|
HC CT ABDOMEN AND PELVIS WO W CON
|
Facility
|
IP
|
$4,346.70
|
|
|
Service Code
|
CPT 74178
|
| Hospital Charge Code |
35200028
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,912.55 |
| Max. Negotiated Rate |
$3,912.03 |
| Rate for Payer: Aetna American Axle |
$2,825.36
|
| Rate for Payer: Aetna Commercial |
$3,694.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,825.36
|
| Rate for Payer: Cash Price |
$3,477.36
|
| Rate for Payer: Cofinity Commercial |
$3,042.69
|
| Rate for Payer: Cofinity Commercial |
$3,738.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,477.36
|
| Rate for Payer: Healthscope Commercial |
$3,912.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,042.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,260.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,694.70
|
| Rate for Payer: PHP Commercial |
$3,694.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,042.69
|
| Rate for Payer: Priority Health SBD |
$2,738.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,912.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,260.02
|
|
|
HC CT ABDOMEN AND PELVIS WO W CON
|
Facility
|
OP
|
$4,346.70
|
|
|
Service Code
|
CPT 74178
|
| Hospital Charge Code |
35200028
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$3,912.03 |
| Rate for Payer: Aetna American Axle |
$2,825.36
|
| Rate for Payer: Aetna Commercial |
$3,694.70
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,825.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$496.02
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$3,477.36
|
| Rate for Payer: Cash Price |
$3,477.36
|
| Rate for Payer: Cofinity Commercial |
$3,738.16
|
| Rate for Payer: Cofinity Commercial |
$3,042.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,477.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$3,912.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,042.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,260.02
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,694.70
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$3,694.70
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,042.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,076.13
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$860.90
|
| Rate for Payer: Priority Health SBD |
$2,738.42
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$377.48
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$343.16
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,608.28
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,260.02
|
|
|
HC CT ABDOMEN ANGIO
|
Facility
|
IP
|
$1,075.90
|
|
|
Service Code
|
CPT 74175
|
| Hospital Charge Code |
35200025
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$473.40 |
| Max. Negotiated Rate |
$968.31 |
| Rate for Payer: Aetna American Axle |
$699.34
|
| Rate for Payer: Aetna Commercial |
$914.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$699.34
|
| Rate for Payer: Cash Price |
$860.72
|
| Rate for Payer: Cofinity Commercial |
$925.27
|
| Rate for Payer: Cofinity Commercial |
$753.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.72
|
| Rate for Payer: Healthscope Commercial |
$968.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$753.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$806.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$914.52
|
| Rate for Payer: PHP Commercial |
$914.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$753.13
|
| Rate for Payer: Priority Health SBD |
$677.82
|
| Rate for Payer: UMR Bronson Commercial |
$473.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$806.92
|
|
|
HC CT ABDOMEN ANGIO
|
Facility
|
OP
|
$1,075.90
|
|
|
Service Code
|
CPT 74175
|
| Hospital Charge Code |
35200025
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,048.00 |
| Rate for Payer: Aetna American Axle |
$699.34
|
| Rate for Payer: Aetna Commercial |
$914.52
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$699.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.15
|
| Rate for Payer: BCBS Complete |
$93.81
|
| Rate for Payer: BCBS MAPPO |
$163.32
|
| Rate for Payer: BCBS Trust/PPO |
$443.44
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$860.72
|
| Rate for Payer: Cash Price |
$860.72
|
| Rate for Payer: Cofinity Commercial |
$753.13
|
| Rate for Payer: Cofinity Commercial |
$925.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$968.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$753.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$806.92
|
| Rate for Payer: Mclaren Medicaid |
$89.34
|
| Rate for Payer: Mclaren Medicare |
$163.32
|
| Rate for Payer: Meridian Medicaid |
$93.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$914.52
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$914.52
|
| Rate for Payer: PHP Medicare Advantage |
$163.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$753.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$514.13
|
| Rate for Payer: Priority Health Medicare |
$163.32
|
| Rate for Payer: Priority Health Narrow Network |
$411.30
|
| Rate for Payer: Priority Health SBD |
$677.82
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$338.93
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$308.12
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$398.08
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$806.92
|
|
|
HC CT ABDOMEN W CON
|
Facility
|
IP
|
$1,921.32
|
|
|
Service Code
|
CPT 74160
|
| Hospital Charge Code |
35200023
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$845.38 |
| Max. Negotiated Rate |
$1,729.19 |
| Rate for Payer: Aetna American Axle |
$1,248.86
|
| Rate for Payer: Aetna Commercial |
$1,633.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,248.86
|
| Rate for Payer: Cash Price |
$1,537.06
|
| Rate for Payer: Cofinity Commercial |
$1,344.92
|
| Rate for Payer: Cofinity Commercial |
$1,652.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,537.06
|
| Rate for Payer: Healthscope Commercial |
$1,729.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,344.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,440.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,633.12
|
| Rate for Payer: PHP Commercial |
$1,633.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.92
|
| Rate for Payer: Priority Health SBD |
$1,210.43
|
| Rate for Payer: UMR Bronson Commercial |
$845.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,440.99
|
|
|
HC CT ABDOMEN W CON
|
Facility
|
OP
|
$1,921.32
|
|
|
Service Code
|
CPT 74160
|
| Hospital Charge Code |
35200023
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,729.19 |
| Rate for Payer: Aetna American Axle |
$1,248.86
|
| Rate for Payer: Aetna Commercial |
$1,633.12
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,248.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.15
|
| Rate for Payer: BCBS Complete |
$93.81
|
| Rate for Payer: BCBS MAPPO |
$163.32
|
| Rate for Payer: BCBS Trust/PPO |
$349.68
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$1,537.06
|
| Rate for Payer: Cash Price |
$1,537.06
|
| Rate for Payer: Cofinity Commercial |
$1,344.92
|
| Rate for Payer: Cofinity Commercial |
$1,652.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,537.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$1,729.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,344.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,440.99
|
| Rate for Payer: Mclaren Medicaid |
$89.34
|
| Rate for Payer: Mclaren Medicare |
$163.32
|
| Rate for Payer: Meridian Medicaid |
$93.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,633.12
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$1,633.12
|
| Rate for Payer: PHP Medicare Advantage |
$163.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$514.13
|
| Rate for Payer: Priority Health Medicare |
$163.32
|
| Rate for Payer: Priority Health Narrow Network |
$411.30
|
| Rate for Payer: Priority Health SBD |
$1,210.43
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.61
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$235.10
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$710.89
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,440.99
|
|
|
HC CT ABDOMEN WO CON
|
Facility
|
IP
|
$1,575.39
|
|
|
Service Code
|
CPT 74150
|
| Hospital Charge Code |
35200022
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$693.17 |
| Max. Negotiated Rate |
$1,417.85 |
| Rate for Payer: Aetna American Axle |
$1,024.00
|
| Rate for Payer: Aetna Commercial |
$1,339.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,024.00
|
| Rate for Payer: Cash Price |
$1,260.31
|
| Rate for Payer: Cofinity Commercial |
$1,102.77
|
| Rate for Payer: Cofinity Commercial |
$1,354.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,260.31
|
| Rate for Payer: Healthscope Commercial |
$1,417.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,102.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,181.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,339.08
|
| Rate for Payer: PHP Commercial |
$1,339.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,102.77
|
| Rate for Payer: Priority Health SBD |
$992.50
|
| Rate for Payer: UMR Bronson Commercial |
$693.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,181.54
|
|
|
HC CT ABDOMEN WO CON
|
Facility
|
OP
|
$1,575.39
|
|
|
Service Code
|
CPT 74150
|
| Hospital Charge Code |
35200022
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$1,417.85 |
| Rate for Payer: Aetna American Axle |
$1,024.00
|
| Rate for Payer: Aetna Commercial |
$1,339.08
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,024.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$162.17
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$1,260.31
|
| Rate for Payer: Cash Price |
$1,260.31
|
| Rate for Payer: Cofinity Commercial |
$1,354.84
|
| Rate for Payer: Cofinity Commercial |
$1,102.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,260.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$1,417.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,102.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,181.54
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,339.08
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$1,339.08
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,102.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$992.50
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.28
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$137.53
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$582.89
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,181.54
|
|
|
HC CT ABDOMEN WO W CON
|
Facility
|
IP
|
$2,405.52
|
|
|
Service Code
|
CPT 74170
|
| Hospital Charge Code |
35200024
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,058.43 |
| Max. Negotiated Rate |
$2,164.97 |
| Rate for Payer: Aetna American Axle |
$1,563.59
|
| Rate for Payer: Aetna Commercial |
$2,044.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,563.59
|
| Rate for Payer: Cash Price |
$1,924.42
|
| Rate for Payer: Cofinity Commercial |
$1,683.86
|
| Rate for Payer: Cofinity Commercial |
$2,068.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,924.42
|
| Rate for Payer: Healthscope Commercial |
$2,164.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,683.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,804.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,044.69
|
| Rate for Payer: PHP Commercial |
$2,044.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,683.86
|
| Rate for Payer: Priority Health SBD |
$1,515.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,058.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,804.14
|
|
|
HC CT ABDOMEN WO W CON
|
Facility
|
OP
|
$2,405.52
|
|
|
Service Code
|
CPT 74170
|
| Hospital Charge Code |
35200024
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$2,164.97 |
| Rate for Payer: Aetna American Axle |
$1,563.59
|
| Rate for Payer: Aetna Commercial |
$2,044.69
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,563.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.15
|
| Rate for Payer: BCBS Complete |
$93.81
|
| Rate for Payer: BCBS MAPPO |
$163.32
|
| Rate for Payer: BCBS Trust/PPO |
$395.30
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$1,924.42
|
| Rate for Payer: Cash Price |
$1,924.42
|
| Rate for Payer: Cofinity Commercial |
$1,683.86
|
| Rate for Payer: Cofinity Commercial |
$2,068.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,924.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$2,164.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,683.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,804.14
|
| Rate for Payer: Mclaren Medicaid |
$89.34
|
| Rate for Payer: Mclaren Medicare |
$163.32
|
| Rate for Payer: Meridian Medicaid |
$93.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,044.69
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$2,044.69
|
| Rate for Payer: PHP Medicare Advantage |
$163.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,683.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$514.13
|
| Rate for Payer: Priority Health Medicare |
$163.32
|
| Rate for Payer: Priority Health Narrow Network |
$411.30
|
| Rate for Payer: Priority Health SBD |
$1,515.48
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.68
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$264.25
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$890.04
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,804.14
|
|
|
HC CT ABLATION PROCEDURE
|
Facility
|
IP
|
$1,075.90
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000030
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$473.40 |
| Max. Negotiated Rate |
$968.31 |
| Rate for Payer: Aetna American Axle |
$699.34
|
| Rate for Payer: Aetna Commercial |
$914.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$699.34
|
| Rate for Payer: Cash Price |
$860.72
|
| Rate for Payer: Cofinity Commercial |
$753.13
|
| Rate for Payer: Cofinity Commercial |
$925.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.72
|
| Rate for Payer: Healthscope Commercial |
$968.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$753.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$806.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$914.52
|
| Rate for Payer: PHP Commercial |
$914.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$753.13
|
| Rate for Payer: Priority Health SBD |
$677.82
|
| Rate for Payer: UMR Bronson Commercial |
$473.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$806.92
|
|
|
HC CT ABLATION PROCEDURE
|
Facility
|
OP
|
$1,075.90
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000030
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$398.08 |
| Max. Negotiated Rate |
$1,048.00 |
| Rate for Payer: Aetna American Axle |
$699.34
|
| Rate for Payer: Aetna Commercial |
$914.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$699.34
|
| Rate for Payer: BCBS Complete |
$430.36
|
| Rate for Payer: BCBS Trust/PPO |
$579.63
|
| Rate for Payer: Cash Price |
$860.72
|
| Rate for Payer: Cash Price |
$860.72
|
| Rate for Payer: Cofinity Commercial |
$753.13
|
| Rate for Payer: Cofinity Commercial |
$925.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.72
|
| Rate for Payer: Healthscope Commercial |
$968.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$753.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$806.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$914.52
|
| Rate for Payer: PHP Commercial |
$914.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$753.13
|
| Rate for Payer: Priority Health SBD |
$677.82
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UMR Bronson Commercial |
$398.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$806.92
|
|
|
HC CT ANGIO ABD AND PELVIS
|
Facility
|
OP
|
$3,025.12
|
|
|
Service Code
|
CPT 74174
|
| Hospital Charge Code |
35000034
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,722.61 |
| Rate for Payer: Aetna American Axle |
$1,966.33
|
| Rate for Payer: Aetna Commercial |
$2,571.35
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,966.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$555.57
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$2,420.10
|
| Rate for Payer: Cash Price |
$2,420.10
|
| Rate for Payer: Cofinity Commercial |
$2,117.58
|
| Rate for Payer: Cofinity Commercial |
$2,601.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,420.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,722.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,117.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,268.84
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,571.35
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$2,571.35
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,117.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,076.13
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$860.90
|
| Rate for Payer: Priority Health SBD |
$1,905.83
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$421.77
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$383.43
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,119.29
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,268.84
|
|
|
HC CT ANGIO ABD AND PELVIS
|
Facility
|
IP
|
$3,025.12
|
|
|
Service Code
|
CPT 74174
|
| Hospital Charge Code |
35000034
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,331.05 |
| Max. Negotiated Rate |
$2,722.61 |
| Rate for Payer: Aetna American Axle |
$1,966.33
|
| Rate for Payer: Aetna Commercial |
$2,571.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,966.33
|
| Rate for Payer: Cash Price |
$2,420.10
|
| Rate for Payer: Cofinity Commercial |
$2,117.58
|
| Rate for Payer: Cofinity Commercial |
$2,601.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,420.10
|
| Rate for Payer: Healthscope Commercial |
$2,722.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,117.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,268.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,571.35
|
| Rate for Payer: PHP Commercial |
$2,571.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,117.58
|
| Rate for Payer: Priority Health SBD |
$1,905.83
|
| Rate for Payer: UMR Bronson Commercial |
$1,331.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,268.84
|
|
|
HC CT ANGIO CORONARY DISCONTINUED
|
Facility
|
IP
|
$1,291.12
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000018
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$568.09 |
| Max. Negotiated Rate |
$1,162.01 |
| Rate for Payer: Aetna American Axle |
$839.23
|
| Rate for Payer: Aetna Commercial |
$1,097.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$839.23
|
| Rate for Payer: Cash Price |
$1,032.90
|
| Rate for Payer: Cofinity Commercial |
$1,110.36
|
| Rate for Payer: Cofinity Commercial |
$903.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,032.90
|
| Rate for Payer: Healthscope Commercial |
$1,162.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$903.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$968.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,097.45
|
| Rate for Payer: PHP Commercial |
$1,097.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$903.78
|
| Rate for Payer: Priority Health SBD |
$813.41
|
| Rate for Payer: UMR Bronson Commercial |
$568.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$968.34
|
|
|
HC CT ANGIO CORONARY DISCONTINUED
|
Facility
|
OP
|
$1,291.12
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000018
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,162.01 |
| Rate for Payer: Aetna American Axle |
$839.23
|
| Rate for Payer: Aetna Commercial |
$1,097.45
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$839.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.15
|
| Rate for Payer: BCBS Complete |
$93.81
|
| Rate for Payer: BCBS MAPPO |
$163.32
|
| Rate for Payer: BCBS Trust/PPO |
$416.20
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$1,032.90
|
| Rate for Payer: Cash Price |
$1,032.90
|
| Rate for Payer: Cofinity Commercial |
$903.78
|
| Rate for Payer: Cofinity Commercial |
$1,110.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,032.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$1,162.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$903.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$968.34
|
| Rate for Payer: Mclaren Medicaid |
$89.34
|
| Rate for Payer: Mclaren Medicare |
$163.32
|
| Rate for Payer: Meridian Medicaid |
$93.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,097.45
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$1,097.45
|
| Rate for Payer: PHP Medicare Advantage |
$163.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$903.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$514.13
|
| Rate for Payer: Priority Health Medicare |
$163.32
|
| Rate for Payer: Priority Health Narrow Network |
$411.30
|
| Rate for Payer: Priority Health SBD |
$813.41
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.59
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$324.17
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$477.71
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$968.34
|
|
|
HC CT AORTA W RUNOFF ANGIO
|
Facility
|
IP
|
$2,114.15
|
|
|
Service Code
|
CPT 75635
|
| Hospital Charge Code |
35000020
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$930.23 |
| Max. Negotiated Rate |
$1,902.74 |
| Rate for Payer: Aetna American Axle |
$1,374.20
|
| Rate for Payer: Aetna Commercial |
$1,797.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,374.20
|
| Rate for Payer: Cash Price |
$1,691.32
|
| Rate for Payer: Cofinity Commercial |
$1,479.90
|
| Rate for Payer: Cofinity Commercial |
$1,818.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,691.32
|
| Rate for Payer: Healthscope Commercial |
$1,902.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,479.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,585.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,797.03
|
| Rate for Payer: PHP Commercial |
$1,797.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,479.90
|
| Rate for Payer: Priority Health SBD |
$1,331.91
|
| Rate for Payer: UMR Bronson Commercial |
$930.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,585.61
|
|
|
HC CT AORTA W RUNOFF ANGIO
|
Facility
|
OP
|
$2,114.15
|
|
|
Service Code
|
CPT 75635
|
| Hospital Charge Code |
35000020
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,902.74 |
| Rate for Payer: Aetna American Axle |
$1,374.20
|
| Rate for Payer: Aetna Commercial |
$1,797.03
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,374.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.15
|
| Rate for Payer: BCBS Complete |
$93.81
|
| Rate for Payer: BCBS MAPPO |
$163.32
|
| Rate for Payer: BCBS Trust/PPO |
$595.47
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$1,691.32
|
| Rate for Payer: Cash Price |
$1,691.32
|
| Rate for Payer: Cofinity Commercial |
$1,479.90
|
| Rate for Payer: Cofinity Commercial |
$1,818.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,691.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$1,902.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,479.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,585.61
|
| Rate for Payer: Mclaren Medicaid |
$89.34
|
| Rate for Payer: Mclaren Medicare |
$163.32
|
| Rate for Payer: Meridian Medicaid |
$93.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,797.03
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$1,797.03
|
| Rate for Payer: PHP Medicare Advantage |
$163.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,479.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$514.13
|
| Rate for Payer: Priority Health Medicare |
$163.32
|
| Rate for Payer: Priority Health Narrow Network |
$411.30
|
| Rate for Payer: Priority Health SBD |
$1,331.91
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$455.28
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$413.89
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$782.24
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,585.61
|
|
|
HC CT BONE LENGTH STUDY
|
Facility
|
IP
|
$678.15
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
32000255
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$298.39 |
| Max. Negotiated Rate |
$610.34 |
| Rate for Payer: Aetna American Axle |
$440.80
|
| Rate for Payer: Aetna Commercial |
$576.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$440.80
|
| Rate for Payer: Cash Price |
$542.52
|
| Rate for Payer: Cofinity Commercial |
$474.70
|
| Rate for Payer: Cofinity Commercial |
$583.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$542.52
|
| Rate for Payer: Healthscope Commercial |
$610.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$474.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$508.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$576.43
|
| Rate for Payer: PHP Commercial |
$576.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$474.70
|
| Rate for Payer: Priority Health SBD |
$427.23
|
| Rate for Payer: UMR Bronson Commercial |
$298.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$508.61
|
|
|
HC CT BONE LENGTH STUDY
|
Facility
|
OP
|
$678.15
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
32000255
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.53 |
| Max. Negotiated Rate |
$610.34 |
| Rate for Payer: Aetna American Axle |
$440.80
|
| Rate for Payer: Aetna Commercial |
$576.43
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$440.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$60.82
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$542.52
|
| Rate for Payer: Cash Price |
$542.52
|
| Rate for Payer: Cofinity Commercial |
$474.70
|
| Rate for Payer: Cofinity Commercial |
$583.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$542.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$610.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$474.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$508.61
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$576.43
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$576.43
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$474.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$427.23
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.98
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$44.53
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$250.92
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$508.61
|
|
|
HC CT BRAIN PERFUSION
|
Facility
|
IP
|
$1,031.42
|
|
|
Service Code
|
CPT 0042T
|
| Hospital Charge Code |
35100011
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$453.82 |
| Max. Negotiated Rate |
$928.28 |
| Rate for Payer: Aetna American Axle |
$670.42
|
| Rate for Payer: Aetna Commercial |
$876.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.42
|
| Rate for Payer: Cash Price |
$825.14
|
| Rate for Payer: Cofinity Commercial |
$721.99
|
| Rate for Payer: Cofinity Commercial |
$887.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.14
|
| Rate for Payer: Healthscope Commercial |
$928.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$721.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$773.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$876.71
|
| Rate for Payer: PHP Commercial |
$876.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$721.99
|
| Rate for Payer: Priority Health SBD |
$649.79
|
| Rate for Payer: UMR Bronson Commercial |
$453.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$773.56
|
|
|
HC CT BRAIN PERFUSION
|
Facility
|
OP
|
$1,031.42
|
|
|
Service Code
|
CPT 0042T
|
| Hospital Charge Code |
35100011
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$281.21 |
| Max. Negotiated Rate |
$1,048.00 |
| Rate for Payer: Aetna American Axle |
$670.42
|
| Rate for Payer: Aetna Commercial |
$876.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.42
|
| Rate for Payer: BCBS Complete |
$412.57
|
| Rate for Payer: BCBS Trust/PPO |
$281.21
|
| Rate for Payer: Cash Price |
$825.14
|
| Rate for Payer: Cash Price |
$825.14
|
| Rate for Payer: Cofinity Commercial |
$887.02
|
| Rate for Payer: Cofinity Commercial |
$721.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.14
|
| Rate for Payer: Healthscope Commercial |
$928.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$721.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$773.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$876.71
|
| Rate for Payer: PHP Commercial |
$876.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$721.99
|
| Rate for Payer: Priority Health SBD |
$649.79
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UMR Bronson Commercial |
$381.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$773.56
|
|
|
HC CT BRAIN W CON
|
Facility
|
OP
|
$1,590.89
|
|
|
Service Code
|
CPT 70460
|
| Hospital Charge Code |
35100002
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,431.80 |
| Rate for Payer: Aetna American Axle |
$1,034.08
|
| Rate for Payer: Aetna Commercial |
$1,352.26
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,034.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.15
|
| Rate for Payer: BCBS Complete |
$93.81
|
| Rate for Payer: BCBS MAPPO |
$163.32
|
| Rate for Payer: BCBS Trust/PPO |
$189.41
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$1,272.71
|
| Rate for Payer: Cash Price |
$1,272.71
|
| Rate for Payer: Cofinity Commercial |
$1,368.17
|
| Rate for Payer: Cofinity Commercial |
$1,113.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,272.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$1,431.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,113.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,193.17
|
| Rate for Payer: Mclaren Medicaid |
$89.34
|
| Rate for Payer: Mclaren Medicare |
$163.32
|
| Rate for Payer: Meridian Medicaid |
$93.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,352.26
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$1,352.26
|
| Rate for Payer: PHP Medicare Advantage |
$163.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,113.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$514.13
|
| Rate for Payer: Priority Health Medicare |
$163.32
|
| Rate for Payer: Priority Health Narrow Network |
$411.30
|
| Rate for Payer: Priority Health SBD |
$1,002.26
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.24
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$149.31
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$588.63
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,193.17
|
|
|
HC CT BRAIN W CON
|
Facility
|
IP
|
$1,590.89
|
|
|
Service Code
|
CPT 70460
|
| Hospital Charge Code |
35100002
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$699.99 |
| Max. Negotiated Rate |
$1,431.80 |
| Rate for Payer: Aetna American Axle |
$1,034.08
|
| Rate for Payer: Aetna Commercial |
$1,352.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,034.08
|
| Rate for Payer: Cash Price |
$1,272.71
|
| Rate for Payer: Cofinity Commercial |
$1,113.62
|
| Rate for Payer: Cofinity Commercial |
$1,368.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,272.71
|
| Rate for Payer: Healthscope Commercial |
$1,431.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,113.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,193.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,352.26
|
| Rate for Payer: PHP Commercial |
$1,352.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,113.62
|
| Rate for Payer: Priority Health SBD |
$1,002.26
|
| Rate for Payer: UMR Bronson Commercial |
$699.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,193.17
|
|
|
HC CT BRAIN WO CON
|
Facility
|
IP
|
$1,484.45
|
|
|
Service Code
|
CPT 70450
|
| Hospital Charge Code |
35100001
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$653.16 |
| Max. Negotiated Rate |
$1,336.00 |
| Rate for Payer: Aetna American Axle |
$964.89
|
| Rate for Payer: Aetna Commercial |
$1,261.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$964.89
|
| Rate for Payer: Cash Price |
$1,187.56
|
| Rate for Payer: Cofinity Commercial |
$1,039.12
|
| Rate for Payer: Cofinity Commercial |
$1,276.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,187.56
|
| Rate for Payer: Healthscope Commercial |
$1,336.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,039.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,113.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,261.78
|
| Rate for Payer: PHP Commercial |
$1,261.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,039.12
|
| Rate for Payer: Priority Health SBD |
$935.20
|
| Rate for Payer: UMR Bronson Commercial |
$653.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,113.34
|
|
