|
HC MR SAFETY IMPLANT/FB ASSMT CLIN STAFF EA ADD 30 MIN.
|
Facility
|
OP
|
$274.00
|
|
|
Service Code
|
CPT 76015
|
| Hospital Charge Code |
61000097
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$101.38 |
| Max. Negotiated Rate |
$246.60 |
| Rate for Payer: Aetna American Axle |
$178.10
|
| Rate for Payer: Aetna Commercial |
$232.90
|
| Rate for Payer: Aetna Medicare |
$137.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.10
|
| Rate for Payer: BCBS Complete |
$109.60
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cofinity Advantage |
$191.80
|
| Rate for Payer: Cofinity Commercial |
$235.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.20
|
| Rate for Payer: Healthscope Commercial |
$246.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$191.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$219.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$205.50
|
| Rate for Payer: PHP Commercial |
$232.90
|
| Rate for Payer: Priority Health SBD |
$172.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.10
|
| Rate for Payer: UHC Core |
$142.75
|
| Rate for Payer: UHC Exchange |
$107.68
|
| Rate for Payer: UMR Bronson Commercial |
$101.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.50
|
|
|
HC MR SAFETY IMPLANT/FB ASSMT CLIN STAFF EA ADD 30 MIN.
|
Facility
|
IP
|
$274.00
|
|
|
Service Code
|
CPT 76015
|
| Hospital Charge Code |
61000097
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$120.56 |
| Max. Negotiated Rate |
$246.60 |
| Rate for Payer: Aetna American Axle |
$178.10
|
| Rate for Payer: Aetna Commercial |
$232.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.10
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cofinity Advantage |
$191.80
|
| Rate for Payer: Cofinity Commercial |
$235.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.20
|
| Rate for Payer: Healthscope Commercial |
$246.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$191.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$205.50
|
| Rate for Payer: PHP Commercial |
$232.90
|
| Rate for Payer: Priority Health SBD |
$172.62
|
| Rate for Payer: UMR Bronson Commercial |
$120.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.50
|
|
|
HC MR SPECTROSCOPY
|
Facility
|
OP
|
$1,938.16
|
|
|
Service Code
|
CPT 76390
|
| Hospital Charge Code |
61000049
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$1,744.34 |
| Rate for Payer: Aetna American Axle |
$1,259.80
|
| Rate for Payer: Aetna Commercial |
$1,647.44
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,259.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$788.59
|
| Rate for Payer: BCN Commercial |
$788.59
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$1,550.53
|
| Rate for Payer: Cash Price |
$1,550.53
|
| Rate for Payer: Cofinity Advantage |
$1,356.71
|
| Rate for Payer: Cofinity Commercial |
$1,666.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,550.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$1,744.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,356.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,453.62
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,647.44
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,453.62
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$1,647.44
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$1,221.04
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,259.80
|
| Rate for Payer: UHC Core |
$1,009.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$761.70
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: UMR Bronson Commercial |
$717.12
|
| Rate for Payer: VA VA |
$86.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,453.62
|
|
|
HC MR SPECTROSCOPY
|
Facility
|
IP
|
$1,938.16
|
|
|
Service Code
|
CPT 76390
|
| Hospital Charge Code |
61000049
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$852.79 |
| Max. Negotiated Rate |
$1,744.34 |
| Rate for Payer: Aetna American Axle |
$1,259.80
|
| Rate for Payer: Aetna Commercial |
$1,647.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,259.80
|
| Rate for Payer: Cash Price |
$1,550.53
|
| Rate for Payer: Cofinity Advantage |
$1,356.71
|
| Rate for Payer: Cofinity Commercial |
$1,666.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,550.53
|
| Rate for Payer: Healthscope Commercial |
$1,744.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,356.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,453.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,647.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,453.62
|
| Rate for Payer: PHP Commercial |
$1,647.44
|
| Rate for Payer: Priority Health SBD |
$1,221.04
|
| Rate for Payer: UMR Bronson Commercial |
$852.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,453.62
|
|
|
HC MR SPINE CERVICAL W CON
|
Facility
|
IP
|
$2,368.79
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200004
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,042.27 |
| Max. Negotiated Rate |
$2,131.91 |
| Rate for Payer: Aetna American Axle |
$1,539.71
|
| Rate for Payer: Aetna Commercial |
$2,013.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,539.71
|
| Rate for Payer: Cash Price |
$1,895.03
|
| Rate for Payer: Cofinity Advantage |
$1,658.15
|
| Rate for Payer: Cofinity Commercial |
$2,037.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,895.03
|
| Rate for Payer: Healthscope Commercial |
$2,131.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,658.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,776.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,013.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,776.59
|
| Rate for Payer: PHP Commercial |
$2,013.47
|
| Rate for Payer: Priority Health SBD |
$1,492.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,042.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,776.59
|
|
|
HC MR SPINE CERVICAL W CON
|
Facility
|
OP
|
$2,368.79
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200004
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,131.91 |
| Rate for Payer: Aetna American Axle |
$1,539.71
|
| Rate for Payer: Aetna Commercial |
$2,013.47
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,539.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$479.41
|
| Rate for Payer: BCN Commercial |
$479.41
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,895.03
|
| Rate for Payer: Cash Price |
$1,895.03
|
| Rate for Payer: Cofinity Advantage |
$1,658.15
|
| Rate for Payer: Cofinity Commercial |
$2,037.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,895.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,131.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,658.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,776.59
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,013.47
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,776.59
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$2,013.47
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$1,492.34
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,539.71
|
| Rate for Payer: UHC Core |
$1,234.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$930.93
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: UMR Bronson Commercial |
$876.45
|
| Rate for Payer: VA VA |
$347.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,776.59
|
|
|
HC MR SPINE CERVICAL W CON LTD
|
Facility
|
IP
|
$1,183.98
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200003
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$520.95 |
| Max. Negotiated Rate |
$1,065.58 |
| Rate for Payer: Aetna American Axle |
$769.59
|
| Rate for Payer: Aetna Commercial |
$1,006.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$769.59
|
| Rate for Payer: Cash Price |
$947.18
|
| Rate for Payer: Cofinity Advantage |
$828.79
|
| Rate for Payer: Cofinity Commercial |
$1,018.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$947.18
|
| Rate for Payer: Healthscope Commercial |
$1,065.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$828.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$887.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,006.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$887.99
|
| Rate for Payer: PHP Commercial |
$1,006.38
|
| Rate for Payer: Priority Health SBD |
$745.91
|
| Rate for Payer: UMR Bronson Commercial |
$520.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$887.99
|
|
|
HC MR SPINE CERVICAL W CON LTD
|
Facility
|
OP
|
$1,183.98
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200003
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,124.16 |
| Rate for Payer: Aetna American Axle |
$769.59
|
| Rate for Payer: Aetna Commercial |
$1,006.38
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$769.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$479.41
|
| Rate for Payer: BCN Commercial |
$479.41
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$947.18
|
| Rate for Payer: Cash Price |
$947.18
|
| Rate for Payer: Cofinity Advantage |
$828.79
|
| Rate for Payer: Cofinity Commercial |
$1,018.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$947.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$1,065.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$828.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$887.99
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,006.38
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$887.99
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$1,006.38
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$745.91
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$769.59
|
| Rate for Payer: UHC Core |
$616.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$465.30
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: UMR Bronson Commercial |
$438.07
|
| Rate for Payer: VA VA |
$347.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$887.99
|
|
|
HC MR SPINE CERVICAL WO CON
|
Facility
|
IP
|
$2,333.80
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200002
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,026.87 |
| Max. Negotiated Rate |
$2,100.42 |
| Rate for Payer: Aetna American Axle |
$1,516.97
|
| Rate for Payer: Aetna Commercial |
$1,983.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,516.97
|
| Rate for Payer: Cash Price |
$1,867.04
|
| Rate for Payer: Cofinity Advantage |
$1,633.66
|
| Rate for Payer: Cofinity Commercial |
$2,007.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,867.04
|
| Rate for Payer: Healthscope Commercial |
$2,100.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,633.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,750.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,983.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,750.35
|
| Rate for Payer: PHP Commercial |
$1,983.73
|
| Rate for Payer: Priority Health SBD |
$1,470.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,026.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,750.35
|
|
|
HC MR SPINE CERVICAL WO CON
|
Facility
|
OP
|
$2,333.80
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200002
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$2,100.42 |
| Rate for Payer: Aetna American Axle |
$1,516.97
|
| Rate for Payer: Aetna Commercial |
$1,983.73
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,516.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$304.55
|
| Rate for Payer: BCN Commercial |
$304.55
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,867.04
|
| Rate for Payer: Cash Price |
$1,867.04
|
| Rate for Payer: Cofinity Advantage |
$1,633.66
|
| Rate for Payer: Cofinity Commercial |
$2,007.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,867.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$2,100.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,633.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,750.35
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,983.73
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,750.35
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,983.73
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$1,470.29
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,516.97
|
| Rate for Payer: UHC Core |
$1,215.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$917.18
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: UMR Bronson Commercial |
$863.51
|
| Rate for Payer: VA VA |
$237.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,750.35
|
|
|
HC MR SPINE CERVICAL WO LIMITED
|
Facility
|
IP
|
$1,167.33
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200001
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$513.63 |
| Max. Negotiated Rate |
$1,050.60 |
| Rate for Payer: Aetna American Axle |
$758.76
|
| Rate for Payer: Aetna Commercial |
$992.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$758.76
|
| Rate for Payer: Cash Price |
$933.86
|
| Rate for Payer: Cofinity Advantage |
$817.13
|
| Rate for Payer: Cofinity Commercial |
$1,003.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$933.86
|
| Rate for Payer: Healthscope Commercial |
$1,050.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$817.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$875.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$992.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$875.50
|
| Rate for Payer: PHP Commercial |
$992.23
|
| Rate for Payer: Priority Health SBD |
$735.42
|
| Rate for Payer: UMR Bronson Commercial |
$513.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$875.50
|
|
|
HC MR SPINE CERVICAL WO LIMITED
|
Facility
|
OP
|
$1,167.33
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200001
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,050.60 |
| Rate for Payer: Aetna American Axle |
$758.76
|
| Rate for Payer: Aetna Commercial |
$992.23
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$758.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$304.55
|
| Rate for Payer: BCN Commercial |
$304.55
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$933.86
|
| Rate for Payer: Cash Price |
$933.86
|
| Rate for Payer: Cofinity Advantage |
$817.13
|
| Rate for Payer: Cofinity Commercial |
$1,003.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$933.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,050.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$817.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$875.50
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$992.23
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$875.50
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$992.23
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$735.42
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$758.76
|
| Rate for Payer: UHC Core |
$608.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$458.76
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: UMR Bronson Commercial |
$431.91
|
| Rate for Payer: VA VA |
$237.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$875.50
|
|
|
HC MR SPINE CERVICAL WO W CON
|
Facility
|
IP
|
$2,827.33
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200013
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,244.03 |
| Max. Negotiated Rate |
$2,544.60 |
| Rate for Payer: Aetna American Axle |
$1,837.76
|
| Rate for Payer: Aetna Commercial |
$2,403.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,837.76
|
| Rate for Payer: Cash Price |
$2,261.86
|
| Rate for Payer: Cofinity Advantage |
$1,979.13
|
| Rate for Payer: Cofinity Commercial |
$2,431.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,261.86
|
| Rate for Payer: Healthscope Commercial |
$2,544.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,979.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,120.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,403.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,120.50
|
| Rate for Payer: PHP Commercial |
$2,403.23
|
| Rate for Payer: Priority Health SBD |
$1,781.22
|
| Rate for Payer: UMR Bronson Commercial |
$1,244.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,120.50
|
|
|
HC MR SPINE CERVICAL WO W CON
|
Facility
|
OP
|
$2,827.33
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200013
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,544.60 |
| Rate for Payer: Aetna American Axle |
$1,837.76
|
| Rate for Payer: Aetna Commercial |
$2,403.23
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,837.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$532.77
|
| Rate for Payer: BCN Commercial |
$532.77
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,261.86
|
| Rate for Payer: Cash Price |
$2,261.86
|
| Rate for Payer: Cofinity Advantage |
$1,979.13
|
| Rate for Payer: Cofinity Commercial |
$2,431.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,261.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,544.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,979.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,120.50
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,403.23
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,120.50
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$2,403.23
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$1,781.22
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,837.76
|
| Rate for Payer: UHC Core |
$1,473.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$1,111.14
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: UMR Bronson Commercial |
$1,046.11
|
| Rate for Payer: VA VA |
$347.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,120.50
|
|
|
HC MR SPINE CERVICAL WO W LTD
|
Facility
|
OP
|
$906.70
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200014
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,124.16 |
| Rate for Payer: Aetna American Axle |
$589.36
|
| Rate for Payer: Aetna Commercial |
$770.70
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$589.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$532.77
|
| Rate for Payer: BCN Commercial |
$532.77
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$725.36
|
| Rate for Payer: Cash Price |
$725.36
|
| Rate for Payer: Cofinity Advantage |
$634.69
|
| Rate for Payer: Cofinity Commercial |
$779.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$725.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$816.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$634.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$680.02
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$770.70
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$680.02
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$770.70
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$571.22
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$589.36
|
| Rate for Payer: UHC Core |
$472.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$356.33
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: UMR Bronson Commercial |
$335.48
|
| Rate for Payer: VA VA |
$347.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$680.02
|
|
|
HC MR SPINE CERVICAL WO W LTD
|
Facility
|
IP
|
$906.70
|
|
|
Service Code
|
CPT 72156
|
| Hospital Charge Code |
61200014
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$398.95 |
| Max. Negotiated Rate |
$816.03 |
| Rate for Payer: Aetna American Axle |
$589.36
|
| Rate for Payer: Aetna Commercial |
$770.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$589.36
|
| Rate for Payer: Cash Price |
$725.36
|
| Rate for Payer: Cofinity Advantage |
$634.69
|
| Rate for Payer: Cofinity Commercial |
$779.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$725.36
|
| Rate for Payer: Healthscope Commercial |
$816.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$634.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$680.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$770.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$680.02
|
| Rate for Payer: PHP Commercial |
$770.70
|
| Rate for Payer: Priority Health SBD |
$571.22
|
| Rate for Payer: UMR Bronson Commercial |
$398.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$680.02
|
|
|
HC MR SPINE LUMBAR W CON
|
Facility
|
OP
|
$2,288.04
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200012
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,059.24 |
| Rate for Payer: Aetna American Axle |
$1,487.23
|
| Rate for Payer: Aetna Commercial |
$1,944.83
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,487.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$467.91
|
| Rate for Payer: BCN Commercial |
$467.91
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,830.43
|
| Rate for Payer: Cash Price |
$1,830.43
|
| Rate for Payer: Cofinity Advantage |
$1,601.63
|
| Rate for Payer: Cofinity Commercial |
$1,967.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,830.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,059.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,601.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,716.03
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,944.83
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,716.03
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$1,944.83
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$1,441.47
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,487.23
|
| Rate for Payer: UHC Core |
$1,192.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$899.20
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: UMR Bronson Commercial |
$846.57
|
| Rate for Payer: VA VA |
$347.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,716.03
|
|
|
HC MR SPINE LUMBAR W CON
|
Facility
|
IP
|
$2,288.04
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200012
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,006.74 |
| Max. Negotiated Rate |
$2,059.24 |
| Rate for Payer: Aetna American Axle |
$1,487.23
|
| Rate for Payer: Aetna Commercial |
$1,944.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,487.23
|
| Rate for Payer: Cash Price |
$1,830.43
|
| Rate for Payer: Cofinity Advantage |
$1,601.63
|
| Rate for Payer: Cofinity Commercial |
$1,967.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,830.43
|
| Rate for Payer: Healthscope Commercial |
$2,059.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,601.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,716.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,944.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,716.03
|
| Rate for Payer: PHP Commercial |
$1,944.83
|
| Rate for Payer: Priority Health SBD |
$1,441.47
|
| Rate for Payer: UMR Bronson Commercial |
$1,006.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,716.03
|
|
|
HC MR SPINE LUMBAR W LTD
|
Facility
|
IP
|
$834.11
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200011
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$367.01 |
| Max. Negotiated Rate |
$750.70 |
| Rate for Payer: Aetna American Axle |
$542.17
|
| Rate for Payer: Aetna Commercial |
$708.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$542.17
|
| Rate for Payer: Cash Price |
$667.29
|
| Rate for Payer: Cofinity Advantage |
$583.88
|
| Rate for Payer: Cofinity Commercial |
$717.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$667.29
|
| Rate for Payer: Healthscope Commercial |
$750.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$583.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$625.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$708.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$625.58
|
| Rate for Payer: PHP Commercial |
$708.99
|
| Rate for Payer: Priority Health SBD |
$525.49
|
| Rate for Payer: UMR Bronson Commercial |
$367.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$625.58
|
|
|
HC MR SPINE LUMBAR W LTD
|
Facility
|
OP
|
$834.11
|
|
|
Service Code
|
CPT 72149
|
| Hospital Charge Code |
61200011
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,124.16 |
| Rate for Payer: Aetna American Axle |
$542.17
|
| Rate for Payer: Aetna Commercial |
$708.99
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$542.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$467.91
|
| Rate for Payer: BCN Commercial |
$467.91
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$667.29
|
| Rate for Payer: Cash Price |
$667.29
|
| Rate for Payer: Cofinity Advantage |
$583.88
|
| Rate for Payer: Cofinity Commercial |
$717.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$667.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$750.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$583.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$625.58
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$708.99
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$625.58
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$708.99
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$525.49
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$542.17
|
| Rate for Payer: UHC Core |
$434.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$327.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: UMR Bronson Commercial |
$308.62
|
| Rate for Payer: VA VA |
$347.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$625.58
|
|
|
HC MR SPINE LUMBAR WO CON
|
Facility
|
IP
|
$2,325.84
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200009
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,023.37 |
| Max. Negotiated Rate |
$2,093.26 |
| Rate for Payer: Aetna American Axle |
$1,511.80
|
| Rate for Payer: Aetna Commercial |
$1,976.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,511.80
|
| Rate for Payer: Cash Price |
$1,860.67
|
| Rate for Payer: Cofinity Advantage |
$1,628.09
|
| Rate for Payer: Cofinity Commercial |
$2,000.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,860.67
|
| Rate for Payer: Healthscope Commercial |
$2,093.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,628.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,744.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,976.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,744.38
|
| Rate for Payer: PHP Commercial |
$1,976.96
|
| Rate for Payer: Priority Health SBD |
$1,465.28
|
| Rate for Payer: UMR Bronson Commercial |
$1,023.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,744.38
|
|
|
HC MR SPINE LUMBAR WO CON
|
Facility
|
OP
|
$2,325.84
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200009
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$2,093.26 |
| Rate for Payer: Aetna American Axle |
$1,511.80
|
| Rate for Payer: Aetna Commercial |
$1,976.96
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,511.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$306.19
|
| Rate for Payer: BCN Commercial |
$306.19
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,860.67
|
| Rate for Payer: Cash Price |
$1,860.67
|
| Rate for Payer: Cofinity Advantage |
$1,628.09
|
| Rate for Payer: Cofinity Commercial |
$2,000.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,860.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$2,093.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,628.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,744.38
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,976.96
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,744.38
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,976.96
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$1,465.28
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,511.80
|
| Rate for Payer: UHC Core |
$1,211.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$914.06
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: UMR Bronson Commercial |
$860.56
|
| Rate for Payer: VA VA |
$237.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,744.38
|
|
|
HC MR SPINE LUMBAR WO LTD
|
Facility
|
IP
|
$2,129.84
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200010
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$937.13 |
| Max. Negotiated Rate |
$1,916.86 |
| Rate for Payer: Aetna American Axle |
$1,384.40
|
| Rate for Payer: Aetna Commercial |
$1,810.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,384.40
|
| Rate for Payer: Cash Price |
$1,703.87
|
| Rate for Payer: Cofinity Advantage |
$1,490.89
|
| Rate for Payer: Cofinity Commercial |
$1,831.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,703.87
|
| Rate for Payer: Healthscope Commercial |
$1,916.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,490.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,597.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,810.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,597.38
|
| Rate for Payer: PHP Commercial |
$1,810.36
|
| Rate for Payer: Priority Health SBD |
$1,341.80
|
| Rate for Payer: UMR Bronson Commercial |
$937.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,597.38
|
|
|
HC MR SPINE LUMBAR WO LTD
|
Facility
|
OP
|
$2,129.84
|
|
|
Service Code
|
CPT 72148
|
| Hospital Charge Code |
61200010
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,916.86 |
| Rate for Payer: Aetna American Axle |
$1,384.40
|
| Rate for Payer: Aetna Commercial |
$1,810.36
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,384.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$306.19
|
| Rate for Payer: BCN Commercial |
$306.19
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,703.87
|
| Rate for Payer: Cash Price |
$1,703.87
|
| Rate for Payer: Cofinity Advantage |
$1,490.89
|
| Rate for Payer: Cofinity Commercial |
$1,831.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,703.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,916.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,490.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,597.38
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,810.36
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,597.38
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,810.36
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$1,341.80
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,384.40
|
| Rate for Payer: UHC Core |
$1,109.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$837.03
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: UMR Bronson Commercial |
$788.04
|
| Rate for Payer: VA VA |
$237.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,597.38
|
|
|
HC MR SPINE LUMBAR WO W CON
|
Facility
|
IP
|
$3,247.14
|
|
|
Service Code
|
CPT 72158
|
| Hospital Charge Code |
61200017
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,428.74 |
| Max. Negotiated Rate |
$2,922.43 |
| Rate for Payer: Aetna American Axle |
$2,110.64
|
| Rate for Payer: Aetna Commercial |
$2,760.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,110.64
|
| Rate for Payer: Cash Price |
$2,597.71
|
| Rate for Payer: Cofinity Advantage |
$2,273.00
|
| Rate for Payer: Cofinity Commercial |
$2,792.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,597.71
|
| Rate for Payer: Healthscope Commercial |
$2,922.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,273.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,435.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,760.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,435.36
|
| Rate for Payer: PHP Commercial |
$2,760.07
|
| Rate for Payer: Priority Health SBD |
$2,045.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,428.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,435.36
|
|
