|
HC EEG AWAKE & ASLEEP
|
Facility
|
IP
|
$2,436.23
|
|
|
Service Code
|
CPT 95819
|
| Hospital Charge Code |
74000006
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,071.94 |
| Max. Negotiated Rate |
$2,192.61 |
| Rate for Payer: Aetna American Axle |
$1,583.55
|
| Rate for Payer: Aetna Commercial |
$2,070.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,583.55
|
| Rate for Payer: Cash Price |
$1,948.98
|
| Rate for Payer: Cofinity Commercial |
$1,705.36
|
| Rate for Payer: Cofinity Commercial |
$2,095.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,948.98
|
| Rate for Payer: Healthscope Commercial |
$2,192.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,705.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,827.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,070.80
|
| Rate for Payer: PHP Commercial |
$2,070.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,705.36
|
| Rate for Payer: Priority Health SBD |
$1,534.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,071.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,827.17
|
|
|
HC EEG AWAKE/DROWSY
|
Facility
|
OP
|
$2,041.16
|
|
|
Service Code
|
CPT 95816
|
| Hospital Charge Code |
74000005
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$152.61 |
| Max. Negotiated Rate |
$1,837.04 |
| Rate for Payer: Aetna American Axle |
$1,326.75
|
| Rate for Payer: Aetna Commercial |
$1,734.99
|
| Rate for Payer: Aetna Medicare |
$290.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,326.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,640.43
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$1,632.93
|
| Rate for Payer: Cash Price |
$1,632.93
|
| Rate for Payer: Cash Price |
$1,632.93
|
| Rate for Payer: Cofinity Commercial |
$1,755.40
|
| Rate for Payer: Cofinity Commercial |
$1,428.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,632.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$1,837.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,428.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,530.87
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,734.99
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$1,734.99
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,428.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$878.32
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$702.66
|
| Rate for Payer: Priority Health SBD |
$1,285.93
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$426.82
|
| Rate for Payer: UHC Core |
$1,633.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.00
|
| Rate for Payer: UHC Exchange |
$388.02
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: UMR Bronson Commercial |
$755.23
|
| Rate for Payer: VA VA |
$279.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,530.87
|
|
|
HC EEG AWAKE/DROWSY
|
Facility
|
IP
|
$2,041.16
|
|
|
Service Code
|
CPT 95816
|
| Hospital Charge Code |
74000005
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$898.11 |
| Max. Negotiated Rate |
$1,837.04 |
| Rate for Payer: Aetna American Axle |
$1,326.75
|
| Rate for Payer: Aetna Commercial |
$1,734.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,326.75
|
| Rate for Payer: Cash Price |
$1,632.93
|
| Rate for Payer: Cofinity Commercial |
$1,428.81
|
| Rate for Payer: Cofinity Commercial |
$1,755.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,632.93
|
| Rate for Payer: Healthscope Commercial |
$1,837.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,428.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,530.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,734.99
|
| Rate for Payer: PHP Commercial |
$1,734.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,428.81
|
| Rate for Payer: Priority Health SBD |
$1,285.93
|
| Rate for Payer: UMR Bronson Commercial |
$898.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,530.87
|
|
|
HC EEG COMA/SLEEP
|
Facility
|
OP
|
$777.04
|
|
|
Service Code
|
CPT 95822
|
| Hospital Charge Code |
74000007
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$152.61 |
| Max. Negotiated Rate |
$1,804.63 |
| Rate for Payer: Aetna American Axle |
$505.08
|
| Rate for Payer: Aetna Commercial |
$660.48
|
| Rate for Payer: Aetna Medicare |
$290.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,804.63
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$621.63
|
| Rate for Payer: Cash Price |
$621.63
|
| Rate for Payer: Cash Price |
$621.63
|
| Rate for Payer: Cofinity Commercial |
$668.25
|
| Rate for Payer: Cofinity Commercial |
$543.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$621.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$699.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$543.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$582.78
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$660.48
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$660.48
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$543.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$878.32
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$702.66
|
| Rate for Payer: Priority Health SBD |
$489.54
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$446.63
|
| Rate for Payer: UHC Core |
$1,633.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.00
|
| Rate for Payer: UHC Exchange |
$406.03
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: UMR Bronson Commercial |
$287.50
|
| Rate for Payer: VA VA |
$279.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$582.78
|
|
|
HC EEG COMA/SLEEP
|
Facility
|
IP
|
$777.04
|
|
|
Service Code
|
CPT 95822
|
| Hospital Charge Code |
74000007
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$341.90 |
| Max. Negotiated Rate |
$699.34 |
| Rate for Payer: Aetna American Axle |
$505.08
|
| Rate for Payer: Aetna Commercial |
$660.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.08
|
| Rate for Payer: Cash Price |
$621.63
|
| Rate for Payer: Cofinity Commercial |
$543.93
|
| Rate for Payer: Cofinity Commercial |
$668.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$621.63
|
| Rate for Payer: Healthscope Commercial |
$699.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$543.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$582.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$660.48
|
| Rate for Payer: PHP Commercial |
$660.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$543.93
|
| Rate for Payer: Priority Health SBD |
$489.54
|
| Rate for Payer: UMR Bronson Commercial |
$341.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$582.78
|
|
|
HC EEG CONT REC W/VID EEG TECH
|
Facility
|
IP
|
$1,187.75
|
|
|
Service Code
|
CPT 95700
|
| Hospital Charge Code |
74000019
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$522.61 |
| Max. Negotiated Rate |
$1,068.98 |
| Rate for Payer: Aetna American Axle |
$772.04
|
| Rate for Payer: Aetna Commercial |
$1,009.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$772.04
|
| Rate for Payer: Cash Price |
$950.20
|
| Rate for Payer: Cofinity Commercial |
$1,021.46
|
| Rate for Payer: Cofinity Commercial |
$831.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$950.20
|
| Rate for Payer: Healthscope Commercial |
$1,068.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$831.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$890.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,009.59
|
| Rate for Payer: PHP Commercial |
$1,009.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$831.42
|
| Rate for Payer: Priority Health SBD |
$748.28
|
| Rate for Payer: UMR Bronson Commercial |
$522.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$890.81
|
|
|
HC EEG CONT REC W/VID EEG TECH
|
Facility
|
OP
|
$1,187.75
|
|
|
Service Code
|
CPT 95700
|
| Hospital Charge Code |
74000019
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$75.95 |
| Max. Negotiated Rate |
$1,633.00 |
| Rate for Payer: Aetna American Axle |
$772.04
|
| Rate for Payer: Aetna Commercial |
$1,009.59
|
| Rate for Payer: Aetna Medicare |
$144.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$772.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.56
|
| Rate for Payer: BCBS Complete |
$79.76
|
| Rate for Payer: BCBS MAPPO |
$138.85
|
| Rate for Payer: BCBS Trust/PPO |
$461.26
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$950.20
|
| Rate for Payer: Cash Price |
$950.20
|
| Rate for Payer: Cash Price |
$950.20
|
| Rate for Payer: Cofinity Commercial |
$1,021.46
|
| Rate for Payer: Cofinity Commercial |
$831.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$950.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$1,068.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$831.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$890.81
|
| Rate for Payer: Mclaren Medicaid |
$75.95
|
| Rate for Payer: Mclaren Medicare |
$138.85
|
| Rate for Payer: Meridian Medicaid |
$79.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,009.59
|
| Rate for Payer: PACE Medicare |
$131.91
|
| Rate for Payer: PACE SWMI |
$138.85
|
| Rate for Payer: PHP Commercial |
$1,009.59
|
| Rate for Payer: PHP Medicare Advantage |
$138.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$831.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$437.09
|
| Rate for Payer: Priority Health Medicare |
$138.85
|
| Rate for Payer: Priority Health Narrow Network |
$349.67
|
| Rate for Payer: Priority Health SBD |
$748.28
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC Core |
$1,633.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.85
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: UMR Bronson Commercial |
$439.47
|
| Rate for Payer: VA VA |
$138.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$890.81
|
|
|
HC EEG ELECTROCEREBRAL SILENCE
|
Facility
|
OP
|
$876.26
|
|
|
Service Code
|
CPT 95824
|
| Hospital Charge Code |
74000008
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$260.60 |
| Max. Negotiated Rate |
$1,633.00 |
| Rate for Payer: Aetna American Axle |
$569.57
|
| Rate for Payer: Aetna Commercial |
$744.82
|
| Rate for Payer: Aetna Medicare |
$495.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$569.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$595.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$595.52
|
| Rate for Payer: BCBS Complete |
$273.66
|
| Rate for Payer: BCBS MAPPO |
$476.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,533.29
|
| Rate for Payer: BCN Medicare Advantage |
$476.42
|
| Rate for Payer: Cash Price |
$701.01
|
| Rate for Payer: Cash Price |
$701.01
|
| Rate for Payer: Cash Price |
$701.01
|
| Rate for Payer: Cofinity Commercial |
$753.58
|
| Rate for Payer: Cofinity Commercial |
$613.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$701.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.42
|
| Rate for Payer: Healthscope Commercial |
$788.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$613.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$657.20
|
| Rate for Payer: Mclaren Medicaid |
$260.60
|
| Rate for Payer: Mclaren Medicare |
$476.42
|
| Rate for Payer: Meridian Medicaid |
$273.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$500.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$547.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$744.82
|
| Rate for Payer: PACE Medicare |
$452.60
|
| Rate for Payer: PACE SWMI |
$476.42
|
| Rate for Payer: PHP Commercial |
$744.82
|
| Rate for Payer: PHP Medicare Advantage |
$476.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$613.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,499.80
|
| Rate for Payer: Priority Health Medicare |
$476.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,199.84
|
| Rate for Payer: Priority Health SBD |
$552.04
|
| Rate for Payer: Railroad Medicare Medicare |
$476.42
|
| Rate for Payer: UHC Core |
$1,633.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$476.42
|
| Rate for Payer: UHC Medicare Advantage |
$490.71
|
| Rate for Payer: UMR Bronson Commercial |
$324.22
|
| Rate for Payer: VA VA |
$476.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$657.20
|
|
|
HC EEG ELECTROCEREBRAL SILENCE
|
Facility
|
IP
|
$876.26
|
|
|
Service Code
|
CPT 95824
|
| Hospital Charge Code |
74000008
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$385.55 |
| Max. Negotiated Rate |
$788.63 |
| Rate for Payer: Aetna American Axle |
$569.57
|
| Rate for Payer: Aetna Commercial |
$744.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$569.57
|
| Rate for Payer: Cash Price |
$701.01
|
| Rate for Payer: Cofinity Commercial |
$613.38
|
| Rate for Payer: Cofinity Commercial |
$753.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$701.01
|
| Rate for Payer: Healthscope Commercial |
$788.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$613.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$657.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$744.82
|
| Rate for Payer: PHP Commercial |
$744.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$613.38
|
| Rate for Payer: Priority Health SBD |
$552.04
|
| Rate for Payer: UMR Bronson Commercial |
$385.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$657.20
|
|
|
HC EEG EXTENDED 41-60 MINUTES
|
Facility
|
OP
|
$1,995.25
|
|
|
Service Code
|
CPT 95812
|
| Hospital Charge Code |
74000003
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$152.61 |
| Max. Negotiated Rate |
$1,795.72 |
| Rate for Payer: Aetna American Axle |
$1,296.91
|
| Rate for Payer: Aetna Commercial |
$1,695.96
|
| Rate for Payer: Aetna Medicare |
$290.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,296.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,452.77
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$1,596.20
|
| Rate for Payer: Cash Price |
$1,596.20
|
| Rate for Payer: Cash Price |
$1,596.20
|
| Rate for Payer: Cofinity Commercial |
$1,715.92
|
| Rate for Payer: Cofinity Commercial |
$1,396.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$1,795.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,396.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,496.44
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,695.96
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$1,695.96
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,396.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$878.32
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$702.66
|
| Rate for Payer: Priority Health SBD |
$1,257.01
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$378.92
|
| Rate for Payer: UHC Core |
$1,633.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.00
|
| Rate for Payer: UHC Exchange |
$344.47
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: UMR Bronson Commercial |
$738.24
|
| Rate for Payer: VA VA |
$279.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,496.44
|
|
|
HC EEG EXTENDED 41-60 MINUTES
|
Facility
|
IP
|
$1,995.25
|
|
|
Service Code
|
CPT 95812
|
| Hospital Charge Code |
74000003
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$877.91 |
| Max. Negotiated Rate |
$1,795.72 |
| Rate for Payer: Aetna American Axle |
$1,296.91
|
| Rate for Payer: Aetna Commercial |
$1,695.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,296.91
|
| Rate for Payer: Cash Price |
$1,596.20
|
| Rate for Payer: Cofinity Commercial |
$1,396.68
|
| Rate for Payer: Cofinity Commercial |
$1,715.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.20
|
| Rate for Payer: Healthscope Commercial |
$1,795.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,396.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,496.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,695.96
|
| Rate for Payer: PHP Commercial |
$1,695.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,396.68
|
| Rate for Payer: Priority Health SBD |
$1,257.01
|
| Rate for Payer: UMR Bronson Commercial |
$877.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,496.44
|
|
|
HC EEG EXTENDED 61-119 MIN
|
Facility
|
OP
|
$2,227.04
|
|
|
Service Code
|
CPT 95813
|
| Hospital Charge Code |
74000004
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$152.61 |
| Max. Negotiated Rate |
$2,004.34 |
| Rate for Payer: Aetna American Axle |
$1,447.58
|
| Rate for Payer: Aetna Commercial |
$1,892.98
|
| Rate for Payer: Aetna Medicare |
$290.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,447.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,729.24
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$1,781.63
|
| Rate for Payer: Cash Price |
$1,781.63
|
| Rate for Payer: Cash Price |
$1,781.63
|
| Rate for Payer: Cofinity Commercial |
$1,558.93
|
| Rate for Payer: Cofinity Commercial |
$1,915.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,781.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$2,004.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,558.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,670.28
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,892.98
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$1,892.98
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,558.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$878.32
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$702.66
|
| Rate for Payer: Priority Health SBD |
$1,403.04
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$479.05
|
| Rate for Payer: UHC Core |
$1,633.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.00
|
| Rate for Payer: UHC Exchange |
$435.50
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: UMR Bronson Commercial |
$824.00
|
| Rate for Payer: VA VA |
$279.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,670.28
|
|
|
HC EEG EXTENDED 61-119 MIN
|
Facility
|
IP
|
$2,227.04
|
|
|
Service Code
|
CPT 95813
|
| Hospital Charge Code |
74000004
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$979.90 |
| Max. Negotiated Rate |
$2,004.34 |
| Rate for Payer: Aetna American Axle |
$1,447.58
|
| Rate for Payer: Aetna Commercial |
$1,892.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,447.58
|
| Rate for Payer: Cash Price |
$1,781.63
|
| Rate for Payer: Cofinity Commercial |
$1,558.93
|
| Rate for Payer: Cofinity Commercial |
$1,915.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,781.63
|
| Rate for Payer: Healthscope Commercial |
$2,004.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,558.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,670.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,892.98
|
| Rate for Payer: PHP Commercial |
$1,892.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,558.93
|
| Rate for Payer: Priority Health SBD |
$1,403.04
|
| Rate for Payer: UMR Bronson Commercial |
$979.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,670.28
|
|
|
HC EEG W/O VID 12-26 HRS CONT MNTR
|
Facility
|
OP
|
$2,754.67
|
|
|
Service Code
|
CPT 95710
|
| Hospital Charge Code |
74000031
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$260.60 |
| Max. Negotiated Rate |
$2,479.20 |
| Rate for Payer: Aetna American Axle |
$1,790.54
|
| Rate for Payer: Aetna Commercial |
$2,341.47
|
| Rate for Payer: Aetna Medicare |
$495.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,790.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$595.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$595.52
|
| Rate for Payer: BCBS Complete |
$273.66
|
| Rate for Payer: BCBS MAPPO |
$476.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,533.29
|
| Rate for Payer: BCN Medicare Advantage |
$476.42
|
| Rate for Payer: Cash Price |
$2,203.74
|
| Rate for Payer: Cash Price |
$2,203.74
|
| Rate for Payer: Cash Price |
$2,203.74
|
| Rate for Payer: Cofinity Commercial |
$2,369.02
|
| Rate for Payer: Cofinity Commercial |
$1,928.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,203.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.42
|
| Rate for Payer: Healthscope Commercial |
$2,479.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,928.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,066.00
|
| Rate for Payer: Mclaren Medicaid |
$260.60
|
| Rate for Payer: Mclaren Medicare |
$476.42
|
| Rate for Payer: Meridian Medicaid |
$273.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$500.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$547.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,341.47
|
| Rate for Payer: PACE Medicare |
$452.60
|
| Rate for Payer: PACE SWMI |
$476.42
|
| Rate for Payer: PHP Commercial |
$2,341.47
|
| Rate for Payer: PHP Medicare Advantage |
$476.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,928.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,499.80
|
| Rate for Payer: Priority Health Medicare |
$476.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,199.84
|
| Rate for Payer: Priority Health SBD |
$1,735.44
|
| Rate for Payer: Railroad Medicare Medicare |
$476.42
|
| Rate for Payer: UHC Core |
$1,633.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$476.42
|
| Rate for Payer: UHC Medicare Advantage |
$490.71
|
| Rate for Payer: UMR Bronson Commercial |
$1,019.23
|
| Rate for Payer: VA VA |
$476.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,066.00
|
|
|
HC EEG W/O VID 12-26 HRS CONT MNTR
|
Facility
|
IP
|
$2,754.67
|
|
|
Service Code
|
CPT 95710
|
| Hospital Charge Code |
74000031
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,212.05 |
| Max. Negotiated Rate |
$2,479.20 |
| Rate for Payer: Aetna American Axle |
$1,790.54
|
| Rate for Payer: Aetna Commercial |
$2,341.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,790.54
|
| Rate for Payer: Cash Price |
$2,203.74
|
| Rate for Payer: Cofinity Commercial |
$1,928.27
|
| Rate for Payer: Cofinity Commercial |
$2,369.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,203.74
|
| Rate for Payer: Healthscope Commercial |
$2,479.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,928.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,066.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,341.47
|
| Rate for Payer: PHP Commercial |
$2,341.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,928.27
|
| Rate for Payer: Priority Health SBD |
$1,735.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,212.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,066.00
|
|
|
HC EEG W/O VID 12-26 HRS INTMT MNTR
|
Facility
|
IP
|
$2,754.67
|
|
|
Service Code
|
CPT 95709
|
| Hospital Charge Code |
74000030
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,212.05 |
| Max. Negotiated Rate |
$2,479.20 |
| Rate for Payer: Aetna American Axle |
$1,790.54
|
| Rate for Payer: Aetna Commercial |
$2,341.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,790.54
|
| Rate for Payer: Cash Price |
$2,203.74
|
| Rate for Payer: Cofinity Commercial |
$1,928.27
|
| Rate for Payer: Cofinity Commercial |
$2,369.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,203.74
|
| Rate for Payer: Healthscope Commercial |
$2,479.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,928.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,066.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,341.47
|
| Rate for Payer: PHP Commercial |
$2,341.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,928.27
|
| Rate for Payer: Priority Health SBD |
$1,735.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,212.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,066.00
|
|
|
HC EEG W/O VID 12-26 HRS INTMT MNTR
|
Facility
|
OP
|
$2,754.67
|
|
|
Service Code
|
CPT 95709
|
| Hospital Charge Code |
74000030
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$260.60 |
| Max. Negotiated Rate |
$2,479.20 |
| Rate for Payer: Aetna American Axle |
$1,790.54
|
| Rate for Payer: Aetna Commercial |
$2,341.47
|
| Rate for Payer: Aetna Medicare |
$495.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,790.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$595.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$595.52
|
| Rate for Payer: BCBS Complete |
$273.66
|
| Rate for Payer: BCBS MAPPO |
$476.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,533.29
|
| Rate for Payer: BCN Medicare Advantage |
$476.42
|
| Rate for Payer: Cash Price |
$2,203.74
|
| Rate for Payer: Cash Price |
$2,203.74
|
| Rate for Payer: Cash Price |
$2,203.74
|
| Rate for Payer: Cofinity Commercial |
$2,369.02
|
| Rate for Payer: Cofinity Commercial |
$1,928.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,203.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.42
|
| Rate for Payer: Healthscope Commercial |
$2,479.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,928.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,066.00
|
| Rate for Payer: Mclaren Medicaid |
$260.60
|
| Rate for Payer: Mclaren Medicare |
$476.42
|
| Rate for Payer: Meridian Medicaid |
$273.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$500.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$547.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,341.47
|
| Rate for Payer: PACE Medicare |
$452.60
|
| Rate for Payer: PACE SWMI |
$476.42
|
| Rate for Payer: PHP Commercial |
$2,341.47
|
| Rate for Payer: PHP Medicare Advantage |
$476.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,928.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,499.80
|
| Rate for Payer: Priority Health Medicare |
$476.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,199.84
|
| Rate for Payer: Priority Health SBD |
$1,735.44
|
| Rate for Payer: Railroad Medicare Medicare |
$476.42
|
| Rate for Payer: UHC Core |
$1,633.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$476.42
|
| Rate for Payer: UHC Medicare Advantage |
$490.71
|
| Rate for Payer: UMR Bronson Commercial |
$1,019.23
|
| Rate for Payer: VA VA |
$476.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,066.00
|
|
|
HC EEG W/O VID 2-12 HRS CONT MNTR
|
Facility
|
OP
|
$1,614.20
|
|
|
Service Code
|
CPT 95707
|
| Hospital Charge Code |
74000029
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$152.61 |
| Max. Negotiated Rate |
$1,633.00 |
| Rate for Payer: Aetna American Axle |
$1,049.23
|
| Rate for Payer: Aetna Commercial |
$1,372.07
|
| Rate for Payer: Aetna Medicare |
$290.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,049.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$888.27
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$1,291.36
|
| Rate for Payer: Cash Price |
$1,291.36
|
| Rate for Payer: Cash Price |
$1,291.36
|
| Rate for Payer: Cofinity Commercial |
$1,388.21
|
| Rate for Payer: Cofinity Commercial |
$1,129.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$1,452.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,129.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,210.65
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,372.07
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$1,372.07
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$878.32
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$702.66
|
| Rate for Payer: Priority Health SBD |
$1,016.95
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC Core |
$1,633.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.00
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: UMR Bronson Commercial |
$597.25
|
| Rate for Payer: VA VA |
$279.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,210.65
|
|
|
HC EEG W/O VID 2-12 HRS CONT MNTR
|
Facility
|
IP
|
$1,614.20
|
|
|
Service Code
|
CPT 95707
|
| Hospital Charge Code |
74000029
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$710.25 |
| Max. Negotiated Rate |
$1,452.78 |
| Rate for Payer: Aetna American Axle |
$1,049.23
|
| Rate for Payer: Aetna Commercial |
$1,372.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,049.23
|
| Rate for Payer: Cash Price |
$1,291.36
|
| Rate for Payer: Cofinity Commercial |
$1,129.94
|
| Rate for Payer: Cofinity Commercial |
$1,388.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.36
|
| Rate for Payer: Healthscope Commercial |
$1,452.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,129.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,210.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,372.07
|
| Rate for Payer: PHP Commercial |
$1,372.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.94
|
| Rate for Payer: Priority Health SBD |
$1,016.95
|
| Rate for Payer: UMR Bronson Commercial |
$710.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,210.65
|
|
|
HC EEG W/O VID 2-12 HRS INTMT MNTR
|
Facility
|
OP
|
$1,614.01
|
|
|
Service Code
|
CPT 95706
|
| Hospital Charge Code |
74000028
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$152.61 |
| Max. Negotiated Rate |
$1,633.00 |
| Rate for Payer: Aetna American Axle |
$1,049.11
|
| Rate for Payer: Aetna Commercial |
$1,371.91
|
| Rate for Payer: Aetna Medicare |
$290.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,049.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$888.27
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$1,291.21
|
| Rate for Payer: Cash Price |
$1,291.21
|
| Rate for Payer: Cash Price |
$1,291.21
|
| Rate for Payer: Cofinity Commercial |
$1,129.81
|
| Rate for Payer: Cofinity Commercial |
$1,388.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$1,452.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,129.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,210.51
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,371.91
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$1,371.91
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$878.32
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$702.66
|
| Rate for Payer: Priority Health SBD |
$1,016.83
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC Core |
$1,633.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.00
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: UMR Bronson Commercial |
$597.18
|
| Rate for Payer: VA VA |
$279.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,210.51
|
|
|
HC EEG W/O VID 2-12 HRS INTMT MNTR
|
Facility
|
IP
|
$1,614.01
|
|
|
Service Code
|
CPT 95706
|
| Hospital Charge Code |
74000028
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$710.16 |
| Max. Negotiated Rate |
$1,452.61 |
| Rate for Payer: Aetna American Axle |
$1,049.11
|
| Rate for Payer: Aetna Commercial |
$1,371.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,049.11
|
| Rate for Payer: Cash Price |
$1,291.21
|
| Rate for Payer: Cofinity Commercial |
$1,388.05
|
| Rate for Payer: Cofinity Commercial |
$1,129.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.21
|
| Rate for Payer: Healthscope Commercial |
$1,452.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,129.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,210.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,371.91
|
| Rate for Payer: PHP Commercial |
$1,371.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.81
|
| Rate for Payer: Priority Health SBD |
$1,016.83
|
| Rate for Payer: UMR Bronson Commercial |
$710.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,210.51
|
|
|
HC EEG W/O VID 2-12 HR UNMNTR
|
Facility
|
OP
|
$1,001.24
|
|
|
Service Code
|
CPT 95705
|
| Hospital Charge Code |
74000020
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$152.61 |
| Max. Negotiated Rate |
$1,633.00 |
| Rate for Payer: Aetna American Axle |
$650.81
|
| Rate for Payer: Aetna Commercial |
$851.05
|
| Rate for Payer: Aetna Medicare |
$290.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$650.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$461.26
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$800.99
|
| Rate for Payer: Cash Price |
$800.99
|
| Rate for Payer: Cash Price |
$800.99
|
| Rate for Payer: Cofinity Commercial |
$700.87
|
| Rate for Payer: Cofinity Commercial |
$861.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$800.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$901.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$700.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$750.93
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$851.05
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$851.05
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$878.32
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$702.66
|
| Rate for Payer: Priority Health SBD |
$630.78
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC Core |
$1,633.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.00
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: UMR Bronson Commercial |
$370.46
|
| Rate for Payer: VA VA |
$279.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$750.93
|
|
|
HC EEG W/O VID 2-12 HR UNMNTR
|
Facility
|
IP
|
$1,001.24
|
|
|
Service Code
|
CPT 95705
|
| Hospital Charge Code |
74000020
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$440.55 |
| Max. Negotiated Rate |
$901.12 |
| Rate for Payer: Aetna American Axle |
$650.81
|
| Rate for Payer: Aetna Commercial |
$851.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$650.81
|
| Rate for Payer: Cash Price |
$800.99
|
| Rate for Payer: Cofinity Commercial |
$700.87
|
| Rate for Payer: Cofinity Commercial |
$861.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$800.99
|
| Rate for Payer: Healthscope Commercial |
$901.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$700.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$750.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$851.05
|
| Rate for Payer: PHP Commercial |
$851.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.87
|
| Rate for Payer: Priority Health SBD |
$630.78
|
| Rate for Payer: UMR Bronson Commercial |
$440.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$750.93
|
|
|
HC EEG W/O VID EA 12-26 HR UNMNTR
|
Facility
|
IP
|
$1,921.04
|
|
|
Service Code
|
CPT 95708
|
| Hospital Charge Code |
74000021
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$845.26 |
| Max. Negotiated Rate |
$1,728.94 |
| Rate for Payer: Aetna American Axle |
$1,248.68
|
| Rate for Payer: Aetna Commercial |
$1,632.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,248.68
|
| Rate for Payer: Cash Price |
$1,536.83
|
| Rate for Payer: Cofinity Commercial |
$1,344.73
|
| Rate for Payer: Cofinity Commercial |
$1,652.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,536.83
|
| Rate for Payer: Healthscope Commercial |
$1,728.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,344.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,440.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,632.88
|
| Rate for Payer: PHP Commercial |
$1,632.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.73
|
| Rate for Payer: Priority Health SBD |
$1,210.26
|
| Rate for Payer: UMR Bronson Commercial |
$845.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,440.78
|
|
|
HC EEG W/O VID EA 12-26 HR UNMNTR
|
Facility
|
OP
|
$1,921.04
|
|
|
Service Code
|
CPT 95708
|
| Hospital Charge Code |
74000021
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$260.60 |
| Max. Negotiated Rate |
$1,728.94 |
| Rate for Payer: Aetna American Axle |
$1,248.68
|
| Rate for Payer: Aetna Commercial |
$1,632.88
|
| Rate for Payer: Aetna Medicare |
$495.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,248.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$595.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$595.52
|
| Rate for Payer: BCBS Complete |
$273.66
|
| Rate for Payer: BCBS MAPPO |
$476.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,533.29
|
| Rate for Payer: BCN Medicare Advantage |
$476.42
|
| Rate for Payer: Cash Price |
$1,536.83
|
| Rate for Payer: Cash Price |
$1,536.83
|
| Rate for Payer: Cash Price |
$1,536.83
|
| Rate for Payer: Cofinity Commercial |
$1,652.09
|
| Rate for Payer: Cofinity Commercial |
$1,344.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,536.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.42
|
| Rate for Payer: Healthscope Commercial |
$1,728.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,344.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,440.78
|
| Rate for Payer: Mclaren Medicaid |
$260.60
|
| Rate for Payer: Mclaren Medicare |
$476.42
|
| Rate for Payer: Meridian Medicaid |
$273.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$500.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$547.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,632.88
|
| Rate for Payer: PACE Medicare |
$452.60
|
| Rate for Payer: PACE SWMI |
$476.42
|
| Rate for Payer: PHP Commercial |
$1,632.88
|
| Rate for Payer: PHP Medicare Advantage |
$476.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,499.80
|
| Rate for Payer: Priority Health Medicare |
$476.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,199.84
|
| Rate for Payer: Priority Health SBD |
$1,210.26
|
| Rate for Payer: Railroad Medicare Medicare |
$476.42
|
| Rate for Payer: UHC Core |
$1,633.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$476.42
|
| Rate for Payer: UHC Medicare Advantage |
$490.71
|
| Rate for Payer: UMR Bronson Commercial |
$710.78
|
| Rate for Payer: VA VA |
$476.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,440.78
|
|
