|
HC EMBOLIZATION URETER
|
Facility
|
IP
|
$420.35
|
|
|
Service Code
|
CPT 50705
|
| Hospital Charge Code |
36100511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$184.95 |
| Max. Negotiated Rate |
$378.32 |
| Rate for Payer: Aetna American Axle |
$273.23
|
| Rate for Payer: Aetna Commercial |
$357.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.23
|
| Rate for Payer: Cash Price |
$336.28
|
| Rate for Payer: Cofinity Commercial |
$294.24
|
| Rate for Payer: Cofinity Commercial |
$361.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.28
|
| Rate for Payer: Healthscope Commercial |
$378.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$294.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$315.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$357.30
|
| Rate for Payer: PHP Commercial |
$357.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.24
|
| Rate for Payer: Priority Health SBD |
$264.82
|
| Rate for Payer: UMR Bronson Commercial |
$184.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$315.26
|
|
|
HC EMBOLIZATION URETER
|
Facility
|
OP
|
$420.35
|
|
|
Service Code
|
CPT 50705
|
| Hospital Charge Code |
36100511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$155.53 |
| Max. Negotiated Rate |
$7,421.18 |
| Rate for Payer: Aetna American Axle |
$273.23
|
| Rate for Payer: Aetna Commercial |
$357.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.23
|
| Rate for Payer: BCBS Complete |
$168.14
|
| Rate for Payer: BCBS Trust/PPO |
$7,421.18
|
| Rate for Payer: Cash Price |
$336.28
|
| Rate for Payer: Cash Price |
$336.28
|
| Rate for Payer: Cofinity Commercial |
$361.50
|
| Rate for Payer: Cofinity Commercial |
$294.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.28
|
| Rate for Payer: Healthscope Commercial |
$378.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$294.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$315.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$357.30
|
| Rate for Payer: PHP Commercial |
$357.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.24
|
| Rate for Payer: Priority Health SBD |
$264.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.22
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$169.29
|
| Rate for Payer: UMR Bronson Commercial |
$155.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$315.26
|
|
|
HC EMBOLIZATION VENOUS OTHER THAN HEMORRHAGE
|
Facility
|
IP
|
$18,025.83
|
|
|
Service Code
|
CPT 37241
|
| Hospital Charge Code |
36100428
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,931.37 |
| Max. Negotiated Rate |
$16,223.25 |
| Rate for Payer: Aetna American Axle |
$11,716.79
|
| Rate for Payer: Aetna Commercial |
$15,321.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,716.79
|
| Rate for Payer: Cash Price |
$14,420.66
|
| Rate for Payer: Cofinity Commercial |
$12,618.08
|
| Rate for Payer: Cofinity Commercial |
$15,502.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,420.66
|
| Rate for Payer: Healthscope Commercial |
$16,223.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,618.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,519.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,321.96
|
| Rate for Payer: PHP Commercial |
$15,321.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,618.08
|
| Rate for Payer: Priority Health SBD |
$11,356.27
|
| Rate for Payer: UMR Bronson Commercial |
$7,931.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,519.37
|
|
|
HC EMBOLIZATION VENOUS OTHER THAN HEMORRHAGE
|
Facility
|
OP
|
$18,025.83
|
|
|
Service Code
|
CPT 37241
|
| Hospital Charge Code |
36100428
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$407.01 |
| Max. Negotiated Rate |
$30,783.77 |
| Rate for Payer: Aetna American Axle |
$11,716.79
|
| Rate for Payer: Aetna Commercial |
$15,321.96
|
| Rate for Payer: Aetna Medicare |
$10,169.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,716.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,223.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,223.36
|
| Rate for Payer: BCBS Complete |
$5,616.88
|
| Rate for Payer: BCBS MAPPO |
$9,778.69
|
| Rate for Payer: BCBS Trust/PPO |
$11,155.47
|
| Rate for Payer: BCN Medicare Advantage |
$9,778.69
|
| Rate for Payer: Cash Price |
$14,420.66
|
| Rate for Payer: Cash Price |
$14,420.66
|
| Rate for Payer: Cofinity Commercial |
$12,618.08
|
| Rate for Payer: Cofinity Commercial |
$15,502.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,420.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,778.69
|
| Rate for Payer: Healthscope Commercial |
$16,223.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,618.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,519.37
|
| Rate for Payer: Mclaren Medicaid |
$5,348.94
|
| Rate for Payer: Mclaren Medicare |
$9,778.69
|
| Rate for Payer: Meridian Medicaid |
$5,616.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,267.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,245.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,321.96
|
| Rate for Payer: PACE Medicare |
$9,289.76
|
| Rate for Payer: PACE SWMI |
$9,778.69
|
| Rate for Payer: PHP Commercial |
$15,321.96
|
| Rate for Payer: PHP Medicare Advantage |
$9,778.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,348.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,618.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30,783.77
|
| Rate for Payer: Priority Health Medicare |
$9,778.69
|
| Rate for Payer: Priority Health Narrow Network |
$24,627.02
|
| Rate for Payer: Priority Health SBD |
$11,356.27
|
| Rate for Payer: Railroad Medicare Medicare |
$9,778.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$447.71
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,778.69
|
| Rate for Payer: UHC Exchange |
$407.01
|
| Rate for Payer: UHC Medicare Advantage |
$10,072.05
|
| Rate for Payer: UMR Bronson Commercial |
$6,669.56
|
| Rate for Payer: VA VA |
$9,778.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,519.37
|
|
|
HC EMBOSHIELD SYSTEM
|
Facility
|
OP
|
$5,786.68
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800010
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,141.07 |
| Max. Negotiated Rate |
$5,208.01 |
| Rate for Payer: Aetna American Axle |
$3,761.34
|
| Rate for Payer: Aetna Commercial |
$4,918.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,761.34
|
| Rate for Payer: BCBS Complete |
$2,314.67
|
| Rate for Payer: Cash Price |
$4,629.34
|
| Rate for Payer: Cofinity Commercial |
$4,050.68
|
| Rate for Payer: Cofinity Commercial |
$4,976.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,629.34
|
| Rate for Payer: Healthscope Commercial |
$5,208.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,050.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,340.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,918.68
|
| Rate for Payer: PHP Commercial |
$4,918.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,050.68
|
| Rate for Payer: Priority Health SBD |
$3,645.61
|
| Rate for Payer: UMR Bronson Commercial |
$2,141.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,340.01
|
|
|
HC EMBOSHIELD SYSTEM
|
Facility
|
IP
|
$5,786.68
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800010
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,546.14 |
| Max. Negotiated Rate |
$5,208.01 |
| Rate for Payer: Aetna American Axle |
$3,761.34
|
| Rate for Payer: Aetna Commercial |
$4,918.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,761.34
|
| Rate for Payer: Cash Price |
$4,629.34
|
| Rate for Payer: Cofinity Commercial |
$4,050.68
|
| Rate for Payer: Cofinity Commercial |
$4,976.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,629.34
|
| Rate for Payer: Healthscope Commercial |
$5,208.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,050.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,340.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,918.68
|
| Rate for Payer: PHP Commercial |
$4,918.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,050.68
|
| Rate for Payer: Priority Health SBD |
$3,645.61
|
| Rate for Payer: UMR Bronson Commercial |
$2,546.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,340.01
|
|
|
HC EMCU OBSERVATION PER HOUR
|
Facility
|
OP
|
$130.53
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200022
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$48.30 |
| Max. Negotiated Rate |
$4,092.00 |
| Rate for Payer: Aetna American Axle |
$84.84
|
| Rate for Payer: Aetna Commercial |
$110.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.84
|
| Rate for Payer: BCBS Complete |
$52.21
|
| Rate for Payer: BCBS Trust/PPO |
$118.88
|
| Rate for Payer: Cash Price |
$104.42
|
| Rate for Payer: Cash Price |
$104.42
|
| Rate for Payer: Cash Price |
$104.42
|
| Rate for Payer: Cofinity Commercial |
$91.37
|
| Rate for Payer: Cofinity Commercial |
$112.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.42
|
| Rate for Payer: Healthscope Commercial |
$117.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.90
|
| Rate for Payer: Meridian Medicaid |
$1,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.95
|
| Rate for Payer: PHP Commercial |
$110.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.37
|
| Rate for Payer: Priority Health SBD |
$82.23
|
| Rate for Payer: UHC Core |
$4,092.00
|
| Rate for Payer: UMR Bronson Commercial |
$48.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.90
|
|
|
HC EMCU OBSERVATION PER HOUR
|
Facility
|
IP
|
$130.53
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200022
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$57.43 |
| Max. Negotiated Rate |
$117.48 |
| Rate for Payer: Aetna American Axle |
$84.84
|
| Rate for Payer: Aetna Commercial |
$110.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.84
|
| Rate for Payer: Cash Price |
$104.42
|
| Rate for Payer: Cofinity Commercial |
$112.26
|
| Rate for Payer: Cofinity Commercial |
$91.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.42
|
| Rate for Payer: Healthscope Commercial |
$117.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.95
|
| Rate for Payer: PHP Commercial |
$110.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.37
|
| Rate for Payer: Priority Health SBD |
$82.23
|
| Rate for Payer: UMR Bronson Commercial |
$57.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.90
|
|
|
HC EMG ANAL SPHINCTER
|
Facility
|
IP
|
$344.16
|
|
|
Service Code
|
CPT 51785
|
| Hospital Charge Code |
92000002
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$151.43 |
| Max. Negotiated Rate |
$309.74 |
| Rate for Payer: Aetna American Axle |
$223.70
|
| Rate for Payer: Aetna Commercial |
$292.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.70
|
| Rate for Payer: Cash Price |
$275.33
|
| Rate for Payer: Cofinity Commercial |
$240.91
|
| Rate for Payer: Cofinity Commercial |
$295.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.33
|
| Rate for Payer: Healthscope Commercial |
$309.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$240.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.54
|
| Rate for Payer: PHP Commercial |
$292.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.91
|
| Rate for Payer: Priority Health SBD |
$216.82
|
| Rate for Payer: UMR Bronson Commercial |
$151.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.12
|
|
|
HC EMG ANAL SPHINCTER
|
Facility
|
OP
|
$344.16
|
|
|
Service Code
|
CPT 51785
|
| Hospital Charge Code |
92000002
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$120.16 |
| Max. Negotiated Rate |
$691.57 |
| Rate for Payer: Aetna American Axle |
$223.70
|
| Rate for Payer: Aetna Commercial |
$292.54
|
| Rate for Payer: Aetna Medicare |
$228.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.60
|
| Rate for Payer: BCBS Complete |
$126.18
|
| Rate for Payer: BCBS MAPPO |
$219.68
|
| Rate for Payer: BCBS Trust/PPO |
$173.36
|
| Rate for Payer: BCN Medicare Advantage |
$219.68
|
| Rate for Payer: Cash Price |
$275.33
|
| Rate for Payer: Cash Price |
$275.33
|
| Rate for Payer: Cash Price |
$275.33
|
| Rate for Payer: Cofinity Commercial |
$295.98
|
| Rate for Payer: Cofinity Commercial |
$240.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.68
|
| Rate for Payer: Healthscope Commercial |
$309.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$240.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.12
|
| Rate for Payer: Mclaren Medicaid |
$120.16
|
| Rate for Payer: Mclaren Medicare |
$219.68
|
| Rate for Payer: Meridian Medicaid |
$126.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$230.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.54
|
| Rate for Payer: PACE Medicare |
$208.70
|
| Rate for Payer: PACE SWMI |
$219.68
|
| Rate for Payer: PHP Commercial |
$292.54
|
| Rate for Payer: PHP Medicare Advantage |
$219.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$691.57
|
| Rate for Payer: Priority Health Medicare |
$219.68
|
| Rate for Payer: Priority Health Narrow Network |
$553.26
|
| Rate for Payer: Priority Health SBD |
$216.82
|
| Rate for Payer: Railroad Medicare Medicare |
$219.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$472.56
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.68
|
| Rate for Payer: UHC Exchange |
$429.60
|
| Rate for Payer: UHC Medicare Advantage |
$226.27
|
| Rate for Payer: UMR Bronson Commercial |
$127.34
|
| Rate for Payer: VA VA |
$219.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.12
|
|
|
HC EMG BLADDER
|
Facility
|
OP
|
$357.96
|
|
|
Service Code
|
CPT 51784
|
| Hospital Charge Code |
92000001
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$39.82 |
| Max. Negotiated Rate |
$437.09 |
| Rate for Payer: Aetna American Axle |
$232.67
|
| Rate for Payer: Aetna Commercial |
$304.27
|
| Rate for Payer: Aetna Medicare |
$144.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.67
|
| 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 |
$39.82
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$286.37
|
| Rate for Payer: Cash Price |
$286.37
|
| Rate for Payer: Cash Price |
$286.37
|
| Rate for Payer: Cofinity Commercial |
$250.57
|
| Rate for Payer: Cofinity Commercial |
$307.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$322.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$250.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.47
|
| 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 |
$304.27
|
| Rate for Payer: PACE Medicare |
$131.91
|
| Rate for Payer: PACE SWMI |
$138.85
|
| Rate for Payer: PHP Commercial |
$304.27
|
| 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 |
$250.57
|
| 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 |
$225.51
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.52
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.85
|
| Rate for Payer: UHC Exchange |
$63.20
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: UMR Bronson Commercial |
$132.45
|
| Rate for Payer: VA VA |
$138.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.47
|
|
|
HC EMG BLADDER
|
Facility
|
IP
|
$357.96
|
|
|
Service Code
|
CPT 51784
|
| Hospital Charge Code |
92000001
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$157.50 |
| Max. Negotiated Rate |
$322.16 |
| Rate for Payer: Aetna American Axle |
$232.67
|
| Rate for Payer: Aetna Commercial |
$304.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.67
|
| Rate for Payer: Cash Price |
$286.37
|
| Rate for Payer: Cofinity Commercial |
$250.57
|
| Rate for Payer: Cofinity Commercial |
$307.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.37
|
| Rate for Payer: Healthscope Commercial |
$322.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$250.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$304.27
|
| Rate for Payer: PHP Commercial |
$304.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.57
|
| Rate for Payer: Priority Health SBD |
$225.51
|
| Rate for Payer: UMR Bronson Commercial |
$157.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.47
|
|
|
HC EMG BLINK REFLEX
|
Facility
|
IP
|
$241.54
|
|
|
Service Code
|
CPT 95933
|
| Hospital Charge Code |
92200019
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$106.28 |
| Max. Negotiated Rate |
$217.39 |
| Rate for Payer: Aetna American Axle |
$157.00
|
| Rate for Payer: Aetna Commercial |
$205.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.00
|
| Rate for Payer: Cash Price |
$193.23
|
| Rate for Payer: Cofinity Commercial |
$169.08
|
| Rate for Payer: Cofinity Commercial |
$207.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.23
|
| Rate for Payer: Healthscope Commercial |
$217.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$169.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$181.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$205.31
|
| Rate for Payer: PHP Commercial |
$205.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.08
|
| Rate for Payer: Priority Health SBD |
$152.17
|
| Rate for Payer: UMR Bronson Commercial |
$106.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$181.16
|
|
|
HC EMG BLINK REFLEX
|
Facility
|
OP
|
$241.54
|
|
|
Service Code
|
CPT 95933
|
| Hospital Charge Code |
92200019
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$29.74 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Aetna American Axle |
$157.00
|
| Rate for Payer: Aetna Commercial |
$205.31
|
| Rate for Payer: Aetna Medicare |
$56.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$258.05
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$193.23
|
| Rate for Payer: Cash Price |
$193.23
|
| Rate for Payer: Cash Price |
$193.23
|
| Rate for Payer: Cofinity Commercial |
$169.08
|
| Rate for Payer: Cofinity Commercial |
$207.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$217.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$169.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$181.16
|
| Rate for Payer: Mclaren Medicaid |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$205.31
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$205.31
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.15
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$136.92
|
| Rate for Payer: Priority Health SBD |
$152.17
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.97
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.37
|
| Rate for Payer: UHC Exchange |
$80.88
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: UMR Bronson Commercial |
$89.37
|
| Rate for Payer: VA VA |
$54.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$181.16
|
|
|
HC EMG CRANIAL CERV THOR LUMB PARASPINE NDL EXAM W NCS UNI
|
Facility
|
OP
|
$600.05
|
|
|
Service Code
|
CPT 95887
|
| Hospital Charge Code |
92200024
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$81.21 |
| Max. Negotiated Rate |
$540.04 |
| Rate for Payer: Aetna American Axle |
$390.03
|
| Rate for Payer: Aetna Commercial |
$510.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.03
|
| Rate for Payer: BCBS Complete |
$240.02
|
| Rate for Payer: BCBS Trust/PPO |
$236.26
|
| Rate for Payer: Cash Price |
$480.04
|
| Rate for Payer: Cash Price |
$480.04
|
| Rate for Payer: Cash Price |
$480.04
|
| Rate for Payer: Cofinity Commercial |
$516.04
|
| Rate for Payer: Cofinity Commercial |
$420.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.04
|
| Rate for Payer: Healthscope Commercial |
$540.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$420.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.04
|
| Rate for Payer: PHP Commercial |
$510.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.04
|
| Rate for Payer: Priority Health SBD |
$378.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.33
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Exchange |
$81.21
|
| Rate for Payer: UMR Bronson Commercial |
$222.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.04
|
|
|
HC EMG CRANIAL CERV THOR LUMB PARASPINE NDL EXAM W NCS UNI
|
Facility
|
IP
|
$600.05
|
|
|
Service Code
|
CPT 95887
|
| Hospital Charge Code |
92200024
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$264.02 |
| Max. Negotiated Rate |
$540.04 |
| Rate for Payer: Aetna American Axle |
$390.03
|
| Rate for Payer: Aetna Commercial |
$510.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.03
|
| Rate for Payer: Cash Price |
$480.04
|
| Rate for Payer: Cofinity Commercial |
$420.04
|
| Rate for Payer: Cofinity Commercial |
$516.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.04
|
| Rate for Payer: Healthscope Commercial |
$540.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$420.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.04
|
| Rate for Payer: PHP Commercial |
$510.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.04
|
| Rate for Payer: Priority Health SBD |
$378.03
|
| Rate for Payer: UMR Bronson Commercial |
$264.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.04
|
|
|
HC EMG NDL GUIDANCE NERVE DEST WITH CHEMODENERVATION
|
Facility
|
IP
|
$183.71
|
|
|
Service Code
|
CPT 95874
|
| Hospital Charge Code |
92200034
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$80.83 |
| Max. Negotiated Rate |
$165.34 |
| Rate for Payer: Aetna American Axle |
$119.41
|
| Rate for Payer: Aetna Commercial |
$156.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.41
|
| Rate for Payer: Cash Price |
$146.97
|
| Rate for Payer: Cofinity Commercial |
$128.60
|
| Rate for Payer: Cofinity Commercial |
$157.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.97
|
| Rate for Payer: Healthscope Commercial |
$165.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$128.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$137.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$156.15
|
| Rate for Payer: PHP Commercial |
$156.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.60
|
| Rate for Payer: Priority Health SBD |
$115.74
|
| Rate for Payer: UMR Bronson Commercial |
$80.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$137.78
|
|
|
HC EMG NDL GUIDANCE NERVE DEST WITH CHEMODENERVATION
|
Facility
|
OP
|
$183.71
|
|
|
Service Code
|
CPT 95874
|
| Hospital Charge Code |
92200034
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$67.97 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Aetna American Axle |
$119.41
|
| Rate for Payer: Aetna Commercial |
$156.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.41
|
| Rate for Payer: BCBS Complete |
$73.48
|
| Rate for Payer: BCBS Trust/PPO |
$291.54
|
| Rate for Payer: Cash Price |
$146.97
|
| Rate for Payer: Cash Price |
$146.97
|
| Rate for Payer: Cash Price |
$146.97
|
| Rate for Payer: Cofinity Commercial |
$157.99
|
| Rate for Payer: Cofinity Commercial |
$128.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.97
|
| Rate for Payer: Healthscope Commercial |
$165.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$128.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$137.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$156.15
|
| Rate for Payer: PHP Commercial |
$156.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.60
|
| Rate for Payer: Priority Health SBD |
$115.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.13
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Exchange |
$74.66
|
| Rate for Payer: UMR Bronson Commercial |
$67.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$137.78
|
|
|
HC EMG NEEDLE EXAM-1 EXT.
|
Facility
|
IP
|
$585.47
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
92200001
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$257.61 |
| Max. Negotiated Rate |
$526.92 |
| Rate for Payer: Aetna American Axle |
$380.56
|
| Rate for Payer: Aetna Commercial |
$497.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$380.56
|
| Rate for Payer: Cash Price |
$468.38
|
| Rate for Payer: Cofinity Commercial |
$409.83
|
| Rate for Payer: Cofinity Commercial |
$503.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$468.38
|
| Rate for Payer: Healthscope Commercial |
$526.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$409.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$439.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$497.65
|
| Rate for Payer: PHP Commercial |
$497.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$409.83
|
| Rate for Payer: Priority Health SBD |
$368.85
|
| Rate for Payer: UMR Bronson Commercial |
$257.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$439.10
|
|
|
HC EMG NEEDLE EXAM-1 EXT.
|
Facility
|
OP
|
$585.47
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
92200001
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$526.92 |
| Rate for Payer: Aetna American Axle |
$380.56
|
| Rate for Payer: Aetna Commercial |
$497.65
|
| Rate for Payer: Aetna Medicare |
$118.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$380.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$313.33
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$468.38
|
| Rate for Payer: Cash Price |
$468.38
|
| Rate for Payer: Cash Price |
$468.38
|
| Rate for Payer: Cofinity Commercial |
$409.83
|
| Rate for Payer: Cofinity Commercial |
$503.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$468.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$526.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$409.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$439.10
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$497.65
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$497.65
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$409.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.43
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$285.94
|
| Rate for Payer: Priority Health SBD |
$368.85
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.38
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.55
|
| Rate for Payer: UHC Exchange |
$110.35
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$216.62
|
| Rate for Payer: VA VA |
$113.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$439.10
|
|
|
HC EMG NEEDLE EXAM 2 EXT
|
Facility
|
IP
|
$690.78
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
92200002
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$303.94 |
| Max. Negotiated Rate |
$621.70 |
| Rate for Payer: Aetna American Axle |
$449.01
|
| Rate for Payer: Aetna Commercial |
$587.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.01
|
| Rate for Payer: Cash Price |
$552.62
|
| Rate for Payer: Cofinity Commercial |
$483.55
|
| Rate for Payer: Cofinity Commercial |
$594.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.62
|
| Rate for Payer: Healthscope Commercial |
$621.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$483.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$587.16
|
| Rate for Payer: PHP Commercial |
$587.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$483.55
|
| Rate for Payer: Priority Health SBD |
$435.19
|
| Rate for Payer: UMR Bronson Commercial |
$303.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.08
|
|
|
HC EMG NEEDLE EXAM 2 EXT
|
Facility
|
OP
|
$690.78
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
92200002
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$621.70 |
| Rate for Payer: Aetna American Axle |
$449.01
|
| Rate for Payer: Aetna Commercial |
$587.16
|
| Rate for Payer: Aetna Medicare |
$118.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$405.50
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$552.62
|
| Rate for Payer: Cash Price |
$552.62
|
| Rate for Payer: Cash Price |
$552.62
|
| Rate for Payer: Cofinity Commercial |
$483.55
|
| Rate for Payer: Cofinity Commercial |
$594.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$621.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$483.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.08
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$587.16
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$587.16
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$483.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.43
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$285.94
|
| Rate for Payer: Priority Health SBD |
$435.19
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.17
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.55
|
| Rate for Payer: UHC Exchange |
$156.52
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$255.59
|
| Rate for Payer: VA VA |
$113.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.08
|
|
|
HC EMG NEEDLE EXAM 3 EXT
|
Facility
|
IP
|
$638.36
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
92200003
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$280.88 |
| Max. Negotiated Rate |
$574.52 |
| Rate for Payer: Aetna American Axle |
$414.93
|
| Rate for Payer: Aetna Commercial |
$542.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.93
|
| Rate for Payer: Cash Price |
$510.69
|
| Rate for Payer: Cofinity Commercial |
$446.85
|
| Rate for Payer: Cofinity Commercial |
$548.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$510.69
|
| Rate for Payer: Healthscope Commercial |
$574.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$446.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$478.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$542.61
|
| Rate for Payer: PHP Commercial |
$542.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.85
|
| Rate for Payer: Priority Health SBD |
$402.17
|
| Rate for Payer: UMR Bronson Commercial |
$280.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$478.77
|
|
|
HC EMG NEEDLE EXAM 3 EXT
|
Facility
|
OP
|
$638.36
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
92200003
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$75.95 |
| Max. Negotiated Rate |
$574.52 |
| Rate for Payer: Aetna American Axle |
$414.93
|
| Rate for Payer: Aetna Commercial |
$542.61
|
| Rate for Payer: Aetna Medicare |
$144.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.93
|
| 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 |
$557.97
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$510.69
|
| Rate for Payer: Cash Price |
$510.69
|
| Rate for Payer: Cash Price |
$510.69
|
| Rate for Payer: Cofinity Commercial |
$548.99
|
| Rate for Payer: Cofinity Commercial |
$446.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$510.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$574.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$446.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$478.77
|
| 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 |
$542.61
|
| Rate for Payer: PACE Medicare |
$131.91
|
| Rate for Payer: PACE SWMI |
$138.85
|
| Rate for Payer: PHP Commercial |
$542.61
|
| 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 |
$446.85
|
| 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 |
$402.17
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.67
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.85
|
| Rate for Payer: UHC Exchange |
$203.34
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: UMR Bronson Commercial |
$236.19
|
| Rate for Payer: VA VA |
$138.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$478.77
|
|
|
HC EMG NEEDLE EXAM 4 EXT
|
Facility
|
IP
|
$800.53
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
92200004
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$352.23 |
| Max. Negotiated Rate |
$720.48 |
| Rate for Payer: Aetna American Axle |
$520.34
|
| Rate for Payer: Aetna Commercial |
$680.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$520.34
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$560.37
|
| Rate for Payer: Cofinity Commercial |
$688.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Healthscope Commercial |
$720.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$560.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: PHP Commercial |
$680.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: Priority Health SBD |
$504.33
|
| Rate for Payer: UMR Bronson Commercial |
$352.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.40
|
|
