|
HC MR MRCP
|
Facility
|
OP
|
$2,110.45
|
|
|
Service Code
|
CPT 74181
|
| Hospital Charge Code |
61000042
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$1,371.79
|
| Rate for Payer: Aetna Commercial |
$1,793.88
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,371.79
|
| 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 |
$1,688.36
|
| Rate for Payer: Cash Price |
$1,688.36
|
| Rate for Payer: Cofinity Commercial |
$1,814.99
|
| Rate for Payer: Cofinity Commercial |
$1,477.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,477.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,688.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,899.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,477.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,582.84
|
| 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 |
$1,793.88
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,793.88
|
| 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 |
$1,371.79
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,329.58
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$1,943.00
|
| 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 |
$780.87
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,582.84
|
|
|
HC MR NEEDLE PLACEMENT
|
Facility
|
IP
|
$1,005.41
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61000081
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$442.38 |
| Max. Negotiated Rate |
$904.87 |
| Rate for Payer: Aetna American Axle |
$653.52
|
| Rate for Payer: Aetna Commercial |
$854.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$653.52
|
| Rate for Payer: Cash Price |
$804.33
|
| Rate for Payer: Cofinity Commercial |
$703.79
|
| Rate for Payer: Cofinity Commercial |
$864.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$703.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$804.33
|
| Rate for Payer: Healthscope Commercial |
$904.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$703.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$754.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$854.60
|
| Rate for Payer: PHP Commercial |
$854.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.52
|
| Rate for Payer: Priority Health SBD |
$633.41
|
| Rate for Payer: UMR Bronson Commercial |
$442.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$754.06
|
|
|
HC MR NEEDLE PLACEMENT
|
Facility
|
OP
|
$1,005.41
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61000081
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$372.00 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$653.52
|
| Rate for Payer: Aetna Commercial |
$854.60
|
| Rate for Payer: Aetna Medicare |
$502.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$653.52
|
| Rate for Payer: BCBS Complete |
$402.16
|
| Rate for Payer: Cash Price |
$804.33
|
| Rate for Payer: Cash Price |
$804.33
|
| Rate for Payer: Cofinity Commercial |
$864.65
|
| Rate for Payer: Cofinity Commercial |
$703.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$703.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$804.33
|
| Rate for Payer: Healthscope Commercial |
$904.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$703.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$754.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$854.60
|
| Rate for Payer: PHP Commercial |
$854.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.52
|
| Rate for Payer: Priority Health SBD |
$633.41
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UMR Bronson Commercial |
$372.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$754.06
|
|
|
HC MR ONLY HEAD W CON
|
Facility
|
IP
|
$2,216.97
|
|
|
Service Code
|
CPT 70545
|
| Hospital Charge Code |
61000005
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$975.47 |
| Max. Negotiated Rate |
$1,995.27 |
| Rate for Payer: Aetna American Axle |
$1,441.03
|
| Rate for Payer: Aetna Commercial |
$1,884.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,441.03
|
| Rate for Payer: Cash Price |
$1,773.58
|
| Rate for Payer: Cofinity Commercial |
$1,551.88
|
| Rate for Payer: Cofinity Commercial |
$1,906.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,551.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,773.58
|
| Rate for Payer: Healthscope Commercial |
$1,995.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,551.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,662.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,884.42
|
| Rate for Payer: PHP Commercial |
$1,884.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,441.03
|
| Rate for Payer: Priority Health SBD |
$1,396.69
|
| Rate for Payer: UMR Bronson Commercial |
$975.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,662.73
|
|
|
HC MR ONLY HEAD W CON
|
Facility
|
OP
|
$2,216.97
|
|
|
Service Code
|
CPT 70545
|
| Hospital Charge Code |
61000005
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$1,995.27 |
| Rate for Payer: Aetna American Axle |
$1,441.03
|
| Rate for Payer: Aetna Commercial |
$1,884.42
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,441.03
|
| 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 |
$1,773.58
|
| Rate for Payer: Cash Price |
$1,773.58
|
| Rate for Payer: Cofinity Commercial |
$1,906.59
|
| Rate for Payer: Cofinity Commercial |
$1,551.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,551.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,773.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$1,995.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,551.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,662.73
|
| 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 |
$1,884.42
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$1,884.42
|
| 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 |
$1,441.03
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,396.69
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,943.00
|
| 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 |
$820.28
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,662.73
|
|
|
HC MR ORBITS FACE NECK W CON
|
Facility
|
OP
|
$2,146.49
|
|
|
Service Code
|
CPT 70542
|
| Hospital Charge Code |
61000003
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$1,395.22
|
| Rate for Payer: Aetna Commercial |
$1,824.52
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,395.22
|
| 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 |
$1,717.19
|
| Rate for Payer: Cash Price |
$1,717.19
|
| Rate for Payer: Cofinity Commercial |
$1,845.98
|
| Rate for Payer: Cofinity Commercial |
$1,502.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,502.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,717.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$1,931.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,502.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,609.87
|
| 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 |
$1,824.52
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$1,824.52
|
| 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 |
$1,395.22
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,352.29
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,943.00
|
| 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 |
$794.20
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,609.87
|
|
|
HC MR ORBITS FACE NECK W CON
|
Facility
|
IP
|
$2,146.49
|
|
|
Service Code
|
CPT 70542
|
| Hospital Charge Code |
61000003
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$944.46 |
| Max. Negotiated Rate |
$1,931.84 |
| Rate for Payer: Aetna American Axle |
$1,395.22
|
| Rate for Payer: Aetna Commercial |
$1,824.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,395.22
|
| Rate for Payer: Cash Price |
$1,717.19
|
| Rate for Payer: Cofinity Commercial |
$1,502.54
|
| Rate for Payer: Cofinity Commercial |
$1,845.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,502.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,717.19
|
| Rate for Payer: Healthscope Commercial |
$1,931.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,502.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,609.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,824.52
|
| Rate for Payer: PHP Commercial |
$1,824.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,395.22
|
| Rate for Payer: Priority Health SBD |
$1,352.29
|
| Rate for Payer: UMR Bronson Commercial |
$944.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,609.87
|
|
|
HC MR ORBITS FACE NECK WO CON
|
Facility
|
IP
|
$2,035.12
|
|
|
Service Code
|
CPT 70540
|
| Hospital Charge Code |
61000002
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$895.45 |
| Max. Negotiated Rate |
$1,831.61 |
| Rate for Payer: Aetna American Axle |
$1,322.83
|
| Rate for Payer: Aetna Commercial |
$1,729.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,322.83
|
| Rate for Payer: Cash Price |
$1,628.10
|
| Rate for Payer: Cofinity Commercial |
$1,424.58
|
| Rate for Payer: Cofinity Commercial |
$1,750.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,424.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,628.10
|
| Rate for Payer: Healthscope Commercial |
$1,831.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,424.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,526.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,729.85
|
| Rate for Payer: PHP Commercial |
$1,729.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,322.83
|
| Rate for Payer: Priority Health SBD |
$1,282.13
|
| Rate for Payer: UMR Bronson Commercial |
$895.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,526.34
|
|
|
HC MR ORBITS FACE NECK WO CON
|
Facility
|
OP
|
$2,035.12
|
|
|
Service Code
|
CPT 70540
|
| Hospital Charge Code |
61000002
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$1,322.83
|
| Rate for Payer: Aetna Commercial |
$1,729.85
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,322.83
|
| 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 |
$1,628.10
|
| Rate for Payer: Cash Price |
$1,628.10
|
| Rate for Payer: Cofinity Commercial |
$1,750.20
|
| Rate for Payer: Cofinity Commercial |
$1,424.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,424.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,628.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,831.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,424.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,526.34
|
| 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 |
$1,729.85
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,729.85
|
| 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 |
$1,322.83
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,282.13
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$1,943.00
|
| 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 |
$752.99
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,526.34
|
|
|
HC MR ORBITS FACE NECK WO/W CON
|
Facility
|
OP
|
$2,788.74
|
|
|
Service Code
|
CPT 70543
|
| Hospital Charge Code |
61000004
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,509.87 |
| Rate for Payer: Aetna American Axle |
$1,812.68
|
| Rate for Payer: Aetna Commercial |
$2,370.43
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,812.68
|
| 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 |
$2,230.99
|
| Rate for Payer: Cash Price |
$2,230.99
|
| Rate for Payer: Cofinity Commercial |
$2,398.32
|
| Rate for Payer: Cofinity Commercial |
$1,952.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,952.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,230.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,509.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,952.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,091.55
|
| 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 |
$2,370.43
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$2,370.43
|
| 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 |
$1,812.68
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,756.91
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,943.00
|
| 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 |
$1,031.83
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,091.55
|
|
|
HC MR ORBITS FACE NECK WO/W CON
|
Facility
|
IP
|
$2,788.74
|
|
|
Service Code
|
CPT 70543
|
| Hospital Charge Code |
61000004
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,227.05 |
| Max. Negotiated Rate |
$2,509.87 |
| Rate for Payer: Aetna American Axle |
$1,812.68
|
| Rate for Payer: Aetna Commercial |
$2,370.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,812.68
|
| Rate for Payer: Cash Price |
$2,230.99
|
| Rate for Payer: Cofinity Commercial |
$1,952.12
|
| Rate for Payer: Cofinity Commercial |
$2,398.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,952.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,230.99
|
| Rate for Payer: Healthscope Commercial |
$2,509.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,952.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,091.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,370.43
|
| Rate for Payer: PHP Commercial |
$2,370.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,812.68
|
| Rate for Payer: Priority Health SBD |
$1,756.91
|
| Rate for Payer: UMR Bronson Commercial |
$1,227.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,091.55
|
|
|
HC MR PELVIS W CON
|
Facility
|
OP
|
$2,243.18
|
|
|
Service Code
|
CPT 72196
|
| Hospital Charge Code |
61000014
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,018.86 |
| Rate for Payer: Aetna American Axle |
$1,458.07
|
| Rate for Payer: Aetna Commercial |
$1,906.70
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,458.07
|
| 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 |
$1,794.54
|
| Rate for Payer: Cash Price |
$1,794.54
|
| Rate for Payer: Cofinity Commercial |
$1,929.13
|
| Rate for Payer: Cofinity Commercial |
$1,570.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,570.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,794.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,018.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,570.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,682.38
|
| Rate for Payer: Mclaren Medicaid |
$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 |
$1,906.70
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$1,906.70
|
| 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 |
$1,458.07
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,413.20
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,943.00
|
| 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 |
$829.98
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,682.38
|
|
|
HC MR PELVIS W CON
|
Facility
|
IP
|
$2,243.18
|
|
|
Service Code
|
CPT 72196
|
| Hospital Charge Code |
61000014
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$987.00 |
| Max. Negotiated Rate |
$2,018.86 |
| Rate for Payer: Aetna American Axle |
$1,458.07
|
| Rate for Payer: Aetna Commercial |
$1,906.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,458.07
|
| Rate for Payer: Cash Price |
$1,794.54
|
| Rate for Payer: Cofinity Commercial |
$1,570.23
|
| Rate for Payer: Cofinity Commercial |
$1,929.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,570.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,794.54
|
| Rate for Payer: Healthscope Commercial |
$2,018.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,570.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,682.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,906.70
|
| Rate for Payer: PHP Commercial |
$1,906.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,458.07
|
| Rate for Payer: Priority Health SBD |
$1,413.20
|
| Rate for Payer: UMR Bronson Commercial |
$987.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,682.38
|
|
|
HC MR PELVIS WO CON
|
Facility
|
IP
|
$2,032.74
|
|
|
Service Code
|
CPT 72195
|
| Hospital Charge Code |
61000013
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$894.41 |
| Max. Negotiated Rate |
$1,829.47 |
| Rate for Payer: Aetna American Axle |
$1,321.28
|
| Rate for Payer: Aetna Commercial |
$1,727.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,321.28
|
| Rate for Payer: Cash Price |
$1,626.19
|
| Rate for Payer: Cofinity Commercial |
$1,422.92
|
| Rate for Payer: Cofinity Commercial |
$1,748.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,422.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,626.19
|
| Rate for Payer: Healthscope Commercial |
$1,829.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,422.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,524.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,727.83
|
| Rate for Payer: PHP Commercial |
$1,727.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,321.28
|
| Rate for Payer: Priority Health SBD |
$1,280.63
|
| Rate for Payer: UMR Bronson Commercial |
$894.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,524.56
|
|
|
HC MR PELVIS WO CON
|
Facility
|
OP
|
$2,032.74
|
|
|
Service Code
|
CPT 72195
|
| Hospital Charge Code |
61000013
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$1,321.28
|
| Rate for Payer: Aetna Commercial |
$1,727.83
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,321.28
|
| 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 |
$1,626.19
|
| Rate for Payer: Cash Price |
$1,626.19
|
| Rate for Payer: Cofinity Commercial |
$1,748.16
|
| Rate for Payer: Cofinity Commercial |
$1,422.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,422.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,626.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,829.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,422.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,524.56
|
| 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 |
$1,727.83
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,727.83
|
| 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 |
$1,321.28
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,280.63
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$1,943.00
|
| 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 |
$752.11
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,524.56
|
|
|
HC MR PELVIS WO W CON
|
Facility
|
OP
|
$3,049.16
|
|
|
Service Code
|
CPT 72197
|
| Hospital Charge Code |
61000015
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,744.24 |
| Rate for Payer: Aetna American Axle |
$1,981.95
|
| Rate for Payer: Aetna Commercial |
$2,591.79
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,981.95
|
| 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 |
$2,439.33
|
| Rate for Payer: Cash Price |
$2,439.33
|
| Rate for Payer: Cofinity Commercial |
$2,622.28
|
| Rate for Payer: Cofinity Commercial |
$2,134.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,134.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,439.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,744.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,134.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,286.87
|
| 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 |
$2,591.79
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$2,591.79
|
| 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 |
$1,981.95
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,920.97
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,943.00
|
| 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 |
$1,128.19
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,286.87
|
|
|
HC MR PELVIS WO W CON
|
Facility
|
IP
|
$3,049.16
|
|
|
Service Code
|
CPT 72197
|
| Hospital Charge Code |
61000015
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,341.63 |
| Max. Negotiated Rate |
$2,744.24 |
| Rate for Payer: Aetna American Axle |
$1,981.95
|
| Rate for Payer: Aetna Commercial |
$2,591.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,981.95
|
| Rate for Payer: Cash Price |
$2,439.33
|
| Rate for Payer: Cofinity Commercial |
$2,134.41
|
| Rate for Payer: Cofinity Commercial |
$2,622.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,134.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,439.33
|
| Rate for Payer: Healthscope Commercial |
$2,744.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,134.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,286.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,591.79
|
| Rate for Payer: PHP Commercial |
$2,591.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,981.95
|
| Rate for Payer: Priority Health SBD |
$1,920.97
|
| Rate for Payer: UMR Bronson Commercial |
$1,341.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,286.87
|
|
|
HC MR SPECTROSCOPY
|
Facility
|
OP
|
$1,900.16
|
|
|
Service Code
|
CPT 76390
|
| Hospital Charge Code |
61000049
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$1,235.10
|
| Rate for Payer: Aetna Commercial |
$1,615.14
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,235.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$1,520.13
|
| Rate for Payer: Cash Price |
$1,520.13
|
| Rate for Payer: Cofinity Commercial |
$1,634.14
|
| Rate for Payer: Cofinity Commercial |
$1,330.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,330.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,520.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$1,710.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,330.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,425.12
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,615.14
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$1,615.14
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,235.10
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$1,197.10
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$164.11
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: UMR Bronson Commercial |
$703.06
|
| Rate for Payer: VA VA |
$85.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,425.12
|
|
|
HC MR SPECTROSCOPY
|
Facility
|
IP
|
$1,900.16
|
|
|
Service Code
|
CPT 76390
|
| Hospital Charge Code |
61000049
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$836.07 |
| Max. Negotiated Rate |
$1,710.14 |
| Rate for Payer: Aetna American Axle |
$1,235.10
|
| Rate for Payer: Aetna Commercial |
$1,615.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,235.10
|
| Rate for Payer: Cash Price |
$1,520.13
|
| Rate for Payer: Cofinity Commercial |
$1,330.11
|
| Rate for Payer: Cofinity Commercial |
$1,634.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,330.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,520.13
|
| Rate for Payer: Healthscope Commercial |
$1,710.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,330.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,425.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,615.14
|
| Rate for Payer: PHP Commercial |
$1,615.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,235.10
|
| Rate for Payer: Priority Health SBD |
$1,197.10
|
| Rate for Payer: UMR Bronson Commercial |
$836.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,425.12
|
|
|
HC MR SPINE CERVICAL W CON
|
Facility
|
OP
|
$2,322.34
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200004
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,090.11 |
| Rate for Payer: Aetna American Axle |
$1,509.52
|
| Rate for Payer: Aetna Commercial |
$1,973.99
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,509.52
|
| 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 |
$1,857.87
|
| Rate for Payer: Cash Price |
$1,857.87
|
| Rate for Payer: Cofinity Commercial |
$1,997.21
|
| Rate for Payer: Cofinity Commercial |
$1,625.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,625.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,857.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,090.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,625.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,741.76
|
| 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 |
$1,973.99
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$1,973.99
|
| 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 |
$1,509.52
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,463.07
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,943.00
|
| 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 |
$859.27
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,741.76
|
|
|
HC MR SPINE CERVICAL W CON
|
Facility
|
IP
|
$2,322.34
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200004
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$1,021.83 |
| Max. Negotiated Rate |
$2,090.11 |
| Rate for Payer: Aetna American Axle |
$1,509.52
|
| Rate for Payer: Aetna Commercial |
$1,973.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,509.52
|
| Rate for Payer: Cash Price |
$1,857.87
|
| Rate for Payer: Cofinity Commercial |
$1,625.64
|
| Rate for Payer: Cofinity Commercial |
$1,997.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,625.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,857.87
|
| Rate for Payer: Healthscope Commercial |
$2,090.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,625.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,741.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,973.99
|
| Rate for Payer: PHP Commercial |
$1,973.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,509.52
|
| Rate for Payer: Priority Health SBD |
$1,463.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,021.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,741.76
|
|
|
HC MR SPINE CERVICAL W CON LTD
|
Facility
|
IP
|
$1,160.76
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200003
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$510.73 |
| Max. Negotiated Rate |
$1,044.68 |
| Rate for Payer: Aetna American Axle |
$754.49
|
| Rate for Payer: Aetna Commercial |
$986.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$754.49
|
| Rate for Payer: Cash Price |
$928.61
|
| Rate for Payer: Cofinity Commercial |
$812.53
|
| Rate for Payer: Cofinity Commercial |
$998.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$812.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.61
|
| Rate for Payer: Healthscope Commercial |
$1,044.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$812.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$870.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$986.65
|
| Rate for Payer: PHP Commercial |
$986.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$754.49
|
| Rate for Payer: Priority Health SBD |
$731.28
|
| Rate for Payer: UMR Bronson Commercial |
$510.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$870.57
|
|
|
HC MR SPINE CERVICAL W CON LTD
|
Facility
|
OP
|
$1,160.76
|
|
|
Service Code
|
CPT 72142
|
| Hospital Charge Code |
61200003
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$754.49
|
| Rate for Payer: Aetna Commercial |
$986.65
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$754.49
|
| 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 |
$928.61
|
| Rate for Payer: Cash Price |
$928.61
|
| Rate for Payer: Cofinity Commercial |
$998.25
|
| Rate for Payer: Cofinity Commercial |
$812.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$812.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$1,044.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$812.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$870.57
|
| 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 |
$986.65
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$986.65
|
| 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 |
$754.49
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$731.28
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,943.00
|
| 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 |
$429.48
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$870.57
|
|
|
HC MR SPINE CERVICAL WO CON
|
Facility
|
OP
|
$2,288.04
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200002
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$126.36 |
| 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 |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,487.23
|
| 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 |
$1,830.43
|
| Rate for Payer: Cash Price |
$1,830.43
|
| Rate for Payer: Cofinity Commercial |
$1,967.71
|
| Rate for Payer: Cofinity Commercial |
$1,601.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,601.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,830.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| 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 |
$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 |
$1,944.83
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,944.83
|
| 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 |
$1,487.23
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,441.47
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$1,943.00
|
| 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 |
$846.57
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,716.03
|
|
|
HC MR SPINE CERVICAL WO CON
|
Facility
|
IP
|
$2,288.04
|
|
|
Service Code
|
CPT 72141
|
| Hospital Charge Code |
61200002
|
|
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 Commercial |
$1,601.63
|
| Rate for Payer: Cofinity Commercial |
$1,967.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,601.63
|
| 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: PHP Commercial |
$1,944.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,487.23
|
| 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
|
|
