▸ Hospital · MI · CCN 230141
Mclaren Flint
401 S. BALLENGER, FLINT, MI, 230141
Compliance grade
A
100/100
Procedures tracked
194
of 209 target codes
Payers
30
with negotiated rates
Rates published
52,220
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 | $22,115 | $11,058 | $4,639.8 | $12,296 | $19,765 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 27 | $396.5 | $295.7 | $79.51 | $156.7 | $483.4 |
| Psychiatric eval with medical services | CPT | 90792 | 26 | $396.5 | $425.1 | $79.51 | $162.75 | $694.88 |
| Psychotherapy 30 minutes | CPT | 90832 | 26 | $201.2 | $222.45 | $45.87 | $137.45 | $363.63 |
| Psychotherapy 45 minutes | CPT | 90834 | 26 | $201.2 | $295.7 | $60.5 | $153.2 | $483.4 |
| 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 | 28 | $165 | $83.2 | $7.24 | $55.76 | $450 |
| ED visit level 2 | CPT | 99282 | 28 | $414 | $209.55 | $26.63 | $150.99 | $450 |
| ED visit level 3 | CPT | 99283 | 29 | $782 | $395.2 | $44.94 | $270.05 | $646 |
| ED visit level 4 | CPT | 99284 | 28 | $1,440 | $720 | $76.68 | $388.67 | $1,010.65 |
| ED visit level 5 | CPT | 99285 | 28 | $2,271 | $1,135.5 | $111.19 | $335.37 | $1,594.6 |
| Critical care, first hour | CPT | 99291 | 27 | $3,375 | $1,687.5 | $135.47 | $460.91 | $2,368.95 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 27 | $2,526.4 | $1,263.2 | $25.56 | $329.04 | $1,955.09 |
| CT head with contrast | CPT | 70460 | 25 | $2,748.6 | $1,464.6 | $33.87 | $323.77 | $2,394.03 |
| CT head with and without contrast | CPT | 70470 | 25 | $2,688.3 | $1,604.25 | $38.13 | $400.17 | $2,622.34 |
| CT neck with contrast | CPT | 70491 | 26 | $1,994.3 | $1,145.65 | $41.32 | $514.34 | $1,872.72 |
| MRI brain without contrast | CPT | 70551 | 27 | $1,954.9 | $977.45 | $44.3 | $282.85 | $1,372.33 |
| MRI brain with contrast | CPT | 70552 | 25 | $3,140.9 | $1,570.45 | $53.46 | $470.52 | $2,204.99 |
| MRI brain with and without contrast | CPT | 70553 | 26 | $3,281.1 | $1,640.55 | $69.01 | $606.61 | $2,303.42 |
| Chest X-ray single view | CPT | 71045 | 27 | $169.9 | $84.95 | $5.54 | $50.03 | $275 |
| Chest X-ray 2 views | CPT | 71046 | 27 | $228.2 | $114.1 | $6.6 | $57.94 | $275 |
| Chest X-ray 3 views | CPT | 71047 | 25 | $310.5 | $155.25 | $8.31 | $63.79 | $275 |
| CT chest without contrast | CPT | 71250 | 28 | $1,585.7 | $842.2 | $32.38 | $405.65 | $1,376.66 |
| CT chest with contrast | CPT | 71260 | 27 | $2,128.2 | $1,064.1 | $34.93 | $514.22 | $1,609.22 |
| CT chest with and without contrast | CPT | 71270 | 25 | $2,422.1 | $1,211.05 | $37.49 | $560.14 | $1,700.43 |
| MRI chest without contrast | CPT | 71550 | 25 | $2,178.7 | $1,089.35 | $43.88 | $260.45 | $1,798.99 |
| MRI chest with contrast | CPT | 71551 | 23 | $187.5 | $1,063.9 | $51.76 | $615.13 | $1,799.37 |
| MRI chest with and without contrast | CPT | 71552 | 25 | $3,738.5 | $1,869.25 | $68.16 | $864.56 | $2,624.55 |
| Lumbosacral spine X-ray | CPT | 72100 | 27 | $253.8 | $156.7 | $6.82 | $62.26 | $275 |
| CT cervical spine without contrast | CPT | 72125 | 27 | $2,220.2 | $1,110.1 | $29.82 | $483.29 | $1,681.9 |
| CT thoracic spine without contrast | CPT | 72128 | 27 | $1,745.3 | $872.65 | $29.82 | $305.68 | $1,383.04 |
| CT lumbar spine without contrast | CPT | 72131 | 27 | $2,191.1 | $1,095.55 | $29.82 | $314.65 | $1,767.24 |
| MRI cervical spine without contrast | CPT | 72141 | 28 | $1,958.7 | $979.35 | $44.52 | $282.85 | $1,375.05 |
| MRI thoracic spine without contrast | CPT | 72146 | 27 | $1,954.9 | $977.45 | $44.52 | $313.39 | $1,372.33 |
| MRI lumbar spine without contrast | CPT | 72148 | 28 | $1,954.9 | $977.45 | $44.52 | $313.39 | $1,372.33 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 25 | $2,317 | $1,158.5 | $53.89 | $348.3 | $1,626.56 |
| MRI cervical spine with and without contrast | CPT | 72156 | 26 | $3,254.9 | $1,627.45 | $69.23 | $606.61 | $2,284.97 |
| MRI lumbar spine with contrast | CPT | 72158 | 27 | $3,253.2 | $1,626.6 | $69.23 | $634.19 | $2,283.78 |
| CT pelvis without contrast | CPT | 72192 | 27 | $2,863.9 | $1,519.35 | $32.59 | $304.74 | $2,483.53 |
| CT pelvis with contrast | CPT | 72193 | 25 | $1,964.1 | $1,085.75 | $34.72 | $334.33 | $1,774.8 |
| Shoulder X-ray | CPT | 73030 | 28 | $224.6 | $112.3 | $5.75 | $50.29 | $275 |
| Humerus X-ray | CPT | 73060 | 27 | $173.5 | $86.75 | $4.9 | $49.1 | $275 |
| Hand X-ray 3 views | CPT | 73130 | 27 | $187 | $93.5 | $5.33 | $48.22 | $275 |
| MRI upper extremity joint without contrast | CPT | 73221 | 27 | $1,952.7 | $976.35 | $40.68 | $275.6 | $1,370.8 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 27 | $3,380.3 | $1,690.15 | $64.97 | $587.11 | $2,373.03 |
| Hip X-ray 2 views | CPT | 73510 | 18 | — | $140.85 | $18.48 | $55.44 | $275 |
| Knee X-ray 1-2 views | CPT | 73560 | 26 | $249.2 | $124.6 | $5.11 | $49.1 | $275 |
| Ankle X-ray 3 views | CPT | 73610 | 27 | $270.1 | $137.6 | $5.33 | $53.29 | $275 |
| MRI lower extremity joint without contrast | CPT | 73721 | 28 | $1,954.9 | $977.45 | $40.68 | $378.12 | $1,396.04 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 25 | $3,378.7 | $1,689.35 | $64.97 | $557.28 | $2,371.84 |
| CT abdomen without contrast | CPT | 74150 | 25 | $1,512.3 | $890.55 | $35.57 | $246.28 | $1,455.71 |
| CT abdomen with contrast | CPT | 74160 | 25 | $2,094.4 | $1,058.15 | $38.13 | $362.5 | $1,729.67 |
| CT abdomen with and without contrast | CPT | 74170 | 25 | $1,955.9 | $1,238.3 | $41.75 | $378.78 | $2,024.11 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 27 | $2,805.9 | $1,402.95 | $52.19 | $323.47 | $2,289.99 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 27 | $3,067.7 | $1,533.85 | $54.95 | $554.11 | $2,311.41 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 27 | $2,557.9 | $1,414.05 | $60.28 | $620.37 | $2,311.41 |
| MRI abdomen without contrast | CPT | 74181 | 25 | $1,871.4 | $935.7 | $43.67 | $260.45 | $1,313.76 |
| MRI abdomen with and without contrast | CPT | 74183 | 25 | $3,292.9 | $1,646.45 | $66.24 | $589.14 | $2,311.58 |
| Abdominal ultrasound complete | CPT | 76700 | 25 | $705.5 | $536.4 | $24.28 | $165.94 | $876.78 |
| Abdominal ultrasound limited | CPT | 76705 | 26 | $760.7 | $380.35 | $17.68 | $142.21 | $581.23 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 28 | $859.2 | $471.05 | $22.15 | $207.22 | $770.02 |
| Obstetric ultrasound first trimester | CPT | 76801 | 26 | $664.6 | $332.3 | $29.82 | $165.94 | $466.57 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 26 | $561 | $280.5 | $30.03 | $167.47 | $577.54 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 25 | $727.6 | $363.8 | $56.87 | $215.11 | $586.39 |
| Transvaginal ultrasound | CPT | 76830 | 27 | $614.7 | $366.75 | $20.87 | $170.58 | $599.51 |
| Pelvic ultrasound complete | CPT | 76856 | 27 | $671.8 | $511.15 | $20.66 | $160.52 | $835.55 |
| Scrotal ultrasound | CPT | 76870 | 26 | $1,054.8 | $757.35 | $19.17 | $144.45 | $1,237.94 |
| Diagnostic mammography unilateral | CPT | 77065 | 24 | $565.3 | $282.65 | $24.28 | $149.75 | $581.95 |
| Diagnostic mammography bilateral | CPT | 77066 | 24 | $720.1 | $360.05 | $29.82 | $220.24 | $741.28 |
| Screening mammography bilateral | CPT | 77067 | 25 | $619.4 | $309.7 | $23 | $188.42 | $612.94 |
| EKG complete | CPT | 93000 | 23 | $34.2 | $44.9 | $13.44 | $30.55 | $275 |
| EKG tracing only | CPT | 93005 | 27 | $141.8 | $78.45 | $12.85 | $32.73 | $275 |
| EKG interpretation only | CPT | 93010 | 23 | $34.2 | $22.9 | $5.11 | $10.08 | $275 |
| Transthoracic echocardiogram complete | CPT | 93306 | 25 | $3,700.2 | $1,850.1 | $43.03 | $528.77 | $1,942.68 |
| Transthoracic echocardiogram | CPT | 93307 | 25 | $906.5 | $514 | $27.26 | $235.74 | $840.23 |
| Stress echocardiogram | CPT | 93350 | 9 | $653.8 | $326.9 | $43.03 | $67.74 | $107.59 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 7 | $43,764 | $21,882 | $6,756.03 | $13,772 | $22,035 |
| COPD w MCC | MS-DRG | 190 | 7 | $25,807 | $12,904 | $7,623.7 | $10,014 | $15,809 |
| COPD w CC | MS-DRG | 191 | 6 | $17,324 | $8,661.76 | $5,801.92 | $7,617.12 | $12,187 |
| COPD w/o CC/MCC | MS-DRG | 192 | 6 | $22,129 | $11,064 | $4,366.82 | $5,898.27 | $9,437.24 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 7 | $19,291 | $9,645.51 | $5,546.58 | $7,299.86 | $11,680 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 6 | $17,619 | $8,809.56 | $4,325.63 | $5,782.83 | $12,934 |
| AMI discharged alive w MCC | MS-DRG | 280 | 8 | $42,691 | $21,346 | $9,126.77 | $14,126 | $22,601 |
| AMI discharged alive w CC | MS-DRG | 281 | 8 | $27,309 | $13,654 | $6,325.67 | $8,956.91 | $14,069 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 8 | $21,345 | $10,672 | $4,976.71 | $7,185.06 | $15,308 |
| Heart failure & shock w MCC | MS-DRG | 291 | 6 | $29,994 | $14,997 | $7,794.7 | $11,387 | $18,219 |
| Heart failure & shock w CC | MS-DRG | 292 | 6 | $17,983 | $8,991.68 | $5,843.21 | $7,668.43 | $12,270 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 6 | $8,927.5 | $4,463.75 | $3,895.47 | $5,248.36 | $8,397.38 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 6 | $28,011 | $14,006 | $8,286.49 | $10,704 | $17,127 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 8 | $20,120 | $10,060 | $4,630.21 | $6,900.54 | $15,697 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 8 | $16,452 | $8,225.8 | $3,866.57 | $5,249.22 | $9,971.64 |
| GI hemorrhage w CC | MS-DRG | 378 | 7 | $29,755 | $14,877 | $6,749.63 | $8,926.59 | $15,895 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 6 | $18,428 | $9,213.83 | $4,338.7 | $5,874.86 | $10,333 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 8 | $21,130 | $10,565 | $5,365.57 | $7,287.21 | $18,068 |
| Kidney/UTI w MCC | MS-DRG | 689 | 6 | $31,426 | $15,713 | $7,985.72 | $10,331 | $16,529 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 6 | $19,156 | $9,578.13 | $5,484.04 | $7,330.65 | $11,729 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 8 | $55,613 | $27,807 | $13,369 | $17,019 | $27,231 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 9 | $32,804 | $16,402 | $3,494.56 | $9,158.96 | $34,652 |
| Initial hospital care, low complexity | CPT | 99221 | 23 | $358 | $232.55 | $52.4 | $134.01 | $380.12 |
| Initial hospital care, moderate complexity | CPT | 99222 | 24 | $520 | $315.05 | $82.64 | $194.36 | $515.02 |
| Initial hospital care, high complexity | CPT | 99223 | 23 | $675 | $462.75 | $110.12 | $272.8 | $756.42 |
| 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 | 23 | $120.9 | $62.35 | $4.63 | $40.12 | $275 |
| Electrolyte panel | CPT | 80051 | 19 | $92.7 | $47.85 | $3.83 | $30.18 | $275 |
| Comprehensive metabolic panel | CPT | 80053 | 22 | $194 | $97 | $5.78 | $59 | $275 |
| Lipid panel | CPT | 80061 | 23 | $101.9 | $50.95 | $7.32 | $30.64 | $275 |
| Renal function panel | CPT | 80069 | 19 | $103.5 | $51.75 | $4.75 | $31.49 | $275 |
| Hepatic function panel | CPT | 80076 | 20 | $94.1 | $47.85 | $4.47 | $28.62 | $275 |
| Urinalysis non-automated | CPT | 81002 | 20 | $19.9 | $9.95 | $1.9 | $4.02 | $25 |
| Urinalysis automated | CPT | 81003 | 23 | $29.7 | $15 | $1.23 | $8.86 | $275 |
| Glucose quantitative | CPT | 82947 | 26 | $50.4 | $25.2 | $2.15 | $8.74 | $275 |
| Hemoglobin A1c | CPT | 83036 | 22 | $94.4 | $47.2 | $5.31 | $14.28 | $275 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 22 | $166.2 | $83.1 | $9.19 | $47.19 | $275 |
| Complete blood count with automated differential | CPT | 85025 | 23 | $86.7 | $44.8 | $4.25 | $28.81 | $275 |
| Complete blood count without differential | CPT | 85027 | 23 | $41 | $20.5 | $3.54 | $12.29 | $275 |
| Urine culture bacterial | CPT | 87086 | 21 | $100.2 | $50.1 | $4.41 | $25.14 | $275 |
| Tissue exam by pathologist level IV | CPT | 88305 | 22 | $735.1 | $367.55 | $29.23 | $91.54 | $353.88 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 26 | $747.7 | $373.85 | $18.53 | $114.03 | $524.88 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 23 | $7,617.5 | $4,315.55 | $275 | $2,928.28 | $7,054.24 |
| Vaginal delivery only | CPT | 59409 | 23 | $4,672.3 | $2,336.2 | $275 | $962.95 | $2,802.98 |
| 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 | 26 | $414 | $207 | $18.48 | $83.94 | $290.7 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 27 | $782 | $391 | $28 | $107.38 | $549.1 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 28 | $1,439 | $719.5 | $39.48 | $140.58 | $1,010.65 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 28 | $2,271 | $1,135.5 | $42.28 | $153.3 | $1,594.6 |
| Office visit, established patient, 5 min | CPT | 99211 | 25 | $164 | $144.05 | $5.54 | $71.42 | $275 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 26 | $414 | $207 | $12.04 | $76.37 | $290.7 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 27 | $782 | $391 | $14 | $78.63 | $549.1 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 27 | $1,439 | $719.5 | $28.28 | $106.57 | $1,010.65 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 26 | $207 | $975.5 | $39.76 | $138.66 | $1,594.6 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 26 | $4,807.97 | $2,403.99 | $77.75 | $914.38 | $2,473.76 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 26 | $6,308.72 | $3,154.36 | $87.33 | $914.38 | $2,563.26 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 26 | $5,506.1 | $2,753.05 | $36.42 | $831.41 | $2,184.84 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 26 | $6,749.25 | $3,374.63 | $46.22 | $889.17 | $2,856.51 |
| Colonoscopy diagnostic | CPT | 45378 | 26 | $5,145.15 | $2,572.58 | $116.72 | $835.12 | $1,927.38 |
| Colonoscopy with biopsy | CPT | 45380 | 26 | $5,020.04 | $2,510.02 | $126.95 | $1,330.57 | $3,588.96 |
| Colonoscopy with polyp removal | CPT | 45385 | 26 | $4,758.41 | $2,379.21 | $159.96 | $1,149.93 | $3,520.02 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 9 | $6,417.2 | $3,208.6 | $931.66 | $1,313.38 | $2,329.59 |
| Hip hemiarthroplasty | CPT | 27125 | 9 | $3,689.7 | $1,844.9 | $732.93 | $1,042.58 | $1,832.68 |
| Total hip replacement | CPT | 27130 | 25 | $79,237 | $39,618 | $275 | $12,549 | $58,873 |
| Total knee replacement | CPT | 27447 | 25 | $66,131 | $33,066 | $275 | $12,549 | $39,106 |
| Knee revision arthroplasty single component | CPT | 27486 | 23 | $10,055 | $18,741 | $275 | $8,984.26 | $31,859 |
| Knee revision arthroplasty all components | CPT | 27487 | 9 | $13,281 | $6,640.3 | $1,128.9 | $1,593.68 | $3,101.03 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 9 | $889.5 | $444.8 | $109.7 | $151.18 | $247.15 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 9 | $3,937.2 | $1,968.6 | $691.61 | $981.48 | $1,729.35 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 25 | $11,574 | $5,786.93 | $275 | $3,021.01 | $8,599.7 |
| ACL reconstruction | CPT | 29888 | 11 | $45,564 | $22,782 | $630.48 | $3,907.62 | $11,147 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 9 | $110,498 | $55,249 | $27,060 | $40,222 | $100,694 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 7 | $71,266 | $35,633 | $16,499 | $20,908 | $33,453 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 8 | $55,509 | $27,754 | $11,583 | $16,061 | $28,213 |
| 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 | 6 | $47,027 | $23,513 | $11,642 | $15,097 | $23,798 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 6 | $34,386 | $17,193 | $9,400.07 | $12,269 | $21,209 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 6 | $47,319 | $23,660 | $23,449 | $29,987 | $59,008 |
| Open appendectomy | CPT | 44950 | 9 | $2,952 | $1,476 | $413.65 | $616.8 | $1,034.31 |
| Laparoscopic appendectomy | CPT | 44970 | 25 | $26,018 | $13,009 | $275 | $5,485.09 | $19,408 |
| Major joint replacement w MCC | MS-DRG | 469 | 6 | $80,243 | $40,122 | $20,876 | $26,742 | $49,641 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 7 | $90,334 | $45,167 | $13,276 | $17,410 | $32,116 |
| Laparoscopic cholecystectomy | CPT | 47562 | 25 | $20,100 | $10,050 | $275 | $4,737.54 | $11,769 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 25 | $26,590 | $13,295 | $275 | $5,403.92 | $16,395 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 6 | $101,307 | $50,653 | $20,044 | $25,692 | $44,937 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 7 | $70,153 | $35,077 | $14,415 | $18,869 | $31,408 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 8 | $58,954 | $29,477 | $11,225 | $15,648 | $24,541 |
| Open umbilical hernia repair | CPT | 49560 | 19 | — | $5,033.34 | $275 | $3,917.45 | $8,556.68 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 19 | — | $4,170.72 | $275 | $3,543.86 | $7,090.22 |
| Lap inguinal hernia repair | CPT | 49650 | 25 | $28,212 | $14,106 | $275 | $5,065.65 | $13,401 |
| Lap incisional hernia repair | CPT | 49652 | 19 | — | $9,811.27 | $275 | $3,071.18 | $16,679 |
| Total abdominal hysterectomy | CPT | 58150 | 9 | $5,253.9 | $2,627 | $653.91 | $948.82 | $1,635.08 |
| Vaginal hysterectomy | CPT | 58260 | 25 | $26,550 | $13,275 | $275 | $4,108.54 | $10,869 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 25 | $37,480 | $18,740 | $275 | $5,626.53 | $21,612 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 25 | $36,712 | $18,356 | $275 | $7,501.88 | $19,846 |
| Lap salpingo-oophorectomy | CPT | 58661 | 25 | $17,410 | $8,704.91 | $26.5 | $3,191.39 | $12,233 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 6 | $53,591 | $26,795 | $19,872 | $25,476 | $40,160 |
| OR procedure for obesity w CC | MS-DRG | 620 | 8 | $57,469 | $28,735 | $11,014 | $14,687 | $23,452 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 8 | $52,047 | $26,023 | $9,855.75 | $13,507 | $22,835 |
| Complex cataract surgery | CPT | 66982 | 25 | $7,787.34 | $3,893.67 | $275 | $2,081.33 | $5,693.02 |
| Cataract surgery with lens implant | CPT | 66984 | 25 | $7,076.52 | $3,538.26 | $12.56 | $1,247.56 | $4,353.58 |
| 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 | 7 | $40,671 | $20,335 | $8,539.07 | $11,429 | $29,256 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 6 | $52,097 | $26,049 | $13,295 | $17,931 | $28,690 |
| PCI single major coronary artery | CPT | 92920 | 25 | $22,389 | $15,508 | $275 | $5,498.43 | $25,349 |
| PCI with drug-eluting stent | CPT | 92928 | 25 | $44,219 | $22,109 | $275 | $10,322 | $26,783 |
| PCI bypass graft | CPT | 92937 | 25 | $54,844 | $27,422 | $275 | $10,772 | $38,501 |
| Left heart catheterization | CPT | 93452 | 25 | $11,453 | $5,726.4 | $146.76 | $3,039.11 | $8,039.98 |
| Coronary angiography with cath | CPT | 93455 | 25 | $6,157 | $4,891 | $173.17 | $3,029.52 | $7,994.93 |
| Coronary angiography with bypass cath | CPT | 93458 | 25 | $6,157 | $4,603.45 | $182.75 | $2,940.68 | $7,524.88 |
Payer mix (top 30)
| Payer | Codes covered | Median rate |
|---|---|---|
| UnitedHealthcare | 194 | $166.31 |
| Blue Cross Blue Shield | 194 | $406.6 |
| Medicare | 193 | $235.74 |
| Humana | 190 | $173.62 |
| Aetna | 168 | $134.32 |
| priority health | 165 | $166.8 |
| Medicaid | 155 | $132.22 |
| TRICARE | 150 | $340.52 |
| mi amish medical board | 150 | $348.3 |
| mclaren commercial ins | 140 | $125.35 |
| u of m health plan | 135 | $96.3 |
| hap - hmo op rate | 133 | $101.91 |
| hap preferred op rate | 133 | $113.45 |
| hap/ahl op rate | 133 | $101.91 |
| priority health op rate | 133 | $139.82 |
| cofinity - wc/auto op rate | 133 | $156.83 |
| cofinity - ppom op rate | 133 | $135.59 |
| First Health | 133 | $235.2 |
| hurley medical center op rate | 133 | $83.33 |
| cofinity wc op rate | 133 | $135.59 |
| cofinity - auto op rate | 133 | $156.83 |
| hp - hmo op rate | 119 | $163.29 |
| health advantage - ppo op rate | 119 | $122.64 |
| hp - ppo op rate | 119 | $217.3 |
| mhp - hmo op rate | 119 | $122.64 |
| workers compensation | 59 | $150.32 |
| cofinity auto | 55 | $197.05 |
| hap - hmo | 25 | $127.95 |
| cofinity group 15892 & 15893 | 23 | $81.27 |
| safe response program | 17 | $175 |