|
HC BRIEF EMOTIONAL/BEHAVIORAL ASSESSMENT
|
Facility
|
OP
|
$24.13
|
|
|
Service Code
|
CPT 96127
|
| Hospital Charge Code |
91800002
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$4.58 |
| Max. Negotiated Rate |
$491.00 |
| Rate for Payer: Aetna American Axle |
$15.68
|
| Rate for Payer: Aetna Commercial |
$20.51
|
| Rate for Payer: Aetna Medicare |
$37.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.56
|
| Rate for Payer: BCBS Complete |
$20.48
|
| Rate for Payer: BCBS MAPPO |
$35.65
|
| Rate for Payer: BCBS Trust/PPO |
$21.79
|
| Rate for Payer: BCN Medicare Advantage |
$35.65
|
| Rate for Payer: Cash Price |
$19.30
|
| Rate for Payer: Cash Price |
$19.30
|
| Rate for Payer: Cash Price |
$19.30
|
| Rate for Payer: Cofinity Commercial |
$16.89
|
| Rate for Payer: Cofinity Commercial |
$20.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.65
|
| Rate for Payer: Healthscope Commercial |
$21.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.10
|
| Rate for Payer: Mclaren Medicaid |
$19.50
|
| Rate for Payer: Mclaren Medicare |
$35.65
|
| Rate for Payer: Meridian Medicaid |
$20.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$37.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.51
|
| Rate for Payer: PACE Medicare |
$33.87
|
| Rate for Payer: PACE SWMI |
$35.65
|
| Rate for Payer: PHP Commercial |
$20.51
|
| Rate for Payer: PHP Medicare Advantage |
$35.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.22
|
| Rate for Payer: Priority Health Medicare |
$35.65
|
| Rate for Payer: Priority Health Narrow Network |
$89.78
|
| Rate for Payer: Priority Health SBD |
$15.20
|
| Rate for Payer: Railroad Medicare Medicare |
$35.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.04
|
| Rate for Payer: UHC Core |
$491.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.65
|
| Rate for Payer: UHC Exchange |
$4.58
|
| Rate for Payer: UHC Medicare Advantage |
$36.72
|
| Rate for Payer: UMR Bronson Commercial |
$8.93
|
| Rate for Payer: VA VA |
$35.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.10
|
|
|
HC BRONCH CMPTR ASST IMAGE ADD ON
|
Facility
|
OP
|
$252.97
|
|
| Hospital Charge Code |
75000007
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$93.60 |
| Max. Negotiated Rate |
$227.67 |
| Rate for Payer: Aetna American Axle |
$164.43
|
| Rate for Payer: Aetna Commercial |
$215.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.43
|
| Rate for Payer: BCBS Complete |
$101.19
|
| Rate for Payer: Cash Price |
$202.38
|
| Rate for Payer: Cofinity Commercial |
$177.08
|
| Rate for Payer: Cofinity Commercial |
$217.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.38
|
| Rate for Payer: Healthscope Commercial |
$227.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$177.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$215.02
|
| Rate for Payer: PHP Commercial |
$215.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.08
|
| Rate for Payer: Priority Health SBD |
$159.37
|
| Rate for Payer: UMR Bronson Commercial |
$93.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.73
|
|
|
HC BRONCH CMPTR ASST IMAGE ADD ON
|
Facility
|
IP
|
$252.97
|
|
| Hospital Charge Code |
75000007
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$111.31 |
| Max. Negotiated Rate |
$227.67 |
| Rate for Payer: Aetna American Axle |
$164.43
|
| Rate for Payer: Aetna Commercial |
$215.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.43
|
| Rate for Payer: Cash Price |
$202.38
|
| Rate for Payer: Cofinity Commercial |
$217.55
|
| Rate for Payer: Cofinity Commercial |
$177.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.38
|
| Rate for Payer: Healthscope Commercial |
$227.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$177.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$215.02
|
| Rate for Payer: PHP Commercial |
$215.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.08
|
| Rate for Payer: Priority Health SBD |
$159.37
|
| Rate for Payer: UMR Bronson Commercial |
$111.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.73
|
|
|
HC BRONCHIAL NAVIGATION
|
Facility
|
OP
|
$3,042.82
|
|
| Hospital Charge Code |
36000102
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,125.84 |
| Max. Negotiated Rate |
$2,738.54 |
| Rate for Payer: Aetna American Axle |
$1,977.83
|
| Rate for Payer: Aetna Commercial |
$2,586.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,977.83
|
| Rate for Payer: BCBS Complete |
$1,217.13
|
| Rate for Payer: Cash Price |
$2,434.26
|
| Rate for Payer: Cofinity Commercial |
$2,129.97
|
| Rate for Payer: Cofinity Commercial |
$2,616.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,434.26
|
| Rate for Payer: Healthscope Commercial |
$2,738.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,129.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,282.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,586.40
|
| Rate for Payer: PHP Commercial |
$2,586.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,129.97
|
| Rate for Payer: Priority Health SBD |
$1,916.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,125.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,282.12
|
|
|
HC BRONCHIAL NAVIGATION
|
Facility
|
IP
|
$3,042.82
|
|
| Hospital Charge Code |
36000102
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,338.84 |
| Max. Negotiated Rate |
$2,738.54 |
| Rate for Payer: Aetna American Axle |
$1,977.83
|
| Rate for Payer: Aetna Commercial |
$2,586.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,977.83
|
| Rate for Payer: Cash Price |
$2,434.26
|
| Rate for Payer: Cofinity Commercial |
$2,129.97
|
| Rate for Payer: Cofinity Commercial |
$2,616.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,434.26
|
| Rate for Payer: Healthscope Commercial |
$2,738.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,129.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,282.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,586.40
|
| Rate for Payer: PHP Commercial |
$2,586.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,129.97
|
| Rate for Payer: Priority Health SBD |
$1,916.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,338.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,282.12
|
|
|
HC BRONCHO HYGIENE INITIAL
|
Facility
|
OP
|
$268.39
|
|
|
Service Code
|
CPT 94667
|
| Hospital Charge Code |
41000010
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$24.56 |
| Max. Negotiated Rate |
$357.43 |
| Rate for Payer: Aetna American Axle |
$174.45
|
| Rate for Payer: Aetna Commercial |
$228.13
|
| Rate for Payer: Aetna Medicare |
$118.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$113.93
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$214.71
|
| Rate for Payer: Cash Price |
$214.71
|
| Rate for Payer: Cash Price |
$214.71
|
| Rate for Payer: Cofinity Commercial |
$187.87
|
| Rate for Payer: Cofinity Commercial |
$230.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$241.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$187.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.29
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$228.13
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$228.13
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.43
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$285.94
|
| Rate for Payer: Priority Health SBD |
$169.09
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.02
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.55
|
| Rate for Payer: UHC Exchange |
$24.56
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$99.30
|
| Rate for Payer: VA VA |
$113.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.29
|
|
|
HC BRONCHO HYGIENE INITIAL
|
Facility
|
IP
|
$268.39
|
|
|
Service Code
|
CPT 94667
|
| Hospital Charge Code |
41000010
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$118.09 |
| Max. Negotiated Rate |
$241.55 |
| Rate for Payer: Aetna American Axle |
$174.45
|
| Rate for Payer: Aetna Commercial |
$228.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.45
|
| Rate for Payer: Cash Price |
$214.71
|
| Rate for Payer: Cofinity Commercial |
$187.87
|
| Rate for Payer: Cofinity Commercial |
$230.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.71
|
| Rate for Payer: Healthscope Commercial |
$241.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$187.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$228.13
|
| Rate for Payer: PHP Commercial |
$228.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.87
|
| Rate for Payer: Priority Health SBD |
$169.09
|
| Rate for Payer: UMR Bronson Commercial |
$118.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.29
|
|
|
HC BRONCHO HYGIENE SUBS
|
Facility
|
IP
|
$257.96
|
|
|
Service Code
|
CPT 94668
|
| Hospital Charge Code |
41000011
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$113.50 |
| Max. Negotiated Rate |
$232.16 |
| Rate for Payer: Aetna American Axle |
$167.67
|
| Rate for Payer: Aetna Commercial |
$219.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.67
|
| Rate for Payer: Cash Price |
$206.37
|
| Rate for Payer: Cofinity Commercial |
$180.57
|
| Rate for Payer: Cofinity Commercial |
$221.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.37
|
| Rate for Payer: Healthscope Commercial |
$232.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$180.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$219.27
|
| Rate for Payer: PHP Commercial |
$219.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.57
|
| Rate for Payer: Priority Health SBD |
$162.51
|
| Rate for Payer: UMR Bronson Commercial |
$113.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.47
|
|
|
HC BRONCHO HYGIENE SUBS
|
Facility
|
OP
|
$257.96
|
|
|
Service Code
|
CPT 94668
|
| Hospital Charge Code |
41000011
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$38.64 |
| Max. Negotiated Rate |
$357.43 |
| Rate for Payer: Aetna American Axle |
$167.67
|
| Rate for Payer: Aetna Commercial |
$219.27
|
| Rate for Payer: Aetna Medicare |
$118.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$179.30
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$206.37
|
| Rate for Payer: Cash Price |
$206.37
|
| Rate for Payer: Cash Price |
$206.37
|
| Rate for Payer: Cofinity Commercial |
$180.57
|
| Rate for Payer: Cofinity Commercial |
$221.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$232.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$180.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.47
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$219.27
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$219.27
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.43
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$285.94
|
| Rate for Payer: Priority Health SBD |
$162.51
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.50
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.55
|
| Rate for Payer: UHC Exchange |
$38.64
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$95.45
|
| Rate for Payer: VA VA |
$113.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.47
|
|
|
HC BRONCHOSCOPY
|
Facility
|
IP
|
$2,514.51
|
|
| Hospital Charge Code |
36000014
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,106.38 |
| Max. Negotiated Rate |
$2,263.06 |
| Rate for Payer: Aetna American Axle |
$1,634.43
|
| Rate for Payer: Aetna Commercial |
$2,137.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,634.43
|
| Rate for Payer: Cash Price |
$2,011.61
|
| Rate for Payer: Cofinity Commercial |
$1,760.16
|
| Rate for Payer: Cofinity Commercial |
$2,162.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,011.61
|
| Rate for Payer: Healthscope Commercial |
$2,263.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,760.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,885.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,137.33
|
| Rate for Payer: PHP Commercial |
$2,137.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,760.16
|
| Rate for Payer: Priority Health SBD |
$1,584.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,106.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,885.88
|
|
|
HC BRONCHOSCOPY
|
Facility
|
OP
|
$2,514.51
|
|
| Hospital Charge Code |
36000014
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$930.37 |
| Max. Negotiated Rate |
$2,263.06 |
| Rate for Payer: Aetna American Axle |
$1,634.43
|
| Rate for Payer: Aetna Commercial |
$2,137.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,634.43
|
| Rate for Payer: BCBS Complete |
$1,005.80
|
| Rate for Payer: Cash Price |
$2,011.61
|
| Rate for Payer: Cofinity Commercial |
$1,760.16
|
| Rate for Payer: Cofinity Commercial |
$2,162.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,011.61
|
| Rate for Payer: Healthscope Commercial |
$2,263.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,760.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,885.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,137.33
|
| Rate for Payer: PHP Commercial |
$2,137.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,760.16
|
| Rate for Payer: Priority Health SBD |
$1,584.14
|
| Rate for Payer: UMR Bronson Commercial |
$930.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,885.88
|
|
|
HC BRONCHOSCOPY W EBUS EXAM
|
Facility
|
IP
|
$3,115.71
|
|
| Hospital Charge Code |
36000015
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,370.91 |
| Max. Negotiated Rate |
$2,804.14 |
| Rate for Payer: Aetna American Axle |
$2,025.21
|
| Rate for Payer: Aetna Commercial |
$2,648.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,025.21
|
| Rate for Payer: Cash Price |
$2,492.57
|
| Rate for Payer: Cofinity Commercial |
$2,181.00
|
| Rate for Payer: Cofinity Commercial |
$2,679.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,492.57
|
| Rate for Payer: Healthscope Commercial |
$2,804.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,181.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,336.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,648.35
|
| Rate for Payer: PHP Commercial |
$2,648.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,181.00
|
| Rate for Payer: Priority Health SBD |
$1,962.90
|
| Rate for Payer: UMR Bronson Commercial |
$1,370.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,336.78
|
|
|
HC BRONCHOSCOPY W EBUS EXAM
|
Facility
|
OP
|
$3,115.71
|
|
| Hospital Charge Code |
36000015
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,152.81 |
| Max. Negotiated Rate |
$2,804.14 |
| Rate for Payer: Aetna American Axle |
$2,025.21
|
| Rate for Payer: Aetna Commercial |
$2,648.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,025.21
|
| Rate for Payer: BCBS Complete |
$1,246.28
|
| Rate for Payer: Cash Price |
$2,492.57
|
| Rate for Payer: Cofinity Commercial |
$2,181.00
|
| Rate for Payer: Cofinity Commercial |
$2,679.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,492.57
|
| Rate for Payer: Healthscope Commercial |
$2,804.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,181.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,336.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,648.35
|
| Rate for Payer: PHP Commercial |
$2,648.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,181.00
|
| Rate for Payer: Priority Health SBD |
$1,962.90
|
| Rate for Payer: UMR Bronson Commercial |
$1,152.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,336.78
|
|
|
HC BRONCHOSPASM PROVOCATION (METHACHOLINE CHALLENGE)
|
Facility
|
OP
|
$694.78
|
|
|
Service Code
|
CPT 94070
|
| Hospital Charge Code |
46000003
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$61.89 |
| Max. Negotiated Rate |
$878.32 |
| Rate for Payer: Aetna American Axle |
$451.61
|
| Rate for Payer: Aetna Commercial |
$590.56
|
| Rate for Payer: Aetna Medicare |
$290.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$451.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$169.24
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$555.82
|
| Rate for Payer: Cash Price |
$555.82
|
| Rate for Payer: Cash Price |
$555.82
|
| Rate for Payer: Cofinity Commercial |
$597.51
|
| Rate for Payer: Cofinity Commercial |
$486.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$555.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$625.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$486.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$521.08
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$590.56
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$590.56
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$486.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$878.32
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$702.66
|
| Rate for Payer: Priority Health SBD |
$437.71
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.08
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.00
|
| Rate for Payer: UHC Exchange |
$61.89
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: UMR Bronson Commercial |
$257.07
|
| Rate for Payer: VA VA |
$279.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$521.08
|
|
|
HC BRONCHOSPASM PROVOCATION (METHACHOLINE CHALLENGE)
|
Facility
|
IP
|
$694.78
|
|
|
Service Code
|
CPT 94070
|
| Hospital Charge Code |
46000003
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$305.70 |
| Max. Negotiated Rate |
$625.30 |
| Rate for Payer: Aetna American Axle |
$451.61
|
| Rate for Payer: Aetna Commercial |
$590.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$451.61
|
| Rate for Payer: Cash Price |
$555.82
|
| Rate for Payer: Cofinity Commercial |
$486.35
|
| Rate for Payer: Cofinity Commercial |
$597.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$555.82
|
| Rate for Payer: Healthscope Commercial |
$625.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$486.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$521.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$590.56
|
| Rate for Payer: PHP Commercial |
$590.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$486.35
|
| Rate for Payer: Priority Health SBD |
$437.71
|
| Rate for Payer: UMR Bronson Commercial |
$305.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$521.08
|
|
|
HC BRUCELLA ANTIBODY
|
Facility
|
OP
|
$72.00
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200236
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.88 |
| Max. Negotiated Rate |
$64.80 |
| Rate for Payer: Aetna American Axle |
$46.80
|
| Rate for Payer: Aetna Commercial |
$61.20
|
| Rate for Payer: Aetna Medicare |
$9.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.16
|
| Rate for Payer: BCBS Complete |
$5.13
|
| Rate for Payer: BCBS MAPPO |
$8.93
|
| Rate for Payer: BCBS Trust/PPO |
$8.03
|
| Rate for Payer: BCN Medicare Advantage |
$8.93
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cofinity Commercial |
$61.92
|
| Rate for Payer: Cofinity Commercial |
$50.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.93
|
| Rate for Payer: Healthscope Commercial |
$64.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.00
|
| Rate for Payer: Mclaren Medicaid |
$4.88
|
| Rate for Payer: Mclaren Medicare |
$8.93
|
| Rate for Payer: Meridian Medicaid |
$5.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.20
|
| Rate for Payer: PACE Medicare |
$8.48
|
| Rate for Payer: PACE SWMI |
$8.93
|
| Rate for Payer: PHP Commercial |
$61.20
|
| Rate for Payer: PHP Medicare Advantage |
$8.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.25
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health Narrow Network |
$9.80
|
| Rate for Payer: Priority Health SBD |
$45.36
|
| Rate for Payer: Railroad Medicare Medicare |
$8.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.72
|
| Rate for Payer: UHC Core |
$14.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.93
|
| Rate for Payer: UHC Exchange |
$8.93
|
| Rate for Payer: UHC Medicare Advantage |
$9.20
|
| Rate for Payer: UMR Bronson Commercial |
$26.64
|
| Rate for Payer: VA VA |
$8.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.00
|
|
|
HC BRUCELLA ANTIBODY
|
Facility
|
IP
|
$72.00
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200236
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.68 |
| Max. Negotiated Rate |
$64.80 |
| Rate for Payer: Aetna American Axle |
$46.80
|
| Rate for Payer: Aetna Commercial |
$61.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.80
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cofinity Commercial |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$61.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.60
|
| Rate for Payer: Healthscope Commercial |
$64.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.20
|
| Rate for Payer: PHP Commercial |
$61.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.40
|
| Rate for Payer: Priority Health SBD |
$45.36
|
| Rate for Payer: UMR Bronson Commercial |
$31.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.00
|
|
|
HC BRUCELLA ANTIBODY CMPT
|
Facility
|
IP
|
$72.00
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200238
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.68 |
| Max. Negotiated Rate |
$64.80 |
| Rate for Payer: Aetna American Axle |
$46.80
|
| Rate for Payer: Aetna Commercial |
$61.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.80
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cofinity Commercial |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$61.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.60
|
| Rate for Payer: Healthscope Commercial |
$64.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.20
|
| Rate for Payer: PHP Commercial |
$61.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.40
|
| Rate for Payer: Priority Health SBD |
$45.36
|
| Rate for Payer: UMR Bronson Commercial |
$31.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.00
|
|
|
HC BRUCELLA ANTIBODY CMPT
|
Facility
|
OP
|
$72.00
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200238
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.88 |
| Max. Negotiated Rate |
$64.80 |
| Rate for Payer: Aetna American Axle |
$46.80
|
| Rate for Payer: Aetna Commercial |
$61.20
|
| Rate for Payer: Aetna Medicare |
$9.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.16
|
| Rate for Payer: BCBS Complete |
$5.13
|
| Rate for Payer: BCBS MAPPO |
$8.93
|
| Rate for Payer: BCBS Trust/PPO |
$8.03
|
| Rate for Payer: BCN Medicare Advantage |
$8.93
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cofinity Commercial |
$61.92
|
| Rate for Payer: Cofinity Commercial |
$50.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.93
|
| Rate for Payer: Healthscope Commercial |
$64.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.00
|
| Rate for Payer: Mclaren Medicaid |
$4.88
|
| Rate for Payer: Mclaren Medicare |
$8.93
|
| Rate for Payer: Meridian Medicaid |
$5.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.20
|
| Rate for Payer: PACE Medicare |
$8.48
|
| Rate for Payer: PACE SWMI |
$8.93
|
| Rate for Payer: PHP Commercial |
$61.20
|
| Rate for Payer: PHP Medicare Advantage |
$8.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.25
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health Narrow Network |
$9.80
|
| Rate for Payer: Priority Health SBD |
$45.36
|
| Rate for Payer: Railroad Medicare Medicare |
$8.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.72
|
| Rate for Payer: UHC Core |
$14.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.93
|
| Rate for Payer: UHC Exchange |
$8.93
|
| Rate for Payer: UHC Medicare Advantage |
$9.20
|
| Rate for Payer: UMR Bronson Commercial |
$26.64
|
| Rate for Payer: VA VA |
$8.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.00
|
|
|
HC BRUCELLA ANTIBODY CONFIRMATION
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200237
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.88 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna American Axle |
$33.80
|
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: Aetna Medicare |
$9.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.16
|
| Rate for Payer: BCBS Complete |
$5.13
|
| Rate for Payer: BCBS MAPPO |
$8.93
|
| Rate for Payer: BCBS Trust/PPO |
$8.03
|
| Rate for Payer: BCN Medicare Advantage |
$8.93
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Cofinity Commercial |
$36.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.93
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.00
|
| Rate for Payer: Mclaren Medicaid |
$4.88
|
| Rate for Payer: Mclaren Medicare |
$8.93
|
| Rate for Payer: Meridian Medicaid |
$5.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.20
|
| Rate for Payer: PACE Medicare |
$8.48
|
| Rate for Payer: PACE SWMI |
$8.93
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: PHP Medicare Advantage |
$8.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.25
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health Narrow Network |
$9.80
|
| Rate for Payer: Priority Health SBD |
$32.76
|
| Rate for Payer: Railroad Medicare Medicare |
$8.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.72
|
| Rate for Payer: UHC Core |
$14.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.93
|
| Rate for Payer: UHC Exchange |
$8.93
|
| Rate for Payer: UHC Medicare Advantage |
$9.20
|
| Rate for Payer: UMR Bronson Commercial |
$19.24
|
| Rate for Payer: VA VA |
$8.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.00
|
|
|
HC BRUCELLA ANTIBODY CONFIRMATION
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200237
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.88 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna American Axle |
$33.80
|
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.80
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$36.40
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.20
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health SBD |
$32.76
|
| Rate for Payer: UMR Bronson Commercial |
$22.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.00
|
|
|
HC BUNDLE OF HIS RECORDING
|
Facility
|
IP
|
$3,942.53
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
48100029
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,734.71 |
| Max. Negotiated Rate |
$3,548.28 |
| Rate for Payer: Aetna American Axle |
$2,562.64
|
| Rate for Payer: Aetna Commercial |
$3,351.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,562.64
|
| Rate for Payer: Cash Price |
$3,154.02
|
| Rate for Payer: Cofinity Commercial |
$2,759.77
|
| Rate for Payer: Cofinity Commercial |
$3,390.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,154.02
|
| Rate for Payer: Healthscope Commercial |
$3,548.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,759.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,956.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,351.15
|
| Rate for Payer: PHP Commercial |
$3,351.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,759.77
|
| Rate for Payer: Priority Health SBD |
$2,483.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,734.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,956.90
|
|
|
HC BUNDLE OF HIS RECORDING
|
Facility
|
OP
|
$3,942.53
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
48100029
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,458.74 |
| Max. Negotiated Rate |
$21,354.26 |
| Rate for Payer: Aetna American Axle |
$2,562.64
|
| Rate for Payer: Aetna Commercial |
$3,351.15
|
| Rate for Payer: Aetna Medicare |
$6,903.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,562.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,297.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,297.88
|
| Rate for Payer: BCBS Complete |
$3,813.04
|
| Rate for Payer: BCBS MAPPO |
$6,638.30
|
| Rate for Payer: BCBS Trust/PPO |
$21,354.26
|
| Rate for Payer: BCN Medicare Advantage |
$6,638.30
|
| Rate for Payer: Cash Price |
$3,154.02
|
| Rate for Payer: Cash Price |
$3,154.02
|
| Rate for Payer: Cofinity Commercial |
$2,759.77
|
| Rate for Payer: Cofinity Commercial |
$3,390.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,154.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,638.30
|
| Rate for Payer: Healthscope Commercial |
$3,548.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,759.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,956.90
|
| Rate for Payer: Mclaren Medicaid |
$3,631.15
|
| Rate for Payer: Mclaren Medicare |
$6,638.30
|
| Rate for Payer: Meridian Medicaid |
$3,813.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,970.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,634.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,351.15
|
| Rate for Payer: PACE Medicare |
$6,306.38
|
| Rate for Payer: PACE SWMI |
$6,638.30
|
| Rate for Payer: PHP Commercial |
$3,351.15
|
| Rate for Payer: PHP Medicare Advantage |
$6,638.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,631.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,759.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,897.69
|
| Rate for Payer: Priority Health Medicare |
$6,638.30
|
| Rate for Payer: Priority Health Narrow Network |
$16,718.15
|
| Rate for Payer: Priority Health SBD |
$2,483.79
|
| Rate for Payer: Railroad Medicare Medicare |
$6,638.30
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,638.30
|
| Rate for Payer: UHC Medicare Advantage |
$6,837.45
|
| Rate for Payer: UMR Bronson Commercial |
$1,458.74
|
| Rate for Payer: VA VA |
$6,638.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,956.90
|
|
|
HC BUPIVACAINE 0.5 MG
|
Facility
|
IP
|
$1.48
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
25000016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.65 |
| Max. Negotiated Rate |
$1.33 |
| Rate for Payer: Aetna American Axle |
$0.96
|
| Rate for Payer: Aetna Commercial |
$1.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.96
|
| Rate for Payer: Cash Price |
$1.18
|
| Rate for Payer: Cofinity Commercial |
$1.04
|
| Rate for Payer: Cofinity Commercial |
$1.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.18
|
| Rate for Payer: Healthscope Commercial |
$1.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1.26
|
| Rate for Payer: PHP Commercial |
$1.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.04
|
| Rate for Payer: Priority Health SBD |
$0.93
|
| Rate for Payer: UMR Bronson Commercial |
$0.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.11
|
|
|
HC BUPIVACAINE 0.5 MG
|
Facility
|
OP
|
$1.48
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
25000016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1.33 |
| Rate for Payer: Aetna American Axle |
$0.96
|
| Rate for Payer: Aetna Commercial |
$1.26
|
| Rate for Payer: Aetna Medicare |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.02
|
| Rate for Payer: BCBS Complete |
$0.01
|
| Rate for Payer: BCBS MAPPO |
$0.01
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Medicare Advantage |
$0.01
|
| Rate for Payer: Cash Price |
$1.18
|
| Rate for Payer: Cash Price |
$1.18
|
| Rate for Payer: Cofinity Commercial |
$1.27
|
| Rate for Payer: Cofinity Commercial |
$1.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$1.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.11
|
| Rate for Payer: Mclaren Medicaid |
$0.01
|
| Rate for Payer: Mclaren Medicare |
$0.01
|
| Rate for Payer: Meridian Medicaid |
$0.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$0.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1.26
|
| Rate for Payer: PACE Medicare |
$0.01
|
| Rate for Payer: PACE SWMI |
$0.01
|
| Rate for Payer: PHP Commercial |
$1.26
|
| Rate for Payer: PHP Medicare Advantage |
$0.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.05
|
| Rate for Payer: Priority Health Medicare |
$0.01
|
| Rate for Payer: Priority Health Narrow Network |
$0.04
|
| Rate for Payer: Priority Health SBD |
$0.93
|
| Rate for Payer: Railroad Medicare Medicare |
$0.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.01
|
| Rate for Payer: UHC Medicare Advantage |
$0.01
|
| Rate for Payer: UMR Bronson Commercial |
$0.55
|
| Rate for Payer: VA VA |
$0.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.11
|
|
