|
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
|
|
|
HC CT BRAIN WO W CON
|
Facility
|
IP
|
$1,790.10
|
|
|
Service Code
|
CPT 70470
|
| Hospital Charge Code |
35100003
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$787.64 |
| Max. Negotiated Rate |
$1,611.09 |
| Rate for Payer: Aetna American Axle |
$1,163.56
|
| Rate for Payer: Aetna Commercial |
$1,521.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,163.56
|
| Rate for Payer: Cash Price |
$1,432.08
|
| Rate for Payer: Cofinity Commercial |
$1,253.07
|
| Rate for Payer: Cofinity Commercial |
$1,539.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,432.08
|
| Rate for Payer: Healthscope Commercial |
$1,611.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,253.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,342.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,521.58
|
| Rate for Payer: PHP Commercial |
$1,521.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,253.07
|
| Rate for Payer: Priority Health SBD |
$1,127.76
|
| Rate for Payer: UMR Bronson Commercial |
$787.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,342.58
|
|
|
HC CT BRAIN WO W CON
|
Facility
|
OP
|
$1,790.10
|
|
|
Service Code
|
CPT 70470
|
| Hospital Charge Code |
35100003
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,611.09 |
| Rate for Payer: Aetna American Axle |
$1,163.56
|
| Rate for Payer: Aetna Commercial |
$1,521.58
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,163.56
|
| 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 |
$228.06
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$1,432.08
|
| Rate for Payer: Cash Price |
$1,432.08
|
| Rate for Payer: Cofinity Commercial |
$1,253.07
|
| Rate for Payer: Cofinity Commercial |
$1,539.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,432.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$1,611.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,253.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,342.58
|
| 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 |
$1,521.58
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$1,521.58
|
| 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 |
$1,253.07
|
| 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 |
$1,127.76
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$192.34
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$174.85
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$662.34
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,342.58
|
|
|
HC CT CHEST ANGIOGRAPHY
|
Facility
|
IP
|
$2,027.45
|
|
|
Service Code
|
CPT 71275
|
| Hospital Charge Code |
35000006
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$892.08 |
| Max. Negotiated Rate |
$1,824.70 |
| Rate for Payer: Aetna American Axle |
$1,317.84
|
| Rate for Payer: Aetna Commercial |
$1,723.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,317.84
|
| Rate for Payer: Cash Price |
$1,621.96
|
| Rate for Payer: Cofinity Commercial |
$1,419.22
|
| Rate for Payer: Cofinity Commercial |
$1,743.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,621.96
|
| Rate for Payer: Healthscope Commercial |
$1,824.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,419.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,520.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,723.33
|
| Rate for Payer: PHP Commercial |
$1,723.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,419.22
|
| Rate for Payer: Priority Health SBD |
$1,277.29
|
| Rate for Payer: UMR Bronson Commercial |
$892.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,520.59
|
|
|
HC CT CHEST ANGIOGRAPHY
|
Facility
|
OP
|
$2,027.45
|
|
|
Service Code
|
CPT 71275
|
| Hospital Charge Code |
35000006
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,824.70 |
| Rate for Payer: Aetna American Axle |
$1,317.84
|
| Rate for Payer: Aetna Commercial |
$1,723.33
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,317.84
|
| 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 |
$391.49
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$1,621.96
|
| Rate for Payer: Cash Price |
$1,621.96
|
| Rate for Payer: Cofinity Commercial |
$1,419.22
|
| Rate for Payer: Cofinity Commercial |
$1,743.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,621.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$1,824.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,419.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,520.59
|
| 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 |
$1,723.33
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$1,723.33
|
| 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 |
$1,419.22
|
| 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 |
$1,277.29
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.92
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$283.56
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$750.16
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,520.59
|
|
|
HC CT CHEST SCREENING LUNG CANCER
|
Facility
|
OP
|
$505.03
|
|
|
Service Code
|
CPT 71271
|
| Hospital Charge Code |
35000040
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$1,048.00 |
| Rate for Payer: Aetna American Axle |
$328.27
|
| Rate for Payer: Aetna Commercial |
$429.28
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$328.27
|
| 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 |
$173.57
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$404.02
|
| Rate for Payer: Cash Price |
$404.02
|
| Rate for Payer: Cofinity Commercial |
$353.52
|
| Rate for Payer: Cofinity Commercial |
$434.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$404.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$454.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$353.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$378.77
|
| 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 |
$429.28
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$429.28
|
| 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 |
$353.52
|
| 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 |
$318.17
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.36
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$138.51
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$186.86
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$378.77
|
|
|
HC CT CHEST SCREENING LUNG CANCER
|
Facility
|
IP
|
$505.03
|
|
|
Service Code
|
CPT 71271
|
| Hospital Charge Code |
35000040
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$222.21 |
| Max. Negotiated Rate |
$454.53 |
| Rate for Payer: Aetna American Axle |
$328.27
|
| Rate for Payer: Aetna Commercial |
$429.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$328.27
|
| Rate for Payer: Cash Price |
$404.02
|
| Rate for Payer: Cofinity Commercial |
$353.52
|
| Rate for Payer: Cofinity Commercial |
$434.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$404.02
|
| Rate for Payer: Healthscope Commercial |
$454.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$353.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$378.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$429.28
|
| Rate for Payer: PHP Commercial |
$429.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$353.52
|
| Rate for Payer: Priority Health SBD |
$318.17
|
| Rate for Payer: UMR Bronson Commercial |
$222.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$378.77
|
|
|
HC CT CHEST WITH CON
|
Facility
|
OP
|
$1,703.09
|
|
|
Service Code
|
CPT 71260
|
| Hospital Charge Code |
35200001
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,532.78 |
| Rate for Payer: Aetna American Axle |
$1,107.01
|
| Rate for Payer: Aetna Commercial |
$1,447.63
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,107.01
|
| 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 |
$223.62
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$1,362.47
|
| Rate for Payer: Cash Price |
$1,362.47
|
| Rate for Payer: Cofinity Commercial |
$1,464.66
|
| Rate for Payer: Cofinity Commercial |
$1,192.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,362.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$1,532.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,192.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,277.32
|
| 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 |
$1,447.63
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$1,447.63
|
| 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 |
$1,192.16
|
| 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 |
$1,072.95
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.14
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$168.31
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$630.14
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,277.32
|
|
|
HC CT CHEST WITH CON
|
Facility
|
IP
|
$1,703.09
|
|
|
Service Code
|
CPT 71260
|
| Hospital Charge Code |
35200001
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$749.36 |
| Max. Negotiated Rate |
$1,532.78 |
| Rate for Payer: Aetna American Axle |
$1,107.01
|
| Rate for Payer: Aetna Commercial |
$1,447.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,107.01
|
| Rate for Payer: Cash Price |
$1,362.47
|
| Rate for Payer: Cofinity Commercial |
$1,464.66
|
| Rate for Payer: Cofinity Commercial |
$1,192.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,362.47
|
| Rate for Payer: Healthscope Commercial |
$1,532.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,192.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,277.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,447.63
|
| Rate for Payer: PHP Commercial |
$1,447.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,192.16
|
| Rate for Payer: Priority Health SBD |
$1,072.95
|
| Rate for Payer: UMR Bronson Commercial |
$749.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,277.32
|
|
|
HC CT CHEST WO CON
|
Facility
|
OP
|
$1,484.40
|
|
|
Service Code
|
CPT 71250
|
| Hospital Charge Code |
35000005
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$1,335.96 |
| Rate for Payer: Aetna American Axle |
$964.86
|
| Rate for Payer: Aetna Commercial |
$1,261.74
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$964.86
|
| 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 |
$164.71
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$1,187.52
|
| Rate for Payer: Cash Price |
$1,187.52
|
| Rate for Payer: Cofinity Commercial |
$1,276.58
|
| Rate for Payer: Cofinity Commercial |
$1,039.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,187.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$1,335.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,039.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,113.30
|
| 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 |
$1,261.74
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$1,261.74
|
| 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 |
$1,039.08
|
| 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 |
$935.17
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.31
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$133.92
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$549.23
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,113.30
|
|
|
HC CT CHEST WO CON
|
Facility
|
IP
|
$1,484.40
|
|
|
Service Code
|
CPT 71250
|
| Hospital Charge Code |
35000005
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$653.14 |
| Max. Negotiated Rate |
$1,335.96 |
| Rate for Payer: Aetna American Axle |
$964.86
|
| Rate for Payer: Aetna Commercial |
$1,261.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$964.86
|
| Rate for Payer: Cash Price |
$1,187.52
|
| Rate for Payer: Cofinity Commercial |
$1,039.08
|
| Rate for Payer: Cofinity Commercial |
$1,276.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,187.52
|
| Rate for Payer: Healthscope Commercial |
$1,335.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,039.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,113.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,261.74
|
| Rate for Payer: PHP Commercial |
$1,261.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,039.08
|
| Rate for Payer: Priority Health SBD |
$935.17
|
| Rate for Payer: UMR Bronson Commercial |
$653.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,113.30
|
|
|
HC CT CHEST WO W CON
|
Facility
|
OP
|
$2,015.62
|
|
|
Service Code
|
CPT 71270
|
| Hospital Charge Code |
35200002
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,814.06 |
| Rate for Payer: Aetna American Axle |
$1,310.15
|
| Rate for Payer: Aetna Commercial |
$1,713.28
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,310.15
|
| 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 |
$275.57
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$1,612.50
|
| Rate for Payer: Cash Price |
$1,612.50
|
| Rate for Payer: Cofinity Commercial |
$1,410.93
|
| Rate for Payer: Cofinity Commercial |
$1,733.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,612.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$1,814.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,410.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,511.72
|
| 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 |
$1,713.28
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$1,713.28
|
| 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 |
$1,410.93
|
| 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 |
$1,269.84
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.55
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$197.77
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$745.78
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,511.72
|
|
|
HC CT CHEST WO W CON
|
Facility
|
IP
|
$2,015.62
|
|
|
Service Code
|
CPT 71270
|
| Hospital Charge Code |
35200002
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$886.87 |
| Max. Negotiated Rate |
$1,814.06 |
| Rate for Payer: Aetna American Axle |
$1,310.15
|
| Rate for Payer: Aetna Commercial |
$1,713.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,310.15
|
| Rate for Payer: Cash Price |
$1,612.50
|
| Rate for Payer: Cofinity Commercial |
$1,410.93
|
| Rate for Payer: Cofinity Commercial |
$1,733.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,612.50
|
| Rate for Payer: Healthscope Commercial |
$1,814.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,410.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,511.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,713.28
|
| Rate for Payer: PHP Commercial |
$1,713.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,410.93
|
| Rate for Payer: Priority Health SBD |
$1,269.84
|
| Rate for Payer: UMR Bronson Commercial |
$886.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,511.72
|
|
|
HC CT CORONARY ANGIO
|
Facility
|
OP
|
$1,353.34
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000019
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,218.01 |
| Rate for Payer: Aetna American Axle |
$879.67
|
| Rate for Payer: Aetna Commercial |
$1,150.34
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$879.67
|
| 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 |
$1,082.67
|
| Rate for Payer: Cash Price |
$1,082.67
|
| Rate for Payer: Cofinity Commercial |
$947.34
|
| Rate for Payer: Cofinity Commercial |
$1,163.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,082.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$1,218.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$947.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,015.00
|
| 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 |
$1,150.34
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$1,150.34
|
| 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 |
$947.34
|
| 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 |
$852.60
|
| 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 |
$500.74
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,015.00
|
|
|
HC CT CORONARY ANGIO
|
Facility
|
IP
|
$1,353.34
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000019
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$595.47 |
| Max. Negotiated Rate |
$1,218.01 |
| Rate for Payer: Aetna American Axle |
$879.67
|
| Rate for Payer: Aetna Commercial |
$1,150.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$879.67
|
| Rate for Payer: Cash Price |
$1,082.67
|
| Rate for Payer: Cofinity Commercial |
$1,163.87
|
| Rate for Payer: Cofinity Commercial |
$947.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,082.67
|
| Rate for Payer: Healthscope Commercial |
$1,218.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$947.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,015.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,150.34
|
| Rate for Payer: PHP Commercial |
$1,150.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$947.34
|
| Rate for Payer: Priority Health SBD |
$852.60
|
| Rate for Payer: UMR Bronson Commercial |
$595.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,015.00
|
|
|
HC CT CRYOABLATION GUIDANCE
|
Facility
|
IP
|
$1,075.08
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000041
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$473.04 |
| Max. Negotiated Rate |
$967.57 |
| Rate for Payer: Aetna American Axle |
$698.80
|
| Rate for Payer: Aetna Commercial |
$913.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$698.80
|
| Rate for Payer: Cash Price |
$860.06
|
| Rate for Payer: Cofinity Commercial |
$752.56
|
| Rate for Payer: Cofinity Commercial |
$924.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.06
|
| Rate for Payer: Healthscope Commercial |
$967.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$752.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$806.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$913.82
|
| Rate for Payer: PHP Commercial |
$913.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$752.56
|
| Rate for Payer: Priority Health SBD |
$677.30
|
| Rate for Payer: UMR Bronson Commercial |
$473.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$806.31
|
|
|
HC CT CRYOABLATION GUIDANCE
|
Facility
|
OP
|
$1,075.08
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000041
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$397.78 |
| Max. Negotiated Rate |
$1,048.00 |
| Rate for Payer: Aetna American Axle |
$698.80
|
| Rate for Payer: Aetna Commercial |
$913.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$698.80
|
| Rate for Payer: BCBS Complete |
$430.03
|
| Rate for Payer: BCBS Trust/PPO |
$579.63
|
| Rate for Payer: Cash Price |
$860.06
|
| Rate for Payer: Cash Price |
$860.06
|
| Rate for Payer: Cofinity Commercial |
$752.56
|
| Rate for Payer: Cofinity Commercial |
$924.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.06
|
| Rate for Payer: Healthscope Commercial |
$967.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$752.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$806.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$913.82
|
| Rate for Payer: PHP Commercial |
$913.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$752.56
|
| Rate for Payer: Priority Health SBD |
$677.30
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UMR Bronson Commercial |
$397.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$806.31
|
|
|
HC CT FACIAL W CON
|
Facility
|
IP
|
$1,560.50
|
|
|
Service Code
|
CPT 70487
|
| Hospital Charge Code |
35100008
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$686.62 |
| Max. Negotiated Rate |
$1,404.45 |
| Rate for Payer: Aetna American Axle |
$1,014.32
|
| Rate for Payer: Aetna Commercial |
$1,326.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,014.32
|
| Rate for Payer: Cash Price |
$1,248.40
|
| Rate for Payer: Cofinity Commercial |
$1,092.35
|
| Rate for Payer: Cofinity Commercial |
$1,342.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.40
|
| Rate for Payer: Healthscope Commercial |
$1,404.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,092.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,170.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,326.42
|
| Rate for Payer: PHP Commercial |
$1,326.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,092.35
|
| Rate for Payer: Priority Health SBD |
$983.12
|
| Rate for Payer: UMR Bronson Commercial |
$686.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,170.38
|
|
|
HC CT FACIAL W CON
|
Facility
|
OP
|
$1,560.50
|
|
|
Service Code
|
CPT 70487
|
| Hospital Charge Code |
35100008
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,404.45 |
| Rate for Payer: Aetna American Axle |
$1,014.32
|
| Rate for Payer: Aetna Commercial |
$1,326.42
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,014.32
|
| 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 |
$197.65
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$1,248.40
|
| Rate for Payer: Cash Price |
$1,248.40
|
| Rate for Payer: Cofinity Commercial |
$1,342.03
|
| Rate for Payer: Cofinity Commercial |
$1,092.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$1,404.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,092.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,170.38
|
| 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 |
$1,326.42
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$1,326.42
|
| 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 |
$1,092.35
|
| 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 |
$983.12
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.56
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$153.24
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$577.38
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,170.38
|
|
|
HC CT FACIAL WO CON
|
Facility
|
OP
|
$1,383.22
|
|
|
Service Code
|
CPT 70486
|
| Hospital Charge Code |
35100007
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$1,244.90 |
| Rate for Payer: Aetna American Axle |
$899.09
|
| Rate for Payer: Aetna Commercial |
$1,175.74
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$899.09
|
| 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 |
$175.48
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$1,106.58
|
| Rate for Payer: Cash Price |
$1,106.58
|
| Rate for Payer: Cofinity Commercial |
$1,189.57
|
| Rate for Payer: Cofinity Commercial |
$968.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,106.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$1,244.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$968.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,037.42
|
| 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 |
$1,175.74
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$1,175.74
|
| 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 |
$968.25
|
| 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 |
$871.43
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.91
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$129.01
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$511.79
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,037.42
|
|
|
HC CT FACIAL WO CON
|
Facility
|
IP
|
$1,383.22
|
|
|
Service Code
|
CPT 70486
|
| Hospital Charge Code |
35100007
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$608.62 |
| Max. Negotiated Rate |
$1,244.90 |
| Rate for Payer: Aetna American Axle |
$899.09
|
| Rate for Payer: Aetna Commercial |
$1,175.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$899.09
|
| Rate for Payer: Cash Price |
$1,106.58
|
| Rate for Payer: Cofinity Commercial |
$1,189.57
|
| Rate for Payer: Cofinity Commercial |
$968.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,106.58
|
| Rate for Payer: Healthscope Commercial |
$1,244.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$968.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,037.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,175.74
|
| Rate for Payer: PHP Commercial |
$1,175.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$968.25
|
| Rate for Payer: Priority Health SBD |
$871.43
|
| Rate for Payer: UMR Bronson Commercial |
$608.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,037.42
|
|
|
HC CT FACIAL WO W CON
|
Facility
|
IP
|
$1,469.30
|
|
|
Service Code
|
CPT 70488
|
| Hospital Charge Code |
35101009
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$646.49 |
| Max. Negotiated Rate |
$1,322.37 |
| Rate for Payer: Aetna American Axle |
$955.04
|
| Rate for Payer: Aetna Commercial |
$1,248.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$955.04
|
| Rate for Payer: Cash Price |
$1,175.44
|
| Rate for Payer: Cofinity Commercial |
$1,028.51
|
| Rate for Payer: Cofinity Commercial |
$1,263.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,175.44
|
| Rate for Payer: Healthscope Commercial |
$1,322.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,028.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,101.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,248.90
|
| Rate for Payer: PHP Commercial |
$1,248.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,028.51
|
| Rate for Payer: Priority Health SBD |
$925.66
|
| Rate for Payer: UMR Bronson Commercial |
$646.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,101.98
|
|
|
HC CT FACIAL WO W CON
|
Facility
|
OP
|
$1,469.30
|
|
|
Service Code
|
CPT 70488
|
| Hospital Charge Code |
35101009
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,322.37 |
| Rate for Payer: Aetna American Axle |
$955.04
|
| Rate for Payer: Aetna Commercial |
$1,248.90
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$955.04
|
| 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 |
$250.23
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$1,175.44
|
| Rate for Payer: Cash Price |
$1,175.44
|
| Rate for Payer: Cofinity Commercial |
$1,028.51
|
| Rate for Payer: Cofinity Commercial |
$1,263.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,175.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$1,322.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,028.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,101.98
|
| 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 |
$1,248.90
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$1,248.90
|
| 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 |
$1,028.51
|
| 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 |
$925.66
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.23
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$185.66
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$543.64
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,101.98
|
|
|
HC CT GUIDE JOINT ASP OR INJECTIO
|
Facility
|
OP
|
$1,420.15
|
|
|
Service Code
|
CPT 77012
|
| Hospital Charge Code |
35000029
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$136.54 |
| Max. Negotiated Rate |
$1,278.14 |
| Rate for Payer: Aetna American Axle |
$923.10
|
| Rate for Payer: Aetna Commercial |
$1,207.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$923.10
|
| Rate for Payer: BCBS Complete |
$568.06
|
| Rate for Payer: BCBS Trust/PPO |
$136.83
|
| Rate for Payer: Cash Price |
$1,136.12
|
| Rate for Payer: Cash Price |
$1,136.12
|
| Rate for Payer: Cofinity Commercial |
$1,221.33
|
| Rate for Payer: Cofinity Commercial |
$994.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,136.12
|
| Rate for Payer: Healthscope Commercial |
$1,278.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$994.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,065.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,207.13
|
| Rate for Payer: PHP Commercial |
$1,207.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.10
|
| Rate for Payer: Priority Health SBD |
$894.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.19
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Exchange |
$136.54
|
| Rate for Payer: UMR Bronson Commercial |
$525.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,065.11
|
|
|
HC CT GUIDE JOINT ASP OR INJECTIO
|
Facility
|
IP
|
$1,420.15
|
|
|
Service Code
|
CPT 77012
|
| Hospital Charge Code |
35000029
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$624.87 |
| Max. Negotiated Rate |
$1,278.14 |
| Rate for Payer: Aetna American Axle |
$923.10
|
| Rate for Payer: Aetna Commercial |
$1,207.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$923.10
|
| Rate for Payer: Cash Price |
$1,136.12
|
| Rate for Payer: Cofinity Commercial |
$1,221.33
|
| Rate for Payer: Cofinity Commercial |
$994.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,136.12
|
| Rate for Payer: Healthscope Commercial |
$1,278.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$994.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,065.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,207.13
|
| Rate for Payer: PHP Commercial |
$1,207.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.10
|
| Rate for Payer: Priority Health SBD |
$894.69
|
| Rate for Payer: UMR Bronson Commercial |
$624.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,065.11
|
|
