|
HC XR HANDS BIL 2 VW
|
Facility
|
OP
|
$340.34
|
|
|
Service Code
|
CPT 73120
|
| Hospital Charge Code |
32000086
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Aetna American Axle |
$221.22
|
| Rate for Payer: Aetna Commercial |
$289.29
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$292.69
|
| Rate for Payer: Cofinity Commercial |
$238.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$238.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$306.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$238.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.25
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.29
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$289.29
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.22
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$214.41
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$125.93
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.25
|
|
|
HC XR HANDS BIL 3 VW
|
Facility
|
IP
|
$451.65
|
|
|
Service Code
|
CPT 73130
|
| Hospital Charge Code |
32000088
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$198.73 |
| Max. Negotiated Rate |
$406.49 |
| Rate for Payer: Aetna American Axle |
$293.57
|
| Rate for Payer: Aetna Commercial |
$383.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$293.57
|
| Rate for Payer: Cash Price |
$361.32
|
| Rate for Payer: Cofinity Commercial |
$316.15
|
| Rate for Payer: Cofinity Commercial |
$388.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$316.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$361.32
|
| Rate for Payer: Healthscope Commercial |
$406.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$316.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$338.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$383.90
|
| Rate for Payer: PHP Commercial |
$383.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$293.57
|
| Rate for Payer: Priority Health SBD |
$284.54
|
| Rate for Payer: UMR Bronson Commercial |
$198.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$338.74
|
|
|
HC XR HANDS BIL 3 VW
|
Facility
|
OP
|
$451.65
|
|
|
Service Code
|
CPT 73130
|
| Hospital Charge Code |
32000088
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$406.49 |
| Rate for Payer: Aetna American Axle |
$293.57
|
| Rate for Payer: Aetna Commercial |
$383.90
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$293.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$361.32
|
| Rate for Payer: Cash Price |
$361.32
|
| Rate for Payer: Cofinity Commercial |
$388.42
|
| Rate for Payer: Cofinity Commercial |
$316.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$316.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$361.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$406.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$316.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$338.74
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$383.90
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$383.90
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$293.57
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$284.54
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$164.11
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: UMR Bronson Commercial |
$167.11
|
| Rate for Payer: VA VA |
$85.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$338.74
|
|
|
HC XR HUMERUS 2 VW
|
Facility
|
IP
|
$306.43
|
|
|
Service Code
|
CPT 73060
|
| Hospital Charge Code |
32000069
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$134.83 |
| Max. Negotiated Rate |
$275.79 |
| Rate for Payer: Aetna American Axle |
$199.18
|
| Rate for Payer: Aetna Commercial |
$260.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.18
|
| Rate for Payer: Cash Price |
$245.14
|
| Rate for Payer: Cofinity Commercial |
$214.50
|
| Rate for Payer: Cofinity Commercial |
$263.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$214.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.14
|
| Rate for Payer: Healthscope Commercial |
$275.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$214.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.47
|
| Rate for Payer: PHP Commercial |
$260.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.18
|
| Rate for Payer: Priority Health SBD |
$193.05
|
| Rate for Payer: UMR Bronson Commercial |
$134.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.82
|
|
|
HC XR HUMERUS 2 VW
|
Facility
|
OP
|
$306.43
|
|
|
Service Code
|
CPT 73060
|
| Hospital Charge Code |
32000069
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$275.79 |
| Rate for Payer: Aetna American Axle |
$199.18
|
| Rate for Payer: Aetna Commercial |
$260.47
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$245.14
|
| Rate for Payer: Cash Price |
$245.14
|
| Rate for Payer: Cofinity Commercial |
$263.53
|
| Rate for Payer: Cofinity Commercial |
$214.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$214.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$275.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$214.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.82
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.47
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$260.47
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.18
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$193.05
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$164.11
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: UMR Bronson Commercial |
$113.38
|
| Rate for Payer: VA VA |
$85.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.82
|
|
|
HC XR HUMERUS BIL 2 VW
|
Facility
|
IP
|
$340.34
|
|
|
Service Code
|
CPT 73060
|
| Hospital Charge Code |
32000070
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$149.75 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Aetna American Axle |
$221.22
|
| Rate for Payer: Aetna Commercial |
$289.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.22
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$238.24
|
| Rate for Payer: Cofinity Commercial |
$292.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$238.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Healthscope Commercial |
$306.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$238.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.29
|
| Rate for Payer: PHP Commercial |
$289.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.22
|
| Rate for Payer: Priority Health SBD |
$214.41
|
| Rate for Payer: UMR Bronson Commercial |
$149.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.25
|
|
|
HC XR HUMERUS BIL 2 VW
|
Facility
|
OP
|
$340.34
|
|
|
Service Code
|
CPT 73060
|
| Hospital Charge Code |
32000070
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Aetna American Axle |
$221.22
|
| Rate for Payer: Aetna Commercial |
$289.29
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$292.69
|
| Rate for Payer: Cofinity Commercial |
$238.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$238.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$306.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$238.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.25
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.29
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$289.29
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.22
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$214.41
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$164.11
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: UMR Bronson Commercial |
$125.93
|
| Rate for Payer: VA VA |
$85.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.25
|
|
|
HC XR HYSTEROSALPINGOGRAM
|
Facility
|
IP
|
$714.62
|
|
|
Service Code
|
CPT 74740
|
| Hospital Charge Code |
32000174
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$314.43 |
| Max. Negotiated Rate |
$643.16 |
| Rate for Payer: Aetna American Axle |
$464.50
|
| Rate for Payer: Aetna Commercial |
$607.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.50
|
| Rate for Payer: Cash Price |
$571.70
|
| Rate for Payer: Cofinity Commercial |
$500.23
|
| Rate for Payer: Cofinity Commercial |
$614.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$500.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.70
|
| Rate for Payer: Healthscope Commercial |
$643.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$500.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$535.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$607.43
|
| Rate for Payer: PHP Commercial |
$607.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.50
|
| Rate for Payer: Priority Health SBD |
$450.21
|
| Rate for Payer: UMR Bronson Commercial |
$314.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$535.97
|
|
|
HC XR HYSTEROSALPINGOGRAM
|
Facility
|
OP
|
$714.62
|
|
|
Service Code
|
CPT 74740
|
| Hospital Charge Code |
32000174
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$663.58 |
| Rate for Payer: Aetna American Axle |
$464.50
|
| Rate for Payer: Aetna Commercial |
$607.43
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$571.70
|
| Rate for Payer: Cash Price |
$571.70
|
| Rate for Payer: Cofinity Commercial |
$614.57
|
| Rate for Payer: Cofinity Commercial |
$500.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$500.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$643.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$500.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$535.97
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$607.43
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$607.43
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.50
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$450.21
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$450.52
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: UMR Bronson Commercial |
$264.41
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$535.97
|
|
|
HC XR INFANT LOWER EXT BIL MIN 2 VW
|
Facility
|
IP
|
$340.34
|
|
|
Service Code
|
CPT 73592
|
| Hospital Charge Code |
32000116
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$149.75 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Aetna American Axle |
$221.22
|
| Rate for Payer: Aetna Commercial |
$289.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.22
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$238.24
|
| Rate for Payer: Cofinity Commercial |
$292.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$238.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Healthscope Commercial |
$306.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$238.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.29
|
| Rate for Payer: PHP Commercial |
$289.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.22
|
| Rate for Payer: Priority Health SBD |
$214.41
|
| Rate for Payer: UMR Bronson Commercial |
$149.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.25
|
|
|
HC XR INFANT LOWER EXT BIL MIN 2 VW
|
Facility
|
OP
|
$340.34
|
|
|
Service Code
|
CPT 73592
|
| Hospital Charge Code |
32000116
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Aetna American Axle |
$221.22
|
| Rate for Payer: Aetna Commercial |
$289.29
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$292.69
|
| Rate for Payer: Cofinity Commercial |
$238.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$238.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$306.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$238.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.25
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.29
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$289.29
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.22
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$214.41
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$164.11
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: UMR Bronson Commercial |
$125.93
|
| Rate for Payer: VA VA |
$85.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.25
|
|
|
HC XR INFANT LOWER EXT MIN 2 VW
|
Facility
|
OP
|
$357.38
|
|
|
Service Code
|
CPT 73592
|
| Hospital Charge Code |
32000115
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$321.64 |
| Rate for Payer: Aetna American Axle |
$232.30
|
| Rate for Payer: Aetna Commercial |
$303.77
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$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 |
$85.87
|
| 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 |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$303.77
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$225.15
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$164.11
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: UMR Bronson Commercial |
$132.23
|
| Rate for Payer: VA VA |
$85.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
|
HC XR INFANT LOWER EXT MIN 2 VW
|
Facility
|
IP
|
$357.38
|
|
|
Service Code
|
CPT 73592
|
| Hospital Charge Code |
32000115
|
|
Hospital Revenue Code
|
320
|
| 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 XR INFANT UPPER EXT
|
Facility
|
IP
|
$306.43
|
|
|
Service Code
|
CPT 73092
|
| Hospital Charge Code |
32000078
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$134.83 |
| Max. Negotiated Rate |
$275.79 |
| Rate for Payer: Aetna American Axle |
$199.18
|
| Rate for Payer: Aetna Commercial |
$260.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.18
|
| Rate for Payer: Cash Price |
$245.14
|
| Rate for Payer: Cofinity Commercial |
$214.50
|
| Rate for Payer: Cofinity Commercial |
$263.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$214.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.14
|
| Rate for Payer: Healthscope Commercial |
$275.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$214.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.47
|
| Rate for Payer: PHP Commercial |
$260.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.18
|
| Rate for Payer: Priority Health SBD |
$193.05
|
| Rate for Payer: UMR Bronson Commercial |
$134.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.82
|
|
|
HC XR INFANT UPPER EXT
|
Facility
|
OP
|
$306.43
|
|
|
Service Code
|
CPT 73092
|
| Hospital Charge Code |
32000078
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$291.93 |
| Rate for Payer: Aetna American Axle |
$199.18
|
| Rate for Payer: Aetna Commercial |
$260.47
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$245.14
|
| Rate for Payer: Cash Price |
$245.14
|
| Rate for Payer: Cofinity Commercial |
$263.53
|
| Rate for Payer: Cofinity Commercial |
$214.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$214.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$275.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$214.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.82
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.47
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$260.47
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.18
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$193.05
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$113.38
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.82
|
|
|
HC XR INFANT UPPER EXT BIL
|
Facility
|
OP
|
$340.34
|
|
|
Service Code
|
CPT 73092
|
| Hospital Charge Code |
32000079
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Aetna American Axle |
$221.22
|
| Rate for Payer: Aetna Commercial |
$289.29
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$292.69
|
| Rate for Payer: Cofinity Commercial |
$238.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$238.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$306.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$238.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.25
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.29
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$289.29
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.22
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$214.41
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$125.93
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.25
|
|
|
HC XR INFANT UPPER EXT BIL
|
Facility
|
IP
|
$340.34
|
|
|
Service Code
|
CPT 73092
|
| Hospital Charge Code |
32000079
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$149.75 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Aetna American Axle |
$221.22
|
| Rate for Payer: Aetna Commercial |
$289.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.22
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$238.24
|
| Rate for Payer: Cofinity Commercial |
$292.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$238.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Healthscope Commercial |
$306.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$238.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.29
|
| Rate for Payer: PHP Commercial |
$289.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.22
|
| Rate for Payer: Priority Health SBD |
$214.41
|
| Rate for Payer: UMR Bronson Commercial |
$149.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.25
|
|
|
HC XR JOINT SURVEY 1 VW
|
Facility
|
OP
|
$313.78
|
|
|
Service Code
|
CPT 77077
|
| Hospital Charge Code |
32000259
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$291.93 |
| Rate for Payer: Aetna American Axle |
$203.96
|
| Rate for Payer: Aetna Commercial |
$266.71
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$251.02
|
| Rate for Payer: Cash Price |
$251.02
|
| Rate for Payer: Cofinity Commercial |
$269.85
|
| Rate for Payer: Cofinity Commercial |
$219.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$219.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$251.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$282.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$219.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$235.34
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$266.71
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$266.71
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.96
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$197.68
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$116.10
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$235.34
|
|
|
HC XR JOINT SURVEY 1 VW
|
Facility
|
IP
|
$313.78
|
|
|
Service Code
|
CPT 77077
|
| Hospital Charge Code |
32000259
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$138.06 |
| Max. Negotiated Rate |
$282.40 |
| Rate for Payer: Aetna American Axle |
$203.96
|
| Rate for Payer: Aetna Commercial |
$266.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.96
|
| Rate for Payer: Cash Price |
$251.02
|
| Rate for Payer: Cofinity Commercial |
$219.65
|
| Rate for Payer: Cofinity Commercial |
$269.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$219.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$251.02
|
| Rate for Payer: Healthscope Commercial |
$282.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$219.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$235.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$266.71
|
| Rate for Payer: PHP Commercial |
$266.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.96
|
| Rate for Payer: Priority Health SBD |
$197.68
|
| Rate for Payer: UMR Bronson Commercial |
$138.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$235.34
|
|
|
HC XR KNEE 1 OR 2 VW
|
Facility
|
OP
|
$306.43
|
|
|
Service Code
|
CPT 73560
|
| Hospital Charge Code |
32000104
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$275.79 |
| Rate for Payer: Aetna American Axle |
$199.18
|
| Rate for Payer: Aetna Commercial |
$260.47
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$245.14
|
| Rate for Payer: Cash Price |
$245.14
|
| Rate for Payer: Cofinity Commercial |
$263.53
|
| Rate for Payer: Cofinity Commercial |
$214.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$214.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$275.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$214.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.82
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.47
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$260.47
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.18
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$193.05
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$164.11
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: UMR Bronson Commercial |
$113.38
|
| Rate for Payer: VA VA |
$85.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.82
|
|
|
HC XR KNEE 1 OR 2 VW
|
Facility
|
IP
|
$306.43
|
|
|
Service Code
|
CPT 73560
|
| Hospital Charge Code |
32000104
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$134.83 |
| Max. Negotiated Rate |
$275.79 |
| Rate for Payer: Aetna American Axle |
$199.18
|
| Rate for Payer: Aetna Commercial |
$260.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.18
|
| Rate for Payer: Cash Price |
$245.14
|
| Rate for Payer: Cofinity Commercial |
$214.50
|
| Rate for Payer: Cofinity Commercial |
$263.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$214.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.14
|
| Rate for Payer: Healthscope Commercial |
$275.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$214.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.47
|
| Rate for Payer: PHP Commercial |
$260.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.18
|
| Rate for Payer: Priority Health SBD |
$193.05
|
| Rate for Payer: UMR Bronson Commercial |
$134.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.82
|
|
|
HC XR KNEE 3 VIEWS
|
Facility
|
IP
|
$367.57
|
|
|
Service Code
|
CPT 73562
|
| Hospital Charge Code |
32000106
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$161.73 |
| Max. Negotiated Rate |
$330.81 |
| Rate for Payer: Aetna American Axle |
$238.92
|
| Rate for Payer: Aetna Commercial |
$312.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.92
|
| Rate for Payer: Cash Price |
$294.06
|
| Rate for Payer: Cofinity Commercial |
$257.30
|
| Rate for Payer: Cofinity Commercial |
$316.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$257.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.06
|
| Rate for Payer: Healthscope Commercial |
$330.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$257.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$275.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$312.43
|
| Rate for Payer: PHP Commercial |
$312.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.92
|
| Rate for Payer: Priority Health SBD |
$231.57
|
| Rate for Payer: UMR Bronson Commercial |
$161.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$275.68
|
|
|
HC XR KNEE 3 VIEWS
|
Facility
|
OP
|
$367.57
|
|
|
Service Code
|
CPT 73562
|
| Hospital Charge Code |
32000106
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$330.81 |
| Rate for Payer: Aetna American Axle |
$238.92
|
| Rate for Payer: Aetna Commercial |
$312.43
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$294.06
|
| Rate for Payer: Cash Price |
$294.06
|
| Rate for Payer: Cofinity Commercial |
$316.11
|
| Rate for Payer: Cofinity Commercial |
$257.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$257.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$330.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$257.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$275.68
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$312.43
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$312.43
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.92
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$231.57
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$164.11
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: UMR Bronson Commercial |
$136.00
|
| Rate for Payer: VA VA |
$85.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$275.68
|
|
|
HC XR KNEE 3 VIEWS BIL
|
Facility
|
OP
|
$486.00
|
|
|
Service Code
|
CPT 73562
|
| Hospital Charge Code |
32000107
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$437.40 |
| Rate for Payer: Aetna American Axle |
$315.90
|
| Rate for Payer: Aetna Commercial |
$413.10
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cofinity Commercial |
$417.96
|
| Rate for Payer: Cofinity Commercial |
$340.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$340.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$388.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$437.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$340.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$364.50
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$413.10
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$413.10
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.90
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$306.18
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$164.11
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: UMR Bronson Commercial |
$179.82
|
| Rate for Payer: VA VA |
$85.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$364.50
|
|
|
HC XR KNEE 3 VIEWS BIL
|
Facility
|
IP
|
$486.00
|
|
|
Service Code
|
CPT 73562
|
| Hospital Charge Code |
32000107
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$213.84 |
| Max. Negotiated Rate |
$437.40 |
| Rate for Payer: Aetna American Axle |
$315.90
|
| Rate for Payer: Aetna Commercial |
$413.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.90
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cofinity Commercial |
$340.20
|
| Rate for Payer: Cofinity Commercial |
$417.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$340.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$388.80
|
| Rate for Payer: Healthscope Commercial |
$437.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$340.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$364.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$413.10
|
| Rate for Payer: PHP Commercial |
$413.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.90
|
| Rate for Payer: Priority Health SBD |
$306.18
|
| Rate for Payer: UMR Bronson Commercial |
$213.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$364.50
|
|
