|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 4 OR 5 VIEW
|
Facility
|
IP
|
$481.76
|
|
|
Service Code
|
CPT 72083
|
| Hospital Charge Code |
32000307
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$211.97 |
| Max. Negotiated Rate |
$433.58 |
| Rate for Payer: Aetna American Axle |
$313.14
|
| Rate for Payer: Aetna Commercial |
$409.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$313.14
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cofinity Commercial |
$337.23
|
| Rate for Payer: Cofinity Commercial |
$414.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$337.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.41
|
| 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: Multiplan/Beech St/PHCS Commercial |
$409.50
|
| Rate for Payer: PHP Commercial |
$409.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.14
|
| Rate for Payer: Priority Health SBD |
$303.51
|
| Rate for Payer: UMR Bronson Commercial |
$211.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.32
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL MIN 6 VIEW
|
Facility
|
IP
|
$602.20
|
|
|
Service Code
|
CPT 72084
|
| Hospital Charge Code |
32000308
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$264.97 |
| Max. Negotiated Rate |
$541.98 |
| Rate for Payer: Aetna American Axle |
$391.43
|
| Rate for Payer: Aetna Commercial |
$511.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$391.43
|
| Rate for Payer: Cash Price |
$481.76
|
| Rate for Payer: Cofinity Commercial |
$421.54
|
| Rate for Payer: Cofinity Commercial |
$517.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$421.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$481.76
|
| Rate for Payer: Healthscope Commercial |
$541.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$421.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$451.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$511.87
|
| Rate for Payer: PHP Commercial |
$511.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$391.43
|
| Rate for Payer: Priority Health SBD |
$379.39
|
| Rate for Payer: UMR Bronson Commercial |
$264.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$451.65
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL MIN 6 VIEW
|
Facility
|
OP
|
$602.20
|
|
|
Service Code
|
CPT 72084
|
| Hospital Charge Code |
32000308
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$541.98 |
| Rate for Payer: Aetna American Axle |
$391.43
|
| Rate for Payer: Aetna Commercial |
$511.87
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$391.43
|
| 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 |
$162.16
|
| Rate for Payer: BCN Commercial |
$162.16
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$481.76
|
| Rate for Payer: Cash Price |
$481.76
|
| Rate for Payer: Cofinity Commercial |
$517.89
|
| Rate for Payer: Cofinity Commercial |
$421.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$421.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$481.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$541.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$421.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$451.65
|
| 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 |
$511.87
|
| 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 |
$511.87
|
| 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 |
$391.43
|
| 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 |
$379.39
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.81
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$89.83
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$222.81
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$451.65
|
|
|
HC SPINE THORACIC W CON
|
Facility
|
IP
|
$2,243.18
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200008
|
|
Hospital Revenue Code
|
612
|
| 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 SPINE THORACIC W CON
|
Facility
|
OP
|
$2,243.18
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200008
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$187.55 |
| 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 |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,458.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$405.03
|
| Rate for Payer: BCN Commercial |
$405.03
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| 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 |
$349.91
|
| 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 |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,906.70
|
| Rate for Payer: Nomi Health Commercial |
$1,049.73
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$1,906.70
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,458.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,099.76
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$879.81
|
| Rate for Payer: Priority Health SBD |
$1,413.20
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$283.13
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$257.39
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: UMR Bronson Commercial |
$829.98
|
| Rate for Payer: VA VA |
$349.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,682.38
|
|
|
HC SP INJECTION TENDON SHEATH
|
Facility
|
IP
|
$320.34
|
|
|
Service Code
|
CPT 20550
|
| Hospital Charge Code |
36100320
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$140.95 |
| Max. Negotiated Rate |
$288.31 |
| Rate for Payer: Aetna American Axle |
$208.22
|
| Rate for Payer: Aetna Commercial |
$272.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.22
|
| Rate for Payer: Cash Price |
$256.27
|
| Rate for Payer: Cofinity Commercial |
$224.24
|
| Rate for Payer: Cofinity Commercial |
$275.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$224.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.27
|
| Rate for Payer: Healthscope Commercial |
$288.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$224.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.29
|
| Rate for Payer: PHP Commercial |
$272.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.22
|
| Rate for Payer: Priority Health SBD |
$201.81
|
| Rate for Payer: UMR Bronson Commercial |
$140.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.26
|
|
|
HC SP INJECTION TENDON SHEATH
|
Facility
|
OP
|
$320.34
|
|
|
Service Code
|
CPT 20550
|
| Hospital Charge Code |
36100320
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$37.65 |
| Max. Negotiated Rate |
$909.03 |
| Rate for Payer: Aetna American Axle |
$208.22
|
| Rate for Payer: Aetna Commercial |
$272.29
|
| Rate for Payer: Aetna Medicare |
$300.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$361.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$361.52
|
| Rate for Payer: BCBS Complete |
$162.77
|
| Rate for Payer: BCBS MAPPO |
$289.22
|
| Rate for Payer: BCBS Trust/PPO |
$304.95
|
| Rate for Payer: BCN Commercial |
$304.95
|
| Rate for Payer: BCN Medicare Advantage |
$289.22
|
| Rate for Payer: Cash Price |
$256.27
|
| Rate for Payer: Cash Price |
$256.27
|
| Rate for Payer: Cash Price |
$256.27
|
| Rate for Payer: Cofinity Commercial |
$275.49
|
| Rate for Payer: Cofinity Commercial |
$224.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$224.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.22
|
| Rate for Payer: Healthscope Commercial |
$288.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$224.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.26
|
| Rate for Payer: Mclaren Medicaid |
$155.02
|
| Rate for Payer: Mclaren Medicare |
$289.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.68
|
| Rate for Payer: Meridian Medicaid |
$162.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.29
|
| Rate for Payer: Nomi Health Commercial |
$607.36
|
| Rate for Payer: PACE Medicare |
$274.76
|
| Rate for Payer: PACE SWMI |
$289.22
|
| Rate for Payer: PHP Commercial |
$272.29
|
| Rate for Payer: PHP Medicare Advantage |
$289.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$909.03
|
| Rate for Payer: Priority Health Medicare |
$289.22
|
| Rate for Payer: Priority Health Narrow Network |
$727.22
|
| Rate for Payer: Priority Health SBD |
$201.81
|
| Rate for Payer: Railroad Medicare Medicare |
$289.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.42
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$289.22
|
| Rate for Payer: UHC Exchange |
$37.65
|
| Rate for Payer: UHC Medicare Advantage |
$289.22
|
| Rate for Payer: UHCCP Medicaid |
$155.02
|
| Rate for Payer: UMR Bronson Commercial |
$118.53
|
| Rate for Payer: VA VA |
$289.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.26
|
|
|
HC SP INSERTION IVC FILTER
|
Facility
|
OP
|
$7,290.10
|
|
|
Service Code
|
CPT 37191
|
| Hospital Charge Code |
36100351
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$209.91 |
| Max. Negotiated Rate |
$16,646.50 |
| Rate for Payer: Aetna American Axle |
$4,738.56
|
| Rate for Payer: Aetna Commercial |
$6,196.58
|
| Rate for Payer: Aetna Medicare |
$5,508.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,738.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,620.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,620.50
|
| Rate for Payer: BCBS Complete |
$2,980.81
|
| Rate for Payer: BCBS MAPPO |
$5,296.40
|
| Rate for Payer: BCBS Trust/PPO |
$4,117.62
|
| Rate for Payer: BCN Commercial |
$4,117.62
|
| Rate for Payer: BCN Medicare Advantage |
$5,296.40
|
| Rate for Payer: Cash Price |
$5,832.08
|
| Rate for Payer: Cash Price |
$5,832.08
|
| Rate for Payer: Cash Price |
$5,832.08
|
| Rate for Payer: Cofinity Commercial |
$6,269.49
|
| Rate for Payer: Cofinity Commercial |
$5,103.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,103.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,832.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,296.40
|
| Rate for Payer: Healthscope Commercial |
$6,561.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,103.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,467.58
|
| Rate for Payer: Mclaren Medicaid |
$2,838.87
|
| Rate for Payer: Mclaren Medicare |
$5,296.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,561.22
|
| Rate for Payer: Meridian Medicaid |
$2,980.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,090.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,196.58
|
| Rate for Payer: Nomi Health Commercial |
$11,122.44
|
| Rate for Payer: PACE Medicare |
$5,031.58
|
| Rate for Payer: PACE SWMI |
$5,296.40
|
| Rate for Payer: PHP Commercial |
$6,196.58
|
| Rate for Payer: PHP Medicare Advantage |
$5,296.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,838.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,738.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,646.50
|
| Rate for Payer: Priority Health Medicare |
$5,296.40
|
| Rate for Payer: Priority Health Narrow Network |
$13,317.20
|
| Rate for Payer: Priority Health SBD |
$4,592.76
|
| Rate for Payer: Railroad Medicare Medicare |
$5,296.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.90
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,296.40
|
| Rate for Payer: UHC Exchange |
$209.91
|
| Rate for Payer: UHC Medicare Advantage |
$5,296.40
|
| Rate for Payer: UHCCP Medicaid |
$2,838.87
|
| Rate for Payer: UMR Bronson Commercial |
$2,697.34
|
| Rate for Payer: VA VA |
$5,296.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,467.58
|
|
|
HC SP INSERTION IVC FILTER
|
Facility
|
IP
|
$7,290.10
|
|
|
Service Code
|
CPT 37191
|
| Hospital Charge Code |
36100351
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,207.64 |
| Max. Negotiated Rate |
$6,561.09 |
| Rate for Payer: Aetna American Axle |
$4,738.56
|
| Rate for Payer: Aetna Commercial |
$6,196.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,738.56
|
| Rate for Payer: Cash Price |
$5,832.08
|
| Rate for Payer: Cofinity Commercial |
$5,103.07
|
| Rate for Payer: Cofinity Commercial |
$6,269.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,103.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,832.08
|
| Rate for Payer: Healthscope Commercial |
$6,561.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,103.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,467.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,196.58
|
| Rate for Payer: PHP Commercial |
$6,196.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,738.56
|
| Rate for Payer: Priority Health SBD |
$4,592.76
|
| Rate for Payer: UMR Bronson Commercial |
$3,207.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,467.58
|
|
|
HC SPIROMETRY
|
Facility
|
OP
|
$321.09
|
|
|
Service Code
|
CPT 94010
|
| Hospital Charge Code |
46000014
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$25.13 |
| Max. Negotiated Rate |
$481.80 |
| Rate for Payer: Aetna American Axle |
$208.71
|
| Rate for Payer: Aetna Commercial |
$272.93
|
| Rate for Payer: Aetna Medicare |
$159.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$81.75
|
| Rate for Payer: BCN Commercial |
$81.75
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$256.87
|
| Rate for Payer: Cash Price |
$256.87
|
| Rate for Payer: Cash Price |
$256.87
|
| Rate for Payer: Cofinity Commercial |
$224.76
|
| Rate for Payer: Cofinity Commercial |
$276.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$224.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$288.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$224.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.82
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.93
|
| Rate for Payer: Nomi Health Commercial |
$459.90
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$272.93
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$481.80
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$385.44
|
| Rate for Payer: Priority Health SBD |
$202.29
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.64
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$25.13
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$82.17
|
| Rate for Payer: UMR Bronson Commercial |
$118.80
|
| Rate for Payer: VA VA |
$153.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.82
|
|
|
HC SPIROMETRY
|
Facility
|
IP
|
$321.09
|
|
|
Service Code
|
CPT 94010
|
| Hospital Charge Code |
46000014
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$141.28 |
| Max. Negotiated Rate |
$288.98 |
| Rate for Payer: Aetna American Axle |
$208.71
|
| Rate for Payer: Aetna Commercial |
$272.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.71
|
| Rate for Payer: Cash Price |
$256.87
|
| Rate for Payer: Cofinity Commercial |
$224.76
|
| Rate for Payer: Cofinity Commercial |
$276.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$224.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.87
|
| Rate for Payer: Healthscope Commercial |
$288.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$224.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.93
|
| Rate for Payer: PHP Commercial |
$272.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.71
|
| Rate for Payer: Priority Health SBD |
$202.29
|
| Rate for Payer: UMR Bronson Commercial |
$141.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.82
|
|
|
HC SPIROMETRY W/DRUG
|
Facility
|
IP
|
$566.31
|
|
|
Service Code
|
CPT 94060
|
| Hospital Charge Code |
46000002
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$249.18 |
| Max. Negotiated Rate |
$509.68 |
| Rate for Payer: Aetna American Axle |
$368.10
|
| Rate for Payer: Aetna Commercial |
$481.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$368.10
|
| Rate for Payer: Cash Price |
$453.05
|
| Rate for Payer: Cofinity Commercial |
$396.42
|
| Rate for Payer: Cofinity Commercial |
$487.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$396.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$453.05
|
| Rate for Payer: Healthscope Commercial |
$509.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$396.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$424.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$481.36
|
| Rate for Payer: PHP Commercial |
$481.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$368.10
|
| Rate for Payer: Priority Health SBD |
$356.78
|
| Rate for Payer: UMR Bronson Commercial |
$249.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$424.73
|
|
|
HC SPIROMETRY W/DRUG
|
Facility
|
OP
|
$566.31
|
|
|
Service Code
|
CPT 94060
|
| Hospital Charge Code |
46000002
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$35.71 |
| Max. Negotiated Rate |
$958.92 |
| Rate for Payer: Aetna American Axle |
$368.10
|
| Rate for Payer: Aetna Commercial |
$481.36
|
| Rate for Payer: Aetna Medicare |
$317.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$368.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.38
|
| Rate for Payer: BCBS Complete |
$171.71
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCBS Trust/PPO |
$122.63
|
| Rate for Payer: BCN Commercial |
$122.63
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| Rate for Payer: Cash Price |
$453.05
|
| Rate for Payer: Cash Price |
$453.05
|
| Rate for Payer: Cash Price |
$453.05
|
| Rate for Payer: Cofinity Commercial |
$396.42
|
| Rate for Payer: Cofinity Commercial |
$487.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$396.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$453.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$509.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$396.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$424.73
|
| Rate for Payer: Mclaren Medicaid |
$163.53
|
| Rate for Payer: Mclaren Medicare |
$305.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.36
|
| Rate for Payer: Meridian Medicaid |
$171.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$481.36
|
| Rate for Payer: Nomi Health Commercial |
$915.30
|
| Rate for Payer: PACE Medicare |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$481.36
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$368.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$958.92
|
| Rate for Payer: Priority Health Medicare |
$305.10
|
| Rate for Payer: Priority Health Narrow Network |
$767.14
|
| Rate for Payer: Priority Health SBD |
$356.78
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.28
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.10
|
| Rate for Payer: UHC Exchange |
$35.71
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$163.53
|
| Rate for Payer: UMR Bronson Commercial |
$209.53
|
| Rate for Payer: VA VA |
$305.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$424.73
|
|
|
HC SPLENOPORTOGRAPHY
|
Facility
|
IP
|
$4,200.93
|
|
|
Service Code
|
CPT 75810
|
| Hospital Charge Code |
32000318
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,848.41 |
| Max. Negotiated Rate |
$3,780.84 |
| Rate for Payer: Aetna American Axle |
$2,730.60
|
| Rate for Payer: Aetna Commercial |
$3,570.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,730.60
|
| Rate for Payer: Cash Price |
$3,360.74
|
| Rate for Payer: Cofinity Commercial |
$2,940.65
|
| Rate for Payer: Cofinity Commercial |
$3,612.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,940.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,360.74
|
| Rate for Payer: Healthscope Commercial |
$3,780.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,940.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,150.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,570.79
|
| Rate for Payer: PHP Commercial |
$3,570.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,730.60
|
| Rate for Payer: Priority Health SBD |
$2,646.59
|
| Rate for Payer: UMR Bronson Commercial |
$1,848.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,150.70
|
|
|
HC SPLENOPORTOGRAPHY
|
Facility
|
OP
|
$4,200.93
|
|
|
Service Code
|
CPT 75810
|
| Hospital Charge Code |
32000318
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna American Axle |
$2,730.60
|
| Rate for Payer: Aetna Commercial |
$3,570.79
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,730.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$3,901.34
|
| Rate for Payer: BCN Commercial |
$3,901.34
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$3,360.74
|
| Rate for Payer: Cash Price |
$3,360.74
|
| Rate for Payer: Cash Price |
$3,360.74
|
| Rate for Payer: Cofinity Commercial |
$2,940.65
|
| Rate for Payer: Cofinity Commercial |
$3,612.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,940.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,360.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$3,780.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,940.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,150.70
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,570.79
|
| Rate for Payer: Nomi Health Commercial |
$6,476.11
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,570.79
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,730.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$2,646.59
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,680.76
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$5,893.56
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,554.34
|
| Rate for Payer: VA VA |
$3,083.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,150.70
|
|
|
HC SPLINT FINGER DYNAMIC
|
Facility
|
OP
|
$140.24
|
|
|
Service Code
|
CPT 29131
|
| Hospital Charge Code |
43000005
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$91.16
|
| Rate for Payer: Aetna Commercial |
$119.20
|
| Rate for Payer: Aetna Medicare |
$60.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.16
|
| 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 |
$50.94
|
| Rate for Payer: BCN Commercial |
$50.94
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$112.19
|
| Rate for Payer: Cash Price |
$112.19
|
| Rate for Payer: Cash Price |
$112.19
|
| Rate for Payer: Cash Price |
$112.19
|
| Rate for Payer: Cofinity Commercial |
$120.61
|
| Rate for Payer: Cofinity Commercial |
$98.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$98.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$126.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.18
|
| 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 |
$119.20
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Commercial |
$119.20
|
| 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 |
$91.16
|
| 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 |
$88.35
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.74
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Exchange |
$33.40
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$31.20
|
| Rate for Payer: UMR Bronson Commercial |
$51.89
|
| Rate for Payer: VA VA |
$58.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.18
|
|
|
HC SPLINT FINGER DYNAMIC
|
Facility
|
IP
|
$140.24
|
|
|
Service Code
|
CPT 29131
|
| Hospital Charge Code |
43000005
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$61.71 |
| Max. Negotiated Rate |
$126.22 |
| Rate for Payer: Aetna American Axle |
$91.16
|
| Rate for Payer: Aetna Commercial |
$119.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.16
|
| Rate for Payer: Cash Price |
$112.19
|
| Rate for Payer: Cofinity Commercial |
$120.61
|
| Rate for Payer: Cofinity Commercial |
$98.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$98.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.19
|
| Rate for Payer: Healthscope Commercial |
$126.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.20
|
| Rate for Payer: PHP Commercial |
$119.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.16
|
| Rate for Payer: Priority Health SBD |
$88.35
|
| Rate for Payer: UMR Bronson Commercial |
$61.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.18
|
|
|
HC SPLINT FINGER STATIC
|
Facility
|
OP
|
$140.24
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
43000004
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$28.18 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$91.16
|
| Rate for Payer: Aetna Commercial |
$119.20
|
| Rate for Payer: Aetna Medicare |
$131.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$75.33
|
| Rate for Payer: BCN Commercial |
$75.33
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$112.19
|
| Rate for Payer: Cash Price |
$112.19
|
| Rate for Payer: Cash Price |
$112.19
|
| Rate for Payer: Cash Price |
$112.19
|
| Rate for Payer: Cofinity Commercial |
$120.61
|
| Rate for Payer: Cofinity Commercial |
$98.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$98.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$126.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.18
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.20
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$119.20
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.95
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$317.56
|
| Rate for Payer: Priority Health SBD |
$88.35
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.00
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$28.18
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: UMR Bronson Commercial |
$51.89
|
| Rate for Payer: VA VA |
$126.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.18
|
|
|
HC SPLINT FINGER STATIC
|
Facility
|
IP
|
$140.24
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
43000004
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$61.71 |
| Max. Negotiated Rate |
$126.22 |
| Rate for Payer: Aetna American Axle |
$91.16
|
| Rate for Payer: Aetna Commercial |
$119.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.16
|
| Rate for Payer: Cash Price |
$112.19
|
| Rate for Payer: Cofinity Commercial |
$120.61
|
| Rate for Payer: Cofinity Commercial |
$98.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$98.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.19
|
| Rate for Payer: Healthscope Commercial |
$126.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.20
|
| Rate for Payer: PHP Commercial |
$119.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.16
|
| Rate for Payer: Priority Health SBD |
$88.35
|
| Rate for Payer: UMR Bronson Commercial |
$61.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.18
|
|
|
HC SPLINT LONG ARM
|
Facility
|
OP
|
$396.97
|
|
|
Service Code
|
CPT 29105
|
| Hospital Charge Code |
70000002
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$40.99 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$258.03
|
| Rate for Payer: Aetna Commercial |
$337.42
|
| Rate for Payer: Aetna Medicare |
$160.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$258.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$193.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$193.25
|
| Rate for Payer: BCBS Complete |
$87.01
|
| Rate for Payer: BCBS MAPPO |
$154.60
|
| Rate for Payer: BCBS Trust/PPO |
$123.88
|
| Rate for Payer: BCN Commercial |
$123.88
|
| Rate for Payer: BCN Medicare Advantage |
$154.60
|
| Rate for Payer: Cash Price |
$317.58
|
| Rate for Payer: Cash Price |
$317.58
|
| Rate for Payer: Cash Price |
$317.58
|
| Rate for Payer: Cofinity Commercial |
$341.39
|
| Rate for Payer: Cofinity Commercial |
$277.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$277.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.60
|
| Rate for Payer: Healthscope Commercial |
$357.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$277.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.73
|
| Rate for Payer: Mclaren Medicaid |
$82.87
|
| Rate for Payer: Mclaren Medicare |
$154.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.33
|
| Rate for Payer: Meridian Medicaid |
$87.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.42
|
| Rate for Payer: Nomi Health Commercial |
$324.66
|
| Rate for Payer: PACE Medicare |
$146.87
|
| Rate for Payer: PACE SWMI |
$154.60
|
| Rate for Payer: PHP Commercial |
$337.42
|
| Rate for Payer: PHP Medicare Advantage |
$154.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$485.91
|
| Rate for Payer: Priority Health Medicare |
$154.60
|
| Rate for Payer: Priority Health Narrow Network |
$388.73
|
| Rate for Payer: Priority Health SBD |
$250.09
|
| Rate for Payer: Railroad Medicare Medicare |
$154.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.09
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.60
|
| Rate for Payer: UHC Exchange |
$40.99
|
| Rate for Payer: UHC Medicare Advantage |
$154.60
|
| Rate for Payer: UHCCP Medicaid |
$82.87
|
| Rate for Payer: UMR Bronson Commercial |
$146.88
|
| Rate for Payer: VA VA |
$154.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.73
|
|
|
HC SPLINT LONG ARM
|
Facility
|
IP
|
$396.97
|
|
|
Service Code
|
CPT 29105
|
| Hospital Charge Code |
70000002
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$174.67 |
| Max. Negotiated Rate |
$357.27 |
| Rate for Payer: Aetna American Axle |
$258.03
|
| Rate for Payer: Aetna Commercial |
$337.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$258.03
|
| Rate for Payer: Cash Price |
$317.58
|
| Rate for Payer: Cofinity Commercial |
$277.88
|
| Rate for Payer: Cofinity Commercial |
$341.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$277.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.58
|
| Rate for Payer: Healthscope Commercial |
$357.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$277.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.42
|
| Rate for Payer: PHP Commercial |
$337.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.03
|
| Rate for Payer: Priority Health SBD |
$250.09
|
| Rate for Payer: UMR Bronson Commercial |
$174.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.73
|
|
|
HC SPLINT LONG LEG
|
Facility
|
IP
|
$357.38
|
|
|
Service Code
|
CPT 29505
|
| Hospital Charge Code |
70000012
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$157.25 |
| Max. Negotiated Rate |
$321.64 |
| Rate for Payer: Aetna American Axle |
$232.30
|
| Rate for Payer: Aetna Commercial |
$303.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.30
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$250.17
|
| Rate for Payer: Cofinity Commercial |
$307.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$250.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Healthscope Commercial |
$321.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$250.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: PHP Commercial |
$303.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health SBD |
$225.15
|
| Rate for Payer: UMR Bronson Commercial |
$157.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
|
HC SPLINT LONG LEG
|
Facility
|
OP
|
$357.38
|
|
|
Service Code
|
CPT 29505
|
| Hospital Charge Code |
70000012
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$50.17 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$232.30
|
| Rate for Payer: Aetna Commercial |
$303.77
|
| Rate for Payer: Aetna Medicare |
$160.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$193.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$193.25
|
| Rate for Payer: BCBS Complete |
$87.01
|
| Rate for Payer: BCBS MAPPO |
$154.60
|
| Rate for Payer: BCBS Trust/PPO |
$131.70
|
| Rate for Payer: BCN Commercial |
$131.70
|
| Rate for Payer: BCN Medicare Advantage |
$154.60
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$307.35
|
| Rate for Payer: Cofinity Commercial |
$250.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$250.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.60
|
| Rate for Payer: Healthscope Commercial |
$321.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$250.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.04
|
| Rate for Payer: Mclaren Medicaid |
$82.87
|
| Rate for Payer: Mclaren Medicare |
$154.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.33
|
| Rate for Payer: Meridian Medicaid |
$87.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: Nomi Health Commercial |
$324.66
|
| Rate for Payer: PACE Medicare |
$146.87
|
| Rate for Payer: PACE SWMI |
$154.60
|
| Rate for Payer: PHP Commercial |
$303.77
|
| Rate for Payer: PHP Medicare Advantage |
$154.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$485.91
|
| Rate for Payer: Priority Health Medicare |
$154.60
|
| Rate for Payer: Priority Health Narrow Network |
$388.73
|
| Rate for Payer: Priority Health SBD |
$225.15
|
| Rate for Payer: Railroad Medicare Medicare |
$154.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.19
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.60
|
| Rate for Payer: UHC Exchange |
$50.17
|
| Rate for Payer: UHC Medicare Advantage |
$154.60
|
| Rate for Payer: UHCCP Medicaid |
$82.87
|
| Rate for Payer: UMR Bronson Commercial |
$132.23
|
| Rate for Payer: VA VA |
$154.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
|
HC SPLINT SHORT ARM DYNAMIC
|
Facility
|
IP
|
$552.32
|
|
|
Service Code
|
CPT 29126
|
| Hospital Charge Code |
43000003
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$243.02 |
| Max. Negotiated Rate |
$497.09 |
| Rate for Payer: Aetna American Axle |
$359.01
|
| Rate for Payer: Aetna Commercial |
$469.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.01
|
| Rate for Payer: Cash Price |
$441.86
|
| Rate for Payer: Cofinity Commercial |
$386.62
|
| Rate for Payer: Cofinity Commercial |
$475.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$386.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$441.86
|
| Rate for Payer: Healthscope Commercial |
$497.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$386.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$414.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$469.47
|
| Rate for Payer: PHP Commercial |
$469.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$359.01
|
| Rate for Payer: Priority Health SBD |
$347.96
|
| Rate for Payer: UMR Bronson Commercial |
$243.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$414.24
|
|
|
HC SPLINT SHORT ARM DYNAMIC
|
Facility
|
OP
|
$552.32
|
|
|
Service Code
|
CPT 29126
|
| Hospital Charge Code |
43000003
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$47.29 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$359.01
|
| Rate for Payer: Aetna Commercial |
$469.47
|
| Rate for Payer: Aetna Medicare |
$131.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$93.42
|
| Rate for Payer: BCN Commercial |
$93.42
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$441.86
|
| Rate for Payer: Cash Price |
$441.86
|
| Rate for Payer: Cash Price |
$441.86
|
| Rate for Payer: Cash Price |
$441.86
|
| Rate for Payer: Cofinity Commercial |
$386.62
|
| Rate for Payer: Cofinity Commercial |
$475.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$386.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$441.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$497.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$386.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$414.24
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$469.47
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$469.47
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$359.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.95
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$317.56
|
| Rate for Payer: Priority Health SBD |
$347.96
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.02
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$47.29
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: UMR Bronson Commercial |
$204.36
|
| Rate for Payer: VA VA |
$126.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$414.24
|
|
