|
HC ATHERECT BRACHIOCEPHAL EA V
|
Facility
|
OP
|
$14,597.63
|
|
|
Service Code
|
CPT 0237T
|
| Hospital Charge Code |
36100301
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,348.94 |
| Max. Negotiated Rate |
$30,783.77 |
| Rate for Payer: Aetna American Axle |
$9,488.46
|
| Rate for Payer: Aetna Commercial |
$12,407.99
|
| Rate for Payer: Aetna Medicare |
$10,169.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,488.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,223.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,223.36
|
| Rate for Payer: BCBS Complete |
$5,616.88
|
| Rate for Payer: BCBS MAPPO |
$9,778.69
|
| Rate for Payer: BCBS Trust/PPO |
$8,684.72
|
| Rate for Payer: BCN Medicare Advantage |
$9,778.69
|
| Rate for Payer: Cash Price |
$11,678.10
|
| Rate for Payer: Cash Price |
$11,678.10
|
| Rate for Payer: Cofinity Commercial |
$12,553.96
|
| Rate for Payer: Cofinity Commercial |
$10,218.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,678.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,778.69
|
| Rate for Payer: Healthscope Commercial |
$13,137.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,218.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,948.22
|
| Rate for Payer: Mclaren Medicaid |
$5,348.94
|
| Rate for Payer: Mclaren Medicare |
$9,778.69
|
| Rate for Payer: Meridian Medicaid |
$5,616.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,267.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,245.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12,407.99
|
| Rate for Payer: PACE Medicare |
$9,289.76
|
| Rate for Payer: PACE SWMI |
$9,778.69
|
| Rate for Payer: PHP Commercial |
$12,407.99
|
| Rate for Payer: PHP Medicare Advantage |
$9,778.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,348.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,218.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30,783.77
|
| Rate for Payer: Priority Health Medicare |
$9,778.69
|
| Rate for Payer: Priority Health Narrow Network |
$24,627.02
|
| Rate for Payer: Priority Health SBD |
$9,196.51
|
| Rate for Payer: Railroad Medicare Medicare |
$9,778.69
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,778.69
|
| Rate for Payer: UHC Medicare Advantage |
$10,072.05
|
| Rate for Payer: UMR Bronson Commercial |
$5,401.12
|
| Rate for Payer: VA VA |
$9,778.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,948.22
|
|
|
HC ATHERECT BRACHIOCEPHAL EA V
|
Facility
|
IP
|
$14,597.63
|
|
|
Service Code
|
CPT 0237T
|
| Hospital Charge Code |
36100301
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,422.96 |
| Max. Negotiated Rate |
$13,137.87 |
| Rate for Payer: Aetna American Axle |
$9,488.46
|
| Rate for Payer: Aetna Commercial |
$12,407.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,488.46
|
| Rate for Payer: Cash Price |
$11,678.10
|
| Rate for Payer: Cofinity Commercial |
$10,218.34
|
| Rate for Payer: Cofinity Commercial |
$12,553.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,678.10
|
| Rate for Payer: Healthscope Commercial |
$13,137.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,218.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,948.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12,407.99
|
| Rate for Payer: PHP Commercial |
$12,407.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,218.34
|
| Rate for Payer: Priority Health SBD |
$9,196.51
|
| Rate for Payer: UMR Bronson Commercial |
$6,422.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,948.22
|
|
|
HC ATHERECT ILIAC ARTERY EA VE
|
Facility
|
IP
|
$11,848.47
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
36100302
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,213.33 |
| Max. Negotiated Rate |
$10,663.62 |
| Rate for Payer: Aetna American Axle |
$7,701.51
|
| Rate for Payer: Aetna Commercial |
$10,071.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,701.51
|
| Rate for Payer: Cash Price |
$9,478.78
|
| Rate for Payer: Cofinity Commercial |
$10,189.68
|
| Rate for Payer: Cofinity Commercial |
$8,293.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,478.78
|
| Rate for Payer: Healthscope Commercial |
$10,663.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,293.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,886.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,071.20
|
| Rate for Payer: PHP Commercial |
$10,071.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,293.93
|
| Rate for Payer: Priority Health SBD |
$7,464.54
|
| Rate for Payer: UMR Bronson Commercial |
$5,213.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,886.35
|
|
|
HC ATHERECT ILIAC ARTERY EA VE
|
Facility
|
OP
|
$11,848.47
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
36100302
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,383.93 |
| Max. Negotiated Rate |
$49,067.27 |
| Rate for Payer: Aetna American Axle |
$7,701.51
|
| Rate for Payer: Aetna Commercial |
$10,071.20
|
| Rate for Payer: Aetna Medicare |
$16,210.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,701.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,483.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,483.22
|
| Rate for Payer: BCBS Complete |
$8,952.93
|
| Rate for Payer: BCBS MAPPO |
$15,586.58
|
| Rate for Payer: BCBS Trust/PPO |
$13,359.03
|
| Rate for Payer: BCN Medicare Advantage |
$15,586.58
|
| Rate for Payer: Cash Price |
$9,478.78
|
| Rate for Payer: Cash Price |
$9,478.78
|
| Rate for Payer: Cofinity Commercial |
$8,293.93
|
| Rate for Payer: Cofinity Commercial |
$10,189.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,478.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,586.58
|
| Rate for Payer: Healthscope Commercial |
$10,663.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,293.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,886.35
|
| Rate for Payer: Mclaren Medicaid |
$8,525.86
|
| Rate for Payer: Mclaren Medicare |
$15,586.58
|
| Rate for Payer: Meridian Medicaid |
$8,952.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,365.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,924.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,071.20
|
| Rate for Payer: PACE Medicare |
$14,807.25
|
| Rate for Payer: PACE SWMI |
$15,586.58
|
| Rate for Payer: PHP Commercial |
$10,071.20
|
| Rate for Payer: PHP Medicare Advantage |
$15,586.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,525.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,293.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49,067.27
|
| Rate for Payer: Priority Health Medicare |
$15,586.58
|
| Rate for Payer: Priority Health Narrow Network |
$39,253.82
|
| Rate for Payer: Priority Health SBD |
$7,464.54
|
| Rate for Payer: Railroad Medicare Medicare |
$15,586.58
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,586.58
|
| Rate for Payer: UHC Medicare Advantage |
$16,054.18
|
| Rate for Payer: UMR Bronson Commercial |
$4,383.93
|
| Rate for Payer: VA VA |
$15,586.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,886.35
|
|
|
HC ATHERECTOMY RENAL ARTERY
|
Facility
|
IP
|
$12,716.17
|
|
|
Service Code
|
CPT 0234T
|
| Hospital Charge Code |
36100304
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,595.11 |
| Max. Negotiated Rate |
$11,444.55 |
| Rate for Payer: Aetna American Axle |
$8,265.51
|
| Rate for Payer: Aetna Commercial |
$10,808.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,265.51
|
| Rate for Payer: Cash Price |
$10,172.94
|
| Rate for Payer: Cofinity Commercial |
$10,935.91
|
| Rate for Payer: Cofinity Commercial |
$8,901.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,172.94
|
| Rate for Payer: Healthscope Commercial |
$11,444.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,901.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,537.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,808.74
|
| Rate for Payer: PHP Commercial |
$10,808.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,901.32
|
| Rate for Payer: Priority Health SBD |
$8,011.19
|
| Rate for Payer: UMR Bronson Commercial |
$5,595.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,537.13
|
|
|
HC ATHERECTOMY RENAL ARTERY
|
Facility
|
OP
|
$12,716.17
|
|
|
Service Code
|
CPT 0234T
|
| Hospital Charge Code |
36100304
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,704.98 |
| Max. Negotiated Rate |
$30,783.77 |
| Rate for Payer: Aetna American Axle |
$8,265.51
|
| Rate for Payer: Aetna Commercial |
$10,808.74
|
| Rate for Payer: Aetna Medicare |
$10,169.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,265.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,223.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,223.36
|
| Rate for Payer: BCBS Complete |
$5,616.88
|
| Rate for Payer: BCBS MAPPO |
$9,778.69
|
| Rate for Payer: BCBS Trust/PPO |
$8,684.72
|
| Rate for Payer: BCN Medicare Advantage |
$9,778.69
|
| Rate for Payer: Cash Price |
$10,172.94
|
| Rate for Payer: Cash Price |
$10,172.94
|
| Rate for Payer: Cofinity Commercial |
$8,901.32
|
| Rate for Payer: Cofinity Commercial |
$10,935.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,172.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,778.69
|
| Rate for Payer: Healthscope Commercial |
$11,444.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,901.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,537.13
|
| Rate for Payer: Mclaren Medicaid |
$5,348.94
|
| Rate for Payer: Mclaren Medicare |
$9,778.69
|
| Rate for Payer: Meridian Medicaid |
$5,616.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,267.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,245.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,808.74
|
| Rate for Payer: PACE Medicare |
$9,289.76
|
| Rate for Payer: PACE SWMI |
$9,778.69
|
| Rate for Payer: PHP Commercial |
$10,808.74
|
| Rate for Payer: PHP Medicare Advantage |
$9,778.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,348.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,901.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30,783.77
|
| Rate for Payer: Priority Health Medicare |
$9,778.69
|
| Rate for Payer: Priority Health Narrow Network |
$24,627.02
|
| Rate for Payer: Priority Health SBD |
$8,011.19
|
| Rate for Payer: Railroad Medicare Medicare |
$9,778.69
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,778.69
|
| Rate for Payer: UHC Medicare Advantage |
$10,072.05
|
| Rate for Payer: UMR Bronson Commercial |
$4,704.98
|
| Rate for Payer: VA VA |
$9,778.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,537.13
|
|
|
HC ATHERECT VISCERAL EACH VESS
|
Facility
|
IP
|
$12,716.17
|
|
|
Service Code
|
CPT 0235T
|
| Hospital Charge Code |
36100303
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,595.11 |
| Max. Negotiated Rate |
$11,444.55 |
| Rate for Payer: Aetna American Axle |
$8,265.51
|
| Rate for Payer: Aetna Commercial |
$10,808.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,265.51
|
| Rate for Payer: Cash Price |
$10,172.94
|
| Rate for Payer: Cofinity Commercial |
$10,935.91
|
| Rate for Payer: Cofinity Commercial |
$8,901.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,172.94
|
| Rate for Payer: Healthscope Commercial |
$11,444.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,901.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,537.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,808.74
|
| Rate for Payer: PHP Commercial |
$10,808.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,901.32
|
| Rate for Payer: Priority Health SBD |
$8,011.19
|
| Rate for Payer: UMR Bronson Commercial |
$5,595.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,537.13
|
|
|
HC ATHERECT VISCERAL EACH VESS
|
Facility
|
OP
|
$12,716.17
|
|
|
Service Code
|
CPT 0235T
|
| Hospital Charge Code |
36100303
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$498.19 |
| Max. Negotiated Rate |
$11,444.55 |
| Rate for Payer: Aetna American Axle |
$8,265.51
|
| Rate for Payer: Aetna Commercial |
$10,808.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,265.51
|
| Rate for Payer: BCBS Complete |
$5,086.47
|
| Rate for Payer: BCBS Trust/PPO |
$498.19
|
| Rate for Payer: Cash Price |
$10,172.94
|
| Rate for Payer: Cash Price |
$10,172.94
|
| Rate for Payer: Cofinity Commercial |
$10,935.91
|
| Rate for Payer: Cofinity Commercial |
$8,901.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,172.94
|
| Rate for Payer: Healthscope Commercial |
$11,444.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,901.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,537.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,808.74
|
| Rate for Payer: PHP Commercial |
$10,808.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,901.32
|
| Rate for Payer: Priority Health SBD |
$8,011.19
|
| Rate for Payer: UHC Core |
$1,879.00
|
| Rate for Payer: UMR Bronson Commercial |
$4,704.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,537.13
|
|
|
HC ATS NON OPEN HEART
|
Facility
|
OP
|
$2,206.32
|
|
| Hospital Charge Code |
27000088
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$816.34 |
| Max. Negotiated Rate |
$1,985.69 |
| Rate for Payer: Aetna American Axle |
$1,434.11
|
| Rate for Payer: Aetna Commercial |
$1,875.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,434.11
|
| Rate for Payer: BCBS Complete |
$882.53
|
| Rate for Payer: Cash Price |
$1,765.06
|
| Rate for Payer: Cofinity Commercial |
$1,544.42
|
| Rate for Payer: Cofinity Commercial |
$1,897.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,765.06
|
| Rate for Payer: Healthscope Commercial |
$1,985.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,544.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,654.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,875.37
|
| Rate for Payer: PHP Commercial |
$1,875.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,544.42
|
| Rate for Payer: Priority Health SBD |
$1,389.98
|
| Rate for Payer: UMR Bronson Commercial |
$816.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,654.74
|
|
|
HC ATS NON OPEN HEART
|
Facility
|
IP
|
$2,206.32
|
|
| Hospital Charge Code |
27000088
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$970.78 |
| Max. Negotiated Rate |
$1,985.69 |
| Rate for Payer: Aetna American Axle |
$1,434.11
|
| Rate for Payer: Aetna Commercial |
$1,875.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,434.11
|
| Rate for Payer: Cash Price |
$1,765.06
|
| Rate for Payer: Cofinity Commercial |
$1,544.42
|
| Rate for Payer: Cofinity Commercial |
$1,897.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,765.06
|
| Rate for Payer: Healthscope Commercial |
$1,985.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,544.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,654.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,875.37
|
| Rate for Payer: PHP Commercial |
$1,875.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,544.42
|
| Rate for Payer: Priority Health SBD |
$1,389.98
|
| Rate for Payer: UMR Bronson Commercial |
$970.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,654.74
|
|
|
HC ATS STAND BY HR
|
Facility
|
IP
|
$1,506.99
|
|
| Hospital Charge Code |
27000089
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$663.08 |
| Max. Negotiated Rate |
$1,356.29 |
| Rate for Payer: Aetna American Axle |
$979.54
|
| Rate for Payer: Aetna Commercial |
$1,280.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$979.54
|
| Rate for Payer: Cash Price |
$1,205.59
|
| Rate for Payer: Cofinity Commercial |
$1,054.89
|
| Rate for Payer: Cofinity Commercial |
$1,296.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,205.59
|
| Rate for Payer: Healthscope Commercial |
$1,356.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,054.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,130.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,280.94
|
| Rate for Payer: PHP Commercial |
$1,280.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,054.89
|
| Rate for Payer: Priority Health SBD |
$949.40
|
| Rate for Payer: UMR Bronson Commercial |
$663.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,130.24
|
|
|
HC ATS STAND BY HR
|
Facility
|
OP
|
$1,506.99
|
|
| Hospital Charge Code |
27000089
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$557.59 |
| Max. Negotiated Rate |
$1,356.29 |
| Rate for Payer: Aetna American Axle |
$979.54
|
| Rate for Payer: Aetna Commercial |
$1,280.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$979.54
|
| Rate for Payer: BCBS Complete |
$602.80
|
| Rate for Payer: Cash Price |
$1,205.59
|
| Rate for Payer: Cofinity Commercial |
$1,054.89
|
| Rate for Payer: Cofinity Commercial |
$1,296.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,205.59
|
| Rate for Payer: Healthscope Commercial |
$1,356.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,054.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,130.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,280.94
|
| Rate for Payer: PHP Commercial |
$1,280.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,054.89
|
| Rate for Payer: Priority Health SBD |
$949.40
|
| Rate for Payer: UMR Bronson Commercial |
$557.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,130.24
|
|
|
HC ATYPICAL PNEUMO EVAL C PNEUM
|
Facility
|
IP
|
$15.30
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200240
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna American Axle |
$9.94
|
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.94
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$10.71
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health SBD |
$9.64
|
| Rate for Payer: UMR Bronson Commercial |
$6.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC ATYPICAL PNEUMO EVAL C PNEUM
|
Facility
|
OP
|
$15.30
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200240
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$19.51 |
| Rate for Payer: Aetna American Axle |
$9.94
|
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna Medicare |
$12.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.78
|
| Rate for Payer: BCBS Complete |
$6.79
|
| Rate for Payer: BCBS MAPPO |
$11.82
|
| Rate for Payer: BCBS Trust/PPO |
$10.64
|
| Rate for Payer: BCN Medicare Advantage |
$11.82
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Cofinity Commercial |
$10.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.82
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Mclaren Medicaid |
$6.47
|
| Rate for Payer: Mclaren Medicare |
$11.82
|
| Rate for Payer: Meridian Medicaid |
$6.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PACE Medicare |
$11.23
|
| Rate for Payer: PACE SWMI |
$11.82
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: PHP Medicare Advantage |
$11.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.22
|
| Rate for Payer: Priority Health Medicare |
$11.82
|
| Rate for Payer: Priority Health Narrow Network |
$12.98
|
| Rate for Payer: Priority Health SBD |
$9.64
|
| Rate for Payer: Railroad Medicare Medicare |
$11.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.18
|
| Rate for Payer: UHC Core |
$19.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.82
|
| Rate for Payer: UHC Exchange |
$11.82
|
| Rate for Payer: UHC Medicare Advantage |
$12.17
|
| Rate for Payer: UMR Bronson Commercial |
$5.66
|
| Rate for Payer: VA VA |
$11.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC ATYPICAL PNEUMO EVAL C PNEUM IGM
|
Facility
|
OP
|
$15.30
|
|
|
Service Code
|
CPT 86632
|
| Hospital Charge Code |
30200243
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$20.93 |
| Rate for Payer: Aetna American Axle |
$9.94
|
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna Medicare |
$13.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.85
|
| Rate for Payer: BCBS Complete |
$7.28
|
| Rate for Payer: BCBS MAPPO |
$12.68
|
| Rate for Payer: BCBS Trust/PPO |
$11.40
|
| Rate for Payer: BCN Medicare Advantage |
$12.68
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$10.71
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.68
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Mclaren Medicaid |
$6.94
|
| Rate for Payer: Mclaren Medicare |
$12.68
|
| Rate for Payer: Meridian Medicaid |
$7.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PACE Medicare |
$12.05
|
| Rate for Payer: PACE SWMI |
$12.68
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: PHP Medicare Advantage |
$12.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.40
|
| Rate for Payer: Priority Health Medicare |
$12.68
|
| Rate for Payer: Priority Health Narrow Network |
$13.92
|
| Rate for Payer: Priority Health SBD |
$9.64
|
| Rate for Payer: Railroad Medicare Medicare |
$12.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.22
|
| Rate for Payer: UHC Core |
$20.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.68
|
| Rate for Payer: UHC Exchange |
$12.68
|
| Rate for Payer: UHC Medicare Advantage |
$13.06
|
| Rate for Payer: UMR Bronson Commercial |
$5.66
|
| Rate for Payer: VA VA |
$12.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC ATYPICAL PNEUMO EVAL C PNEUM IGM
|
Facility
|
IP
|
$15.30
|
|
|
Service Code
|
CPT 86632
|
| Hospital Charge Code |
30200243
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna American Axle |
$9.94
|
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.94
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$10.71
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health SBD |
$9.64
|
| Rate for Payer: UMR Bronson Commercial |
$6.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC ATYPICAL PNEUMO EVAL L PNEUM
|
Facility
|
IP
|
$21.42
|
|
|
Service Code
|
CPT 86713
|
| Hospital Charge Code |
30200302
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.42 |
| Max. Negotiated Rate |
$19.28 |
| Rate for Payer: Aetna American Axle |
$13.92
|
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.92
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$14.99
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.21
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.99
|
| Rate for Payer: Priority Health SBD |
$13.49
|
| Rate for Payer: UMR Bronson Commercial |
$9.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.06
|
|
|
HC ATYPICAL PNEUMO EVAL L PNEUM
|
Facility
|
OP
|
$21.42
|
|
|
Service Code
|
CPT 86713
|
| Hospital Charge Code |
30200302
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.93 |
| Max. Negotiated Rate |
$25.25 |
| Rate for Payer: Aetna American Axle |
$13.92
|
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: BCBS Complete |
$8.79
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$13.77
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$14.99
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.06
|
| Rate for Payer: Mclaren Medicaid |
$8.37
|
| Rate for Payer: Mclaren Medicare |
$15.30
|
| Rate for Payer: Meridian Medicaid |
$8.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.21
|
| Rate for Payer: PACE Medicare |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.23
|
| Rate for Payer: Priority Health Medicare |
$15.30
|
| Rate for Payer: Priority Health Narrow Network |
$14.58
|
| Rate for Payer: Priority Health SBD |
$13.49
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.36
|
| Rate for Payer: UHC Core |
$25.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.30
|
| Rate for Payer: UHC Exchange |
$15.30
|
| Rate for Payer: UHC Medicare Advantage |
$15.76
|
| Rate for Payer: UMR Bronson Commercial |
$7.93
|
| Rate for Payer: VA VA |
$15.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.06
|
|
|
HC ATYPICAL PNEUMO EVAL M PNEUM
|
Facility
|
OP
|
$14.28
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200308
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.28 |
| Max. Negotiated Rate |
$21.84 |
| Rate for Payer: Aetna American Axle |
$9.28
|
| Rate for Payer: Aetna Commercial |
$12.14
|
| Rate for Payer: Aetna Medicare |
$13.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: BCBS Complete |
$7.61
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$11.91
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$11.42
|
| Rate for Payer: Cash Price |
$11.42
|
| Rate for Payer: Cofinity Commercial |
$10.00
|
| Rate for Payer: Cofinity Commercial |
$12.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$12.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.71
|
| Rate for Payer: Mclaren Medicaid |
$7.24
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Medicaid |
$7.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12.14
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$12.14
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.16
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health Narrow Network |
$14.53
|
| Rate for Payer: Priority Health SBD |
$9.00
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.89
|
| Rate for Payer: UHC Core |
$21.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.24
|
| Rate for Payer: UHC Exchange |
$13.24
|
| Rate for Payer: UHC Medicare Advantage |
$13.64
|
| Rate for Payer: UMR Bronson Commercial |
$5.28
|
| Rate for Payer: VA VA |
$13.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.71
|
|
|
HC ATYPICAL PNEUMO EVAL M PNEUM
|
Facility
|
IP
|
$14.28
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200308
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.28 |
| Max. Negotiated Rate |
$12.85 |
| Rate for Payer: Aetna American Axle |
$9.28
|
| Rate for Payer: Aetna Commercial |
$12.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.28
|
| Rate for Payer: Cash Price |
$11.42
|
| Rate for Payer: Cofinity Commercial |
$10.00
|
| Rate for Payer: Cofinity Commercial |
$12.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.42
|
| Rate for Payer: Healthscope Commercial |
$12.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12.14
|
| Rate for Payer: PHP Commercial |
$12.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.00
|
| Rate for Payer: Priority Health SBD |
$9.00
|
| Rate for Payer: UMR Bronson Commercial |
$6.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.71
|
|
|
HC ATYPICAL PNEUMO EVALUATION
|
Facility
|
IP
|
$15.30
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200241
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna American Axle |
$9.94
|
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.94
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$10.71
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health SBD |
$9.64
|
| Rate for Payer: UMR Bronson Commercial |
$6.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC ATYPICAL PNEUMO EVALUATION
|
Facility
|
OP
|
$15.30
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200241
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$19.51 |
| Rate for Payer: Aetna American Axle |
$9.94
|
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna Medicare |
$12.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.78
|
| Rate for Payer: BCBS Complete |
$6.79
|
| Rate for Payer: BCBS MAPPO |
$11.82
|
| Rate for Payer: BCBS Trust/PPO |
$10.64
|
| Rate for Payer: BCN Medicare Advantage |
$11.82
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$10.71
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.82
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Mclaren Medicaid |
$6.47
|
| Rate for Payer: Mclaren Medicare |
$11.82
|
| Rate for Payer: Meridian Medicaid |
$6.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PACE Medicare |
$11.23
|
| Rate for Payer: PACE SWMI |
$11.82
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: PHP Medicare Advantage |
$11.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.22
|
| Rate for Payer: Priority Health Medicare |
$11.82
|
| Rate for Payer: Priority Health Narrow Network |
$12.98
|
| Rate for Payer: Priority Health SBD |
$9.64
|
| Rate for Payer: Railroad Medicare Medicare |
$11.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.18
|
| Rate for Payer: UHC Core |
$19.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.82
|
| Rate for Payer: UHC Exchange |
$11.82
|
| Rate for Payer: UHC Medicare Advantage |
$12.17
|
| Rate for Payer: UMR Bronson Commercial |
$5.66
|
| Rate for Payer: VA VA |
$11.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC AUDIOMETRY AIR AND BONE
|
Facility
|
IP
|
$208.01
|
|
|
Service Code
|
CPT 92553
|
| Hospital Charge Code |
47100010
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$91.52 |
| Max. Negotiated Rate |
$187.21 |
| Rate for Payer: Aetna American Axle |
$135.21
|
| Rate for Payer: Aetna Commercial |
$176.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.21
|
| Rate for Payer: Cash Price |
$166.41
|
| Rate for Payer: Cofinity Commercial |
$145.61
|
| Rate for Payer: Cofinity Commercial |
$178.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.41
|
| Rate for Payer: Healthscope Commercial |
$187.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$145.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$176.81
|
| Rate for Payer: PHP Commercial |
$176.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.61
|
| Rate for Payer: Priority Health SBD |
$131.05
|
| Rate for Payer: UMR Bronson Commercial |
$91.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.01
|
|
|
HC AUDIOMETRY AIR AND BONE
|
Facility
|
OP
|
$208.01
|
|
|
Service Code
|
CPT 92553
|
| Hospital Charge Code |
47100010
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$45.19 |
| Max. Negotiated Rate |
$437.09 |
| Rate for Payer: Aetna American Axle |
$135.21
|
| Rate for Payer: Aetna Commercial |
$176.81
|
| Rate for Payer: Aetna Medicare |
$144.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.56
|
| Rate for Payer: BCBS Complete |
$79.76
|
| Rate for Payer: BCBS MAPPO |
$138.85
|
| Rate for Payer: BCBS Trust/PPO |
$216.15
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$166.41
|
| Rate for Payer: Cash Price |
$166.41
|
| Rate for Payer: Cash Price |
$166.41
|
| Rate for Payer: Cofinity Commercial |
$178.89
|
| Rate for Payer: Cofinity Commercial |
$145.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$187.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$145.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.01
|
| Rate for Payer: Mclaren Medicaid |
$75.95
|
| Rate for Payer: Mclaren Medicare |
$138.85
|
| Rate for Payer: Meridian Medicaid |
$79.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$176.81
|
| Rate for Payer: PACE Medicare |
$131.91
|
| Rate for Payer: PACE SWMI |
$138.85
|
| Rate for Payer: PHP Commercial |
$176.81
|
| Rate for Payer: PHP Medicare Advantage |
$138.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$437.09
|
| Rate for Payer: Priority Health Medicare |
$138.85
|
| Rate for Payer: Priority Health Narrow Network |
$349.67
|
| Rate for Payer: Priority Health SBD |
$131.05
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.71
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.85
|
| Rate for Payer: UHC Exchange |
$45.19
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: UMR Bronson Commercial |
$76.96
|
| Rate for Payer: VA VA |
$138.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.01
|
|
|
HC AUDITORY EVOKED POTENTIAL SCREENING
|
Facility
|
OP
|
$251.11
|
|
|
Service Code
|
CPT 92650
|
| Hospital Charge Code |
47100015
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$23.17 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$163.22
|
| Rate for Payer: Aetna Commercial |
$213.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.22
|
| Rate for Payer: BCBS Complete |
$100.44
|
| Rate for Payer: BCBS Trust/PPO |
$93.82
|
| Rate for Payer: Cash Price |
$200.89
|
| Rate for Payer: Cash Price |
$200.89
|
| Rate for Payer: Cash Price |
$200.89
|
| Rate for Payer: Cofinity Commercial |
$175.78
|
| Rate for Payer: Cofinity Commercial |
$215.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.89
|
| Rate for Payer: Healthscope Commercial |
$226.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$175.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$213.44
|
| Rate for Payer: PHP Commercial |
$213.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.96
|
| Rate for Payer: Priority Health Narrow Network |
$23.17
|
| Rate for Payer: Priority Health SBD |
$158.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.17
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$26.52
|
| Rate for Payer: UMR Bronson Commercial |
$92.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.33
|
|
