|
HC COMPLEMENT CH50 TOTAL
|
Facility
|
OP
|
$38.76
|
|
|
Service Code
|
CPT 86162
|
| Hospital Charge Code |
30200154
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.12 |
| Max. Negotiated Rate |
$34.88 |
| Rate for Payer: Aetna American Axle |
$25.19
|
| Rate for Payer: Aetna Commercial |
$32.95
|
| Rate for Payer: Aetna Medicare |
$21.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.40
|
| Rate for Payer: BCBS Complete |
$11.67
|
| Rate for Payer: BCBS MAPPO |
$20.32
|
| Rate for Payer: BCBS Trust/PPO |
$18.27
|
| Rate for Payer: BCN Medicare Advantage |
$20.32
|
| Rate for Payer: Cash Price |
$31.01
|
| Rate for Payer: Cash Price |
$31.01
|
| Rate for Payer: Cofinity Commercial |
$33.33
|
| Rate for Payer: Cofinity Commercial |
$27.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.32
|
| Rate for Payer: Healthscope Commercial |
$34.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.07
|
| Rate for Payer: Mclaren Medicaid |
$11.12
|
| Rate for Payer: Mclaren Medicare |
$20.32
|
| Rate for Payer: Meridian Medicaid |
$11.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.95
|
| Rate for Payer: PACE Medicare |
$19.30
|
| Rate for Payer: PACE SWMI |
$20.32
|
| Rate for Payer: PHP Commercial |
$32.95
|
| Rate for Payer: PHP Medicare Advantage |
$20.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.88
|
| Rate for Payer: Priority Health Medicare |
$20.32
|
| Rate for Payer: Priority Health Narrow Network |
$22.30
|
| Rate for Payer: Priority Health SBD |
$24.42
|
| Rate for Payer: Railroad Medicare Medicare |
$20.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.38
|
| Rate for Payer: UHC Core |
$33.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.32
|
| Rate for Payer: UHC Exchange |
$20.32
|
| Rate for Payer: UHC Medicare Advantage |
$20.93
|
| Rate for Payer: UMR Bronson Commercial |
$14.34
|
| Rate for Payer: VA VA |
$20.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.07
|
|
|
HC COMPLEX CYSTOMETROGRAM
|
Facility
|
OP
|
$389.48
|
|
|
Service Code
|
CPT 51726
|
| Hospital Charge Code |
76100190
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$120.16 |
| Max. Negotiated Rate |
$691.57 |
| Rate for Payer: Aetna American Axle |
$253.16
|
| Rate for Payer: Aetna Commercial |
$331.06
|
| Rate for Payer: Aetna Medicare |
$228.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.60
|
| Rate for Payer: BCBS Complete |
$126.18
|
| Rate for Payer: BCBS MAPPO |
$219.68
|
| Rate for Payer: BCBS Trust/PPO |
$479.38
|
| Rate for Payer: BCN Medicare Advantage |
$219.68
|
| Rate for Payer: Cash Price |
$311.58
|
| Rate for Payer: Cash Price |
$311.58
|
| Rate for Payer: Cofinity Commercial |
$272.64
|
| Rate for Payer: Cofinity Commercial |
$334.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$311.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.68
|
| Rate for Payer: Healthscope Commercial |
$350.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$272.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.11
|
| Rate for Payer: Mclaren Medicaid |
$120.16
|
| Rate for Payer: Mclaren Medicare |
$219.68
|
| Rate for Payer: Meridian Medicaid |
$126.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$230.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$331.06
|
| Rate for Payer: PACE Medicare |
$208.70
|
| Rate for Payer: PACE SWMI |
$219.68
|
| Rate for Payer: PHP Commercial |
$331.06
|
| Rate for Payer: PHP Medicare Advantage |
$219.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$272.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$691.57
|
| Rate for Payer: Priority Health Medicare |
$219.68
|
| Rate for Payer: Priority Health Narrow Network |
$553.26
|
| Rate for Payer: Priority Health SBD |
$245.37
|
| Rate for Payer: Railroad Medicare Medicare |
$219.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.68
|
| Rate for Payer: UHC Exchange |
$295.03
|
| Rate for Payer: UHC Medicare Advantage |
$226.27
|
| Rate for Payer: UMR Bronson Commercial |
$144.11
|
| Rate for Payer: VA VA |
$219.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.11
|
|
|
HC COMPLEX CYSTOMETROGRAM
|
Facility
|
IP
|
$389.48
|
|
|
Service Code
|
CPT 51726
|
| Hospital Charge Code |
76100190
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$171.37 |
| Max. Negotiated Rate |
$350.53 |
| Rate for Payer: Aetna American Axle |
$253.16
|
| Rate for Payer: Aetna Commercial |
$331.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.16
|
| Rate for Payer: Cash Price |
$311.58
|
| Rate for Payer: Cofinity Commercial |
$334.95
|
| Rate for Payer: Cofinity Commercial |
$272.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$311.58
|
| Rate for Payer: Healthscope Commercial |
$350.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$272.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$331.06
|
| Rate for Payer: PHP Commercial |
$331.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$272.64
|
| Rate for Payer: Priority Health SBD |
$245.37
|
| Rate for Payer: UMR Bronson Commercial |
$171.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.11
|
|
|
HC COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE
|
Facility
|
IP
|
$859.86
|
|
|
Service Code
|
CPT 51727
|
| Hospital Charge Code |
76100220
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$378.34 |
| Max. Negotiated Rate |
$773.87 |
| Rate for Payer: Aetna American Axle |
$558.91
|
| Rate for Payer: Aetna Commercial |
$730.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$558.91
|
| Rate for Payer: Cash Price |
$687.89
|
| Rate for Payer: Cofinity Commercial |
$601.90
|
| Rate for Payer: Cofinity Commercial |
$739.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$687.89
|
| Rate for Payer: Healthscope Commercial |
$773.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$601.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$644.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$730.88
|
| Rate for Payer: PHP Commercial |
$730.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$601.90
|
| Rate for Payer: Priority Health SBD |
$541.71
|
| Rate for Payer: UMR Bronson Commercial |
$378.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$644.90
|
|
|
HC COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE
|
Facility
|
OP
|
$859.86
|
|
|
Service Code
|
CPT 51727
|
| Hospital Charge Code |
76100220
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$259.89 |
| Max. Negotiated Rate |
$1,911.48 |
| Rate for Payer: Aetna American Axle |
$558.91
|
| Rate for Payer: Aetna Commercial |
$730.88
|
| Rate for Payer: Aetna Medicare |
$631.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$558.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$759.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$759.00
|
| Rate for Payer: BCBS Complete |
$348.78
|
| Rate for Payer: BCBS MAPPO |
$607.20
|
| Rate for Payer: BCBS Trust/PPO |
$259.89
|
| Rate for Payer: BCN Medicare Advantage |
$607.20
|
| Rate for Payer: Cash Price |
$687.89
|
| Rate for Payer: Cash Price |
$687.89
|
| Rate for Payer: Cofinity Commercial |
$601.90
|
| Rate for Payer: Cofinity Commercial |
$739.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$687.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.20
|
| Rate for Payer: Healthscope Commercial |
$773.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$601.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$644.90
|
| Rate for Payer: Mclaren Medicaid |
$332.14
|
| Rate for Payer: Mclaren Medicare |
$607.20
|
| Rate for Payer: Meridian Medicaid |
$348.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$637.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$698.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$730.88
|
| Rate for Payer: PACE Medicare |
$576.84
|
| Rate for Payer: PACE SWMI |
$607.20
|
| Rate for Payer: PHP Commercial |
$730.88
|
| Rate for Payer: PHP Medicare Advantage |
$607.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$601.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,911.48
|
| Rate for Payer: Priority Health Medicare |
$607.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,529.18
|
| Rate for Payer: Priority Health SBD |
$541.71
|
| Rate for Payer: Railroad Medicare Medicare |
$607.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$395.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$607.20
|
| Rate for Payer: UHC Exchange |
$359.53
|
| Rate for Payer: UHC Medicare Advantage |
$625.42
|
| Rate for Payer: UMR Bronson Commercial |
$318.15
|
| Rate for Payer: VA VA |
$607.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$644.90
|
|
|
HC COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES
|
Facility
|
OP
|
$860.25
|
|
|
Service Code
|
CPT 51728
|
| Hospital Charge Code |
76100191
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$267.57 |
| Max. Negotiated Rate |
$1,911.48 |
| Rate for Payer: Aetna American Axle |
$559.16
|
| Rate for Payer: Aetna Commercial |
$731.21
|
| Rate for Payer: Aetna Medicare |
$631.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$559.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$759.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$759.00
|
| Rate for Payer: BCBS Complete |
$348.78
|
| Rate for Payer: BCBS MAPPO |
$607.20
|
| Rate for Payer: BCBS Trust/PPO |
$267.57
|
| Rate for Payer: BCN Medicare Advantage |
$607.20
|
| Rate for Payer: Cash Price |
$688.20
|
| Rate for Payer: Cash Price |
$688.20
|
| Rate for Payer: Cofinity Commercial |
$602.18
|
| Rate for Payer: Cofinity Commercial |
$739.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$688.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.20
|
| Rate for Payer: Healthscope Commercial |
$774.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$602.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$645.19
|
| Rate for Payer: Mclaren Medicaid |
$332.14
|
| Rate for Payer: Mclaren Medicare |
$607.20
|
| Rate for Payer: Meridian Medicaid |
$348.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$637.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$698.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$731.21
|
| Rate for Payer: PACE Medicare |
$576.84
|
| Rate for Payer: PACE SWMI |
$607.20
|
| Rate for Payer: PHP Commercial |
$731.21
|
| Rate for Payer: PHP Medicare Advantage |
$607.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$602.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,911.48
|
| Rate for Payer: Priority Health Medicare |
$607.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,529.18
|
| Rate for Payer: Priority Health SBD |
$541.96
|
| Rate for Payer: Railroad Medicare Medicare |
$607.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$607.20
|
| Rate for Payer: UHC Exchange |
$357.24
|
| Rate for Payer: UHC Medicare Advantage |
$625.42
|
| Rate for Payer: UMR Bronson Commercial |
$318.29
|
| Rate for Payer: VA VA |
$607.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$645.19
|
|
|
HC COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES
|
Facility
|
IP
|
$860.25
|
|
|
Service Code
|
CPT 51728
|
| Hospital Charge Code |
76100191
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$378.51 |
| Max. Negotiated Rate |
$774.22 |
| Rate for Payer: Aetna American Axle |
$559.16
|
| Rate for Payer: Aetna Commercial |
$731.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$559.16
|
| Rate for Payer: Cash Price |
$688.20
|
| Rate for Payer: Cofinity Commercial |
$602.18
|
| Rate for Payer: Cofinity Commercial |
$739.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$688.20
|
| Rate for Payer: Healthscope Commercial |
$774.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$602.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$645.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$731.21
|
| Rate for Payer: PHP Commercial |
$731.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$602.18
|
| Rate for Payer: Priority Health SBD |
$541.96
|
| Rate for Payer: UMR Bronson Commercial |
$378.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$645.19
|
|
|
HC COMPLEX MULTILAYER COMP DSG
|
Facility
|
OP
|
$795.00
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100024
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$25.87 |
| Max. Negotiated Rate |
$715.50 |
| Rate for Payer: Aetna American Axle |
$516.75
|
| Rate for Payer: Aetna Commercial |
$675.75
|
| Rate for Payer: Aetna Medicare |
$145.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$516.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.08
|
| Rate for Payer: BCBS Complete |
$80.45
|
| Rate for Payer: BCBS MAPPO |
$140.06
|
| Rate for Payer: BCBS Trust/PPO |
$145.99
|
| Rate for Payer: BCN Medicare Advantage |
$140.06
|
| Rate for Payer: Cash Price |
$636.00
|
| Rate for Payer: Cash Price |
$636.00
|
| Rate for Payer: Cofinity Commercial |
$683.70
|
| Rate for Payer: Cofinity Commercial |
$556.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$636.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.06
|
| Rate for Payer: Healthscope Commercial |
$715.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$556.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$596.25
|
| Rate for Payer: Mclaren Medicaid |
$76.61
|
| Rate for Payer: Mclaren Medicare |
$140.06
|
| Rate for Payer: Meridian Medicaid |
$80.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$675.75
|
| Rate for Payer: PACE Medicare |
$133.06
|
| Rate for Payer: PACE SWMI |
$140.06
|
| Rate for Payer: PHP Commercial |
$675.75
|
| Rate for Payer: PHP Medicare Advantage |
$140.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$556.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$440.92
|
| Rate for Payer: Priority Health Medicare |
$140.06
|
| Rate for Payer: Priority Health Narrow Network |
$352.74
|
| Rate for Payer: Priority Health SBD |
$500.85
|
| Rate for Payer: Railroad Medicare Medicare |
$140.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.06
|
| Rate for Payer: UHC Exchange |
$25.87
|
| Rate for Payer: UHC Medicare Advantage |
$144.26
|
| Rate for Payer: UMR Bronson Commercial |
$294.15
|
| Rate for Payer: VA VA |
$140.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$596.25
|
|
|
HC COMPLEX MULTILAYER COMP DSG
|
Facility
|
IP
|
$795.00
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100024
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$349.80 |
| Max. Negotiated Rate |
$715.50 |
| Rate for Payer: Aetna American Axle |
$516.75
|
| Rate for Payer: Aetna Commercial |
$675.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$516.75
|
| Rate for Payer: Cash Price |
$636.00
|
| Rate for Payer: Cofinity Commercial |
$556.50
|
| Rate for Payer: Cofinity Commercial |
$683.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$636.00
|
| Rate for Payer: Healthscope Commercial |
$715.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$556.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$596.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$675.75
|
| Rate for Payer: PHP Commercial |
$675.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$556.50
|
| Rate for Payer: Priority Health SBD |
$500.85
|
| Rate for Payer: UMR Bronson Commercial |
$349.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$596.25
|
|
|
HC COMPLEX UROFLOWMETRY
|
Facility
|
OP
|
$228.81
|
|
|
Service Code
|
CPT 51741
|
| Hospital Charge Code |
76100192
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$14.08 |
| Max. Negotiated Rate |
$878.32 |
| Rate for Payer: Aetna American Axle |
$148.73
|
| Rate for Payer: Aetna Commercial |
$194.49
|
| Rate for Payer: Aetna Medicare |
$290.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.73
|
| 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 |
$122.46
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$183.05
|
| Rate for Payer: Cash Price |
$183.05
|
| Rate for Payer: Cofinity Commercial |
$160.17
|
| Rate for Payer: Cofinity Commercial |
$196.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$205.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$160.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.61
|
| 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 |
$194.49
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$194.49
|
| 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 |
$160.17
|
| 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 |
$144.15
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.00
|
| Rate for Payer: UHC Exchange |
$14.08
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: UMR Bronson Commercial |
$84.66
|
| Rate for Payer: VA VA |
$279.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.61
|
|
|
HC COMPLEX UROFLOWMETRY
|
Facility
|
IP
|
$228.81
|
|
|
Service Code
|
CPT 51741
|
| Hospital Charge Code |
76100192
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$100.68 |
| Max. Negotiated Rate |
$205.93 |
| Rate for Payer: Aetna American Axle |
$148.73
|
| Rate for Payer: Aetna Commercial |
$194.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.73
|
| Rate for Payer: Cash Price |
$183.05
|
| Rate for Payer: Cofinity Commercial |
$160.17
|
| Rate for Payer: Cofinity Commercial |
$196.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.05
|
| Rate for Payer: Healthscope Commercial |
$205.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$160.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$194.49
|
| Rate for Payer: PHP Commercial |
$194.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.17
|
| Rate for Payer: Priority Health SBD |
$144.15
|
| Rate for Payer: UMR Bronson Commercial |
$100.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.61
|
|
|
HC COMP METABOLIC PANEL
|
Facility
|
OP
|
$38.40
|
|
|
Service Code
|
CPT 80053
|
| Hospital Charge Code |
30100013
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.78 |
| Max. Negotiated Rate |
$34.56 |
| Rate for Payer: Aetna American Axle |
$24.96
|
| Rate for Payer: Aetna Commercial |
$32.64
|
| Rate for Payer: Aetna Medicare |
$10.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.20
|
| Rate for Payer: BCBS Complete |
$6.07
|
| Rate for Payer: BCBS MAPPO |
$10.56
|
| Rate for Payer: BCBS Trust/PPO |
$18.21
|
| Rate for Payer: BCN Medicare Advantage |
$10.56
|
| Rate for Payer: Cash Price |
$30.72
|
| Rate for Payer: Cash Price |
$30.72
|
| Rate for Payer: Cofinity Commercial |
$33.02
|
| Rate for Payer: Cofinity Commercial |
$26.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.56
|
| Rate for Payer: Healthscope Commercial |
$34.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.80
|
| Rate for Payer: Mclaren Medicaid |
$5.78
|
| Rate for Payer: Mclaren Medicare |
$10.56
|
| Rate for Payer: Meridian Medicaid |
$6.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.64
|
| Rate for Payer: PACE Medicare |
$10.03
|
| Rate for Payer: PACE SWMI |
$10.56
|
| Rate for Payer: PHP Commercial |
$32.64
|
| Rate for Payer: PHP Medicare Advantage |
$10.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.27
|
| Rate for Payer: Priority Health Medicare |
$10.56
|
| Rate for Payer: Priority Health Narrow Network |
$11.42
|
| Rate for Payer: Priority Health SBD |
$24.19
|
| Rate for Payer: Railroad Medicare Medicare |
$10.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.67
|
| Rate for Payer: UHC Core |
$17.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.56
|
| Rate for Payer: UHC Exchange |
$10.56
|
| Rate for Payer: UHC Medicare Advantage |
$10.88
|
| Rate for Payer: UMR Bronson Commercial |
$14.21
|
| Rate for Payer: VA VA |
$10.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.80
|
|
|
HC COMP METABOLIC PANEL
|
Facility
|
IP
|
$38.40
|
|
|
Service Code
|
CPT 80053
|
| Hospital Charge Code |
30100013
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.90 |
| Max. Negotiated Rate |
$34.56 |
| Rate for Payer: Aetna American Axle |
$24.96
|
| Rate for Payer: Aetna Commercial |
$32.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.96
|
| Rate for Payer: Cash Price |
$30.72
|
| Rate for Payer: Cofinity Commercial |
$26.88
|
| Rate for Payer: Cofinity Commercial |
$33.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.72
|
| Rate for Payer: Healthscope Commercial |
$34.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.64
|
| Rate for Payer: PHP Commercial |
$32.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.88
|
| Rate for Payer: Priority Health SBD |
$24.19
|
| Rate for Payer: UMR Bronson Commercial |
$16.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.80
|
|
|
HC COMPONENT POOLING
|
Facility
|
IP
|
$121.70
|
|
|
Service Code
|
CPT 86965
|
| Hospital Charge Code |
39000027
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$53.55 |
| Max. Negotiated Rate |
$109.53 |
| Rate for Payer: Aetna American Axle |
$79.10
|
| Rate for Payer: Aetna Commercial |
$103.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.10
|
| Rate for Payer: Cash Price |
$97.36
|
| Rate for Payer: Cofinity Commercial |
$104.66
|
| Rate for Payer: Cofinity Commercial |
$85.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.36
|
| Rate for Payer: Healthscope Commercial |
$109.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.44
|
| Rate for Payer: PHP Commercial |
$103.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.19
|
| Rate for Payer: Priority Health SBD |
$76.67
|
| Rate for Payer: UMR Bronson Commercial |
$53.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.28
|
|
|
HC COMPONENT POOLING
|
Facility
|
OP
|
$121.70
|
|
|
Service Code
|
CPT 86965
|
| Hospital Charge Code |
39000027
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$11.02 |
| Max. Negotiated Rate |
$477.95 |
| Rate for Payer: Aetna American Axle |
$79.10
|
| Rate for Payer: Aetna Commercial |
$103.44
|
| Rate for Payer: Aetna Medicare |
$157.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$189.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$189.78
|
| Rate for Payer: BCBS Complete |
$87.21
|
| Rate for Payer: BCBS MAPPO |
$151.82
|
| Rate for Payer: BCBS Trust/PPO |
$11.02
|
| Rate for Payer: BCN Medicare Advantage |
$151.82
|
| Rate for Payer: Cash Price |
$97.36
|
| Rate for Payer: Cash Price |
$97.36
|
| Rate for Payer: Cash Price |
$97.36
|
| Rate for Payer: Cofinity Commercial |
$85.19
|
| Rate for Payer: Cofinity Commercial |
$104.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.82
|
| Rate for Payer: Healthscope Commercial |
$109.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.28
|
| Rate for Payer: Mclaren Medicaid |
$83.05
|
| Rate for Payer: Mclaren Medicare |
$151.82
|
| Rate for Payer: Meridian Medicaid |
$87.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$159.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.44
|
| Rate for Payer: PACE Medicare |
$144.23
|
| Rate for Payer: PACE SWMI |
$151.82
|
| Rate for Payer: PHP Commercial |
$103.44
|
| Rate for Payer: PHP Medicare Advantage |
$151.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$477.95
|
| Rate for Payer: Priority Health Medicare |
$151.82
|
| Rate for Payer: Priority Health Narrow Network |
$382.36
|
| Rate for Payer: Priority Health SBD |
$76.67
|
| Rate for Payer: Railroad Medicare Medicare |
$151.82
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$151.82
|
| Rate for Payer: UHC Medicare Advantage |
$156.37
|
| Rate for Payer: UMR Bronson Commercial |
$45.03
|
| Rate for Payer: VA VA |
$151.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.28
|
|
|
HC COMPONENT THAWING
|
Facility
|
IP
|
$106.00
|
|
|
Service Code
|
CPT 86927
|
| Hospital Charge Code |
39000025
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$46.64 |
| Max. Negotiated Rate |
$95.40 |
| Rate for Payer: Aetna American Axle |
$68.90
|
| Rate for Payer: Aetna Commercial |
$90.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.90
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$74.20
|
| Rate for Payer: Cofinity Commercial |
$91.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.80
|
| Rate for Payer: Healthscope Commercial |
$95.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$90.10
|
| Rate for Payer: PHP Commercial |
$90.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.20
|
| Rate for Payer: Priority Health SBD |
$66.78
|
| Rate for Payer: UMR Bronson Commercial |
$46.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.50
|
|
|
HC COMPONENT THAWING
|
Facility
|
OP
|
$106.00
|
|
|
Service Code
|
CPT 86927
|
| Hospital Charge Code |
39000025
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$477.95 |
| Rate for Payer: Aetna American Axle |
$68.90
|
| Rate for Payer: Aetna Commercial |
$90.10
|
| Rate for Payer: Aetna Medicare |
$157.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$189.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$189.78
|
| Rate for Payer: BCBS Complete |
$87.21
|
| Rate for Payer: BCBS MAPPO |
$151.82
|
| Rate for Payer: BCBS Trust/PPO |
$2.94
|
| Rate for Payer: BCN Medicare Advantage |
$151.82
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$74.20
|
| Rate for Payer: Cofinity Commercial |
$91.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.82
|
| Rate for Payer: Healthscope Commercial |
$95.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.50
|
| Rate for Payer: Mclaren Medicaid |
$83.05
|
| Rate for Payer: Mclaren Medicare |
$151.82
|
| Rate for Payer: Meridian Medicaid |
$87.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$159.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$90.10
|
| Rate for Payer: PACE Medicare |
$144.23
|
| Rate for Payer: PACE SWMI |
$151.82
|
| Rate for Payer: PHP Commercial |
$90.10
|
| Rate for Payer: PHP Medicare Advantage |
$151.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$477.95
|
| Rate for Payer: Priority Health Medicare |
$151.82
|
| Rate for Payer: Priority Health Narrow Network |
$382.36
|
| Rate for Payer: Priority Health SBD |
$66.78
|
| Rate for Payer: Railroad Medicare Medicare |
$151.82
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$151.82
|
| Rate for Payer: UHC Medicare Advantage |
$156.37
|
| Rate for Payer: UMR Bronson Commercial |
$39.22
|
| Rate for Payer: VA VA |
$151.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.50
|
|
|
HC COMPREHENSIVE HEARING TEST
|
Facility
|
IP
|
$208.01
|
|
|
Service Code
|
CPT 92557
|
| Hospital Charge Code |
47100012
|
|
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 |
$178.89
|
| Rate for Payer: Cofinity Commercial |
$145.61
|
| 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 COMPREHENSIVE HEARING TEST
|
Facility
|
OP
|
$208.01
|
|
|
Service Code
|
CPT 92557
|
| Hospital Charge Code |
47100012
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$30.78 |
| 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 |
$80.43
|
| 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 |
$145.61
|
| Rate for Payer: Cofinity Commercial |
$178.89
|
| 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) |
$33.86
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.85
|
| Rate for Payer: UHC Exchange |
$30.78
|
| 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 COMPRESS BURN GARM GAUNTLET-EL
|
Facility
|
OP
|
$86.00
|
|
|
Service Code
|
HCPCS A6505
|
| Hospital Charge Code |
98300069
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$31.82 |
| Max. Negotiated Rate |
$456.72 |
| Rate for Payer: Aetna American Axle |
$55.90
|
| Rate for Payer: Aetna Commercial |
$73.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.90
|
| Rate for Payer: BCBS Complete |
$34.40
|
| Rate for Payer: BCBS Trust/PPO |
$456.72
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Cofinity Commercial |
$60.20
|
| Rate for Payer: Cofinity Commercial |
$73.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.80
|
| Rate for Payer: Healthscope Commercial |
$77.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$73.10
|
| Rate for Payer: PHP Commercial |
$73.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.20
|
| Rate for Payer: Priority Health SBD |
$54.18
|
| Rate for Payer: UMR Bronson Commercial |
$31.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.50
|
|
|
HC COMPRESS BURN GARM GAUNTLET-EL
|
Facility
|
IP
|
$86.00
|
|
|
Service Code
|
HCPCS A6505
|
| Hospital Charge Code |
98300069
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.84 |
| Max. Negotiated Rate |
$77.40 |
| Rate for Payer: Aetna American Axle |
$55.90
|
| Rate for Payer: Aetna Commercial |
$73.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.90
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Cofinity Commercial |
$60.20
|
| Rate for Payer: Cofinity Commercial |
$73.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.80
|
| Rate for Payer: Healthscope Commercial |
$77.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$73.10
|
| Rate for Payer: PHP Commercial |
$73.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.20
|
| Rate for Payer: Priority Health SBD |
$54.18
|
| Rate for Payer: UMR Bronson Commercial |
$37.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.50
|
|
|
HC CONDITIONING PLAY AUDIOMETRY
|
Facility
|
OP
|
$146.00
|
|
|
Service Code
|
CPT 92582
|
| Hospital Charge Code |
76100512
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$54.02 |
| Max. Negotiated Rate |
$437.09 |
| Rate for Payer: Aetna American Axle |
$94.90
|
| Rate for Payer: Aetna Commercial |
$124.10
|
| Rate for Payer: Aetna Medicare |
$144.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.90
|
| 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 |
$408.86
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cofinity Commercial |
$125.56
|
| Rate for Payer: Cofinity Commercial |
$102.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$131.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$102.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.50
|
| 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 |
$124.10
|
| Rate for Payer: PACE Medicare |
$131.91
|
| Rate for Payer: PACE SWMI |
$138.85
|
| Rate for Payer: PHP Commercial |
$124.10
|
| 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 |
$102.20
|
| 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 |
$91.98
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.64
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.85
|
| Rate for Payer: UHC Exchange |
$85.13
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: UMR Bronson Commercial |
$54.02
|
| Rate for Payer: VA VA |
$138.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.50
|
|
|
HC CONDITIONING PLAY AUDIOMETRY
|
Facility
|
IP
|
$146.00
|
|
|
Service Code
|
CPT 92582
|
| Hospital Charge Code |
76100512
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$64.24 |
| Max. Negotiated Rate |
$131.40 |
| Rate for Payer: Aetna American Axle |
$94.90
|
| Rate for Payer: Aetna Commercial |
$124.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.90
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cofinity Commercial |
$102.20
|
| Rate for Payer: Cofinity Commercial |
$125.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.80
|
| Rate for Payer: Healthscope Commercial |
$131.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$102.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.10
|
| Rate for Payer: PHP Commercial |
$124.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.20
|
| Rate for Payer: Priority Health SBD |
$91.98
|
| Rate for Payer: UMR Bronson Commercial |
$64.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.50
|
|
|
HC CONFIRMED DRUG ABUSE PANEL 9 U
|
Facility
|
IP
|
$102.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100643
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.88 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna American Axle |
$66.30
|
| Rate for Payer: Aetna Commercial |
$86.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.30
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$71.40
|
| Rate for Payer: Cofinity Commercial |
$87.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.70
|
| Rate for Payer: PHP Commercial |
$86.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: Priority Health SBD |
$64.26
|
| Rate for Payer: UMR Bronson Commercial |
$44.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.50
|
|
|
HC CONFIRMED DRUG ABUSE PANEL 9 U
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100643
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.99 |
| Max. Negotiated Rate |
$95.77 |
| Rate for Payer: Aetna American Axle |
$66.30
|
| Rate for Payer: Aetna Commercial |
$86.70
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: BCBS Complete |
$35.69
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$55.89
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$87.72
|
| Rate for Payer: Cofinity Commercial |
$71.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.50
|
| Rate for Payer: Mclaren Medicaid |
$33.99
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Medicaid |
$35.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.70
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$86.70
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.58
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$38.86
|
| Rate for Payer: Priority Health SBD |
$64.26
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.57
|
| Rate for Payer: UHC Core |
$95.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$62.14
|
| Rate for Payer: UHC Medicare Advantage |
$64.00
|
| Rate for Payer: UMR Bronson Commercial |
$37.74
|
| Rate for Payer: VA VA |
$62.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.50
|
|
