|
HC SPEECH FLUENCY EVAL
|
Facility
|
OP
|
$295.57
|
|
|
Service Code
|
CPT 92521
|
| Hospital Charge Code |
44400012
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$86.82 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$192.12
|
| Rate for Payer: Aetna Commercial |
$251.23
|
| Rate for Payer: Aetna Medicare |
$147.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.12
|
| Rate for Payer: BCBS Complete |
$118.23
|
| Rate for Payer: BCBS Trust/PPO |
$160.96
|
| Rate for Payer: BCN Commercial |
$160.96
|
| Rate for Payer: Cash Price |
$236.46
|
| Rate for Payer: Cash Price |
$236.46
|
| Rate for Payer: Cash Price |
$236.46
|
| Rate for Payer: Cofinity Commercial |
$206.90
|
| Rate for Payer: Cofinity Commercial |
$254.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$206.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.46
|
| Rate for Payer: Healthscope Commercial |
$266.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$206.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$221.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.23
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$251.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.53
|
| Rate for Payer: Priority Health Narrow Network |
$86.82
|
| Rate for Payer: Priority Health SBD |
$186.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.67
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$126.06
|
| Rate for Payer: UMR Bronson Commercial |
$109.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$221.68
|
|
|
HC SPEECH FLUENCY EVAL
|
Facility
|
IP
|
$295.57
|
|
|
Service Code
|
CPT 92521
|
| Hospital Charge Code |
44400012
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$130.05 |
| Max. Negotiated Rate |
$266.01 |
| Rate for Payer: Aetna American Axle |
$192.12
|
| Rate for Payer: Aetna Commercial |
$251.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.12
|
| Rate for Payer: Cash Price |
$236.46
|
| Rate for Payer: Cofinity Commercial |
$206.90
|
| Rate for Payer: Cofinity Commercial |
$254.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$206.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.46
|
| Rate for Payer: Healthscope Commercial |
$266.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$206.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$221.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.23
|
| Rate for Payer: PHP Commercial |
$251.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.12
|
| Rate for Payer: Priority Health SBD |
$186.21
|
| Rate for Payer: UMR Bronson Commercial |
$130.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$221.68
|
|
|
HC SPEECH/LANGUAGE/HEARING THERAPY
|
Facility
|
IP
|
$216.40
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
44000001
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$95.22 |
| Max. Negotiated Rate |
$194.76 |
| Rate for Payer: Aetna American Axle |
$140.66
|
| Rate for Payer: Aetna Commercial |
$183.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.66
|
| Rate for Payer: Cash Price |
$173.12
|
| Rate for Payer: Cofinity Commercial |
$151.48
|
| Rate for Payer: Cofinity Commercial |
$186.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$151.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.12
|
| Rate for Payer: Healthscope Commercial |
$194.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$151.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.94
|
| Rate for Payer: PHP Commercial |
$183.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.66
|
| Rate for Payer: Priority Health SBD |
$136.33
|
| Rate for Payer: UMR Bronson Commercial |
$95.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.30
|
|
|
HC SPEECH/LANGUAGE/HEARING THERAPY
|
Facility
|
OP
|
$216.40
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
44000001
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$66.40 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$140.66
|
| Rate for Payer: Aetna Commercial |
$183.94
|
| Rate for Payer: Aetna Medicare |
$108.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.66
|
| Rate for Payer: BCBS Complete |
$86.56
|
| Rate for Payer: BCBS Trust/PPO |
$92.38
|
| Rate for Payer: BCN Commercial |
$92.38
|
| Rate for Payer: Cash Price |
$173.12
|
| Rate for Payer: Cash Price |
$173.12
|
| Rate for Payer: Cash Price |
$173.12
|
| Rate for Payer: Cofinity Commercial |
$151.48
|
| Rate for Payer: Cofinity Commercial |
$186.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$151.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.12
|
| Rate for Payer: Healthscope Commercial |
$194.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$151.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.94
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$183.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.00
|
| Rate for Payer: Priority Health Narrow Network |
$66.40
|
| Rate for Payer: Priority Health SBD |
$136.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.60
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$72.36
|
| Rate for Payer: UMR Bronson Commercial |
$80.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.30
|
|
|
HC SPEECH SOUND PRODUCTION EVAL
|
Facility
|
IP
|
$259.56
|
|
|
Service Code
|
CPT 92522
|
| Hospital Charge Code |
44400010
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$114.21 |
| Max. Negotiated Rate |
$233.60 |
| Rate for Payer: Aetna American Axle |
$168.71
|
| Rate for Payer: Aetna Commercial |
$220.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.71
|
| Rate for Payer: Cash Price |
$207.65
|
| Rate for Payer: Cofinity Commercial |
$181.69
|
| Rate for Payer: Cofinity Commercial |
$223.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$181.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.65
|
| Rate for Payer: Healthscope Commercial |
$233.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$181.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.63
|
| Rate for Payer: PHP Commercial |
$220.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.71
|
| Rate for Payer: Priority Health SBD |
$163.52
|
| Rate for Payer: UMR Bronson Commercial |
$114.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.67
|
|
|
HC SPEECH SOUND PRODUCTION EVAL
|
Facility
|
OP
|
$259.56
|
|
|
Service Code
|
CPT 92522
|
| Hospital Charge Code |
44400010
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$168.71
|
| Rate for Payer: Aetna Commercial |
$220.63
|
| Rate for Payer: Aetna Medicare |
$129.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.71
|
| Rate for Payer: BCBS Complete |
$103.82
|
| Rate for Payer: BCBS Trust/PPO |
$134.73
|
| Rate for Payer: BCN Commercial |
$134.73
|
| Rate for Payer: Cash Price |
$207.65
|
| Rate for Payer: Cash Price |
$207.65
|
| Rate for Payer: Cash Price |
$207.65
|
| Rate for Payer: Cofinity Commercial |
$181.69
|
| Rate for Payer: Cofinity Commercial |
$223.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$181.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.65
|
| Rate for Payer: Healthscope Commercial |
$233.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$181.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.63
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$220.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.12
|
| Rate for Payer: Priority Health Narrow Network |
$70.50
|
| Rate for Payer: Priority Health SBD |
$163.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.41
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$105.83
|
| Rate for Payer: UMR Bronson Commercial |
$96.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.67
|
|
|
HC SPEECH THRESHOLD AUDIOMETRY
|
Facility
|
OP
|
$50.12
|
|
|
Service Code
|
CPT 92555
|
| Hospital Charge Code |
47100011
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$18.54 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$32.58
|
| Rate for Payer: Aetna Commercial |
$42.60
|
| Rate for Payer: Aetna Medicare |
$60.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.75
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$121.21
|
| Rate for Payer: BCN Commercial |
$121.21
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$40.10
|
| Rate for Payer: Cash Price |
$40.10
|
| Rate for Payer: Cash Price |
$40.10
|
| Rate for Payer: Cofinity Commercial |
$35.08
|
| Rate for Payer: Cofinity Commercial |
$43.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$45.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.59
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$58.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.11
|
| Rate for Payer: Meridian Medicaid |
$32.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.60
|
| Rate for Payer: Nomi Health Commercial |
$174.60
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Commercial |
$42.60
|
| Rate for Payer: PHP Medicare Advantage |
$58.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.90
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$146.32
|
| Rate for Payer: Priority Health SBD |
$31.58
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.64
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Exchange |
$26.04
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$31.20
|
| Rate for Payer: UMR Bronson Commercial |
$18.54
|
| Rate for Payer: VA VA |
$58.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.59
|
|
|
HC SPEECH THRESHOLD AUDIOMETRY
|
Facility
|
IP
|
$50.12
|
|
|
Service Code
|
CPT 92555
|
| Hospital Charge Code |
47100011
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$22.05 |
| Max. Negotiated Rate |
$45.11 |
| Rate for Payer: Aetna American Axle |
$32.58
|
| Rate for Payer: Aetna Commercial |
$42.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.58
|
| Rate for Payer: Cash Price |
$40.10
|
| Rate for Payer: Cofinity Commercial |
$35.08
|
| Rate for Payer: Cofinity Commercial |
$43.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.10
|
| Rate for Payer: Healthscope Commercial |
$45.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.60
|
| Rate for Payer: PHP Commercial |
$42.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.58
|
| Rate for Payer: Priority Health SBD |
$31.58
|
| Rate for Payer: UMR Bronson Commercial |
$22.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.59
|
|
|
HC SPEECH VIDEO FLUORO EVAL
|
Facility
|
IP
|
$397.01
|
|
|
Service Code
|
CPT 92611
|
| Hospital Charge Code |
44000004
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$174.68 |
| Max. Negotiated Rate |
$357.31 |
| Rate for Payer: Aetna American Axle |
$258.06
|
| Rate for Payer: Aetna Commercial |
$337.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$258.06
|
| Rate for Payer: Cash Price |
$317.61
|
| Rate for Payer: Cofinity Commercial |
$277.91
|
| Rate for Payer: Cofinity Commercial |
$341.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$277.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.61
|
| Rate for Payer: Healthscope Commercial |
$357.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$277.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.46
|
| Rate for Payer: PHP Commercial |
$337.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.06
|
| Rate for Payer: Priority Health SBD |
$250.12
|
| Rate for Payer: UMR Bronson Commercial |
$174.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.76
|
|
|
HC SPEECH VIDEO FLUORO EVAL
|
Facility
|
OP
|
$397.01
|
|
|
Service Code
|
CPT 92611
|
| Hospital Charge Code |
44000004
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$86.84 |
| Max. Negotiated Rate |
$357.31 |
| Rate for Payer: Aetna American Axle |
$258.06
|
| Rate for Payer: Aetna Commercial |
$337.46
|
| Rate for Payer: Aetna Medicare |
$198.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$258.06
|
| Rate for Payer: BCBS Complete |
$158.80
|
| Rate for Payer: BCBS Trust/PPO |
$188.84
|
| Rate for Payer: BCN Commercial |
$188.84
|
| Rate for Payer: Cash Price |
$317.61
|
| Rate for Payer: Cash Price |
$317.61
|
| Rate for Payer: Cash Price |
$317.61
|
| Rate for Payer: Cofinity Commercial |
$277.91
|
| Rate for Payer: Cofinity Commercial |
$341.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$277.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.61
|
| Rate for Payer: Healthscope Commercial |
$357.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$277.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.46
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$337.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$115.00
|
| Rate for Payer: Priority Health Narrow Network |
$92.00
|
| Rate for Payer: Priority Health SBD |
$250.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.52
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$86.84
|
| Rate for Payer: UMR Bronson Commercial |
$146.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.76
|
|
|
HC SPEECH VOICE EVALUATION
|
Facility
|
IP
|
$288.45
|
|
|
Service Code
|
CPT 92524
|
| Hospital Charge Code |
44400011
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$126.92 |
| Max. Negotiated Rate |
$259.60 |
| Rate for Payer: Aetna American Axle |
$187.49
|
| Rate for Payer: Aetna Commercial |
$245.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.49
|
| Rate for Payer: Cash Price |
$230.76
|
| Rate for Payer: Cofinity Commercial |
$201.92
|
| Rate for Payer: Cofinity Commercial |
$248.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$201.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$230.76
|
| Rate for Payer: Healthscope Commercial |
$259.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$201.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$216.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$245.18
|
| Rate for Payer: PHP Commercial |
$245.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.49
|
| Rate for Payer: Priority Health SBD |
$181.72
|
| Rate for Payer: UMR Bronson Commercial |
$126.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$216.34
|
|
|
HC SPEECH VOICE EVALUATION
|
Facility
|
OP
|
$288.45
|
|
|
Service Code
|
CPT 92524
|
| Hospital Charge Code |
44400011
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$73.49 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$187.49
|
| Rate for Payer: Aetna Commercial |
$245.18
|
| Rate for Payer: Aetna Medicare |
$144.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.49
|
| Rate for Payer: BCBS Complete |
$115.38
|
| Rate for Payer: BCBS Trust/PPO |
$132.72
|
| Rate for Payer: BCN Commercial |
$132.72
|
| Rate for Payer: Cash Price |
$230.76
|
| Rate for Payer: Cash Price |
$230.76
|
| Rate for Payer: Cash Price |
$230.76
|
| Rate for Payer: Cofinity Commercial |
$201.92
|
| Rate for Payer: Cofinity Commercial |
$248.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$201.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$230.76
|
| Rate for Payer: Healthscope Commercial |
$259.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$201.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$216.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$245.18
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$245.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.86
|
| Rate for Payer: Priority Health Narrow Network |
$73.49
|
| Rate for Payer: Priority Health SBD |
$181.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.77
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$104.34
|
| Rate for Payer: UMR Bronson Commercial |
$106.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$216.34
|
|
|
HC SPIKE BLOOD ACCESS
|
Facility
|
IP
|
$16.07
|
|
| Hospital Charge Code |
27000669
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$14.46 |
| Rate for Payer: Aetna American Axle |
$10.45
|
| Rate for Payer: Aetna Commercial |
$13.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.45
|
| Rate for Payer: Cash Price |
$12.86
|
| Rate for Payer: Cofinity Commercial |
$11.25
|
| Rate for Payer: Cofinity Commercial |
$13.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.86
|
| Rate for Payer: Healthscope Commercial |
$14.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.66
|
| Rate for Payer: PHP Commercial |
$13.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.45
|
| Rate for Payer: Priority Health SBD |
$10.12
|
| Rate for Payer: UMR Bronson Commercial |
$7.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.05
|
|
|
HC SPIKE BLOOD ACCESS
|
Facility
|
OP
|
$16.07
|
|
| Hospital Charge Code |
27000669
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.95 |
| Max. Negotiated Rate |
$14.46 |
| Rate for Payer: Aetna American Axle |
$10.45
|
| Rate for Payer: Aetna Commercial |
$13.66
|
| Rate for Payer: Aetna Medicare |
$8.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.45
|
| Rate for Payer: BCBS Complete |
$6.43
|
| Rate for Payer: Cash Price |
$12.86
|
| Rate for Payer: Cofinity Commercial |
$11.25
|
| Rate for Payer: Cofinity Commercial |
$13.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.86
|
| Rate for Payer: Healthscope Commercial |
$14.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.66
|
| Rate for Payer: PHP Commercial |
$13.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.45
|
| Rate for Payer: Priority Health SBD |
$10.12
|
| Rate for Payer: UMR Bronson Commercial |
$5.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.05
|
|
|
HC SPINAL/EPI ADDL 15 MIN
|
Facility
|
OP
|
$159.71
|
|
| Hospital Charge Code |
37000013
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$59.09 |
| Max. Negotiated Rate |
$143.74 |
| Rate for Payer: Aetna American Axle |
$103.81
|
| Rate for Payer: Aetna Commercial |
$135.75
|
| Rate for Payer: Aetna Medicare |
$79.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.81
|
| Rate for Payer: BCBS Complete |
$63.88
|
| Rate for Payer: Cash Price |
$127.77
|
| Rate for Payer: Cofinity Commercial |
$111.80
|
| Rate for Payer: Cofinity Commercial |
$137.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$111.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.77
|
| Rate for Payer: Healthscope Commercial |
$143.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$111.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.75
|
| Rate for Payer: PHP Commercial |
$135.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.81
|
| Rate for Payer: Priority Health SBD |
$100.62
|
| Rate for Payer: UMR Bronson Commercial |
$59.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.78
|
|
|
HC SPINAL/EPI ADDL 15 MIN
|
Facility
|
IP
|
$159.71
|
|
| Hospital Charge Code |
37000013
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$70.27 |
| Max. Negotiated Rate |
$143.74 |
| Rate for Payer: Aetna American Axle |
$103.81
|
| Rate for Payer: Aetna Commercial |
$135.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.81
|
| Rate for Payer: Cash Price |
$127.77
|
| Rate for Payer: Cofinity Commercial |
$111.80
|
| Rate for Payer: Cofinity Commercial |
$137.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$111.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.77
|
| Rate for Payer: Healthscope Commercial |
$143.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$111.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.75
|
| Rate for Payer: PHP Commercial |
$135.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.81
|
| Rate for Payer: Priority Health SBD |
$100.62
|
| Rate for Payer: UMR Bronson Commercial |
$70.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.78
|
|
|
HC SPINAL/EPI INIT 30 MIN
|
Facility
|
IP
|
$436.73
|
|
| Hospital Charge Code |
37000014
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$192.16 |
| Max. Negotiated Rate |
$393.06 |
| Rate for Payer: Aetna American Axle |
$283.87
|
| Rate for Payer: Aetna Commercial |
$371.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.87
|
| Rate for Payer: Cash Price |
$349.38
|
| Rate for Payer: Cofinity Commercial |
$305.71
|
| Rate for Payer: Cofinity Commercial |
$375.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$305.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.38
|
| Rate for Payer: Healthscope Commercial |
$393.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$305.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$327.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.22
|
| Rate for Payer: PHP Commercial |
$371.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$283.87
|
| Rate for Payer: Priority Health SBD |
$275.14
|
| Rate for Payer: UMR Bronson Commercial |
$192.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$327.55
|
|
|
HC SPINAL/EPI INIT 30 MIN
|
Facility
|
OP
|
$436.73
|
|
| Hospital Charge Code |
37000014
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$161.59 |
| Max. Negotiated Rate |
$393.06 |
| Rate for Payer: Aetna American Axle |
$283.87
|
| Rate for Payer: Aetna Commercial |
$371.22
|
| Rate for Payer: Aetna Medicare |
$218.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.87
|
| Rate for Payer: BCBS Complete |
$174.69
|
| Rate for Payer: Cash Price |
$349.38
|
| Rate for Payer: Cofinity Commercial |
$305.71
|
| Rate for Payer: Cofinity Commercial |
$375.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$305.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.38
|
| Rate for Payer: Healthscope Commercial |
$393.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$305.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$327.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.22
|
| Rate for Payer: PHP Commercial |
$371.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$283.87
|
| Rate for Payer: Priority Health SBD |
$275.14
|
| Rate for Payer: UMR Bronson Commercial |
$161.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$327.55
|
|
|
HC SPINE JACK
|
Facility
|
IP
|
$14,119.00
|
|
|
Service Code
|
CPT C1062
|
| Hospital Charge Code |
27800148
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,212.36 |
| Max. Negotiated Rate |
$12,707.10 |
| Rate for Payer: Aetna American Axle |
$9,177.35
|
| Rate for Payer: Aetna Commercial |
$12,001.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,177.35
|
| Rate for Payer: Cash Price |
$11,295.20
|
| Rate for Payer: Cofinity Commercial |
$12,142.34
|
| Rate for Payer: Cofinity Commercial |
$9,883.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,883.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,295.20
|
| Rate for Payer: Healthscope Commercial |
$12,707.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,883.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,589.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,001.15
|
| Rate for Payer: PHP Commercial |
$12,001.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,177.35
|
| Rate for Payer: Priority Health SBD |
$8,894.97
|
| Rate for Payer: UMR Bronson Commercial |
$6,212.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,589.25
|
|
|
HC SPINE JACK
|
Facility
|
OP
|
$14,119.00
|
|
|
Service Code
|
CPT C1062
|
| Hospital Charge Code |
27800148
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,969.89 |
| Max. Negotiated Rate |
$12,707.10 |
| Rate for Payer: Aetna American Axle |
$9,177.35
|
| Rate for Payer: Aetna Commercial |
$12,001.15
|
| Rate for Payer: Aetna Medicare |
$7,059.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,177.35
|
| Rate for Payer: BCBS Complete |
$5,647.60
|
| Rate for Payer: Cash Price |
$11,295.20
|
| Rate for Payer: Cofinity Commercial |
$12,142.34
|
| Rate for Payer: Cofinity Commercial |
$9,883.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,883.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,295.20
|
| Rate for Payer: Healthscope Commercial |
$12,707.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,883.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,589.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,001.15
|
| Rate for Payer: PHP Commercial |
$12,001.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,177.35
|
| Rate for Payer: Priority Health SBD |
$8,894.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,969.89
|
| Rate for Payer: UHC Exchange |
$5,788.79
|
| Rate for Payer: UMR Bronson Commercial |
$5,224.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,589.25
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 1 VIEW
|
Facility
|
OP
|
$150.54
|
|
|
Service Code
|
CPT 72081
|
| Hospital Charge Code |
32000317
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$39.11 |
| Max. Negotiated Rate |
$271.13 |
| Rate for Payer: Aetna American Axle |
$97.85
|
| Rate for Payer: Aetna Commercial |
$127.96
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$62.26
|
| Rate for Payer: BCN Commercial |
$62.26
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$120.43
|
| Rate for Payer: Cash Price |
$120.43
|
| Rate for Payer: Cofinity Commercial |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$105.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$105.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$135.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.90
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.96
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$127.96
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$94.84
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.02
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$39.11
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$55.70
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.90
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 1 VIEW
|
Facility
|
IP
|
$150.54
|
|
|
Service Code
|
CPT 72081
|
| Hospital Charge Code |
32000317
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$66.24 |
| Max. Negotiated Rate |
$135.49 |
| Rate for Payer: Aetna American Axle |
$97.85
|
| Rate for Payer: Aetna Commercial |
$127.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.85
|
| Rate for Payer: Cash Price |
$120.43
|
| Rate for Payer: Cofinity Commercial |
$105.38
|
| Rate for Payer: Cofinity Commercial |
$129.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$105.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.43
|
| Rate for Payer: Healthscope Commercial |
$135.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.96
|
| Rate for Payer: PHP Commercial |
$127.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.85
|
| Rate for Payer: Priority Health SBD |
$94.84
|
| Rate for Payer: UMR Bronson Commercial |
$66.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.90
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 2 OR 3 VIEW
|
Facility
|
OP
|
$361.32
|
|
|
Service Code
|
CPT 72082
|
| Hospital Charge Code |
32000306
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$327.48 |
| Rate for Payer: Aetna American Axle |
$234.86
|
| Rate for Payer: Aetna Commercial |
$307.12
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$113.57
|
| Rate for Payer: BCN Commercial |
$113.57
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$289.06
|
| Rate for Payer: Cash Price |
$289.06
|
| Rate for Payer: Cofinity Commercial |
$310.74
|
| Rate for Payer: Cofinity Commercial |
$252.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$252.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$325.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$252.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$270.99
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$307.12
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$307.12
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$227.63
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.51
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$64.10
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$133.69
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$270.99
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 2 OR 3 VIEW
|
Facility
|
IP
|
$361.32
|
|
|
Service Code
|
CPT 72082
|
| Hospital Charge Code |
32000306
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$158.98 |
| Max. Negotiated Rate |
$325.19 |
| Rate for Payer: Aetna American Axle |
$234.86
|
| Rate for Payer: Aetna Commercial |
$307.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.86
|
| Rate for Payer: Cash Price |
$289.06
|
| Rate for Payer: Cofinity Commercial |
$252.92
|
| Rate for Payer: Cofinity Commercial |
$310.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$252.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.06
|
| Rate for Payer: Healthscope Commercial |
$325.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$252.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$270.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$307.12
|
| Rate for Payer: PHP Commercial |
$307.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.86
|
| Rate for Payer: Priority Health SBD |
$227.63
|
| Rate for Payer: UMR Bronson Commercial |
$158.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$270.99
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 4 OR 5 VIEW
|
Facility
|
OP
|
$481.76
|
|
|
Service Code
|
CPT 72083
|
| Hospital Charge Code |
32000307
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$433.58 |
| Rate for Payer: Aetna American Axle |
$313.14
|
| Rate for Payer: Aetna Commercial |
$409.50
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$313.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$127.95
|
| Rate for Payer: BCN Commercial |
$127.95
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cofinity Commercial |
$414.31
|
| Rate for Payer: Cofinity Commercial |
$337.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$337.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$433.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$337.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.32
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.50
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$409.50
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$303.51
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.41
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$72.19
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$178.25
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.32
|
|
