|
HC XR SPINE CERV 6VW OR MORE
|
Facility
|
OP
|
$520.60
|
|
|
Service Code
|
CPT 72052
|
| Hospital Charge Code |
32000037
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$468.54 |
| Rate for Payer: Aetna American Axle |
$338.39
|
| Rate for Payer: Aetna Commercial |
$442.51
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$117.39
|
| Rate for Payer: BCN Commercial |
$117.39
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cofinity Advantage |
$364.42
|
| Rate for Payer: Cofinity Commercial |
$447.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$468.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$364.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.45
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.51
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.45
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$442.51
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$327.98
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$338.39
|
| Rate for Payer: UHC Core |
$271.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$204.60
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$192.62
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.45
|
|
|
HC XR SPINE CERV 6VW OR MORE
|
Facility
|
IP
|
$520.60
|
|
|
Service Code
|
CPT 72052
|
| Hospital Charge Code |
32000037
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$229.06 |
| Max. Negotiated Rate |
$468.54 |
| Rate for Payer: Aetna American Axle |
$338.39
|
| Rate for Payer: Aetna Commercial |
$442.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.39
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cofinity Advantage |
$364.42
|
| Rate for Payer: Cofinity Commercial |
$447.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.48
|
| Rate for Payer: Healthscope Commercial |
$468.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$364.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.45
|
| Rate for Payer: PHP Commercial |
$442.51
|
| Rate for Payer: Priority Health SBD |
$327.98
|
| Rate for Payer: UMR Bronson Commercial |
$229.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.45
|
|
|
HC XR SPINE CERVICAL 3VW OR LESS
|
Facility
|
IP
|
$385.45
|
|
|
Service Code
|
CPT 72040
|
| Hospital Charge Code |
32000035
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$169.60 |
| Max. Negotiated Rate |
$346.90 |
| Rate for Payer: Aetna American Axle |
$250.54
|
| Rate for Payer: Aetna Commercial |
$327.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.54
|
| Rate for Payer: Cash Price |
$308.36
|
| Rate for Payer: Cofinity Advantage |
$269.81
|
| Rate for Payer: Cofinity Commercial |
$331.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.36
|
| Rate for Payer: Healthscope Commercial |
$346.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$269.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.09
|
| Rate for Payer: PHP Commercial |
$327.63
|
| Rate for Payer: Priority Health SBD |
$242.83
|
| Rate for Payer: UMR Bronson Commercial |
$169.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.09
|
|
|
HC XR SPINE CERVICAL 3VW OR LESS
|
Facility
|
OP
|
$385.45
|
|
|
Service Code
|
CPT 72040
|
| Hospital Charge Code |
32000035
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$346.90 |
| Rate for Payer: Aetna American Axle |
$250.54
|
| Rate for Payer: Aetna Commercial |
$327.63
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$71.42
|
| Rate for Payer: BCN Commercial |
$71.42
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$308.36
|
| Rate for Payer: Cash Price |
$308.36
|
| Rate for Payer: Cofinity Advantage |
$269.81
|
| Rate for Payer: Cofinity Commercial |
$331.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$346.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$269.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.09
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.63
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.09
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$327.63
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$242.83
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.54
|
| Rate for Payer: UHC Core |
$200.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$151.48
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: UMR Bronson Commercial |
$142.62
|
| Rate for Payer: VA VA |
$86.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.09
|
|
|
HC XR SPINE CERVICAL 4 OR 5 VW
|
Facility
|
IP
|
$479.01
|
|
|
Service Code
|
CPT 72050
|
| Hospital Charge Code |
32000036
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$210.76 |
| Max. Negotiated Rate |
$431.11 |
| Rate for Payer: Aetna American Axle |
$311.36
|
| Rate for Payer: Aetna Commercial |
$407.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.36
|
| Rate for Payer: Cash Price |
$383.21
|
| Rate for Payer: Cofinity Advantage |
$335.31
|
| Rate for Payer: Cofinity Commercial |
$411.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$383.21
|
| Rate for Payer: Healthscope Commercial |
$431.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$335.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$359.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$407.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$359.26
|
| Rate for Payer: PHP Commercial |
$407.16
|
| Rate for Payer: Priority Health SBD |
$301.78
|
| Rate for Payer: UMR Bronson Commercial |
$210.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$359.26
|
|
|
HC XR SPINE CERVICAL 4 OR 5 VW
|
Facility
|
OP
|
$479.01
|
|
|
Service Code
|
CPT 72050
|
| Hospital Charge Code |
32000036
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$431.11 |
| Rate for Payer: Aetna American Axle |
$311.36
|
| Rate for Payer: Aetna Commercial |
$407.16
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$100.97
|
| Rate for Payer: BCN Commercial |
$100.97
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$383.21
|
| Rate for Payer: Cash Price |
$383.21
|
| Rate for Payer: Cofinity Advantage |
$335.31
|
| Rate for Payer: Cofinity Commercial |
$411.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$383.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$431.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$335.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$359.26
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$407.16
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$359.26
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$407.16
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$301.78
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.36
|
| Rate for Payer: UHC Core |
$249.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$188.25
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$177.23
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$359.26
|
|
|
HC XR SPINE LUMBAR 2 OR 3 VW
|
Facility
|
OP
|
$416.36
|
|
|
Service Code
|
CPT 72100
|
| Hospital Charge Code |
32000044
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna American Axle |
$270.63
|
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$71.42
|
| Rate for Payer: BCN Commercial |
$71.42
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Advantage |
$291.45
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.27
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$262.31
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.63
|
| Rate for Payer: UHC Core |
$216.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$163.63
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$154.05
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.27
|
|
|
HC XR SPINE LUMBAR 2 OR 3 VW
|
Facility
|
IP
|
$416.36
|
|
|
Service Code
|
CPT 72100
|
| Hospital Charge Code |
32000044
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$183.20 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna American Axle |
$270.63
|
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.63
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Advantage |
$291.45
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: Priority Health SBD |
$262.31
|
| Rate for Payer: UMR Bronson Commercial |
$183.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.27
|
|
|
HC XR SPINE LUMBAR BENDING ONLY 4
|
Facility
|
IP
|
$396.48
|
|
|
Service Code
|
CPT 72120
|
| Hospital Charge Code |
32000047
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$174.45 |
| Max. Negotiated Rate |
$356.83 |
| Rate for Payer: Aetna American Axle |
$257.71
|
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.71
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Advantage |
$277.54
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$277.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: Priority Health SBD |
$249.78
|
| Rate for Payer: UMR Bronson Commercial |
$174.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.36
|
|
|
HC XR SPINE LUMBAR BENDING ONLY 4
|
Facility
|
OP
|
$396.48
|
|
|
Service Code
|
CPT 72120
|
| Hospital Charge Code |
32000047
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$356.83 |
| Rate for Payer: Aetna American Axle |
$257.71
|
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$73.87
|
| Rate for Payer: BCN Commercial |
$73.87
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Advantage |
$277.54
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$277.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.36
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$249.78
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.71
|
| Rate for Payer: UHC Core |
$206.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$155.82
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$146.70
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.36
|
|
|
HC XR SPINE LUMBAR MIN 4 VW
|
Facility
|
IP
|
$446.38
|
|
|
Service Code
|
CPT 72110
|
| Hospital Charge Code |
32000045
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$196.41 |
| Max. Negotiated Rate |
$401.74 |
| Rate for Payer: Aetna American Axle |
$290.15
|
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.15
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Advantage |
$312.47
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: Priority Health SBD |
$281.22
|
| Rate for Payer: UMR Bronson Commercial |
$196.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC XR SPINE LUMBAR MIN 4 VW
|
Facility
|
OP
|
$446.38
|
|
|
Service Code
|
CPT 72110
|
| Hospital Charge Code |
32000045
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$401.74 |
| Rate for Payer: Aetna American Axle |
$290.15
|
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$96.87
|
| Rate for Payer: BCN Commercial |
$96.87
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Advantage |
$312.47
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$281.22
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.15
|
| Rate for Payer: UHC Core |
$232.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$175.43
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$165.16
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC XR SPINE LUMB COMP W BEND MIN 6 VW
|
Facility
|
OP
|
$574.54
|
|
|
Service Code
|
CPT 72114
|
| Hospital Charge Code |
32000046
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$517.09 |
| Rate for Payer: Aetna American Axle |
$373.45
|
| Rate for Payer: Aetna Commercial |
$488.36
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$373.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$114.92
|
| Rate for Payer: BCN Commercial |
$114.92
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$459.63
|
| Rate for Payer: Cash Price |
$459.63
|
| Rate for Payer: Cofinity Advantage |
$402.18
|
| Rate for Payer: Cofinity Commercial |
$494.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$459.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$517.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$402.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$430.90
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$488.36
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$430.90
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$488.36
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$361.96
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$373.45
|
| Rate for Payer: UHC Core |
$299.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$225.79
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$212.58
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$430.90
|
|
|
HC XR SPINE LUMB COMP W BEND MIN 6 VW
|
Facility
|
IP
|
$574.54
|
|
|
Service Code
|
CPT 72114
|
| Hospital Charge Code |
32000046
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$252.80 |
| Max. Negotiated Rate |
$517.09 |
| Rate for Payer: Aetna American Axle |
$373.45
|
| Rate for Payer: Aetna Commercial |
$488.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$373.45
|
| Rate for Payer: Cash Price |
$459.63
|
| Rate for Payer: Cofinity Advantage |
$402.18
|
| Rate for Payer: Cofinity Commercial |
$494.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$459.63
|
| Rate for Payer: Healthscope Commercial |
$517.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$402.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$430.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$488.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$430.90
|
| Rate for Payer: PHP Commercial |
$488.36
|
| Rate for Payer: Priority Health SBD |
$361.96
|
| Rate for Payer: UMR Bronson Commercial |
$252.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$430.90
|
|
|
HC XR SPINE SINGLE VW
|
Facility
|
IP
|
$191.46
|
|
|
Service Code
|
CPT 72020
|
| Hospital Charge Code |
32000034
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$84.24 |
| Max. Negotiated Rate |
$172.31 |
| Rate for Payer: Aetna American Axle |
$124.45
|
| Rate for Payer: Aetna Commercial |
$162.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.45
|
| Rate for Payer: Cash Price |
$153.17
|
| Rate for Payer: Cofinity Advantage |
$134.02
|
| Rate for Payer: Cofinity Commercial |
$164.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.17
|
| Rate for Payer: Healthscope Commercial |
$172.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$134.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.59
|
| Rate for Payer: PHP Commercial |
$162.74
|
| Rate for Payer: Priority Health SBD |
$120.62
|
| Rate for Payer: UMR Bronson Commercial |
$84.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.59
|
|
|
HC XR SPINE SINGLE VW
|
Facility
|
OP
|
$191.46
|
|
|
Service Code
|
CPT 72020
|
| Hospital Charge Code |
32000034
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$41.04 |
| Max. Negotiated Rate |
$280.42 |
| Rate for Payer: Aetna American Axle |
$124.45
|
| Rate for Payer: Aetna Commercial |
$162.74
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$41.04
|
| Rate for Payer: BCN Commercial |
$41.04
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$153.17
|
| Rate for Payer: Cash Price |
$153.17
|
| Rate for Payer: Cofinity Advantage |
$134.02
|
| Rate for Payer: Cofinity Commercial |
$164.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$172.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$134.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.59
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.74
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.59
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$162.74
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$120.62
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.45
|
| Rate for Payer: UHC Core |
$99.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$75.24
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: UMR Bronson Commercial |
$70.84
|
| Rate for Payer: VA VA |
$86.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.59
|
|
|
HC XR SPINE THORACIC 2 VW
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 72070
|
| Hospital Charge Code |
32000039
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$160.39 |
| Max. Negotiated Rate |
$328.08 |
| Rate for Payer: Aetna American Axle |
$236.94
|
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.94
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Advantage |
$255.17
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$255.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: Priority Health SBD |
$229.65
|
| Rate for Payer: UMR Bronson Commercial |
$160.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.40
|
|
|
HC XR SPINE THORACIC 2 VW
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 72070
|
| Hospital Charge Code |
32000039
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$336.87 |
| Rate for Payer: Aetna American Axle |
$236.94
|
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$57.46
|
| Rate for Payer: BCN Commercial |
$57.46
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Advantage |
$255.17
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$255.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.40
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$229.65
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.94
|
| Rate for Payer: UHC Core |
$189.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$143.26
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$134.88
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.40
|
|
|
HC XR SPINE THORACIC 3 VW
|
Facility
|
OP
|
$416.36
|
|
|
Service Code
|
CPT 72072
|
| Hospital Charge Code |
32000040
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna American Axle |
$270.63
|
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$70.59
|
| Rate for Payer: BCN Commercial |
$70.59
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Advantage |
$291.45
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.27
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$262.31
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.63
|
| Rate for Payer: UHC Core |
$216.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$163.63
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$154.05
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.27
|
|
|
HC XR SPINE THORACIC 3 VW
|
Facility
|
IP
|
$416.36
|
|
|
Service Code
|
CPT 72072
|
| Hospital Charge Code |
32000040
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$183.20 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna American Axle |
$270.63
|
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.63
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Advantage |
$291.45
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: Priority Health SBD |
$262.31
|
| Rate for Payer: UMR Bronson Commercial |
$183.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.27
|
|
|
HC XR SPINE THORACIC 4 VW OR MORE
|
Facility
|
IP
|
$520.60
|
|
|
Service Code
|
CPT 72074
|
| Hospital Charge Code |
32000041
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$229.06 |
| Max. Negotiated Rate |
$468.54 |
| Rate for Payer: Aetna American Axle |
$338.39
|
| Rate for Payer: Aetna Commercial |
$442.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.39
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cofinity Advantage |
$364.42
|
| Rate for Payer: Cofinity Commercial |
$447.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.48
|
| Rate for Payer: Healthscope Commercial |
$468.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$364.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.45
|
| Rate for Payer: PHP Commercial |
$442.51
|
| Rate for Payer: Priority Health SBD |
$327.98
|
| Rate for Payer: UMR Bronson Commercial |
$229.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.45
|
|
|
HC XR SPINE THORACIC 4 VW OR MORE
|
Facility
|
OP
|
$520.60
|
|
|
Service Code
|
CPT 72074
|
| Hospital Charge Code |
32000041
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$468.54 |
| Rate for Payer: Aetna American Axle |
$338.39
|
| Rate for Payer: Aetna Commercial |
$442.51
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$81.27
|
| Rate for Payer: BCN Commercial |
$81.27
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cofinity Advantage |
$364.42
|
| Rate for Payer: Cofinity Commercial |
$447.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$468.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$364.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.45
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.51
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.45
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$442.51
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$327.98
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$338.39
|
| Rate for Payer: UHC Core |
$271.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$204.60
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$192.62
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.45
|
|
|
HC XR SPINE THORACOLUMBAR 2 VW
|
Facility
|
OP
|
$390.58
|
|
|
Service Code
|
CPT 72080
|
| Hospital Charge Code |
32000042
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$351.52 |
| Rate for Payer: Aetna American Axle |
$253.88
|
| Rate for Payer: Aetna Commercial |
$331.99
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$60.74
|
| Rate for Payer: BCN Commercial |
$60.74
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$312.46
|
| Rate for Payer: Cash Price |
$312.46
|
| Rate for Payer: Cofinity Advantage |
$273.41
|
| Rate for Payer: Cofinity Commercial |
$335.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$351.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$273.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.94
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.99
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$292.94
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$331.99
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$246.07
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$253.88
|
| Rate for Payer: UHC Core |
$203.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$153.50
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: UMR Bronson Commercial |
$144.51
|
| Rate for Payer: VA VA |
$86.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.94
|
|
|
HC XR SPINE THORACOLUMBAR 2 VW
|
Facility
|
IP
|
$390.58
|
|
|
Service Code
|
CPT 72080
|
| Hospital Charge Code |
32000042
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$171.86 |
| Max. Negotiated Rate |
$351.52 |
| Rate for Payer: Aetna American Axle |
$253.88
|
| Rate for Payer: Aetna Commercial |
$331.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.88
|
| Rate for Payer: Cash Price |
$312.46
|
| Rate for Payer: Cofinity Advantage |
$273.41
|
| Rate for Payer: Cofinity Commercial |
$335.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.46
|
| Rate for Payer: Healthscope Commercial |
$351.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$273.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$292.94
|
| Rate for Payer: PHP Commercial |
$331.99
|
| Rate for Payer: Priority Health SBD |
$246.07
|
| Rate for Payer: UMR Bronson Commercial |
$171.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.94
|
|
|
HC XR STERNOCLAV JTS MIN 3 VW
|
Facility
|
IP
|
$312.56
|
|
|
Service Code
|
CPT 71130
|
| Hospital Charge Code |
32000032
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$137.53 |
| Max. Negotiated Rate |
$281.30 |
| Rate for Payer: Aetna American Axle |
$203.16
|
| Rate for Payer: Aetna Commercial |
$265.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.16
|
| Rate for Payer: Cash Price |
$250.05
|
| Rate for Payer: Cofinity Advantage |
$218.79
|
| Rate for Payer: Cofinity Commercial |
$268.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$250.05
|
| Rate for Payer: Healthscope Commercial |
$281.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$218.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.42
|
| Rate for Payer: PHP Commercial |
$265.68
|
| Rate for Payer: Priority Health SBD |
$196.91
|
| Rate for Payer: UMR Bronson Commercial |
$137.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.42
|
|
