|
HC CT PELVIS W CON
|
Facility
|
OP
|
$1,898.80
|
|
|
Service Code
|
CPT 72193
|
| Hospital Charge Code |
35200011
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,708.92 |
| Rate for Payer: Aetna American Axle |
$1,234.22
|
| Rate for Payer: Aetna Commercial |
$1,613.98
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,234.22
|
| 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 |
$351.59
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$1,519.04
|
| Rate for Payer: Cash Price |
$1,519.04
|
| Rate for Payer: Cofinity Commercial |
$1,329.16
|
| Rate for Payer: Cofinity Commercial |
$1,632.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,519.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$1,708.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,329.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,424.10
|
| 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 |
$1,613.98
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$1,613.98
|
| 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 |
$1,329.16
|
| 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 |
$1,196.24
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$253.94
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$230.85
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$702.56
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,424.10
|
|
|
HC CT PELVIS W CON
|
Facility
|
IP
|
$1,898.80
|
|
|
Service Code
|
CPT 72193
|
| Hospital Charge Code |
35200011
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$835.47 |
| Max. Negotiated Rate |
$1,708.92 |
| Rate for Payer: Aetna American Axle |
$1,234.22
|
| Rate for Payer: Aetna Commercial |
$1,613.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,234.22
|
| Rate for Payer: Cash Price |
$1,519.04
|
| Rate for Payer: Cofinity Commercial |
$1,632.97
|
| Rate for Payer: Cofinity Commercial |
$1,329.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,519.04
|
| Rate for Payer: Healthscope Commercial |
$1,708.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,329.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,424.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,613.98
|
| Rate for Payer: PHP Commercial |
$1,613.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,329.16
|
| Rate for Payer: Priority Health SBD |
$1,196.24
|
| Rate for Payer: UMR Bronson Commercial |
$835.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,424.10
|
|
|
HC CT PELVIS WO CON
|
Facility
|
OP
|
$1,392.30
|
|
|
Service Code
|
CPT 72192
|
| Hospital Charge Code |
35200010
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$1,253.07 |
| Rate for Payer: Aetna American Axle |
$905.00
|
| Rate for Payer: Aetna Commercial |
$1,183.46
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$905.00
|
| 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 |
$164.07
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$1,113.84
|
| Rate for Payer: Cash Price |
$1,113.84
|
| Rate for Payer: Cofinity Commercial |
$1,197.38
|
| Rate for Payer: Cofinity Commercial |
$974.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,113.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$1,253.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$974.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,044.22
|
| 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 |
$1,183.46
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$1,183.46
|
| 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 |
$974.61
|
| 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 |
$877.15
|
| 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 |
$515.15
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,044.22
|
|
|
HC CT PELVIS WO CON
|
Facility
|
IP
|
$1,392.30
|
|
|
Service Code
|
CPT 72192
|
| Hospital Charge Code |
35200010
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$612.61 |
| Max. Negotiated Rate |
$1,253.07 |
| Rate for Payer: Aetna American Axle |
$905.00
|
| Rate for Payer: Aetna Commercial |
$1,183.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$905.00
|
| Rate for Payer: Cash Price |
$1,113.84
|
| Rate for Payer: Cofinity Commercial |
$1,197.38
|
| Rate for Payer: Cofinity Commercial |
$974.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,113.84
|
| Rate for Payer: Healthscope Commercial |
$1,253.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$974.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,044.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,183.46
|
| Rate for Payer: PHP Commercial |
$1,183.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$974.61
|
| Rate for Payer: Priority Health SBD |
$877.15
|
| Rate for Payer: UMR Bronson Commercial |
$612.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,044.22
|
|
|
HC CT PELVIS WO W CON
|
Facility
|
OP
|
$2,162.45
|
|
|
Service Code
|
CPT 72194
|
| Hospital Charge Code |
35200012
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,946.20 |
| Rate for Payer: Aetna American Axle |
$1,405.59
|
| Rate for Payer: Aetna Commercial |
$1,838.08
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,405.59
|
| 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 |
$393.39
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$1,729.96
|
| Rate for Payer: Cash Price |
$1,729.96
|
| Rate for Payer: Cofinity Commercial |
$1,513.72
|
| Rate for Payer: Cofinity Commercial |
$1,859.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,729.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$1,946.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,513.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,621.84
|
| 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 |
$1,838.08
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$1,838.08
|
| 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 |
$1,513.72
|
| 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 |
$1,362.34
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$280.22
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$254.75
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$800.11
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,621.84
|
|
|
HC CT PELVIS WO W CON
|
Facility
|
IP
|
$2,162.45
|
|
|
Service Code
|
CPT 72194
|
| Hospital Charge Code |
35200012
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$951.48 |
| Max. Negotiated Rate |
$1,946.20 |
| Rate for Payer: Aetna American Axle |
$1,405.59
|
| Rate for Payer: Aetna Commercial |
$1,838.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,405.59
|
| Rate for Payer: Cash Price |
$1,729.96
|
| Rate for Payer: Cofinity Commercial |
$1,513.72
|
| Rate for Payer: Cofinity Commercial |
$1,859.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,729.96
|
| Rate for Payer: Healthscope Commercial |
$1,946.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,513.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,621.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,838.08
|
| Rate for Payer: PHP Commercial |
$1,838.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,513.72
|
| Rate for Payer: Priority Health SBD |
$1,362.34
|
| Rate for Payer: UMR Bronson Commercial |
$951.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,621.84
|
|
|
HC CT PLEURAL FIBRINOLYSIS INITIAL
|
Facility
|
OP
|
$964.69
|
|
|
Service Code
|
CPT 32561
|
| Hospital Charge Code |
36100323
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$64.83 |
| Max. Negotiated Rate |
$1,757.86 |
| Rate for Payer: Aetna American Axle |
$627.05
|
| Rate for Payer: Aetna Commercial |
$819.99
|
| Rate for Payer: Aetna Medicare |
$580.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$627.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$698.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$698.00
|
| Rate for Payer: BCBS Complete |
$320.74
|
| Rate for Payer: BCBS MAPPO |
$558.40
|
| Rate for Payer: BCBS Trust/PPO |
$609.22
|
| Rate for Payer: BCN Medicare Advantage |
$558.40
|
| Rate for Payer: Cash Price |
$771.75
|
| Rate for Payer: Cash Price |
$771.75
|
| Rate for Payer: Cofinity Commercial |
$829.63
|
| Rate for Payer: Cofinity Commercial |
$675.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$771.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.40
|
| Rate for Payer: Healthscope Commercial |
$868.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$675.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$723.52
|
| Rate for Payer: Mclaren Medicaid |
$305.44
|
| Rate for Payer: Mclaren Medicare |
$558.40
|
| Rate for Payer: Meridian Medicaid |
$320.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$642.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$819.99
|
| Rate for Payer: PACE Medicare |
$530.48
|
| Rate for Payer: PACE SWMI |
$558.40
|
| Rate for Payer: PHP Commercial |
$819.99
|
| Rate for Payer: PHP Medicare Advantage |
$558.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,757.86
|
| Rate for Payer: Priority Health Medicare |
$558.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,406.29
|
| Rate for Payer: Priority Health SBD |
$607.75
|
| Rate for Payer: Railroad Medicare Medicare |
$558.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.31
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$558.40
|
| Rate for Payer: UHC Exchange |
$64.83
|
| Rate for Payer: UHC Medicare Advantage |
$575.15
|
| Rate for Payer: UMR Bronson Commercial |
$356.94
|
| Rate for Payer: VA VA |
$558.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$723.52
|
|
|
HC CT PLEURAL FIBRINOLYSIS INITIAL
|
Facility
|
IP
|
$964.69
|
|
|
Service Code
|
CPT 32561
|
| Hospital Charge Code |
36100323
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$424.46 |
| Max. Negotiated Rate |
$868.22 |
| Rate for Payer: Aetna American Axle |
$627.05
|
| Rate for Payer: Aetna Commercial |
$819.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$627.05
|
| Rate for Payer: Cash Price |
$771.75
|
| Rate for Payer: Cofinity Commercial |
$675.28
|
| Rate for Payer: Cofinity Commercial |
$829.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$771.75
|
| Rate for Payer: Healthscope Commercial |
$868.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$675.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$723.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$819.99
|
| Rate for Payer: PHP Commercial |
$819.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.28
|
| Rate for Payer: Priority Health SBD |
$607.75
|
| Rate for Payer: UMR Bronson Commercial |
$424.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$723.52
|
|
|
HC CT PLEURAL FIBRINOLYSIS SUB DAY
|
Facility
|
IP
|
$964.69
|
|
|
Service Code
|
CPT 32562
|
| Hospital Charge Code |
36100322
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$424.46 |
| Max. Negotiated Rate |
$868.22 |
| Rate for Payer: Aetna American Axle |
$627.05
|
| Rate for Payer: Aetna Commercial |
$819.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$627.05
|
| Rate for Payer: Cash Price |
$771.75
|
| Rate for Payer: Cofinity Commercial |
$675.28
|
| Rate for Payer: Cofinity Commercial |
$829.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$771.75
|
| Rate for Payer: Healthscope Commercial |
$868.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$675.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$723.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$819.99
|
| Rate for Payer: PHP Commercial |
$819.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.28
|
| Rate for Payer: Priority Health SBD |
$607.75
|
| Rate for Payer: UMR Bronson Commercial |
$424.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$723.52
|
|
|
HC CT PLEURAL FIBRINOLYSIS SUB DAY
|
Facility
|
OP
|
$964.69
|
|
|
Service Code
|
CPT 32562
|
| Hospital Charge Code |
36100322
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$57.96 |
| Max. Negotiated Rate |
$1,757.86 |
| Rate for Payer: Aetna American Axle |
$627.05
|
| Rate for Payer: Aetna Commercial |
$819.99
|
| Rate for Payer: Aetna Medicare |
$580.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$627.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$698.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$698.00
|
| Rate for Payer: BCBS Complete |
$320.74
|
| Rate for Payer: BCBS MAPPO |
$558.40
|
| Rate for Payer: BCBS Trust/PPO |
$609.22
|
| Rate for Payer: BCN Medicare Advantage |
$558.40
|
| Rate for Payer: Cash Price |
$771.75
|
| Rate for Payer: Cash Price |
$771.75
|
| Rate for Payer: Cofinity Commercial |
$675.28
|
| Rate for Payer: Cofinity Commercial |
$829.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$771.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.40
|
| Rate for Payer: Healthscope Commercial |
$868.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$675.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$723.52
|
| Rate for Payer: Mclaren Medicaid |
$305.44
|
| Rate for Payer: Mclaren Medicare |
$558.40
|
| Rate for Payer: Meridian Medicaid |
$320.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$642.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$819.99
|
| Rate for Payer: PACE Medicare |
$530.48
|
| Rate for Payer: PACE SWMI |
$558.40
|
| Rate for Payer: PHP Commercial |
$819.99
|
| Rate for Payer: PHP Medicare Advantage |
$558.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,757.86
|
| Rate for Payer: Priority Health Medicare |
$558.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,406.29
|
| Rate for Payer: Priority Health SBD |
$607.75
|
| Rate for Payer: Railroad Medicare Medicare |
$558.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.76
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$558.40
|
| Rate for Payer: UHC Exchange |
$57.96
|
| Rate for Payer: UHC Medicare Advantage |
$575.15
|
| Rate for Payer: UMR Bronson Commercial |
$356.94
|
| Rate for Payer: VA VA |
$558.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$723.52
|
|
|
HC CT RF/MICROWAVE ABLATION
|
Facility
|
IP
|
$1,075.08
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000042
|
|
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 RF/MICROWAVE ABLATION
|
Facility
|
OP
|
$1,075.08
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000042
|
|
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 |
$924.57
|
| Rate for Payer: Cofinity Commercial |
$752.56
|
| 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 CTRL NASAL HEMRRG POSTERIOR PACKS/CAUTERY SUBSQ
|
Facility
|
OP
|
$585.00
|
|
|
Service Code
|
CPT 30906
|
| Hospital Charge Code |
76100394
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$118.76 |
| Max. Negotiated Rate |
$683.51 |
| Rate for Payer: Aetna American Axle |
$380.25
|
| Rate for Payer: Aetna Commercial |
$497.25
|
| Rate for Payer: Aetna Medicare |
$225.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$380.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.40
|
| Rate for Payer: BCBS Complete |
$124.71
|
| Rate for Payer: BCBS MAPPO |
$217.12
|
| Rate for Payer: BCBS Trust/PPO |
$142.11
|
| Rate for Payer: BCN Medicare Advantage |
$217.12
|
| Rate for Payer: Cash Price |
$468.00
|
| Rate for Payer: Cash Price |
$468.00
|
| Rate for Payer: Cofinity Commercial |
$409.50
|
| Rate for Payer: Cofinity Commercial |
$503.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$468.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.12
|
| Rate for Payer: Healthscope Commercial |
$526.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$409.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$438.75
|
| Rate for Payer: Mclaren Medicaid |
$118.76
|
| Rate for Payer: Mclaren Medicare |
$217.12
|
| Rate for Payer: Meridian Medicaid |
$124.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$227.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$497.25
|
| Rate for Payer: PACE Medicare |
$206.26
|
| Rate for Payer: PACE SWMI |
$217.12
|
| Rate for Payer: PHP Commercial |
$497.25
|
| Rate for Payer: PHP Medicare Advantage |
$217.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$409.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$683.51
|
| Rate for Payer: Priority Health Medicare |
$217.12
|
| Rate for Payer: Priority Health Narrow Network |
$546.81
|
| Rate for Payer: Priority Health SBD |
$368.55
|
| Rate for Payer: Railroad Medicare Medicare |
$217.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.12
|
| Rate for Payer: UHC Exchange |
$129.67
|
| Rate for Payer: UHC Medicare Advantage |
$223.63
|
| Rate for Payer: UMR Bronson Commercial |
$216.45
|
| Rate for Payer: VA VA |
$217.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$438.75
|
|
|
HC CTRL NASAL HEMRRG POSTERIOR PACKS/CAUTERY SUBSQ
|
Facility
|
IP
|
$585.00
|
|
|
Service Code
|
CPT 30906
|
| Hospital Charge Code |
76100394
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$257.40 |
| Max. Negotiated Rate |
$526.50 |
| Rate for Payer: Aetna American Axle |
$380.25
|
| Rate for Payer: Aetna Commercial |
$497.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$380.25
|
| Rate for Payer: Cash Price |
$468.00
|
| Rate for Payer: Cofinity Commercial |
$409.50
|
| Rate for Payer: Cofinity Commercial |
$503.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$468.00
|
| Rate for Payer: Healthscope Commercial |
$526.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$409.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$438.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$497.25
|
| Rate for Payer: PHP Commercial |
$497.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$409.50
|
| Rate for Payer: Priority Health SBD |
$368.55
|
| Rate for Payer: UMR Bronson Commercial |
$257.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$438.75
|
|
|
HC CT SI JTS W CON
|
Facility
|
IP
|
$691.66
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000025
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$304.33 |
| Max. Negotiated Rate |
$622.49 |
| Rate for Payer: Aetna American Axle |
$449.58
|
| Rate for Payer: Aetna Commercial |
$587.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.58
|
| Rate for Payer: Cash Price |
$553.33
|
| Rate for Payer: Cofinity Commercial |
$484.16
|
| Rate for Payer: Cofinity Commercial |
$594.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$553.33
|
| Rate for Payer: Healthscope Commercial |
$622.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$484.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$587.91
|
| Rate for Payer: PHP Commercial |
$587.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.16
|
| Rate for Payer: Priority Health SBD |
$435.75
|
| Rate for Payer: UMR Bronson Commercial |
$304.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.74
|
|
|
HC CT SI JTS W CON
|
Facility
|
OP
|
$691.66
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000025
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$1,048.00 |
| Rate for Payer: Aetna American Axle |
$449.58
|
| Rate for Payer: Aetna Commercial |
$587.91
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$172.95
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$553.33
|
| Rate for Payer: Cash Price |
$553.33
|
| Rate for Payer: Cofinity Commercial |
$594.83
|
| Rate for Payer: Cofinity Commercial |
$484.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$553.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$622.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$484.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.74
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$587.91
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$587.91
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.27
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$203.42
|
| Rate for Payer: Priority Health SBD |
$435.75
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.79
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Exchange |
$131.63
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$255.91
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.74
|
|
|
HC CT SI JTS WO CON
|
Facility
|
OP
|
$691.66
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000023
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$1,048.00 |
| Rate for Payer: Aetna American Axle |
$449.58
|
| Rate for Payer: Aetna Commercial |
$587.91
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$172.95
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$553.33
|
| Rate for Payer: Cash Price |
$553.33
|
| Rate for Payer: Cofinity Commercial |
$484.16
|
| Rate for Payer: Cofinity Commercial |
$594.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$553.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$622.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$484.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.74
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$587.91
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$587.91
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.27
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$203.42
|
| Rate for Payer: Priority Health SBD |
$435.75
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.79
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Exchange |
$131.63
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$255.91
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.74
|
|
|
HC CT SI JTS WO CON
|
Facility
|
IP
|
$691.66
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000023
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$304.33 |
| Max. Negotiated Rate |
$622.49 |
| Rate for Payer: Aetna American Axle |
$449.58
|
| Rate for Payer: Aetna Commercial |
$587.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.58
|
| Rate for Payer: Cash Price |
$553.33
|
| Rate for Payer: Cofinity Commercial |
$484.16
|
| Rate for Payer: Cofinity Commercial |
$594.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$553.33
|
| Rate for Payer: Healthscope Commercial |
$622.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$484.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$587.91
|
| Rate for Payer: PHP Commercial |
$587.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.16
|
| Rate for Payer: Priority Health SBD |
$435.75
|
| Rate for Payer: UMR Bronson Commercial |
$304.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.74
|
|
|
HC CT SI JTS WO W CON
|
Facility
|
OP
|
$691.66
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000026
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$1,048.00 |
| Rate for Payer: Aetna American Axle |
$449.58
|
| Rate for Payer: Aetna Commercial |
$587.91
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$172.95
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$553.33
|
| Rate for Payer: Cash Price |
$553.33
|
| Rate for Payer: Cofinity Commercial |
$484.16
|
| Rate for Payer: Cofinity Commercial |
$594.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$553.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$622.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$484.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.74
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$587.91
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$587.91
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.27
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$203.42
|
| Rate for Payer: Priority Health SBD |
$435.75
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.79
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Exchange |
$131.63
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$255.91
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.74
|
|
|
HC CT SI JTS WO W CON
|
Facility
|
IP
|
$691.66
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000026
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$304.33 |
| Max. Negotiated Rate |
$622.49 |
| Rate for Payer: Aetna American Axle |
$449.58
|
| Rate for Payer: Aetna Commercial |
$587.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.58
|
| Rate for Payer: Cash Price |
$553.33
|
| Rate for Payer: Cofinity Commercial |
$484.16
|
| Rate for Payer: Cofinity Commercial |
$594.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$553.33
|
| Rate for Payer: Healthscope Commercial |
$622.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$484.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$587.91
|
| Rate for Payer: PHP Commercial |
$587.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.16
|
| Rate for Payer: Priority Health SBD |
$435.75
|
| Rate for Payer: UMR Bronson Commercial |
$304.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.74
|
|
|
HC CT SOFT TISS NECK W CON
|
Facility
|
OP
|
$1,602.22
|
|
|
Service Code
|
CPT 70491
|
| Hospital Charge Code |
35000002
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,442.00 |
| Rate for Payer: Aetna American Axle |
$1,041.44
|
| Rate for Payer: Aetna Commercial |
$1,361.89
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,041.44
|
| 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 |
$239.46
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$1,281.78
|
| Rate for Payer: Cash Price |
$1,281.78
|
| Rate for Payer: Cofinity Commercial |
$1,377.91
|
| Rate for Payer: Cofinity Commercial |
$1,121.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,281.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$1,442.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,121.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,201.66
|
| 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 |
$1,361.89
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$1,361.89
|
| 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 |
$1,121.55
|
| 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 |
$1,009.40
|
| 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 |
$592.82
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,201.66
|
|
|
HC CT SOFT TISS NECK W CON
|
Facility
|
IP
|
$1,602.22
|
|
|
Service Code
|
CPT 70491
|
| Hospital Charge Code |
35000002
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$704.98 |
| Max. Negotiated Rate |
$1,442.00 |
| Rate for Payer: Aetna American Axle |
$1,041.44
|
| Rate for Payer: Aetna Commercial |
$1,361.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,041.44
|
| Rate for Payer: Cash Price |
$1,281.78
|
| Rate for Payer: Cofinity Commercial |
$1,121.55
|
| Rate for Payer: Cofinity Commercial |
$1,377.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,281.78
|
| Rate for Payer: Healthscope Commercial |
$1,442.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,121.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,201.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,361.89
|
| Rate for Payer: PHP Commercial |
$1,361.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,121.55
|
| Rate for Payer: Priority Health SBD |
$1,009.40
|
| Rate for Payer: UMR Bronson Commercial |
$704.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,201.66
|
|
|
HC CT SOFT TISS NECK WO CON
|
Facility
|
OP
|
$1,356.10
|
|
|
Service Code
|
CPT 70490
|
| Hospital Charge Code |
35000001
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$1,220.49 |
| Rate for Payer: Aetna American Axle |
$881.46
|
| Rate for Payer: Aetna Commercial |
$1,152.68
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$881.46
|
| 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 |
$179.91
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$1,084.88
|
| Rate for Payer: Cash Price |
$1,084.88
|
| Rate for Payer: Cofinity Commercial |
$1,166.25
|
| Rate for Payer: Cofinity Commercial |
$949.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,084.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$1,220.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$949.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,017.08
|
| 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 |
$1,152.68
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$1,152.68
|
| 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 |
$949.27
|
| 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 |
$854.34
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$166.04
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$150.95
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$501.76
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,017.08
|
|
|
HC CT SOFT TISS NECK WO CON
|
Facility
|
IP
|
$1,356.10
|
|
|
Service Code
|
CPT 70490
|
| Hospital Charge Code |
35000001
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$596.68 |
| Max. Negotiated Rate |
$1,220.49 |
| Rate for Payer: Aetna American Axle |
$881.46
|
| Rate for Payer: Aetna Commercial |
$1,152.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$881.46
|
| Rate for Payer: Cash Price |
$1,084.88
|
| Rate for Payer: Cofinity Commercial |
$1,166.25
|
| Rate for Payer: Cofinity Commercial |
$949.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,084.88
|
| Rate for Payer: Healthscope Commercial |
$1,220.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$949.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,017.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,152.68
|
| Rate for Payer: PHP Commercial |
$1,152.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$949.27
|
| Rate for Payer: Priority Health SBD |
$854.34
|
| Rate for Payer: UMR Bronson Commercial |
$596.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,017.08
|
|
|
HC CT SOFT TISS NECK WO W CON
|
Facility
|
OP
|
$1,844.57
|
|
|
Service Code
|
CPT 70492
|
| Hospital Charge Code |
35000003
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,660.11 |
| Rate for Payer: Aetna American Axle |
$1,198.97
|
| Rate for Payer: Aetna Commercial |
$1,567.88
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,198.97
|
| 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 |
$292.66
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$1,475.66
|
| Rate for Payer: Cash Price |
$1,475.66
|
| Rate for Payer: Cofinity Commercial |
$1,586.33
|
| Rate for Payer: Cofinity Commercial |
$1,291.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,475.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$1,660.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,291.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,383.43
|
| 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 |
$1,567.88
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$1,567.88
|
| 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 |
$1,291.20
|
| 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 |
$1,162.08
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.93
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$222.66
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$682.49
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,383.43
|
|
