▸ Hospital · MI · CCN 230193
Mclaren Lapeer Region
1375 NORTH MAIN STREET, LAPEER, MI, 230193
Compliance grade
A
100/100
Procedures tracked
191
of 209 target codes
Payers
28
with negotiated rates
Rates published
48,425
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 10 | $18,867 | $9,433.65 | $1,693.99 | $12,282 | $20,019 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 12 | $396.5 | $198.25 | $87.89 | $143.67 | $250.72 |
| Psychiatric eval with medical services | CPT | 90792 | 14 | $396.5 | $198.25 | $87.89 | $156.7 | $277.55 |
| Psychotherapy 30 minutes | CPT | 90832 | 12 | $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 | 25 | $382 | $191 | $7.24 | $85.87 | $315 |
| ED visit level 2 | CPT | 99282 | 26 | $765 | $382.5 | $26.63 | $154.45 | $633 |
| ED visit level 3 | CPT | 99283 | 27 | $1,432 | $716 | $44.94 | $270.05 | $1,184 |
| ED visit level 4 | CPT | 99284 | 27 | $2,075 | $1,037.5 | $76.68 | $415.29 | $1,714 |
| ED visit level 5 | CPT | 99285 | 27 | $2,540 | $1,270 | $111.19 | $597.94 | $2,098 |
| Critical care, first hour | CPT | 99291 | 27 | $4,445 | $2,222.5 | $135.47 | $821.78 | $3,671 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 26 | $1,623.7 | $811.85 | $25.56 | $103.71 | $1,341.1 |
| CT head with contrast | CPT | 70460 | 23 | $1,880.6 | $940.3 | $33.87 | $173.62 | $1,553.2 |
| CT head with and without contrast | CPT | 70470 | 24 | $2,846.7 | $1,423.35 | $38.13 | $173.62 | $2,351.1 |
| CT neck with contrast | CPT | 70491 | 25 | $2,220 | $1,110 | $41.32 | $173.62 | $1,833.5 |
| MRI brain without contrast | CPT | 70551 | 25 | $2,150.9 | $1,075.45 | $44.3 | $235.74 | $1,776.4 |
| MRI brain with contrast | CPT | 70552 | 23 | $2,824.6 | $1,412.3 | $53.46 | $348.3 | $2,332.9 |
| MRI brain with and without contrast | CPT | 70553 | 26 | $4,389.7 | $2,194.85 | $69.01 | $348.3 | $3,625.5 |
| Chest X-ray single view | CPT | 71045 | 26 | $280.3 | $140.15 | $5.54 | $71.4 | $258.8 |
| Chest X-ray 2 views | CPT | 71046 | 26 | $280.3 | $140.15 | $6.6 | $49.8 | $231.5 |
| Chest X-ray 3 views | CPT | 71047 | 23 | $280.3 | $140.15 | $8.31 | $80.84 | $231.5 |
| CT chest without contrast | CPT | 71250 | 24 | $1,623.3 | $811.65 | $32.38 | $103.71 | $1,340.7 |
| CT chest with contrast | CPT | 71260 | 26 | $2,273.5 | $1,136.75 | $34.93 | $173.62 | $1,877.7 |
| CT chest with and without contrast | CPT | 71270 | 23 | $2,355.9 | $1,177.95 | $37.49 | $173.62 | $1,945.8 |
| MRI chest without contrast | CPT | 71550 | 23 | $2,688.6 | $1,344.3 | $43.88 | $235.74 | $2,220.5 |
| MRI chest with contrast | CPT | 71551 | 21 | $187.5 | $1,213.1 | $51.76 | $686.11 | $2,332.9 |
| MRI chest with and without contrast | CPT | 71552 | 23 | $2,987.8 | $1,639.4 | $68.16 | $725.72 | $3,152.6 |
| Lumbosacral spine X-ray | CPT | 72100 | 25 | $442.6 | $221.3 | $6.82 | $71.4 | $365.6 |
| CT cervical spine without contrast | CPT | 72125 | 26 | $1,629.3 | $814.65 | $29.82 | $103.71 | $1,345.7 |
| CT thoracic spine without contrast | CPT | 72128 | 25 | $2,036.7 | $1,018.35 | $29.82 | $103.71 | $1,682 |
| CT lumbar spine without contrast | CPT | 72131 | 25 | $1,632.5 | $816.25 | $29.82 | $103.71 | $1,348.3 |
| MRI cervical spine without contrast | CPT | 72141 | 25 | $2,150.9 | $1,075.45 | $44.52 | $235.74 | $1,776.4 |
| MRI thoracic spine without contrast | CPT | 72146 | 25 | $3,091.9 | $1,545.95 | $44.52 | $235.74 | $2,553.6 |
| MRI lumbar spine without contrast | CPT | 72148 | 26 | $3,091.9 | $1,545.95 | $44.52 | $235.74 | $2,553.6 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 23 | $1,124.7 | $1,364.8 | $53.89 | $348.3 | $2,624.5 |
| MRI cervical spine with and without contrast | CPT | 72156 | 24 | $4,389.7 | $2,194.85 | $69.23 | $348.3 | $3,625.5 |
| MRI lumbar spine with contrast | CPT | 72158 | 25 | $3,053.8 | $1,526.9 | $69.23 | $348.3 | $2,522.1 |
| CT pelvis without contrast | CPT | 72192 | 25 | $1,930 | $965 | $32.59 | $103.71 | $1,593.9 |
| CT pelvis with contrast | CPT | 72193 | 23 | $1,977 | $988.5 | $34.72 | $173.62 | $1,632.8 |
| Shoulder X-ray | CPT | 73030 | 25 | $328.3 | $164.15 | $5.75 | $71.4 | $271.2 |
| Humerus X-ray | CPT | 73060 | 25 | $280.3 | $140.15 | $4.9 | $59.03 | $231.5 |
| Hand X-ray 3 views | CPT | 73130 | 25 | $375.2 | $187.6 | $5.33 | $71.4 | $309.9 |
| MRI upper extremity joint without contrast | CPT | 73221 | 25 | $2,150.9 | $1,075.45 | $40.68 | $235.74 | $1,776.4 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 23 | $3,817.1 | $1,908.55 | $64.97 | $348.3 | $3,152.6 |
| Hip X-ray 2 views | CPT | 73510 | 16 | — | $127.3 | $19.41 | $69.42 | $244.82 |
| Knee X-ray 1-2 views | CPT | 73560 | 25 | $204.6 | $102.3 | $5.11 | $49.7 | $169 |
| Ankle X-ray 3 views | CPT | 73610 | 25 | $368.9 | $184.45 | $5.33 | $71.4 | $304.6 |
| MRI lower extremity joint without contrast | CPT | 73721 | 25 | $2,150.9 | $1,075.45 | $40.68 | $235.74 | $1,776.4 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 24 | $3,817.1 | $1,908.55 | $64.97 | $348.3 | $3,152.6 |
| CT abdomen without contrast | CPT | 74150 | 24 | $1,623.3 | $811.65 | $35.57 | $103.71 | $1,340.7 |
| CT abdomen with contrast | CPT | 74160 | 23 | $2,491.1 | $1,245.55 | $38.13 | $575.98 | $2,057.4 |
| CT abdomen with and without contrast | CPT | 74170 | 25 | $2,932.6 | $1,466.3 | $41.75 | $643.17 | $2,421.9 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 25 | $1,473.1 | $736.55 | $52.19 | $235.74 | $1,216.7 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 26 | $2,183.2 | $1,091.6 | $54.95 | $348.3 | $1,803.2 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 23 | $2,434.2 | $1,217.1 | $60.28 | $348.3 | $2,010.4 |
| MRI abdomen without contrast | CPT | 74181 | 23 | $2,150.9 | $1,075.45 | $43.67 | $235.74 | $1,776.4 |
| MRI abdomen with and without contrast | CPT | 74183 | 24 | $3,053.8 | $1,526.9 | $66.24 | $348.3 | $2,522.1 |
| Abdominal ultrasound complete | CPT | 76700 | 23 | $779.3 | $389.65 | $24.28 | $103.71 | $643.6 |
| Abdominal ultrasound limited | CPT | 76705 | 23 | $632.6 | $316.3 | $17.68 | $103.71 | $522.5 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 24 | $779.3 | $389.65 | $22.15 | $103.71 | $643.6 |
| Obstetric ultrasound first trimester | CPT | 76801 | 23 | $436.8 | $218.4 | $29.82 | $101.51 | $360.8 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 23 | $866.8 | $433.4 | $30.03 | $98.98 | $715.9 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 21 | $202.8 | $393.9 | $56.87 | $222.75 | $757.4 |
| Transvaginal ultrasound | CPT | 76830 | 25 | $968.6 | $484.3 | $20.87 | $103.71 | $799.9 |
| Pelvic ultrasound complete | CPT | 76856 | 25 | $1,076.6 | $538.3 | $20.66 | $151.4 | $967.3 |
| Scrotal ultrasound | CPT | 76870 | 25 | $906.9 | $453.45 | $19.17 | $103.71 | $748.9 |
| Diagnostic mammography unilateral | CPT | 77065 | 21 | $505.5 | $252.75 | $24.28 | $133.13 | $417.4 |
| Diagnostic mammography bilateral | CPT | 77066 | 22 | $851.1 | $425.55 | $29.82 | $241.69 | $703 |
| Screening mammography bilateral | CPT | 77067 | 23 | $712.7 | $356.35 | $23 | $198.45 | $588.6 |
| EKG complete | CPT | 93000 | 21 | $34.2 | $32.4 | $14.67 | $27.53 | $62.3 |
| EKG tracing only | CPT | 93005 | 25 | $182.4 | $91.2 | $12.73 | $43.3 | $150.6 |
| EKG interpretation only | CPT | 93010 | 9 | $34.2 | $17.1 | $5.11 | $8.4 | $11.3 |
| Transthoracic echocardiogram complete | CPT | 93306 | 23 | $4,376.3 | $2,188.15 | $43.03 | $534.75 | $2,002.5 |
| Transthoracic echocardiogram | CPT | 93307 | 21 | $104.7 | $586.2 | $27.26 | $331.54 | $1,127.3 |
| Stress echocardiogram | CPT | 93350 | 21 | $653.8 | $966.3 | $43.03 | $664.42 | $1,858.2 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 6 | $42,871 | $21,435 | $10,833 | $13,986 | $22,378 |
| COPD w MCC | MS-DRG | 190 | 6 | $31,164 | $15,582 | $7,679.24 | $9,942.27 | $15,908 |
| COPD w CC | MS-DRG | 191 | 6 | $20,170 | $10,085 | $5,848.12 | $7,589.68 | $12,143 |
| COPD w/o CC/MCC | MS-DRG | 192 | 6 | $28,859 | $14,430 | $4,258.02 | $5,803.24 | $9,285.19 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 6 | $24,197 | $12,099 | $5,590.75 | $7,259.95 | $11,616 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 6 | $20,527 | $10,264 | $4,360.08 | $5,683.25 | $9,093.21 |
| AMI discharged alive w MCC | MS-DRG | 280 | 7 | $42,532 | $21,266 | $11,128 | $14,354 | $22,967 |
| AMI discharged alive w CC | MS-DRG | 281 | 6 | $24,648 | $12,324 | $6,376.05 | $8,390.03 | $14,140 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 6 | $19,794 | $9,897.11 | $5,016.34 | $6,621.9 | $12,269 |
| Heart failure & shock w MCC | MS-DRG | 291 | 9 | $35,839 | $17,919 | $8,906.08 | $11,853 | $22,899 |
| Heart failure & shock w CC | MS-DRG | 292 | 6 | $25,879 | $12,940 | $5,889.75 | $7,643.01 | $12,229 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 6 | $45,026 | $22,513 | $8,156.32 | $10,798 | $17,277 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 7 | $21,840 | $10,920 | $4,514.85 | $6,636.02 | $18,584 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 8 | $22,848 | $11,424 | $3,835.36 | $5,205.59 | $22,556 |
| GI hemorrhage w CC | MS-DRG | 378 | 6 | $30,784 | $15,392 | $6,803.39 | $8,813.53 | $14,273 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 6 | $15,278 | $7,638.75 | $4,373.26 | $5,751.26 | $10,524 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 8 | $24,191 | $12,096 | $5,024.27 | $7,026.2 | $11,242 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 6 | $90,769 | $45,384 | $10,876 | $14,212 | $22,449 |
| Kidney/UTI w MCC | MS-DRG | 689 | 7 | $29,879 | $14,940 | $8,049.32 | $10,410 | $16,656 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 7 | $23,707 | $11,853 | $5,019.47 | $7,291.94 | $11,667 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 9 | $52,100 | $26,050 | $13,476 | $17,362 | $36,811 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 6 | $26,394 | $13,197 | $6,398.51 | $9,192.15 | $14,707 |
| Initial hospital care, low complexity | CPT | 99221 | 21 | $358 | $195.8 | $52.4 | $113.01 | $376.5 |
| 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 | 19 | $198.1 | $99.05 | $4.63 | $15.68 | $163.6 |
| Electrolyte panel | CPT | 80051 | 17 | $168.5 | $84.25 | $3.83 | $9.48 | $139.1 |
| Comprehensive metabolic panel | CPT | 80053 | 19 | $212.7 | $106.35 | $5.78 | $19.57 | $175.7 |
| Lipid panel | CPT | 80061 | 20 | $101.9 | $50.95 | $7.32 | $25.06 | $92.1 |
| Renal function panel | CPT | 80069 | 16 | $201.5 | $100.75 | $4.75 | $8.68 | $166.4 |
| Hepatic function panel | CPT | 80076 | 16 | $154 | $77 | $4.47 | $10.46 | $127.2 |
| Urinalysis non-automated | CPT | 81002 | 17 | $9.1 | $4.55 | $1.9 | $3.39 | $25 |
| Urinalysis automated | CPT | 81003 | 20 | $74.6 | $37.3 | $1.23 | $8.63 | $62.8 |
| Glucose quantitative | CPT | 82947 | 19 | $92.7 | $46.35 | $2.15 | $17.91 | $76.6 |
| Hemoglobin A1c | CPT | 83036 | 19 | $94.4 | $48 | $5.31 | $13.23 | $92.2 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 19 | $166.2 | $91.7 | $9.19 | $54.53 | $176.3 |
| Complete blood count with automated differential | CPT | 85025 | 20 | $86 | $43 | $4.25 | $16.54 | $65.4 |
| Complete blood count without differential | CPT | 85027 | 20 | $41 | $20.5 | $3.54 | $10.8 | $45 |
| Urine culture bacterial | CPT | 87086 | 18 | $132.2 | $66.1 | $4.41 | $20 | $109.2 |
| Urine culture identification | CPT | 87088 | 12 | — | $23.6 | $4.93 | $22 | $45.3 |
| Tissue exam by pathologist level IV | CPT | 88305 | 16 | $522.4 | $342.5 | $29.23 | $144.86 | $658.7 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 24 | $503 | $251.5 | $18.53 | $119.39 | $415.4 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 21 | $7,617.5 | $3,808.8 | $2,043 | $2,838.62 | $7,093 |
| Vaginal delivery only | CPT | 59409 | 21 | $4,672.3 | $2,336.2 | $660.37 | $1,003.69 | $2,621.16 |
| Vaginal delivery with postpartum | CPT | 59410 | 21 | $5,081.4 | $2,540.7 | $984.03 | $1,514.19 | $4,226 |
| Routine obstetric care with C-section | CPT | 59510 | 21 | $8,039.1 | $4,890.9 | $2,309 | $3,504.67 | $9,405.6 |
| C-section delivery only | CPT | 59514 | 22 | $5,092.4 | $2,546.2 | $461.74 | $859.3 | $1,706.1 |
| C-section with postpartum | CPT | 59515 | 21 | $5,821.9 | $2,911 | $1,221.92 | $1,806.35 | $5,039 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 23 | $337.4 | $207 | $29.82 | $134.11 | $398 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 24 | $446.1 | $269.4 | $41.17 | $168.92 | $518 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 25 | $559.9 | $341.1 | $44.62 | $203.16 | $656 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 24 | $731.7 | $485.7 | $47.94 | $274.69 | $934 |
| Office visit, established patient, 5 min | CPT | 99211 | 23 | $283.6 | $141.8 | $5.54 | $104.73 | $262 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 23 | $337.4 | $196.6 | $22.37 | $129.96 | $378 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 24 | $337.4 | $207 | $17.68 | $81.21 | $398 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 24 | $193 | $269.4 | $35.09 | $153.54 | $518 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 23 | $207 | $341.1 | $47.94 | $192.93 | $656 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 24 | $8,105.9 | $4,052.95 | $77.75 | $745.6 | $2,004.3 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 24 | $7,454.41 | $3,727.21 | $87.33 | $912.3 | $3,268.3 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 24 | $4,374.76 | $2,187.38 | $36.42 | $608.46 | $1,907.7 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 24 | $6,190.7 | $3,095.35 | $46.22 | $696.82 | $1,907.7 |
| Colonoscopy diagnostic | CPT | 45378 | 24 | $5,521.53 | $2,760.77 | $116.72 | $804.07 | $2,134.9 |
| Colonoscopy with biopsy | CPT | 45380 | 24 | $5,778.23 | $2,889.12 | $126.95 | $1,047.8 | $3,467.6 |
| Colonoscopy with polyp removal | CPT | 45385 | 24 | $5,094.79 | $2,547.4 | $159.96 | $1,046.86 | $3,467.6 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 11 | $80,605 | $40,303 | $931.66 | $10,059 | $28,697 |
| Hip hemiarthroplasty | CPT | 27125 | 9 | $3,689.7 | $1,844.9 | $732.93 | $1,042.58 | $1,832.68 |
| Total hip replacement | CPT | 27130 | 23 | $50,014 | $25,007 | $829.21 | $12,141 | $39,969 |
| Total knee replacement | CPT | 27447 | 23 | $50,188 | $25,094 | $828.14 | $12,141 | $37,700 |
| 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 | 21 | $13,281 | $32,358 | $1,128.9 | $10,361 | $64,716 |
| 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 | 23 | $8,496.14 | $4,248.07 | $354.43 | $2,564.15 | $6,892.87 |
| ACL reconstruction | CPT | 29888 | 9 | $8,601.5 | $4,300.8 | $630.48 | $894.17 | $1,731.9 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 6 | $85,915 | $42,958 | $31,887 | $40,950 | $65,520 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 8 | $59,580 | $29,790 | $16,630 | $21,724 | $36,350 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 6 | $40,371 | $20,186 | $11,675 | $15,280 | $24,087 |
| 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 | $40,189 | $20,095 | $11,735 | $15,359 | $24,224 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 7 | $40,716 | $20,358 | $9,474.93 | $12,603 | $21,601 |
| Open appendectomy | CPT | 44950 | 9 | $2,952 | $1,476 | $413.65 | $616.8 | $1,034.31 |
| Laparoscopic appendectomy | CPT | 44970 | 23 | $25,175 | $12,588 | $389.58 | $5,560.35 | $24,535 |
| Major joint replacement w MCC | MS-DRG | 469 | 6 | $143,346 | $71,673 | $21,042 | $27,462 | $50,559 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 6 | $73,180 | $36,590 | $13,381 | $17,500 | $27,585 |
| Laparoscopic cholecystectomy | CPT | 47562 | 23 | $16,421 | $13,587 | $427.28 | $5,560.35 | $27,174 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 23 | $23,907 | $11,954 | $464.55 | $5,560.35 | $20,030 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 6 | $86,141 | $43,071 | $20,203 | $26,371 | $45,768 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 7 | $63,217 | $31,608 | $14,530 | $19,274 | $33,410 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 8 | $53,135 | $26,568 | $11,315 | $14,812 | $33,564 |
| Open umbilical hernia repair | CPT | 49560 | 17 | — | $10,557 | $1,941.88 | $10,251 | $21,114 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 17 | — | $4,534.21 | $1,941.88 | $4,402.72 | $9,068.42 |
| Lap inguinal hernia repair | CPT | 49650 | 23 | $17,507 | $8,753.45 | $281.59 | $4,799.11 | $13,210 |
| Lap incisional hernia repair | CPT | 49652 | 17 | — | $8,989.32 | $3,086.87 | $8,728.64 | $17,979 |
| Total abdominal hysterectomy | CPT | 58150 | 21 | $29,844 | $14,922 | $368.51 | $877.1 | $10,400 |
| Vaginal hysterectomy | CPT | 58260 | 21 | $4,733.9 | $2,367 | $538.04 | $1,300.43 | $4,406.1 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 21 | $3,544.5 | $9,154.4 | $566.58 | $5,220.56 | $18,309 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 21 | $3,734.8 | $12,611 | $629.84 | $6,425.83 | $25,223 |
| Lap salpingo-oophorectomy | CPT | 58661 | 23 | $9,633.82 | $4,816.91 | $30 | $597.29 | $9,104.22 |
| Complex cataract surgery | CPT | 66982 | 23 | $7,065.96 | $3,665.99 | $470.52 | $2,156.33 | $7,331.98 |
| Cataract surgery with lens implant | CPT | 66984 | 23 | $6,102.94 | $3,267.21 | $119.8 | $1,247.56 | $6,534.43 |
| 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 | $30,107 | $15,054 | $8,607.08 | $11,223 | $17,799 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 6 | $46,493 | $23,247 | $12,964 | $18,309 | $29,295 |
| PCI single major coronary artery | CPT | 92920 | 9 | $1,651.8 | $825.9 | $329.94 | $400.25 | $825 |
| PCI with drug-eluting stent | CPT | 92928 | 9 | $1,835.2 | $917.6 | $366.57 | $479.52 | $916.6 |
| PCI bypass graft | CPT | 92937 | 9 | $1,833.8 | $916.9 | $366.36 | $542.1 | $916.07 |
| Left heart catheterization | CPT | 93452 | 21 | $821.2 | $6,483.7 | $146.76 | $3,667.04 | $12,469 |
| Coronary angiography with cath | CPT | 93455 | 21 | $1,256.4 | $4,891.2 | $173.17 | $2,766.33 | $9,406.1 |
| Coronary angiography with bypass cath | CPT | 93458 | 21 | $1,328.8 | $5,511.2 | $182.75 | $3,116.99 | $10,598 |
Payer mix (top 28)
| Payer | Codes covered | Median rate |
|---|---|---|
| Blue Cross Blue Shield | 191 | $365.6 |
| UnitedHealthcare | 191 | $156.7 |
| Medicare | 190 | $175.35 |
| Humana | 186 | $156.7 |
| Aetna | 163 | $178.9 |
| priority health | 160 | $154.6 |
| Medicaid | 156 | $114.09 |
| mclaren commercial ins | 137 | $119 |
| u of m health plan | 135 | $96.3 |
| TRICARE | 135 | $332.41 |
| mi amish medical board | 135 | $348.3 |
| cofinity-ppom op rate | 130 | $224.88 |
| cofinity - wc op rate | 130 | $224.51 |
| priority health op rate | 130 | $184.68 |
| health advantage - ppo op rate | 130 | $121.51 |
| hap - hmo op rate | 130 | $142.04 |
| cofinity - auto op rate | 130 | $256.57 |
| hap preferred op rate | 130 | $165.34 |
| hp - ppo op rate | 114 | $322.62 |
| First Health | 114 | $560 |
| hap - ppo op rate | 114 | $322.62 |
| hp - hmo op rate | 114 | $242.21 |
| mhp - hmo op rate | 114 | $164.7 |
| cofinity auto | 55 | $197.05 |
| workers compensation | 55 | $114.52 |
| cofinity group 15892 & 15893 | 32 | $319.51 |
| hap - hmo | 25 | $127.95 |
| safe response program | 17 | $175 |