|
HC DEVICE NOT RETURNED AIR 10 OXIMETRY
|
Professional
|
Both
|
$310.00
|
|
|
Service Code
|
HCPCS 00616
|
| Hospital Charge Code |
27000616
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$124.00 |
| Max. Negotiated Rate |
$217.00 |
| Rate for Payer: BCBS Complete |
$124.00
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.00
|
| Rate for Payer: UMR Bronson Commercial |
$142.60
|
|
|
HC DEVICE NOT RETURNED AIR 10 OXIMETRY
|
Facility
|
OP
|
$310.00
|
|
| Hospital Charge Code |
27000616
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$114.70 |
| Max. Negotiated Rate |
$279.00 |
| Rate for Payer: Aetna American Axle |
$201.50
|
| Rate for Payer: Aetna Commercial |
$263.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.50
|
| Rate for Payer: BCBS Complete |
$124.00
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cofinity Commercial |
$217.00
|
| Rate for Payer: Cofinity Commercial |
$266.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.00
|
| Rate for Payer: Healthscope Commercial |
$279.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$217.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$263.50
|
| Rate for Payer: PHP Commercial |
$263.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.00
|
| Rate for Payer: Priority Health SBD |
$195.30
|
| Rate for Payer: UMR Bronson Commercial |
$114.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.50
|
|
|
HC DEVICE NOT RETURNED AIR 10 OXIMETRY
|
Facility
|
IP
|
$310.00
|
|
| Hospital Charge Code |
27000616
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$136.40 |
| Max. Negotiated Rate |
$279.00 |
| Rate for Payer: Aetna American Axle |
$201.50
|
| Rate for Payer: Aetna Commercial |
$263.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.50
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cofinity Commercial |
$217.00
|
| Rate for Payer: Cofinity Commercial |
$266.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.00
|
| Rate for Payer: Healthscope Commercial |
$279.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$217.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$263.50
|
| Rate for Payer: PHP Commercial |
$263.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.00
|
| Rate for Payer: Priority Health SBD |
$195.30
|
| Rate for Payer: UMR Bronson Commercial |
$136.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.50
|
|
|
HC DEVICE NOT RETURNED AIR 10 OXIMETRY
|
Professional
|
Both
|
$310.00
|
|
|
Service Code
|
HCPCS 00616
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$124.00 |
| Max. Negotiated Rate |
$217.00 |
| Rate for Payer: BCBS Complete |
$124.00
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.00
|
| Rate for Payer: UMR Bronson Commercial |
$142.60
|
|
|
HC DEVICE NOT RETURNED APNEALINK
|
Professional
|
Both
|
$828.00
|
|
|
Service Code
|
HCPCS 00602
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$331.20 |
| Max. Negotiated Rate |
$579.60 |
| Rate for Payer: BCBS Complete |
$331.20
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$579.60
|
| Rate for Payer: UMR Bronson Commercial |
$380.88
|
|
|
HC DEVICE NOT RETURNED APNEALINK PLUS
|
Facility
|
IP
|
$1,548.00
|
|
| Hospital Charge Code |
27000603
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$681.12 |
| Max. Negotiated Rate |
$1,393.20 |
| Rate for Payer: Aetna American Axle |
$1,006.20
|
| Rate for Payer: Aetna Commercial |
$1,315.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,006.20
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Cofinity Commercial |
$1,083.60
|
| Rate for Payer: Cofinity Commercial |
$1,331.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,238.40
|
| Rate for Payer: Healthscope Commercial |
$1,393.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,083.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,161.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,315.80
|
| Rate for Payer: PHP Commercial |
$1,315.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,083.60
|
| Rate for Payer: Priority Health SBD |
$975.24
|
| Rate for Payer: UMR Bronson Commercial |
$681.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,161.00
|
|
|
HC DEVICE NOT RETURNED APNEALINK PLUS
|
Professional
|
Both
|
$1,548.00
|
|
|
Service Code
|
HCPCS 00603
|
| Hospital Charge Code |
27000603
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$619.20 |
| Max. Negotiated Rate |
$1,083.60 |
| Rate for Payer: BCBS Complete |
$619.20
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,083.60
|
| Rate for Payer: UMR Bronson Commercial |
$712.08
|
|
|
HC DEVICE NOT RETURNED APNEALINK PLUS
|
Professional
|
Both
|
$1,548.00
|
|
|
Service Code
|
HCPCS 00603
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$619.20 |
| Max. Negotiated Rate |
$1,083.60 |
| Rate for Payer: BCBS Complete |
$619.20
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,083.60
|
| Rate for Payer: UMR Bronson Commercial |
$712.08
|
|
|
HC DEVICE NOT RETURNED APNEALINK PLUS
|
Facility
|
OP
|
$1,548.00
|
|
| Hospital Charge Code |
27000603
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$572.76 |
| Max. Negotiated Rate |
$1,393.20 |
| Rate for Payer: Aetna American Axle |
$1,006.20
|
| Rate for Payer: Aetna Commercial |
$1,315.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,006.20
|
| Rate for Payer: BCBS Complete |
$619.20
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Cofinity Commercial |
$1,083.60
|
| Rate for Payer: Cofinity Commercial |
$1,331.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,238.40
|
| Rate for Payer: Healthscope Commercial |
$1,393.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,083.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,161.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,315.80
|
| Rate for Payer: PHP Commercial |
$1,315.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,083.60
|
| Rate for Payer: Priority Health SBD |
$975.24
|
| Rate for Payer: UMR Bronson Commercial |
$572.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,161.00
|
|
|
HC DEVICE NOT RETURNED CADD PUMP
|
Facility
|
OP
|
$3,723.00
|
|
| Hospital Charge Code |
27000642
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,377.51 |
| Max. Negotiated Rate |
$3,350.70 |
| Rate for Payer: Aetna American Axle |
$2,419.95
|
| Rate for Payer: Aetna Commercial |
$3,164.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,419.95
|
| Rate for Payer: BCBS Complete |
$1,489.20
|
| Rate for Payer: Cash Price |
$2,978.40
|
| Rate for Payer: Cofinity Commercial |
$2,606.10
|
| Rate for Payer: Cofinity Commercial |
$3,201.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,978.40
|
| Rate for Payer: Healthscope Commercial |
$3,350.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,606.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,792.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,164.55
|
| Rate for Payer: PHP Commercial |
$3,164.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,606.10
|
| Rate for Payer: Priority Health SBD |
$2,345.49
|
| Rate for Payer: UMR Bronson Commercial |
$1,377.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,792.25
|
|
|
HC DEVICE NOT RETURNED CADD PUMP
|
Facility
|
IP
|
$3,723.00
|
|
| Hospital Charge Code |
27000642
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,638.12 |
| Max. Negotiated Rate |
$3,350.70 |
| Rate for Payer: Aetna American Axle |
$2,419.95
|
| Rate for Payer: Aetna Commercial |
$3,164.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,419.95
|
| Rate for Payer: Cash Price |
$2,978.40
|
| Rate for Payer: Cofinity Commercial |
$2,606.10
|
| Rate for Payer: Cofinity Commercial |
$3,201.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,978.40
|
| Rate for Payer: Healthscope Commercial |
$3,350.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,606.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,792.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,164.55
|
| Rate for Payer: PHP Commercial |
$3,164.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,606.10
|
| Rate for Payer: Priority Health SBD |
$2,345.49
|
| Rate for Payer: UMR Bronson Commercial |
$1,638.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,792.25
|
|
|
HC DEVICE NOT RETURNED RU SLEEPING
|
Professional
|
Both
|
$495.00
|
|
|
Service Code
|
HCPCS 00614
|
| Hospital Charge Code |
27000614
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$198.00 |
| Max. Negotiated Rate |
$346.50 |
| Rate for Payer: BCBS Complete |
$198.00
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$346.50
|
| Rate for Payer: UMR Bronson Commercial |
$227.70
|
|
|
HC DEVICE NOT RETURNED RU SLEEPING
|
Professional
|
Both
|
$495.00
|
|
|
Service Code
|
HCPCS 00614
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$198.00 |
| Max. Negotiated Rate |
$346.50 |
| Rate for Payer: BCBS Complete |
$198.00
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$346.50
|
| Rate for Payer: UMR Bronson Commercial |
$227.70
|
|
|
HC DEVICE NOT RETURNED RU SLEEPING
|
Facility
|
IP
|
$495.00
|
|
| Hospital Charge Code |
27000614
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$217.80 |
| Max. Negotiated Rate |
$445.50 |
| Rate for Payer: Aetna American Axle |
$321.75
|
| Rate for Payer: Aetna Commercial |
$420.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.75
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cofinity Commercial |
$346.50
|
| Rate for Payer: Cofinity Commercial |
$425.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.00
|
| Rate for Payer: Healthscope Commercial |
$445.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$346.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$420.75
|
| Rate for Payer: PHP Commercial |
$420.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$346.50
|
| Rate for Payer: Priority Health SBD |
$311.85
|
| Rate for Payer: UMR Bronson Commercial |
$217.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.25
|
|
|
HC DEVICE NOT RETURNED RU SLEEPING
|
Facility
|
OP
|
$495.00
|
|
| Hospital Charge Code |
27000614
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$183.15 |
| Max. Negotiated Rate |
$445.50 |
| Rate for Payer: Aetna American Axle |
$321.75
|
| Rate for Payer: Aetna Commercial |
$420.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.75
|
| Rate for Payer: BCBS Complete |
$198.00
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cofinity Commercial |
$346.50
|
| Rate for Payer: Cofinity Commercial |
$425.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.00
|
| Rate for Payer: Healthscope Commercial |
$445.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$346.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$420.75
|
| Rate for Payer: PHP Commercial |
$420.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$346.50
|
| Rate for Payer: Priority Health SBD |
$311.85
|
| Rate for Payer: UMR Bronson Commercial |
$183.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.25
|
|
|
HC DEVICE NOT RETURNED WATCHPAT
|
Professional
|
Both
|
$4,950.00
|
|
|
Service Code
|
HCPCS 00604
|
| Hospital Charge Code |
27000604
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,980.00 |
| Max. Negotiated Rate |
$3,465.00 |
| Rate for Payer: BCBS Complete |
$1,980.00
|
| Rate for Payer: Cash Price |
$3,960.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,465.00
|
| Rate for Payer: UMR Bronson Commercial |
$2,277.00
|
|
|
HC DEVICE NOT RETURNED WATCHPAT
|
Facility
|
IP
|
$4,950.00
|
|
| Hospital Charge Code |
27000604
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2,178.00 |
| Max. Negotiated Rate |
$4,455.00 |
| Rate for Payer: Aetna American Axle |
$3,217.50
|
| Rate for Payer: Aetna Commercial |
$4,207.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,217.50
|
| Rate for Payer: Cash Price |
$3,960.00
|
| Rate for Payer: Cofinity Commercial |
$3,465.00
|
| Rate for Payer: Cofinity Commercial |
$4,257.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,960.00
|
| Rate for Payer: Healthscope Commercial |
$4,455.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,465.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,712.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,207.50
|
| Rate for Payer: PHP Commercial |
$4,207.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,465.00
|
| Rate for Payer: Priority Health SBD |
$3,118.50
|
| Rate for Payer: UMR Bronson Commercial |
$2,178.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,712.50
|
|
|
HC DEVICE NOT RETURNED WATCHPAT
|
Facility
|
OP
|
$4,950.00
|
|
| Hospital Charge Code |
27000604
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,831.50 |
| Max. Negotiated Rate |
$4,455.00 |
| Rate for Payer: Aetna American Axle |
$3,217.50
|
| Rate for Payer: Aetna Commercial |
$4,207.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,217.50
|
| Rate for Payer: BCBS Complete |
$1,980.00
|
| Rate for Payer: Cash Price |
$3,960.00
|
| Rate for Payer: Cofinity Commercial |
$3,465.00
|
| Rate for Payer: Cofinity Commercial |
$4,257.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,960.00
|
| Rate for Payer: Healthscope Commercial |
$4,455.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,465.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,712.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,207.50
|
| Rate for Payer: PHP Commercial |
$4,207.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,465.00
|
| Rate for Payer: Priority Health SBD |
$3,118.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,831.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,712.50
|
|
|
HC DEVICE NOT RETURNED WATCHPAT
|
Professional
|
Both
|
$4,950.00
|
|
|
Service Code
|
HCPCS 00604
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,980.00 |
| Max. Negotiated Rate |
$3,465.00 |
| Rate for Payer: BCBS Complete |
$1,980.00
|
| Rate for Payer: Cash Price |
$3,960.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,465.00
|
| Rate for Payer: UMR Bronson Commercial |
$2,277.00
|
|
|
HC DEXA BONE DENSITY
|
Facility
|
IP
|
$531.00
|
|
|
Service Code
|
CPT 77080
|
| Hospital Charge Code |
32000260
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$233.64 |
| Max. Negotiated Rate |
$477.90 |
| Rate for Payer: Aetna American Axle |
$345.15
|
| Rate for Payer: Aetna Commercial |
$451.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.15
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cofinity Commercial |
$371.70
|
| Rate for Payer: Cofinity Commercial |
$456.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.80
|
| Rate for Payer: Healthscope Commercial |
$477.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$371.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$398.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$451.35
|
| Rate for Payer: PHP Commercial |
$451.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$371.70
|
| Rate for Payer: Priority Health SBD |
$334.53
|
| Rate for Payer: UMR Bronson Commercial |
$233.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$398.25
|
|
|
HC DEXA BONE DENSITY
|
Facility
|
OP
|
$531.00
|
|
|
Service Code
|
CPT 77080
|
| Hospital Charge Code |
32000260
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$38.31 |
| Max. Negotiated Rate |
$477.90 |
| Rate for Payer: Aetna American Axle |
$345.15
|
| Rate for Payer: Aetna Commercial |
$451.35
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.15
|
| 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 |
$54.48
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cofinity Commercial |
$456.66
|
| Rate for Payer: Cofinity Commercial |
$371.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$477.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$371.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$398.25
|
| 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 |
$451.35
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$451.35
|
| 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 |
$371.70
|
| 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 |
$334.53
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.14
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$38.31
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$196.47
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$398.25
|
|
|
HC DEXA BONE DENSITY APPENDICULAR
|
Facility
|
IP
|
$200.23
|
|
|
Service Code
|
CPT 77081
|
| Hospital Charge Code |
32000261
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$88.10 |
| Max. Negotiated Rate |
$180.21 |
| Rate for Payer: Aetna American Axle |
$130.15
|
| Rate for Payer: Aetna Commercial |
$170.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.15
|
| Rate for Payer: Cash Price |
$160.18
|
| Rate for Payer: Cofinity Commercial |
$140.16
|
| Rate for Payer: Cofinity Commercial |
$172.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.18
|
| Rate for Payer: Healthscope Commercial |
$180.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$170.20
|
| Rate for Payer: PHP Commercial |
$170.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.16
|
| Rate for Payer: Priority Health SBD |
$126.14
|
| Rate for Payer: UMR Bronson Commercial |
$88.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.17
|
|
|
HC DEXA BONE DENSITY APPENDICULAR
|
Facility
|
OP
|
$200.23
|
|
|
Service Code
|
CPT 77081
|
| Hospital Charge Code |
32000261
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$31.11 |
| Max. Negotiated Rate |
$262.00 |
| Rate for Payer: Aetna American Axle |
$130.15
|
| Rate for Payer: Aetna Commercial |
$170.20
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.15
|
| 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 |
$41.18
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$160.18
|
| Rate for Payer: Cash Price |
$160.18
|
| Rate for Payer: Cofinity Commercial |
$172.20
|
| Rate for Payer: Cofinity Commercial |
$140.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$180.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.17
|
| 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 |
$170.20
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$170.20
|
| 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 |
$140.16
|
| 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 |
$126.14
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.22
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Exchange |
$31.11
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$74.09
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.17
|
|
|
HC DEXAMETHASONE DEXA
|
Facility
|
OP
|
$147.48
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100751
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.20 |
| Max. Negotiated Rate |
$132.73 |
| Rate for Payer: Aetna American Axle |
$95.86
|
| Rate for Payer: Aetna Commercial |
$125.36
|
| Rate for Payer: Aetna Medicare |
$19.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: BCBS Complete |
$10.71
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCBS Trust/PPO |
$16.76
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$117.98
|
| Rate for Payer: Cash Price |
$117.98
|
| Rate for Payer: Cofinity Commercial |
$126.83
|
| Rate for Payer: Cofinity Commercial |
$103.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$132.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.61
|
| Rate for Payer: Mclaren Medicaid |
$10.20
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Medicaid |
$10.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.36
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$125.36
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.24
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health SBD |
$92.91
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.37
|
| Rate for Payer: UHC Core |
$22.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.64
|
| Rate for Payer: UHC Exchange |
$18.64
|
| Rate for Payer: UHC Medicare Advantage |
$19.20
|
| Rate for Payer: UMR Bronson Commercial |
$54.57
|
| Rate for Payer: VA VA |
$18.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.61
|
|
|
HC DEXAMETHASONE DEXA
|
Facility
|
IP
|
$147.48
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100751
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$64.89 |
| Max. Negotiated Rate |
$132.73 |
| Rate for Payer: Aetna American Axle |
$95.86
|
| Rate for Payer: Aetna Commercial |
$125.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.86
|
| Rate for Payer: Cash Price |
$117.98
|
| Rate for Payer: Cofinity Commercial |
$103.24
|
| Rate for Payer: Cofinity Commercial |
$126.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.98
|
| Rate for Payer: Healthscope Commercial |
$132.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.36
|
| Rate for Payer: PHP Commercial |
$125.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.24
|
| Rate for Payer: Priority Health SBD |
$92.91
|
| Rate for Payer: UMR Bronson Commercial |
$64.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.61
|
|
