|
LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT[S], [EG, SPINAL OR LATERAL RECESS STENOSIS]), SINGLE VERTEBRAL SEGMENT; CERVICAL
|
Facility
|
OP
|
$23,381.57
|
|
|
Service Code
|
CPT 63045
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$10,495.56
|
| Rate for Payer: BCN Commercial |
$10,495.56
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Mclaren Medicaid |
$7,230.12
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT[S], [EG, SPINAL OR LATERAL RECESS STENOSIS]), SINGLE VERTEBRAL SEGMENT; EACH ADDITIONAL VERTEBRAL SEGMENT, CERVICAL, THORACIC, OR LUMBAR (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
|
Facility
|
OP
|
$11,486.33
|
|
|
Service Code
|
CPT 63048
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$11,486.33 |
| Max. Negotiated Rate |
$11,486.33 |
| Rate for Payer: BCBS Trust/PPO |
$11,486.33
|
| Rate for Payer: BCN Commercial |
$11,486.33
|
|
|
LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT[S], [EG, SPINAL OR LATERAL RECESS STENOSIS]), SINGLE VERTEBRAL SEGMENT; LUMBAR
|
Facility
|
OP
|
$23,381.57
|
|
|
Service Code
|
CPT 63047
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$10,702.12
|
| Rate for Payer: BCN Commercial |
$10,702.12
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Mclaren Medicaid |
$7,230.12
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT[S], [EG, SPINAL OR LATERAL RECESS STENOSIS]), SINGLE VERTEBRAL SEGMENT; THORACIC
|
Facility
|
OP
|
$23,381.57
|
|
|
Service Code
|
CPT 63046
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$10,495.56
|
| Rate for Payer: BCN Commercial |
$10,495.56
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Mclaren Medicaid |
$7,230.12
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
LAMINECTOMY, FACETECTOMY, OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT[S] [EG, SPINAL OR LATERAL RECESS STENOSIS]), DURING POSTERIOR INTERBODY ARTHRODESIS, LUMBAR; EACH ADDITIONAL VERTEBRAL SEGMENT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
|
Facility
|
OP
|
$786.78
|
|
|
Service Code
|
CPT 63053
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$786.78 |
| Max. Negotiated Rate |
$786.78 |
| Rate for Payer: BCBS Trust/PPO |
$786.78
|
| Rate for Payer: BCN Commercial |
$786.78
|
|
|
LAMINECTOMY, FACETECTOMY, OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT[S] [EG, SPINAL OR LATERAL RECESS STENOSIS]), DURING POSTERIOR INTERBODY ARTHRODESIS, LUMBAR; SINGLE VERTEBRAL SEGMENT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
|
Facility
|
OP
|
$1,051.81
|
|
|
Service Code
|
CPT 63052
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,051.81 |
| Max. Negotiated Rate |
$1,051.81 |
| Rate for Payer: BCBS Trust/PPO |
$1,051.81
|
| Rate for Payer: BCN Commercial |
$1,051.81
|
|
|
LAMINECTOMY FOR EXCISION OR EVACUATION OF INTRASPINAL LESION OTHER THAN NEOPLASM, EXTRADURAL; LUMBAR
|
Facility
|
OP
|
$23,381.57
|
|
|
Service Code
|
CPT 63267
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$7,283.08
|
| Rate for Payer: BCN Commercial |
$7,283.08
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Mclaren Medicaid |
$7,230.12
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
LAMINECTOMY FOR EXCISION OR EVACUATION OF INTRASPINAL LESION OTHER THAN NEOPLASM, EXTRADURAL; THORACIC
|
Facility
|
OP
|
$23,381.57
|
|
|
Service Code
|
CPT 63266
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$7,674.71
|
| Rate for Payer: BCN Commercial |
$7,674.71
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Mclaren Medicaid |
$7,230.12
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
LAMINECTOMY FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES, PLATE/PADDLE, EPIDURAL
|
Facility
|
OP
|
$62,512.62
|
|
|
Service Code
|
CPT 63655
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$10,109.77 |
| Max. Negotiated Rate |
$62,512.62 |
| Rate for Payer: Aetna Medicare |
$20,103.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24,162.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24,162.94
|
| Rate for Payer: BCBS Complete |
$10,616.23
|
| Rate for Payer: BCBS MAPPO |
$19,330.35
|
| Rate for Payer: BCBS Trust/PPO |
$27,336.27
|
| Rate for Payer: BCN Commercial |
$27,336.27
|
| Rate for Payer: BCN Medicare Advantage |
$19,330.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,330.35
|
| Rate for Payer: Mclaren Medicaid |
$19,330.35
|
| Rate for Payer: Mclaren Medicare |
$19,330.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,296.87
|
| Rate for Payer: Meridian Medicaid |
$20,296.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$21,263.38
|
| Rate for Payer: Nomi Health Commercial |
$57,991.05
|
| Rate for Payer: PACE Medicare |
$18,363.83
|
| Rate for Payer: PACE SWMI |
$19,330.35
|
| Rate for Payer: PHP Medicare Advantage |
$19,330.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,109.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$62,512.62
|
| Rate for Payer: Priority Health Medicare |
$19,330.35
|
| Rate for Payer: Priority Health Tiered Network |
$50,010.10
|
| Rate for Payer: Railroad Medicare Medicare |
$19,330.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19,330.35
|
| Rate for Payer: UHC Medicaid |
$10,109.77
|
| Rate for Payer: UHCCP Medicaid |
$10,109.77
|
| Rate for Payer: VA VA |
$19,330.35
|
|
|
LAMINECTOMY WITH EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, WITHOUT FACETECTOMY, FORAMINOTOMY OR DISCECTOMY (EG, SPINAL STENOSIS), 1 OR 2 VERTEBRAL SEGMENTS; CERVICAL
|
Facility
|
OP
|
$23,381.57
|
|
|
Service Code
|
CPT 63001
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$10,046.55
|
| Rate for Payer: BCN Commercial |
$10,046.55
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Mclaren Medicaid |
$7,230.12
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
LAMINECTOMY WITH REMOVAL OF ABNORMAL FACETS AND/OR PARS INTER-ARTICULARIS WITH DECOMPRESSION OF CAUDA EQUINA AND NERVE ROOTS FOR SPONDYLOLISTHESIS, LUMBAR (GILL TYPE PROCEDURE)
|
Facility
|
OP
|
$23,381.57
|
|
|
Service Code
|
CPT 63012
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$11,303.30
|
| Rate for Payer: BCN Commercial |
$11,303.30
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Mclaren Medicaid |
$7,230.12
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
LAMINOTOMY (HEMILAMINECTOMY), WITH DECOMPRESSION OF NERVE ROOT(S), INCLUDING PARTIAL FACETECTOMY, FORAMINOTOMY AND/OR EXCISION OF HERNIATED INTERVERTEBRAL DISC; 1 INTERSPACE, CERVICAL
|
Facility
|
OP
|
$23,381.57
|
|
|
Service Code
|
CPT 63020
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$10,453.57
|
| Rate for Payer: BCN Commercial |
$10,453.57
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Mclaren Medicaid |
$7,230.12
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
LAMINOTOMY (HEMILAMINECTOMY), WITH DECOMPRESSION OF NERVE ROOT(S), INCLUDING PARTIAL FACETECTOMY, FORAMINOTOMY AND/OR EXCISION OF HERNIATED INTERVERTEBRAL DISC; 1 INTERSPACE, LUMBAR
|
Facility
|
OP
|
$23,381.57
|
|
|
Service Code
|
CPT 63030
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$8,980.83
|
| Rate for Payer: BCN Commercial |
$8,980.83
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Mclaren Medicaid |
$7,230.12
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
LAMINOTOMY (HEMILAMINECTOMY), WITH DECOMPRESSION OF NERVE ROOT(S), INCLUDING PARTIAL FACETECTOMY, FORAMINOTOMY AND/OR EXCISION OF HERNIATED INTERVERTEBRAL DISC; EACH ADDITIONAL INTERSPACE, CERVICAL OR LUMBAR (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
|
Facility
|
OP
|
$14,273.95
|
|
|
Service Code
|
CPT 63035
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$14,273.95 |
| Max. Negotiated Rate |
$14,273.95 |
| Rate for Payer: BCBS Trust/PPO |
$14,273.95
|
| Rate for Payer: BCN Commercial |
$14,273.95
|
|
|
LAMINOTOMY (HEMILAMINECTOMY), WITH DECOMPRESSION OF NERVE ROOT(S), INCLUDING PARTIAL FACETECTOMY, FORAMINOTOMY AND/OR EXCISION OF HERNIATED INTERVERTEBRAL DISC, REEXPLORATION, SINGLE INTERSPACE; EACH ADDITIONAL LUMBAR INTERSPACE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
|
Facility
|
OP
|
$162.40
|
|
|
Service Code
|
CPT 63044
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$162.40 |
| Max. Negotiated Rate |
$162.40 |
| Rate for Payer: BCBS Trust/PPO |
$162.40
|
| Rate for Payer: BCN Commercial |
$162.40
|
|
|
LAMINOTOMY (HEMILAMINECTOMY), WITH DECOMPRESSION OF NERVE ROOT(S), INCLUDING PARTIAL FACETECTOMY, FORAMINOTOMY AND/OR EXCISION OF HERNIATED INTERVERTEBRAL DISC, REEXPLORATION, SINGLE INTERSPACE; LUMBAR
|
Facility
|
OP
|
$23,381.57
|
|
|
Service Code
|
CPT 63042
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$10,075.75
|
| Rate for Payer: BCN Commercial |
$10,075.75
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Mclaren Medicaid |
$7,230.12
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
LAMIVUDINE 10 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$706.80
|
|
|
Service Code
|
NDC 57237027424
|
| Hospital Charge Code |
15881
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$310.99 |
| Max. Negotiated Rate |
$636.12 |
| Rate for Payer: Aetna American Axle |
$459.42
|
| Rate for Payer: Aetna Commercial |
$600.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$459.42
|
| Rate for Payer: Cash Price |
$565.44
|
| Rate for Payer: Cofinity Advantage |
$494.76
|
| Rate for Payer: Cofinity Commercial |
$607.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$565.44
|
| Rate for Payer: Healthscope Commercial |
$636.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$494.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$530.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$600.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$530.10
|
| Rate for Payer: PHP Commercial |
$600.78
|
| Rate for Payer: Priority Health SBD |
$445.28
|
| Rate for Payer: UMR Bronson Commercial |
$310.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$530.10
|
|
|
LAMIVUDINE 10 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$1,026.00
|
|
|
Service Code
|
NDC 49702020548
|
| Hospital Charge Code |
15881
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$379.62 |
| Max. Negotiated Rate |
$923.40 |
| Rate for Payer: Aetna American Axle |
$666.90
|
| Rate for Payer: Aetna Commercial |
$872.10
|
| Rate for Payer: Aetna Medicare |
$513.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$666.90
|
| Rate for Payer: BCBS Complete |
$410.40
|
| Rate for Payer: Cash Price |
$820.80
|
| Rate for Payer: Cofinity Advantage |
$718.20
|
| Rate for Payer: Cofinity Commercial |
$882.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$820.80
|
| Rate for Payer: Healthscope Commercial |
$923.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$718.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$769.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$820.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$872.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$769.50
|
| Rate for Payer: PHP Commercial |
$872.10
|
| Rate for Payer: Priority Health SBD |
$646.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$666.90
|
| Rate for Payer: UHC Core |
$534.55
|
| Rate for Payer: UHC Exchange |
$403.22
|
| Rate for Payer: UMR Bronson Commercial |
$379.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$769.50
|
|
|
LAMIVUDINE 10 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$706.80
|
|
|
Service Code
|
NDC 57237027424
|
| Hospital Charge Code |
15881
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$261.52 |
| Max. Negotiated Rate |
$636.12 |
| Rate for Payer: Aetna American Axle |
$459.42
|
| Rate for Payer: Aetna Commercial |
$600.78
|
| Rate for Payer: Aetna Medicare |
$353.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$459.42
|
| Rate for Payer: BCBS Complete |
$282.72
|
| Rate for Payer: Cash Price |
$565.44
|
| Rate for Payer: Cofinity Advantage |
$494.76
|
| Rate for Payer: Cofinity Commercial |
$607.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$565.44
|
| Rate for Payer: Healthscope Commercial |
$636.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$494.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$530.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$565.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$600.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$530.10
|
| Rate for Payer: PHP Commercial |
$600.78
|
| Rate for Payer: Priority Health SBD |
$445.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$459.42
|
| Rate for Payer: UHC Core |
$368.24
|
| Rate for Payer: UHC Exchange |
$277.77
|
| Rate for Payer: UMR Bronson Commercial |
$261.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$530.10
|
|
|
LAMIVUDINE 10 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$1,026.00
|
|
|
Service Code
|
NDC 49702020548
|
| Hospital Charge Code |
15881
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$451.44 |
| Max. Negotiated Rate |
$923.40 |
| Rate for Payer: Aetna American Axle |
$666.90
|
| Rate for Payer: Aetna Commercial |
$872.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$666.90
|
| Rate for Payer: Cash Price |
$820.80
|
| Rate for Payer: Cofinity Advantage |
$718.20
|
| Rate for Payer: Cofinity Commercial |
$882.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$820.80
|
| Rate for Payer: Healthscope Commercial |
$923.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$718.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$769.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$872.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$769.50
|
| Rate for Payer: PHP Commercial |
$872.10
|
| Rate for Payer: Priority Health SBD |
$646.38
|
| Rate for Payer: UMR Bronson Commercial |
$451.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$769.50
|
|
|
LAMIVUDINE 150 MG TABLET
|
Facility
|
IP
|
$1,182.82
|
|
|
Service Code
|
NDC 68180060207
|
| Hospital Charge Code |
15880
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$520.44 |
| Max. Negotiated Rate |
$1,064.54 |
| Rate for Payer: Aetna American Axle |
$768.83
|
| Rate for Payer: Aetna Commercial |
$1,005.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$768.83
|
| Rate for Payer: Cash Price |
$946.26
|
| Rate for Payer: Cofinity Advantage |
$827.97
|
| Rate for Payer: Cofinity Commercial |
$1,017.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$946.26
|
| Rate for Payer: Healthscope Commercial |
$1,064.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$827.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$887.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,005.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$887.12
|
| Rate for Payer: PHP Commercial |
$1,005.40
|
| Rate for Payer: Priority Health SBD |
$745.18
|
| Rate for Payer: UMR Bronson Commercial |
$520.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$887.12
|
|
|
LAMIVUDINE 150 MG TABLET
|
Facility
|
OP
|
$608.95
|
|
|
Service Code
|
NDC 00904658304
|
| Hospital Charge Code |
15880
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$225.31 |
| Max. Negotiated Rate |
$548.05 |
| Rate for Payer: Aetna American Axle |
$395.82
|
| Rate for Payer: Aetna Commercial |
$517.61
|
| Rate for Payer: Aetna Medicare |
$304.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$395.82
|
| Rate for Payer: BCBS Complete |
$243.58
|
| Rate for Payer: Cash Price |
$487.16
|
| Rate for Payer: Cofinity Advantage |
$426.26
|
| Rate for Payer: Cofinity Commercial |
$523.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$487.16
|
| Rate for Payer: Healthscope Commercial |
$548.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$426.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$456.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$487.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$517.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$456.71
|
| Rate for Payer: PHP Commercial |
$517.61
|
| Rate for Payer: Priority Health SBD |
$383.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$395.82
|
| Rate for Payer: UHC Core |
$317.26
|
| Rate for Payer: UHC Exchange |
$239.32
|
| Rate for Payer: UMR Bronson Commercial |
$225.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$456.71
|
|
|
LAMIVUDINE 150 MG TABLET
|
Facility
|
OP
|
$774.34
|
|
|
Service Code
|
NDC 60505325106
|
| Hospital Charge Code |
15880
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$286.51 |
| Max. Negotiated Rate |
$696.91 |
| Rate for Payer: Aetna American Axle |
$503.32
|
| Rate for Payer: Aetna Commercial |
$658.19
|
| Rate for Payer: Aetna Medicare |
$387.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$503.32
|
| Rate for Payer: BCBS Complete |
$309.74
|
| Rate for Payer: Cash Price |
$619.47
|
| Rate for Payer: Cofinity Advantage |
$542.04
|
| Rate for Payer: Cofinity Commercial |
$665.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$619.47
|
| Rate for Payer: Healthscope Commercial |
$696.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$542.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$580.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$619.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$658.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$580.75
|
| Rate for Payer: PHP Commercial |
$658.19
|
| Rate for Payer: Priority Health SBD |
$487.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$503.32
|
| Rate for Payer: UHC Core |
$403.43
|
| Rate for Payer: UHC Exchange |
$304.32
|
| Rate for Payer: UMR Bronson Commercial |
$286.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$580.75
|
|
|
LAMIVUDINE 150 MG TABLET
|
Facility
|
OP
|
$1,182.82
|
|
|
Service Code
|
NDC 68180060207
|
| Hospital Charge Code |
15880
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$437.64 |
| Max. Negotiated Rate |
$1,064.54 |
| Rate for Payer: Aetna American Axle |
$768.83
|
| Rate for Payer: Aetna Commercial |
$1,005.40
|
| Rate for Payer: Aetna Medicare |
$591.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$768.83
|
| Rate for Payer: BCBS Complete |
$473.13
|
| Rate for Payer: Cash Price |
$946.26
|
| Rate for Payer: Cofinity Advantage |
$827.97
|
| Rate for Payer: Cofinity Commercial |
$1,017.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$946.26
|
| Rate for Payer: Healthscope Commercial |
$1,064.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$827.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$887.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$946.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,005.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$887.12
|
| Rate for Payer: PHP Commercial |
$1,005.40
|
| Rate for Payer: Priority Health SBD |
$745.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$768.83
|
| Rate for Payer: UHC Core |
$616.25
|
| Rate for Payer: UHC Exchange |
$464.85
|
| Rate for Payer: UMR Bronson Commercial |
$437.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$887.12
|
|
|
LAMIVUDINE 150 MG TABLET
|
Facility
|
IP
|
$608.95
|
|
|
Service Code
|
NDC 00904658304
|
| Hospital Charge Code |
15880
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$267.94 |
| Max. Negotiated Rate |
$548.05 |
| Rate for Payer: Aetna American Axle |
$395.82
|
| Rate for Payer: Aetna Commercial |
$517.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$395.82
|
| Rate for Payer: Cash Price |
$487.16
|
| Rate for Payer: Cofinity Advantage |
$426.26
|
| Rate for Payer: Cofinity Commercial |
$523.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$487.16
|
| Rate for Payer: Healthscope Commercial |
$548.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$426.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$456.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$517.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$456.71
|
| Rate for Payer: PHP Commercial |
$517.61
|
| Rate for Payer: Priority Health SBD |
$383.64
|
| Rate for Payer: UMR Bronson Commercial |
$267.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$456.71
|
|
