|
CPT 70492
|
| Hospital Charge Code |
35000003
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,693.31 |
| Rate for Payer: Aetna American Axle |
$1,222.95
|
| Rate for Payer: Aetna Commercial |
$1,599.24
|
| Rate for Payer: Aetna Medicare |
$180.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,222.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,505.17
|
| Rate for Payer: Cash Price |
$1,505.17
|
| Rate for Payer: Cofinity Commercial |
$1,618.06
|
| Rate for Payer: Cofinity Commercial |
$1,317.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,317.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,505.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,693.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,317.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,411.10
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,599.24
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$1,599.24
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,222.95
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health SBD |
$1,185.32
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.72
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$331.81
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$93.06
|
| Rate for Payer: UMR Bronson Commercial |
$696.14
|
| Rate for Payer: VA VA |
$173.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,411.10
|
|
|
HC CT SOFT TISS NECK WO W CON
|
Facility
|
IP
|
$1,881.46
|
|
|
Service Code
|
CPT 70492
|
| Hospital Charge Code |
35000003
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$827.84 |
| Max. Negotiated Rate |
$1,693.31 |
| Rate for Payer: Aetna American Axle |
$1,222.95
|
| Rate for Payer: Aetna Commercial |
$1,599.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,222.95
|
| Rate for Payer: Cash Price |
$1,505.17
|
| Rate for Payer: Cofinity Commercial |
$1,317.02
|
| Rate for Payer: Cofinity Commercial |
$1,618.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,317.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,505.17
|
| Rate for Payer: Healthscope Commercial |
$1,693.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,317.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,411.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,599.24
|
| Rate for Payer: PHP Commercial |
$1,599.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,222.95
|
| Rate for Payer: Priority Health SBD |
$1,185.32
|
| Rate for Payer: UMR Bronson Commercial |
$827.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,411.10
|
|
|
HC CT SPINE CERVICAL W CON
|
Facility
|
OP
|
$1,938.61
|
|
|
Service Code
|
CPT 72126
|
| Hospital Charge Code |
35200004
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$1,744.75 |
| Rate for Payer: Aetna American Axle |
$1,260.10
|
| Rate for Payer: Aetna Commercial |
$1,647.82
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,260.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$1,550.89
|
| Rate for Payer: Cash Price |
$1,550.89
|
| Rate for Payer: Cofinity Commercial |
$1,667.20
|
| Rate for Payer: Cofinity Commercial |
$1,357.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,357.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,550.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$1,744.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,357.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,453.96
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,647.82
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$1,647.82
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,260.10
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,221.32
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$665.64
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: UMR Bronson Commercial |
$717.29
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,453.96
|
|
|
HC CT SPINE CERVICAL W CON
|
Facility
|
IP
|
$1,938.61
|
|
|
Service Code
|
CPT 72126
|
| Hospital Charge Code |
35200004
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$852.99 |
| Max. Negotiated Rate |
$1,744.75 |
| Rate for Payer: Aetna American Axle |
$1,260.10
|
| Rate for Payer: Aetna Commercial |
$1,647.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,260.10
|
| Rate for Payer: Cash Price |
$1,550.89
|
| Rate for Payer: Cofinity Commercial |
$1,357.03
|
| Rate for Payer: Cofinity Commercial |
$1,667.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,357.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,550.89
|
| Rate for Payer: Healthscope Commercial |
$1,744.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,357.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,453.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,647.82
|
| Rate for Payer: PHP Commercial |
$1,647.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,260.10
|
| Rate for Payer: Priority Health SBD |
$1,221.32
|
| Rate for Payer: UMR Bronson Commercial |
$852.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,453.96
|
|
|
HC CT SPINE CERVICAL WO CON
|
Facility
|
IP
|
$1,617.92
|
|
|
Service Code
|
CPT 72125
|
| Hospital Charge Code |
35200003
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$711.88 |
| Max. Negotiated Rate |
$1,456.13 |
| Rate for Payer: Aetna American Axle |
$1,051.65
|
| Rate for Payer: Aetna Commercial |
$1,375.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,051.65
|
| Rate for Payer: Cash Price |
$1,294.34
|
| Rate for Payer: Cofinity Commercial |
$1,132.54
|
| Rate for Payer: Cofinity Commercial |
$1,391.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,132.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,294.34
|
| Rate for Payer: Healthscope Commercial |
$1,456.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,132.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,213.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,375.23
|
| Rate for Payer: PHP Commercial |
$1,375.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.65
|
| Rate for Payer: Priority Health SBD |
$1,019.29
|
| Rate for Payer: UMR Bronson Commercial |
$711.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,213.44
|
|
|
HC CT SPINE CERVICAL WO CON
|
Facility
|
OP
|
$1,617.92
|
|
|
Service Code
|
CPT 72125
|
| Hospital Charge Code |
35200003
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$1,456.13 |
| Rate for Payer: Aetna American Axle |
$1,051.65
|
| Rate for Payer: Aetna Commercial |
$1,375.23
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,051.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$1,294.34
|
| Rate for Payer: Cash Price |
$1,294.34
|
| Rate for Payer: Cofinity Commercial |
$1,391.41
|
| Rate for Payer: Cofinity Commercial |
$1,132.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,132.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,294.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$1,456.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,132.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,213.44
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,375.23
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$1,375.23
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.65
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$1,019.29
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$598.63
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,213.44
|
|
|
HC CT SPINE CERVICAL WO W CON
|
Facility
|
IP
|
$2,203.10
|
|
|
Service Code
|
CPT 72127
|
| Hospital Charge Code |
35000007
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$969.36 |
| Max. Negotiated Rate |
$1,982.79 |
| Rate for Payer: Aetna American Axle |
$1,432.02
|
| Rate for Payer: Aetna Commercial |
$1,872.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,432.02
|
| Rate for Payer: Cash Price |
$1,762.48
|
| Rate for Payer: Cofinity Commercial |
$1,542.17
|
| Rate for Payer: Cofinity Commercial |
$1,894.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,542.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,762.48
|
| Rate for Payer: Healthscope Commercial |
$1,982.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,542.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,652.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,872.63
|
| Rate for Payer: PHP Commercial |
$1,872.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,432.02
|
| Rate for Payer: Priority Health SBD |
$1,387.95
|
| Rate for Payer: UMR Bronson Commercial |
$969.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,652.33
|
|
|
HC CT SPINE CERVICAL WO W CON
|
Facility
|
OP
|
$2,203.10
|
|
|
Service Code
|
CPT 72127
|
| Hospital Charge Code |
35000007
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,982.79 |
| Rate for Payer: Aetna American Axle |
$1,432.02
|
| Rate for Payer: Aetna Commercial |
$1,872.63
|
| Rate for Payer: Aetna Medicare |
$180.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,432.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,762.48
|
| Rate for Payer: Cash Price |
$1,762.48
|
| Rate for Payer: Cofinity Commercial |
$1,894.67
|
| Rate for Payer: Cofinity Commercial |
$1,542.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,542.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,762.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,982.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,542.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,652.33
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,872.63
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$1,872.63
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,432.02
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health SBD |
$1,387.95
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.72
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$331.81
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$93.06
|
| Rate for Payer: UMR Bronson Commercial |
$815.15
|
| Rate for Payer: VA VA |
$173.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,652.33
|
|
|
HC CT SPINE LUMBAR W CON
|
Facility
|
IP
|
$1,977.38
|
|
|
Service Code
|
CPT 72132
|
| Hospital Charge Code |
35200008
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$870.05 |
| Max. Negotiated Rate |
$1,779.64 |
| Rate for Payer: Aetna American Axle |
$1,285.30
|
| Rate for Payer: Aetna Commercial |
$1,680.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,285.30
|
| Rate for Payer: Cash Price |
$1,581.90
|
| Rate for Payer: Cofinity Commercial |
$1,384.17
|
| Rate for Payer: Cofinity Commercial |
$1,700.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,384.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,581.90
|
| Rate for Payer: Healthscope Commercial |
$1,779.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,384.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,483.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,680.77
|
| Rate for Payer: PHP Commercial |
$1,680.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,285.30
|
| Rate for Payer: Priority Health SBD |
$1,245.75
|
| Rate for Payer: UMR Bronson Commercial |
$870.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,483.04
|
|
