|
HC XR RIBS INC PA CHST
|
Facility
|
OP
|
$408.20
|
|
|
Service Code
|
CPT 71101
|
| Hospital Charge Code |
32000028
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$38.84 |
| Max. Negotiated Rate |
$367.38 |
| Rate for Payer: Aetna American Axle |
$265.33
|
| Rate for Payer: Aetna Commercial |
$346.97
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$60.89
|
| Rate for Payer: BCN Commercial |
$60.89
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cofinity Commercial |
$351.05
|
| Rate for Payer: Cofinity Commercial |
$285.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$285.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$367.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$285.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.15
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.97
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$346.97
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$257.17
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.72
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$38.84
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$151.03
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.15
|
|
|
HC XR RIBS INC PA CHST
|
Facility
|
IP
|
$408.20
|
|
|
Service Code
|
CPT 71101
|
| Hospital Charge Code |
32000028
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$179.61 |
| Max. Negotiated Rate |
$367.38 |
| Rate for Payer: Aetna American Axle |
$265.33
|
| Rate for Payer: Aetna Commercial |
$346.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.33
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cofinity Commercial |
$285.74
|
| Rate for Payer: Cofinity Commercial |
$351.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$285.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.56
|
| Rate for Payer: Healthscope Commercial |
$367.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$285.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.97
|
| Rate for Payer: PHP Commercial |
$346.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.33
|
| Rate for Payer: Priority Health SBD |
$257.17
|
| Rate for Payer: UMR Bronson Commercial |
$179.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.15
|
|
|
HC XR SACROILIAC JTS 3 VW OR LESS
|
Facility
|
IP
|
$188.76
|
|
|
Service Code
|
CPT 72200
|
| Hospital Charge Code |
32000050
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$83.05 |
| Max. Negotiated Rate |
$169.88 |
| Rate for Payer: Aetna American Axle |
$122.69
|
| Rate for Payer: Aetna Commercial |
$160.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.69
|
| Rate for Payer: Cash Price |
$151.01
|
| Rate for Payer: Cofinity Commercial |
$132.13
|
| Rate for Payer: Cofinity Commercial |
$162.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$132.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.01
|
| Rate for Payer: Healthscope Commercial |
$169.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$132.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$141.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.45
|
| Rate for Payer: PHP Commercial |
$160.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.69
|
| Rate for Payer: Priority Health SBD |
$118.92
|
| Rate for Payer: UMR Bronson Commercial |
$83.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$141.57
|
|
|
HC XR SACROILIAC JTS 3 VW OR LESS
|
Facility
|
OP
|
$188.76
|
|
|
Service Code
|
CPT 72200
|
| Hospital Charge Code |
32000050
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$30.50 |
| Max. Negotiated Rate |
$327.48 |
| Rate for Payer: Aetna American Axle |
$122.69
|
| Rate for Payer: Aetna Commercial |
$160.45
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$52.00
|
| Rate for Payer: BCN Commercial |
$52.00
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$151.01
|
| Rate for Payer: Cash Price |
$151.01
|
| Rate for Payer: Cofinity Commercial |
$162.33
|
| Rate for Payer: Cofinity Commercial |
$132.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$132.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$169.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$132.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$141.57
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.45
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$160.45
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$118.92
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.55
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$30.50
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$69.84
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$141.57
|
|
|
HC XR SACROILIAC JTS 3 VW OR MORE
|
Facility
|
IP
|
$357.38
|
|
|
Service Code
|
CPT 72202
|
| Hospital Charge Code |
32000051
|
|
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 SACROILIAC JTS 3 VW OR MORE
|
Facility
|
OP
|
$357.38
|
|
|
Service Code
|
CPT 72202
|
| Hospital Charge Code |
32000051
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$36.04 |
| Max. Negotiated Rate |
$327.48 |
| Rate for Payer: Aetna American Axle |
$232.30
|
| Rate for Payer: Aetna Commercial |
$303.77
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$58.83
|
| Rate for Payer: BCN Commercial |
$58.83
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| 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 |
$104.19
|
| 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 |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$303.77
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$225.15
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.64
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$36.04
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$132.23
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
|
HC XR SACRUM COCCYX MIN 2 VW
|
Facility
|
OP
|
$306.43
|
|
|
Service Code
|
CPT 72220
|
| Hospital Charge Code |
32000052
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$29.90 |
| 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 |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$49.95
|
| Rate for Payer: BCN Commercial |
$49.95
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| 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 |
$86.27
|
| 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 |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.47
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$260.47
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$193.05
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.89
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$29.90
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$113.38
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.82
|
|
|
HC XR SACRUM COCCYX MIN 2 VW
|
Facility
|
IP
|
$306.43
|
|
|
Service Code
|
CPT 72220
|
| Hospital Charge Code |
32000052
|
|
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 SCAPULA
|
Facility
|
IP
|
$367.57
|
|
|
Service Code
|
CPT 73010
|
| Hospital Charge Code |
32000062
|
|
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 SCAPULA
|
Facility
|
OP
|
$367.57
|
|
|
Service Code
|
CPT 73010
|
| Hospital Charge Code |
32000062
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$22.14 |
| 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 |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$31.47
|
| Rate for Payer: BCN Commercial |
$31.47
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| 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 |
$104.19
|
| 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 |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$312.43
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$312.43
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$231.57
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.35
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$22.14
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$136.00
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$275.68
|
|
|
HC XR SCAPULA BILATERAL
|
Facility
|
OP
|
$306.00
|
|
|
Service Code
|
CPT 73010
|
| Hospital Charge Code |
32000337
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$22.14 |
| Max. Negotiated Rate |
$327.48 |
| Rate for Payer: Aetna American Axle |
$198.90
|
| Rate for Payer: Aetna Commercial |
$260.10
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$31.47
|
| Rate for Payer: BCN Commercial |
$31.47
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$263.16
|
| Rate for Payer: Cofinity Commercial |
$214.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$214.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$275.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$214.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.50
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.10
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$260.10
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$192.78
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.35
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$22.14
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$113.22
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.50
|
|
|
HC XR SCAPULA BILATERAL
|
Facility
|
IP
|
$306.00
|
|
|
Service Code
|
CPT 73010
|
| Hospital Charge Code |
32000337
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$134.64 |
| Max. Negotiated Rate |
$275.40 |
| Rate for Payer: Aetna American Axle |
$198.90
|
| Rate for Payer: Aetna Commercial |
$260.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.90
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$214.20
|
| Rate for Payer: Cofinity Commercial |
$263.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$214.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.80
|
| Rate for Payer: Healthscope Commercial |
$275.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$214.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.10
|
| Rate for Payer: PHP Commercial |
$260.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: Priority Health SBD |
$192.78
|
| Rate for Payer: UMR Bronson Commercial |
$134.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.50
|
|
|
HC XR SELLA TURCICA
|
Facility
|
OP
|
$357.38
|
|
|
Service Code
|
CPT 70240
|
| Hospital Charge Code |
32000016
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$30.26 |
| 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 |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$49.26
|
| Rate for Payer: BCN Commercial |
$49.26
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| 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 |
$86.27
|
| 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 |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$303.77
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$225.15
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.29
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$30.26
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$132.23
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
|
HC XR SELLA TURCICA
|
Facility
|
IP
|
$357.38
|
|
|
Service Code
|
CPT 70240
|
| Hospital Charge Code |
32000016
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$157.25 |
| Max. Negotiated Rate |
$321.64 |
| Rate for Payer: Cofinity Commercial |
$307.35
|
| 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 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 SHOULDER 1 VW
|
Facility
|
OP
|
$132.76
|
|
|
Service Code
|
CPT 73020
|
| Hospital Charge Code |
32000063
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$271.13 |
| Rate for Payer: Aetna American Axle |
$86.29
|
| Rate for Payer: Aetna Commercial |
$112.85
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$29.42
|
| Rate for Payer: BCN Commercial |
$29.42
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$106.21
|
| Rate for Payer: Cash Price |
$106.21
|
| Rate for Payer: Cofinity Commercial |
$92.93
|
| Rate for Payer: Cofinity Commercial |
$114.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$92.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$119.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.57
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.85
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$112.85
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$83.64
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.00
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$20.00
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$49.12
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.57
|
|
|
HC XR SHOULDER 1 VW
|
Facility
|
IP
|
$132.76
|
|
|
Service Code
|
CPT 73020
|
| Hospital Charge Code |
32000063
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$58.41 |
| Max. Negotiated Rate |
$119.48 |
| Rate for Payer: Aetna American Axle |
$86.29
|
| Rate for Payer: Aetna Commercial |
$112.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.29
|
| Rate for Payer: Cash Price |
$106.21
|
| Rate for Payer: Cofinity Commercial |
$114.17
|
| Rate for Payer: Cofinity Commercial |
$92.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$92.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.21
|
| Rate for Payer: Healthscope Commercial |
$119.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.85
|
| Rate for Payer: PHP Commercial |
$112.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.29
|
| Rate for Payer: Priority Health SBD |
$83.64
|
| Rate for Payer: UMR Bronson Commercial |
$58.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.57
|
|
|
HC XR SHOULDER 1 VW BILATERAL
|
Facility
|
OP
|
$249.90
|
|
|
Service Code
|
CPT 73020
|
| Hospital Charge Code |
32000338
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$271.13 |
| Rate for Payer: Aetna American Axle |
$162.44
|
| Rate for Payer: Aetna Commercial |
$212.42
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$29.42
|
| Rate for Payer: BCN Commercial |
$29.42
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Cofinity Commercial |
$174.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$174.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.42
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.42
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$212.42
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$157.44
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.00
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$20.00
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$92.46
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.42
|
|
|
HC XR SHOULDER 1 VW BILATERAL
|
Facility
|
IP
|
$249.90
|
|
|
Service Code
|
CPT 73020
|
| Hospital Charge Code |
32000338
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$109.96 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Cofinity Commercial |
$174.93
|
| Rate for Payer: Aetna American Axle |
$162.44
|
| Rate for Payer: Aetna Commercial |
$212.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.44
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$174.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.42
|
| Rate for Payer: PHP Commercial |
$212.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.44
|
| Rate for Payer: Priority Health SBD |
$157.44
|
| Rate for Payer: UMR Bronson Commercial |
$109.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.42
|
|
|
HC XR SHOULDER BIL 1 VW
|
Facility
|
IP
|
$175.07
|
|
|
Service Code
|
CPT 73020
|
| Hospital Charge Code |
32000064
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$77.03 |
| Max. Negotiated Rate |
$157.56 |
| Rate for Payer: Aetna American Axle |
$113.80
|
| Rate for Payer: Aetna Commercial |
$148.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.80
|
| Rate for Payer: Cash Price |
$140.06
|
| Rate for Payer: Cofinity Commercial |
$122.55
|
| Rate for Payer: Cofinity Commercial |
$150.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$122.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.06
|
| Rate for Payer: Healthscope Commercial |
$157.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$122.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.81
|
| Rate for Payer: PHP Commercial |
$148.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.80
|
| Rate for Payer: Priority Health SBD |
$110.29
|
| Rate for Payer: UMR Bronson Commercial |
$77.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.30
|
|
|
HC XR SHOULDER BIL 1 VW
|
Facility
|
OP
|
$175.07
|
|
|
Service Code
|
CPT 73020
|
| Hospital Charge Code |
32000064
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$271.13 |
| Rate for Payer: Aetna American Axle |
$113.80
|
| Rate for Payer: Aetna Commercial |
$148.81
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$29.42
|
| Rate for Payer: BCN Commercial |
$29.42
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$140.06
|
| Rate for Payer: Cash Price |
$140.06
|
| Rate for Payer: Cofinity Commercial |
$150.56
|
| Rate for Payer: Cofinity Commercial |
$122.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$122.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$157.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$122.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.30
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.81
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$148.81
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$110.29
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.00
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$20.00
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$64.78
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.30
|
|
|
HC XR SHOULDER BIL MIN 2 VW
|
Facility
|
IP
|
$451.65
|
|
|
Service Code
|
CPT 73030
|
| Hospital Charge Code |
32000066
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$198.73 |
| Max. Negotiated Rate |
$406.48 |
| 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 |
$316.16
|
| Rate for Payer: Cofinity Commercial |
$388.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$316.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$361.32
|
| Rate for Payer: Healthscope Commercial |
$406.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$316.16
|
| 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 SHOULDER BIL MIN 2 VW
|
Facility
|
OP
|
$451.65
|
|
|
Service Code
|
CPT 73030
|
| Hospital Charge Code |
32000066
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.02 |
| Max. Negotiated Rate |
$406.48 |
| Rate for Payer: Aetna American Axle |
$293.57
|
| Rate for Payer: Aetna Commercial |
$383.90
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$293.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$53.36
|
| Rate for Payer: BCN Commercial |
$53.36
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| 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 |
$316.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$316.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$361.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$406.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$316.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$338.74
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$383.90
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$383.90
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$293.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$284.54
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.22
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$32.02
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$167.11
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$338.74
|
|
|
HC XR SHOULDER MIN 2 VW
|
Facility
|
IP
|
$408.20
|
|
|
Service Code
|
CPT 73030
|
| Hospital Charge Code |
32000065
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$179.61 |
| Max. Negotiated Rate |
$367.38 |
| Rate for Payer: Aetna American Axle |
$265.33
|
| Rate for Payer: Aetna Commercial |
$346.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.33
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cofinity Commercial |
$285.74
|
| Rate for Payer: Cofinity Commercial |
$351.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$285.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.56
|
| Rate for Payer: Healthscope Commercial |
$367.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$285.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.97
|
| Rate for Payer: PHP Commercial |
$346.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.33
|
| Rate for Payer: Priority Health SBD |
$257.17
|
| Rate for Payer: UMR Bronson Commercial |
$179.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.15
|
|
|
HC XR SHOULDER MIN 2 VW
|
Facility
|
OP
|
$408.20
|
|
|
Service Code
|
CPT 73030
|
| Hospital Charge Code |
32000065
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.02 |
| Max. Negotiated Rate |
$367.38 |
| Rate for Payer: Aetna American Axle |
$265.33
|
| Rate for Payer: Aetna Commercial |
$346.97
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$53.36
|
| Rate for Payer: BCN Commercial |
$53.36
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cofinity Commercial |
$351.05
|
| Rate for Payer: Cofinity Commercial |
$285.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$285.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$367.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$285.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.15
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.97
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$346.97
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$257.17
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.22
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$32.02
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$151.03
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.15
|
|
|
HC XR SINUSES LESS THAN 3 VW
|
Facility
|
IP
|
$204.23
|
|
|
Service Code
|
CPT 70210
|
| Hospital Charge Code |
32000013
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$89.86 |
| Max. Negotiated Rate |
$183.81 |
| Rate for Payer: Aetna American Axle |
$132.75
|
| Rate for Payer: Aetna Commercial |
$173.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.75
|
| Rate for Payer: Cash Price |
$163.38
|
| Rate for Payer: Cofinity Commercial |
$142.96
|
| Rate for Payer: Cofinity Commercial |
$175.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$142.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.38
|
| Rate for Payer: Healthscope Commercial |
$183.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$142.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.60
|
| Rate for Payer: PHP Commercial |
$173.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.75
|
| Rate for Payer: Priority Health SBD |
$128.66
|
| Rate for Payer: UMR Bronson Commercial |
$89.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.17
|
|
