▸ Hospital · MI · CCN 230105
Mclaren Northern Michigan
416 CONNABLE AVENUE, PETOSKEY, MI, 230105
Compliance grade
A
100/100
Procedures tracked
189
of 209 target codes
Payers
21
with negotiated rates
Rates published
49,380
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 8 | $16,783 | $8,391.73 | $4,286.08 | $12,043 | $19,269 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 12 | $396.5 | $198.25 | $87.89 | $141.21 | $250.72 |
| Psychiatric eval with medical services | CPT | 90792 | 12 | $396.5 | $198.25 | $87.89 | $156.7 | $250.72 |
| Psychotherapy 30 minutes | CPT | 90832 | 13 | $201.2 | $100.6 | $45.87 | $87.89 | $250.72 |
| Psychotherapy 45 minutes | CPT | 90834 | 12 | $201.2 | $100.6 | $60.5 | $93.73 | $250.72 |
| Psychotherapy 60 minutes | CPT | 90837 | 12 | $221.7 | $110.9 | $87.89 | $138 | $250.72 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 12 | $221.7 | $110.9 | $86.77 | $132.17 | $250.72 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 17 | $373 | $186.5 | $7.24 | $85.87 | $279.75 |
| ED visit level 2 | CPT | 99282 | 17 | $513 | $256.5 | $26.63 | $153.97 | $384.75 |
| ED visit level 3 | CPT | 99283 | 18 | $904 | $452 | $44.94 | $270.05 | $678 |
| ED visit level 4 | CPT | 99284 | 18 | $1,640 | $820 | $76.68 | $415.29 | $1,230 |
| ED visit level 5 | CPT | 99285 | 18 | $1,775 | $887.5 | $111.19 | $540.63 | $1,380.6 |
| Critical care, first hour | CPT | 99291 | 17 | $4,038 | $2,019 | $135.47 | $782.4 | $3,028.5 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 17 | $1,623 | $811.5 | $25.56 | $103.71 | $1,217.25 |
| CT head with contrast | CPT | 70460 | 14 | $2,130.7 | $1,065.35 | $33.87 | $104.61 | $1,583.73 |
| CT head with and without contrast | CPT | 70470 | 14 | $2,495.6 | $1,247.8 | $38.13 | $108.92 | $1,871.7 |
| CT neck with contrast | CPT | 70491 | 14 | $2,099.4 | $1,049.7 | $41.32 | $132.95 | $1,574.55 |
| MRI brain without contrast | CPT | 70551 | 16 | $2,643.7 | $1,321.85 | $44.3 | $216.82 | $1,982.77 |
| MRI brain with contrast | CPT | 70552 | 14 | $2,432.4 | $1,216.2 | $53.46 | $212.88 | $1,807.92 |
| MRI brain with and without contrast | CPT | 70553 | 17 | $4,292.5 | $2,146.25 | $69.01 | $348.3 | $3,219.38 |
| Chest X-ray single view | CPT | 71045 | 17 | $218.2 | $109.1 | $5.54 | $65.29 | $163.65 |
| Chest X-ray 2 views | CPT | 71046 | 17 | $233.4 | $116.7 | $6.6 | $72.99 | $175.05 |
| Chest X-ray 3 views | CPT | 71047 | 14 | $293.8 | $146.9 | $8.31 | $49.35 | $218.43 |
| CT chest without contrast | CPT | 71250 | 16 | $1,623 | $811.5 | $32.38 | $98.74 | $1,217.25 |
| CT chest with contrast | CPT | 71260 | 16 | $2,163.9 | $1,081.95 | $34.93 | $164.03 | $1,622.93 |
| CT chest with and without contrast | CPT | 71270 | 14 | $2,572.2 | $1,286.1 | $37.49 | $104.61 | $1,911.87 |
| MRI chest without contrast | CPT | 71550 | 14 | $2,522.3 | $1,261.15 | $43.88 | $136.19 | $1,874.88 |
| MRI chest with contrast | CPT | 71551 | 12 | $187.5 | $1,135 | $51.76 | $105.83 | $1,964.43 |
| MRI chest with and without contrast | CPT | 71552 | 14 | $3,246.5 | $1,623.25 | $68.16 | $201.21 | $2,413.17 |
| Lumbosacral spine X-ray | CPT | 72100 | 16 | $248.2 | $124.1 | $6.82 | $75.94 | $197.05 |
| CT cervical spine without contrast | CPT | 72125 | 16 | $1,623 | $811.5 | $29.82 | $98.74 | $1,217.25 |
| CT thoracic spine without contrast | CPT | 72128 | 16 | $1,623 | $811.5 | $29.82 | $98.74 | $1,217.25 |
| CT lumbar spine without contrast | CPT | 72131 | 16 | $1,623 | $811.5 | $29.82 | $98.74 | $1,217.25 |
| MRI cervical spine without contrast | CPT | 72141 | 16 | $2,745 | $1,372.5 | $44.52 | $216.82 | $2,058.75 |
| MRI thoracic spine without contrast | CPT | 72146 | 16 | $2,703.8 | $1,351.9 | $44.52 | $216.82 | $2,027.85 |
| MRI lumbar spine without contrast | CPT | 72148 | 17 | $2,703.8 | $1,351.9 | $44.52 | $220.49 | $2,027.85 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 14 | $3,039.6 | $1,519.8 | $53.89 | $201.21 | $2,259.36 |
| MRI cervical spine with and without contrast | CPT | 72156 | 16 | $4,812.1 | $2,406.05 | $69.23 | $331.61 | $3,609.08 |
| MRI lumbar spine with contrast | CPT | 72158 | 16 | $4,765.5 | $2,382.75 | $69.23 | $314.92 | $3,542.22 |
| CT pelvis without contrast | CPT | 72192 | 16 | $1,608.6 | $804.3 | $32.59 | $87.63 | $1,195.65 |
| CT pelvis with contrast | CPT | 72193 | 16 | $2,144 | $1,072 | $34.72 | $132.95 | $1,593.63 |
| Shoulder X-ray | CPT | 73030 | 16 | $231.8 | $188.35 | $5.75 | $83.31 | $325.98 |
| Humerus X-ray | CPT | 73060 | 16 | $218.2 | $186.95 | $4.9 | $85.87 | $323.55 |
| Hand X-ray 3 views | CPT | 73130 | 17 | $258.4 | $186.95 | $5.33 | $85.87 | $323.55 |
| MRI upper extremity joint without contrast | CPT | 73221 | 16 | $2,680.5 | $2,166.5 | $40.68 | $235.74 | $3,749.67 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 15 | $3,913 | $1,956.5 | $64.97 | $224.55 | $2,908.62 |
| Knee X-ray 1-2 views | CPT | 73560 | 17 | $209.3 | $175.9 | $5.11 | $85.77 | $304.47 |
| Ankle X-ray 3 views | CPT | 73610 | 17 | $229.3 | $186.95 | $5.33 | $85.87 | $323.55 |
| MRI lower extremity joint without contrast | CPT | 73721 | 16 | $2,680.5 | $2,166.5 | $40.68 | $235.74 | $3,749.67 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 14 | $3,769.3 | $3,047.05 | $64.97 | $348.3 | $5,273.73 |
| CT abdomen without contrast | CPT | 74150 | 14 | $1,608.6 | $804.3 | $35.57 | $85.19 | $1,195.65 |
| CT abdomen with contrast | CPT | 74160 | 15 | $2,144 | $1,072 | $38.13 | $132.95 | $1,608 |
| CT abdomen with and without contrast | CPT | 74170 | 14 | $2,546.8 | $1,273.4 | $41.75 | $108.92 | $1,893.15 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 15 | $3,215.8 | $1,607.9 | $52.19 | $213.15 | $2,411.85 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 16 | $4,287.9 | $2,143.95 | $54.95 | $331.61 | $3,215.92 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 15 | $5,086 | $2,543 | $60.28 | $314.92 | $3,814.5 |
| MRI abdomen without contrast | CPT | 74181 | 14 | $2,763.2 | $1,381.6 | $43.67 | $140.38 | $2,072.4 |
| MRI abdomen with and without contrast | CPT | 74183 | 14 | $3,752.5 | $1,876.25 | $66.24 | $269.74 | $2,814.38 |
| Abdominal ultrasound complete | CPT | 76700 | 14 | $962.9 | $481.45 | $24.28 | $66.47 | $722.18 |
| Abdominal ultrasound limited | CPT | 76705 | 15 | $612.1 | $306.05 | $17.68 | $93.77 | $459.08 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 15 | $671.3 | $335.65 | $22.15 | $93.77 | $503.47 |
| Obstetric ultrasound first trimester | CPT | 76801 | 14 | $783.2 | $391.6 | $29.82 | $74.56 | $587.4 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 14 | $455.8 | $227.9 | $30.03 | $68.27 | $358.06 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 12 | $202.8 | $307.65 | $56.87 | $109.92 | $532.44 |
| Transvaginal ultrasound | CPT | 76830 | 14 | $602.3 | $301.15 | $20.87 | $80.12 | $451.72 |
| Pelvic ultrasound complete | CPT | 76856 | 14 | $498.7 | $249.35 | $20.66 | $103.71 | $374.03 |
| Scrotal ultrasound | CPT | 76870 | 15 | $537.8 | $268.9 | $19.17 | $93.77 | $403.35 |
| Diagnostic mammography unilateral | CPT | 77065 | 13 | $363 | $181.5 | $24.28 | $58.16 | $360.79 |
| Diagnostic mammography bilateral | CPT | 77066 | 13 | $483.2 | $241.6 | $29.82 | $71.42 | $459.57 |
| Screening mammography bilateral | CPT | 77067 | 14 | $370.4 | $185.2 | $23 | $71.34 | $380.01 |
| EKG complete | CPT | 93000 | 8 | $34.2 | $17.1 | $14.67 | $16.87 | $31.16 |
| EKG tracing only | CPT | 93005 | 16 | $182.6 | $91.3 | $16.39 | $53.33 | $136.95 |
| EKG interpretation only | CPT | 93010 | 9 | $34.2 | $17.1 | $5.11 | $8.4 | $11.3 |
| Transthoracic echocardiogram complete | CPT | 93306 | 14 | $1,183.9 | $591.95 | $43.03 | $371 | $883.8 |
| Transthoracic echocardiogram | CPT | 93307 | 9 | $104.7 | $52.4 | $27.26 | $43.23 | $68.17 |
| Stress echocardiogram | CPT | 93350 | 12 | $653.8 | $623.15 | $43.03 | $201.08 | $1,078.56 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 6 | $28,839 | $14,420 | $10,263 | $13,473 | $21,671 |
| COPD w MCC | MS-DRG | 190 | 6 | $16,102 | $8,050.78 | $7,275.07 | $9,550.34 | $16,207 |
| COPD w CC | MS-DRG | 191 | 7 | $17,929 | $8,964.28 | $5,850.84 | $7,268.16 | $14,422 |
| COPD w/o CC/MCC | MS-DRG | 192 | 6 | $8,641 | $4,320.5 | $4,033.91 | $5,535.18 | $10,582 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 7 | $16,539 | $8,269.35 | $5,593.35 | $7,052.52 | $11,117 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 7 | $7,284 | $3,642 | $4,207.54 | $5,418.78 | $8,670.06 |
| AMI discharged alive w MCC | MS-DRG | 280 | 9 | $35,703 | $17,852 | $9,447.09 | $13,830 | $24,649 |
| AMI discharged alive w CC | MS-DRG | 281 | 7 | $20,871 | $10,435 | $6,379.01 | $8,162 | $17,143 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 6 | $18,050 | $9,024.95 | $5,018.67 | $6,327.92 | $14,875 |
| Heart failure & shock w MCC | MS-DRG | 291 | 8 | $26,303 | $13,152 | $8,693.02 | $11,401 | $101,146 |
| Heart failure & shock w CC | MS-DRG | 292 | 6 | $13,773 | $6,886.5 | $5,892.48 | $7,319.89 | $13,168 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 6 | $15,477 | $7,738.5 | $3,928.32 | $4,879.92 | $8,633.58 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 7 | $24,368 | $12,184 | $7,727.04 | $10,381 | $18,432 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 7 | $17,298 | $8,648.84 | $4,277.22 | $6,343.04 | $13,395 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 8 | $15,894 | $7,946.95 | $3,633.5 | $4,954 | $15,052 |
| GI hemorrhage w CC | MS-DRG | 378 | 6 | $19,741 | $9,870.44 | $6,806.55 | $8,455.37 | $17,304 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 6 | $13,518 | $6,759.2 | $4,375.29 | $5,466.08 | $12,759 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 8 | $16,890 | $8,444.83 | $5,195.67 | $6,822.36 | $14,533 |
| Kidney/UTI w MCC | MS-DRG | 689 | 6 | $25,643 | $12,821 | $8,053.06 | $10,004 | $16,006 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 7 | $16,608 | $8,304.04 | $5,065.96 | $6,979.33 | $22,974 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 9 | $40,929 | $20,465 | $6,179.88 | $16,999 | $28,850 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 8 | $22,145 | $11,072 | $6,061.75 | $8,955 | $23,023 |
| Initial hospital care, low complexity | CPT | 99221 | 9 | $358 | $179 | $52.4 | $75.96 | $113.01 |
| Initial hospital care, moderate complexity | CPT | 99222 | 10 | $520 | $260 | $82.64 | $119.43 | $170.65 |
| Initial hospital care, high complexity | CPT | 99223 | 9 | $675 | $337.5 | $110.12 | $158.79 | $226.05 |
| Hospital discharge, <30 min | CPT | 99238 | 9 | $342 | $171 | $51.55 | $75.37 | $128.89 |
| Hospital discharge, >30 min | CPT | 99239 | 9 | $368 | $184 | $72.85 | $107.3 | $182.15 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 16 | $68.7 | $34.35 | $4.63 | $8.25 | $50.94 |
| Electrolyte panel | CPT | 80051 | 14 | $41.2 | $20.6 | $3.83 | $6.84 | $50 |
| Comprehensive metabolic panel | CPT | 80053 | 16 | $87.6 | $43.8 | $5.78 | $10.3 | $65.07 |
| Lipid panel | CPT | 80061 | 17 | $101.9 | $50.95 | $7.32 | $20.44 | $61.76 |
| Renal function panel | CPT | 80069 | 14 | $85.7 | $42.85 | $4.75 | $8.47 | $63.72 |
| Hepatic function panel | CPT | 80076 | 16 | $67.8 | $33.9 | $4.47 | $7.97 | $50.49 |
| Urinalysis non-automated | CPT | 81002 | 13 | $17.8 | $8.9 | $1.9 | $3.39 | $25 |
| Urinalysis automated | CPT | 81003 | 17 | $16.8 | $8.4 | $1.23 | $3.7 | $25 |
| Glucose quantitative | CPT | 82947 | 16 | $50.4 | $25.2 | $2.15 | $3.88 | $30.55 |
| Hemoglobin A1c | CPT | 83036 | 16 | $94.4 | $47.2 | $5.31 | $15.15 | $57.69 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 16 | $166.2 | $83.1 | $9.19 | $21.51 | $100.73 |
| Complete blood count with automated differential | CPT | 85025 | 17 | $86 | $43 | $4.25 | $7.68 | $52.12 |
| Complete blood count without differential | CPT | 85027 | 17 | $41 | $20.5 | $3.54 | $6.39 | $45 |
| Urine culture bacterial | CPT | 87086 | 16 | $52.3 | $26.15 | $4.41 | $7.87 | $38.88 |
| Tissue exam by pathologist level IV | CPT | 88305 | 16 | $259.3 | $129.65 | $29.23 | $52.11 | $162.18 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 14 | $461.5 | $230.75 | $18.53 | $110.04 | $346.13 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 9 | $7,617.5 | $3,808.8 | $2,043 | $2,260.13 | $3,504.67 |
| Vaginal delivery only | CPT | 59409 | 12 | $4,672.3 | $2,336.2 | $729.76 | $1,050.79 | $2,565 |
| Vaginal delivery with postpartum | CPT | 59410 | 9 | $5,081.4 | $2,540.7 | $984.03 | $1,014.27 | $1,980.33 |
| Routine obstetric care with C-section | CPT | 59510 | 9 | $8,039.1 | $4,019.6 | $2,309 | $2,533.33 | $3,780.59 |
| C-section delivery only | CPT | 59514 | 10 | $5,092.4 | $2,546.2 | $834.27 | $877.84 | $1,706.1 |
| C-section with postpartum | CPT | 59515 | 9 | $5,821.9 | $2,911 | $1,221.92 | $1,267.79 | $1,980.33 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 12 | $900 | $450 | $29.82 | $46.83 | $269.28 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 13 | $990 | $495 | $52.19 | $80.13 | $600.04 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 13 | $1,089 | $544.5 | $57.45 | $127.6 | $660.04 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 13 | $1,200 | $600 | $61.93 | $160.73 | $275 |
| Office visit, established patient, 5 min | CPT | 99211 | 11 | $708 | $354 | $5.54 | $8.91 | $429.12 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 11 | $779 | $389.5 | $21.87 | $33.1 | $584.25 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 12 | $858 | $429 | $41.96 | $61.96 | $520.03 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 12 | $943 | $471.5 | $57.75 | $86.95 | $571.55 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 10 | $1,038 | $519 | $61.93 | $124.89 | $629.13 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 15 | $3,999.77 | $1,999.89 | $77.75 | $512.85 | $1,463.01 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 15 | $3,946.39 | $1,973.2 | $87.33 | $512.85 | $1,463.01 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 15 | $3,719.49 | $1,859.75 | $36.42 | $513.67 | $2,013.66 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 15 | $4,122.59 | $2,061.3 | $46.22 | $543.59 | $2,541.56 |
| Colonoscopy diagnostic | CPT | 45378 | 15 | $3,239.93 | $1,619.97 | $116.72 | $679.5 | $2,019.88 |
| Colonoscopy with biopsy | CPT | 45380 | 15 | $3,861.21 | $1,930.61 | $126.95 | $780.61 | $2,529.29 |
| Colonoscopy with polyp removal | CPT | 45385 | 15 | $3,744.37 | $1,872.19 | $159.96 | $779.22 | $2,903.23 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 14 | $52,872 | $26,436 | $931.66 | $10,059 | $41,867 |
| Hip hemiarthroplasty | CPT | 27125 | 9 | $3,689.7 | $1,844.9 | $732.93 | $1,042.58 | $1,832.68 |
| Total hip replacement | CPT | 27130 | 14 | $35,394 | $17,697 | $829.21 | $7,249.3 | $26,422 |
| Total knee replacement | CPT | 27447 | 14 | $31,300 | $15,650 | $828.14 | $11,178 | $26,639 |
| Knee revision arthroplasty single component | CPT | 27486 | 9 | $10,055 | $5,027.5 | $907.38 | $1,286.59 | $2,268.88 |
| Knee revision arthroplasty all components | CPT | 27487 | 12 | $13,281 | $38,167 | $1,128.9 | $2,354.48 | $68,701 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 12 | $889.5 | $7,430.14 | $109.7 | $199.06 | $13,374 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 12 | $3,937.2 | $6,617.39 | $691.61 | $1,428.68 | $11,911 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 14 | $8,225.96 | $4,112.98 | $354.43 | $1,774.8 | $5,063.05 |
| ACL reconstruction | CPT | 29888 | 14 | $24,946 | $12,473 | $630.48 | $3,907.62 | $12,918 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 8 | $79,554 | $39,777 | $31,446 | $39,630 | $63,408 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 7 | $44,638 | $22,319 | $16,638 | $20,978 | $38,480 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 7 | $41,690 | $20,845 | $11,680 | $14,945 | $36,730 |
| CABG single arterial graft | CPT | 33533 | 9 | $7,204.2 | $3,602.1 | $1,178.1 | $1,802.84 | $2,945.81 |
| CABG 2 arterial grafts | CPT | 33534 | 9 | $8,297.6 | $4,148.8 | $1,383.86 | $2,115.76 | $3,460.3 |
| CABG 3 arterial grafts | CPT | 33535 | 9 | $9,146.1 | $4,573.1 | $1,537.22 | $2,348.18 | $3,857.27 |
| CABG 4+ arterial grafts | CPT | 33536 | 9 | $9,785.4 | $4,892.7 | $1,655.86 | $2,529.15 | $4,146.09 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 7 | $45,270 | $22,635 | $11,741 | $14,929 | $29,369 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 8 | $42,127 | $21,063 | $9,479.34 | $12,366 | $33,455 |
| Open appendectomy | CPT | 44950 | 12 | $2,952 | $6,190.27 | $413.65 | $971.01 | $11,142 |
| Laparoscopic appendectomy | CPT | 44970 | 14 | $18,739 | $9,369.73 | $389.58 | $4,325.63 | $13,874 |
| Major joint replacement w MCC | MS-DRG | 469 | 6 | $36,883 | $18,442 | $21,052 | $26,544 | $61,295 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 8 | $43,277 | $21,639 | $13,388 | $17,303 | $38,250 |
| Laparoscopic cholecystectomy | CPT | 47562 | 14 | $14,625 | $7,312.4 | $427.28 | $3,191.39 | $9,760.29 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 12 | $3,083.3 | $7,089.47 | $464.55 | $1,078.1 | $12,761 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 9 | $57,379 | $28,690 | $7,424.14 | $25,862 | $57,751 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 7 | $45,853 | $22,926 | $14,537 | $19,684 | $51,934 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 8 | $33,921 | $16,960 | $11,320 | $15,035 | $32,343 |
| Open umbilical hernia repair | CPT | 49560 | 9 | — | $3,579.97 | $1,941.88 | $3,050.09 | $6,443.95 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 9 | — | $2,656.54 | $1,941.88 | $3,050.09 | $4,781.76 |
| Lap inguinal hernia repair | CPT | 49650 | 14 | $13,142 | $6,570.81 | $281.59 | $3,191.39 | $9,104.22 |
| Lap incisional hernia repair | CPT | 49652 | 9 | — | $5,678.03 | $3,086.87 | $4,848.51 | $10,220 |
| Total abdominal hysterectomy | CPT | 58150 | 12 | $5,253.9 | $8,121.53 | $653.91 | $1,147.62 | $14,619 |
| Vaginal hysterectomy | CPT | 58260 | 12 | $4,733.9 | $5,085.01 | $538.04 | $1,212.73 | $9,153.02 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 12 | $3,544.5 | $6,629.09 | $566.58 | $1,295.51 | $11,932 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 12 | $3,734.8 | $7,777.98 | $629.84 | $1,440.52 | $14,000 |
| Lap salpingo-oophorectomy | CPT | 58661 | 14 | $11,189 | $5,594.61 | $418.55 | $3,191.39 | $9,104.22 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 8 | $36,286 | $18,143 | $10,469 | $13,726 | $29,577 |
| Complex cataract surgery | CPT | 66982 | 14 | $7,055.13 | $3,527.57 | $470.52 | $1,268.29 | $5,279.61 |
| Cataract surgery with lens implant | CPT | 66984 | 14 | $6,620.12 | $3,310.06 | $343.57 | $1,249.41 | $3,712.43 |
| Vitrectomy mechanical | CPT | 67042 | 9 | $2,797.4 | $1,398.7 | $719.51 | $950.47 | $1,937.43 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 6 | $27,010 | $13,505 | $8,611.08 | $10,697 | $20,489 |
| PCI single major coronary artery | CPT | 92920 | 14 | $12,942 | $6,471 | $329.94 | $3,118.73 | $8,896.93 |
| PCI with drug-eluting stent | CPT | 92928 | 12 | $1,835.2 | $6,349.9 | $366.57 | $691.74 | $10,990 |
| PCI bypass graft | CPT | 92937 | 14 | $1,833.8 | $6,349.9 | $366.36 | $6,203.29 | $17,696 |
| Left heart catheterization | CPT | 93452 | 12 | $821.2 | $3,770.5 | $146.76 | $310.26 | $6,525.9 |
| Coronary angiography with cath | CPT | 93455 | 14 | $3,349.5 | $3,397.65 | $173.17 | $1,768.4 | $5,880.51 |
| Coronary angiography with bypass cath | CPT | 93458 | 14 | $3,582.2 | $4,087.45 | $182.75 | $1,768.4 | $7,074.45 |
Payer mix (top 21)
| Payer | Codes covered | Median rate |
|---|---|---|
| UnitedHealthcare | 189 | $163.65 |
| Medicare | 189 | $220.49 |
| Blue Cross Blue Shield | 189 | $373.49 |
| Humana | 189 | $173.62 |
| Aetna | 169 | $381.6 |
| priority health | 169 | $199.46 |
| Medicaid | 153 | $91.1 |
| TRICARE | 139 | $314.92 |
| mi amish medical board | 139 | $348.3 |
| mclaren commercial ins | 138 | $128 |
| u of m health plan | 135 | $96.3 |
| mclaren health op rate | 119 | $507.48 |
| hap op rate | 119 | $921.26 |
| priority health op rate | 119 | $852.63 |
| workers compensation | 54 | $178.56 |
| cofinity auto | 52 | $197.05 |
| hap - hmo | 25 | $127.95 |
| cofinity group 15892 & 15893 | 24 | $126.12 |
| safe response program | 17 | $175 |
| little traverse bay op rate | 15 | $8.17 |
| bcccnp | 12 | $86.42 |