|
HC CT SPINE LUMBAR W CON
|
Facility
|
OP
|
$1,977.38
|
|
|
Service Code
|
CPT 72132
|
| Hospital Charge Code |
35200008
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$186.69 |
| 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 Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,285.30
|
| 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 |
$1,581.90
|
| Rate for Payer: Cash Price |
$1,581.90
|
| Rate for Payer: Cofinity Commercial |
$1,700.55
|
| Rate for Payer: Cofinity Commercial |
$1,384.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,384.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,581.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| 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: 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 |
$1,680.77
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$1,680.77
|
| 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 |
$1,285.30
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,245.75
|
| 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 |
$731.63
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,483.04
|
|
|
HC CT SPINE LUMBAR WO CON
|
Facility
|
IP
|
$1,617.92
|
|
|
Service Code
|
CPT 72131
|
| Hospital Charge Code |
35200007
|
|
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 LUMBAR WO CON
|
Facility
|
OP
|
$1,617.92
|
|
|
Service Code
|
CPT 72131
|
| Hospital Charge Code |
35200007
|
|
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 LUMBAR WO W CON
|
Facility
|
OP
|
$2,203.10
|
|
|
Service Code
|
CPT 72133
|
| Hospital Charge Code |
35200009
|
|
Hospital Revenue Code
|
352
|
| 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 WO W CON
|
Facility
|
IP
|
$2,203.10
|
|
|
Service Code
|
CPT 72133
|
| Hospital Charge Code |
35200009
|
|
Hospital Revenue Code
|
352
|
| 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 THORACIC W CON
|
Facility
|
IP
|
$1,977.38
|
|
|
Service Code
|
CPT 72129
|
| Hospital Charge Code |
35200006
|
|
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
|
|
|
HC CT SPINE THORACIC W CON
|
Facility
|
OP
|
$1,977.38
|
|
|
Service Code
|
CPT 72129
|
| Hospital Charge Code |
35200006
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$93.06 |
| 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 Medicare |
$180.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,285.30
|
| 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 |
$1,581.90
|
| Rate for Payer: Cash Price |
$1,581.90
|
| Rate for Payer: Cofinity Commercial |
$1,700.55
|
| Rate for Payer: Cofinity Commercial |
$1,384.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,384.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,581.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| 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: 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 |
$1,680.77
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$1,680.77
|
| 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 |
$1,285.30
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health SBD |
$1,245.75
|
| 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 |
$731.63
|
| Rate for Payer: VA VA |
$173.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,483.04
|
|
|
HC CT SPINE THORACIC WO CON
|
Facility
|
OP
|
$1,617.92
|
|
|
Service Code
|
CPT 72128
|
| Hospital Charge Code |
35200005
|
|
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 THORACIC WO CON
|
Facility
|
IP
|
$1,617.92
|
|
|
Service Code
|
CPT 72128
|
| Hospital Charge Code |
35200005
|
|
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 THORACIC WO W CON
|
Facility
|
OP
|
$2,203.10
|
|
|
Service Code
|
CPT 72130
|
| Hospital Charge Code |
35000008
|
|
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 THORACIC WO W CON
|
Facility
|
IP
|
$2,203.10
|
|
|
Service Code
|
CPT 72130
|
| Hospital Charge Code |
35000008
|
|
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 UPPER EXTREM ANGIO
|
Facility
|
OP
|
$1,835.27
|
|
|
Service Code
|
CPT 73206
|
| Hospital Charge Code |
35000010
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,651.74 |
| Rate for Payer: Aetna American Axle |
$1,192.93
|
| Rate for Payer: Aetna Commercial |
$1,559.98
|
| Rate for Payer: Aetna Medicare |
$180.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,192.93
|
| 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 |
$1,468.22
|
| Rate for Payer: Cash Price |
$1,468.22
|
| Rate for Payer: Cofinity Commercial |
$1,578.33
|
| Rate for Payer: Cofinity Commercial |
$1,284.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,284.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,468.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,651.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,284.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,376.45
|
| 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 |
$1,559.98
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$1,559.98
|
| 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 |
$1,192.93
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health SBD |
$1,156.22
|
| 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 |
$679.05
|
| Rate for Payer: VA VA |
$173.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,376.45
|
|
|
HC CT UPPER EXTREM ANGIO
|
Facility
|
IP
|
$1,835.27
|
|
|
Service Code
|
CPT 73206
|
| Hospital Charge Code |
35000010
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$807.52 |
| Max. Negotiated Rate |
$1,651.74 |
| Rate for Payer: Aetna American Axle |
$1,192.93
|
| Rate for Payer: Aetna Commercial |
$1,559.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,192.93
|
| Rate for Payer: Cash Price |
$1,468.22
|
| Rate for Payer: Cofinity Commercial |
$1,284.69
|
| Rate for Payer: Cofinity Commercial |
$1,578.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,284.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,468.22
|
| Rate for Payer: Healthscope Commercial |
$1,651.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,284.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,376.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,559.98
|
| Rate for Payer: PHP Commercial |
$1,559.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,192.93
|
| Rate for Payer: Priority Health SBD |
$1,156.22
|
| Rate for Payer: UMR Bronson Commercial |
$807.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,376.45
|
|
|
HC CT UPPER EXTREMITY W CON
|
Facility
|
OP
|
$1,450.32
|
|
|
Service Code
|
CPT 73201
|
| Hospital Charge Code |
35200014
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$1,305.29 |
| Rate for Payer: Aetna American Axle |
$942.71
|
| Rate for Payer: Aetna Commercial |
$1,232.77
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$942.71
|
| 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 |
$1,160.26
|
| Rate for Payer: Cash Price |
$1,160.26
|
| Rate for Payer: Cofinity Commercial |
$1,247.28
|
| Rate for Payer: Cofinity Commercial |
$1,015.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,015.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,160.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$1,305.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,015.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,087.74
|
| 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 |
$1,232.77
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$1,232.77
|
| 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 |
$942.71
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$913.70
|
| 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 |
$536.62
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,087.74
|
|
|
HC CT UPPER EXTREMITY W CON
|
Facility
|
IP
|
$1,450.32
|
|
|
Service Code
|
CPT 73201
|
| Hospital Charge Code |
35200014
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$638.14 |
| Max. Negotiated Rate |
$1,305.29 |
| Rate for Payer: Aetna American Axle |
$942.71
|
| Rate for Payer: Aetna Commercial |
$1,232.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$942.71
|
| Rate for Payer: Cash Price |
$1,160.26
|
| Rate for Payer: Cofinity Commercial |
$1,015.22
|
| Rate for Payer: Cofinity Commercial |
$1,247.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,015.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,160.26
|
| Rate for Payer: Healthscope Commercial |
$1,305.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,015.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,087.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,232.77
|
| Rate for Payer: PHP Commercial |
$1,232.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$942.71
|
| Rate for Payer: Priority Health SBD |
$913.70
|
| Rate for Payer: UMR Bronson Commercial |
$638.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,087.74
|
|
|
HC CT UPPER EXTREMITY WO CON
|
Facility
|
IP
|
$1,215.19
|
|
|
Service Code
|
CPT 73200
|
| Hospital Charge Code |
35200013
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$534.68 |
| Max. Negotiated Rate |
$1,093.67 |
| Rate for Payer: Aetna American Axle |
$789.87
|
| Rate for Payer: Aetna Commercial |
$1,032.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$789.87
|
| Rate for Payer: Cash Price |
$972.15
|
| Rate for Payer: Cofinity Commercial |
$1,045.06
|
| Rate for Payer: Cofinity Commercial |
$850.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$850.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$972.15
|
| Rate for Payer: Healthscope Commercial |
$1,093.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$850.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$911.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,032.91
|
| Rate for Payer: PHP Commercial |
$1,032.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$789.87
|
| Rate for Payer: Priority Health SBD |
$765.57
|
| Rate for Payer: UMR Bronson Commercial |
$534.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$911.39
|
|
|
HC CT UPPER EXTREMITY WO CON
|
Facility
|
OP
|
$1,215.19
|
|
|
Service Code
|
CPT 73200
|
| Hospital Charge Code |
35200013
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$1,093.67 |
| Rate for Payer: Aetna American Axle |
$789.87
|
| Rate for Payer: Aetna Commercial |
$1,032.91
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$789.87
|
| 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 |
$972.15
|
| Rate for Payer: Cash Price |
$972.15
|
| Rate for Payer: Cofinity Commercial |
$850.63
|
| Rate for Payer: Cofinity Commercial |
$1,045.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$850.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$972.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$1,093.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$850.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$911.39
|
| 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 |
$1,032.91
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$1,032.91
|
| 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 |
$789.87
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$765.57
|
| 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 |
$449.62
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$911.39
|
|
|
HC CT UPPER EXTREMITY WO W CON
|
Facility
|
OP
|
$1,690.85
|
|
|
Service Code
|
CPT 73202
|
| Hospital Charge Code |
35200015
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,521.77 |
| Rate for Payer: Aetna American Axle |
$1,099.05
|
| Rate for Payer: Aetna Commercial |
$1,437.22
|
| Rate for Payer: Aetna Medicare |
$180.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,099.05
|
| 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 |
$1,352.68
|
| Rate for Payer: Cash Price |
$1,352.68
|
| Rate for Payer: Cofinity Commercial |
$1,454.13
|
| Rate for Payer: Cofinity Commercial |
$1,183.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,183.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,352.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,521.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,183.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,268.14
|
| 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 |
$1,437.22
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$1,437.22
|
| 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 |
$1,099.05
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health SBD |
$1,065.24
|
| 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 |
$625.61
|
| Rate for Payer: VA VA |
$173.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,268.14
|
|
|
HC CT UPPER EXTREMITY WO W CON
|
Facility
|
IP
|
$1,690.85
|
|
|
Service Code
|
CPT 73202
|
| Hospital Charge Code |
35200015
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$743.97 |
| Max. Negotiated Rate |
$1,521.77 |
| Rate for Payer: Aetna American Axle |
$1,099.05
|
| Rate for Payer: Aetna Commercial |
$1,437.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,099.05
|
| Rate for Payer: Cash Price |
$1,352.68
|
| Rate for Payer: Cofinity Commercial |
$1,183.60
|
| Rate for Payer: Cofinity Commercial |
$1,454.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,183.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,352.68
|
| Rate for Payer: Healthscope Commercial |
$1,521.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,183.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,268.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,437.22
|
| Rate for Payer: PHP Commercial |
$1,437.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,099.05
|
| Rate for Payer: Priority Health SBD |
$1,065.24
|
| Rate for Payer: UMR Bronson Commercial |
$743.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,268.14
|
|
|
HC CT VIRTUAL COLONOSCOPY SCREENING
|
Facility
|
OP
|
$1,013.98
|
|
|
Service Code
|
CPT 74263
|
| Hospital Charge Code |
35000014
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,048.00 |
| Rate for Payer: Aetna American Axle |
$659.09
|
| Rate for Payer: Aetna Commercial |
$861.88
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$659.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$811.18
|
| Rate for Payer: Cash Price |
$811.18
|
| Rate for Payer: Cofinity Commercial |
$872.02
|
| Rate for Payer: Cofinity Commercial |
$709.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$709.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$811.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$912.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$709.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$760.49
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$861.88
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$861.88
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$659.09
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$638.81
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$450.52
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: UMR Bronson Commercial |
$375.17
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$760.49
|
|
|
HC CT VIRTUAL COLONOSCOPY SCREENING
|
Facility
|
IP
|
$1,013.98
|
|
|
Service Code
|
CPT 74263
|
| Hospital Charge Code |
35000014
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$446.15 |
| Max. Negotiated Rate |
$912.58 |
| Rate for Payer: Aetna American Axle |
$659.09
|
| Rate for Payer: Aetna Commercial |
$861.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$659.09
|
| Rate for Payer: Cash Price |
$811.18
|
| Rate for Payer: Cofinity Commercial |
$709.79
|
| Rate for Payer: Cofinity Commercial |
$872.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$709.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$811.18
|
| Rate for Payer: Healthscope Commercial |
$912.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$709.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$760.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$861.88
|
| Rate for Payer: PHP Commercial |
$861.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$659.09
|
| Rate for Payer: Priority Health SBD |
$638.81
|
| Rate for Payer: UMR Bronson Commercial |
$446.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$760.49
|
|
|
HC CT VIRTUAL COLON W CON DIAG
|
Facility
|
OP
|
$1,286.53
|
|
|
Service Code
|
CPT 74262
|
| Hospital Charge Code |
35000013
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,157.88 |
| Rate for Payer: Aetna American Axle |
$836.24
|
| Rate for Payer: Aetna Commercial |
$1,093.55
|
| Rate for Payer: Aetna Medicare |
$180.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$836.24
|
| 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 |
$1,029.22
|
| Rate for Payer: Cash Price |
$1,029.22
|
| Rate for Payer: Cofinity Commercial |
$900.57
|
| Rate for Payer: Cofinity Commercial |
$1,106.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$900.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,029.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,157.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$900.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$964.90
|
| 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 |
$1,093.55
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$1,093.55
|
| 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 |
$836.24
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health SBD |
$810.51
|
| 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 |
$476.02
|
| Rate for Payer: VA VA |
$173.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$964.90
|
|
|
HC CT VIRTUAL COLON W CON DIAG
|
Facility
|
IP
|
$1,286.53
|
|
|
Service Code
|
CPT 74262
|
| Hospital Charge Code |
35000013
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$566.07 |
| Max. Negotiated Rate |
$1,157.88 |
| Rate for Payer: Aetna American Axle |
$836.24
|
| Rate for Payer: Aetna Commercial |
$1,093.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$836.24
|
| Rate for Payer: Cash Price |
$1,029.22
|
| Rate for Payer: Cofinity Commercial |
$1,106.42
|
| Rate for Payer: Cofinity Commercial |
$900.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$900.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,029.22
|
| Rate for Payer: Healthscope Commercial |
$1,157.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$900.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$964.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,093.55
|
| Rate for Payer: PHP Commercial |
$1,093.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$836.24
|
| Rate for Payer: Priority Health SBD |
$810.51
|
| Rate for Payer: UMR Bronson Commercial |
$566.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$964.90
|
|
|
HC CT VIRTUAL COLON WO CON DIAG
|
Facility
|
OP
|
$1,286.53
|
|
|
Service Code
|
CPT 74261
|
| Hospital Charge Code |
35000012
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$1,157.88 |
| Rate for Payer: Aetna American Axle |
$836.24
|
| Rate for Payer: Aetna Commercial |
$1,093.55
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$836.24
|
| 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 |
$1,029.22
|
| Rate for Payer: Cash Price |
$1,029.22
|
| Rate for Payer: Cofinity Commercial |
$900.57
|
| Rate for Payer: Cofinity Commercial |
$1,106.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$900.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,029.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$1,157.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$900.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$964.90
|
| 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 |
$1,093.55
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$1,093.55
|
| 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 |
$836.24
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$810.51
|
| 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 |
$476.02
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$964.90
|
|
|
HC CT VIRTUAL COLON WO CON DIAG
|
Facility
|
IP
|
$1,286.53
|
|
|
Service Code
|
CPT 74261
|
| Hospital Charge Code |
35000012
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$566.07 |
| Max. Negotiated Rate |
$1,157.88 |
| Rate for Payer: Aetna American Axle |
$836.24
|
| Rate for Payer: Aetna Commercial |
$1,093.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$836.24
|
| Rate for Payer: Cash Price |
$1,029.22
|
| Rate for Payer: Cofinity Commercial |
$1,106.42
|
| Rate for Payer: Cofinity Commercial |
$900.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$900.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,029.22
|
| Rate for Payer: Healthscope Commercial |
$1,157.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$900.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$964.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,093.55
|
| Rate for Payer: PHP Commercial |
$1,093.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$836.24
|
| Rate for Payer: Priority Health SBD |
$810.51
|
| Rate for Payer: UMR Bronson Commercial |
$566.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$964.90
|
|
