HC EMG NEEDLE EXAM 4 EXT
|
Facility
|
OP
|
$800.53
|
|
Service Code
|
CPT 95864
|
Hospital Charge Code |
92200004
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$75.95 |
Max. Negotiated Rate |
$720.48 |
Rate for Payer: Aetna American Axle |
$520.34
|
Rate for Payer: Aetna Commercial |
$680.45
|
Rate for Payer: Aetna Medicare |
$144.40
|
Rate for Payer: Aetna New Business (MI Preferred) |
$520.34
|
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 |
$651.82
|
Rate for Payer: BCN Medicare Advantage |
$138.85
|
Rate for Payer: Cash Price |
$640.42
|
Rate for Payer: Cash Price |
$640.42
|
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: Health Alliance Plan Medicare Advantage |
$138.85
|
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: 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 |
$680.45
|
Rate for Payer: PACE Medicare |
$131.91
|
Rate for Payer: PACE SWMI |
$138.85
|
Rate for Payer: PHP Commercial |
$680.45
|
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 |
$560.37
|
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 |
$504.33
|
Rate for Payer: Railroad Medicare Medicare |
$138.85
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$249.96
|
Rate for Payer: UHC Core |
$522.00
|
Rate for Payer: UHC Dual Complete DSNP |
$138.85
|
Rate for Payer: UHC Exchange |
$227.24
|
Rate for Payer: UHC Medicare Advantage |
$143.02
|
Rate for Payer: UMR Bronson Commercial |
$296.20
|
Rate for Payer: VA VA |
$138.85
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.40
|
|
HC EMG NEEDLE EXAM CRANIAL BILAT NCS
|
Facility
|
OP
|
$800.53
|
|
Service Code
|
CPT 95868
|
Hospital Charge Code |
92200007
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$135.89 |
Max. Negotiated Rate |
$878.32 |
Rate for Payer: Aetna American Axle |
$520.34
|
Rate for Payer: Aetna Commercial |
$680.45
|
Rate for Payer: Aetna Medicare |
$290.16
|
Rate for Payer: Aetna New Business (MI Preferred) |
$520.34
|
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 |
$393.77
|
Rate for Payer: BCN Medicare Advantage |
$279.00
|
Rate for Payer: Cash Price |
$640.42
|
Rate for Payer: Cash Price |
$640.42
|
Rate for Payer: Cash Price |
$640.42
|
Rate for Payer: Cofinity Commercial |
$688.46
|
Rate for Payer: Cofinity Commercial |
$560.37
|
Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
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: 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 |
$680.45
|
Rate for Payer: PACE Medicare |
$265.05
|
Rate for Payer: PACE SWMI |
$279.00
|
Rate for Payer: PHP Commercial |
$680.45
|
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 |
$560.37
|
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 |
$504.33
|
Rate for Payer: Railroad Medicare Medicare |
$279.00
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$149.48
|
Rate for Payer: UHC Core |
$522.00
|
Rate for Payer: UHC Dual Complete DSNP |
$279.00
|
Rate for Payer: UHC Exchange |
$135.89
|
Rate for Payer: UHC Medicare Advantage |
$287.37
|
Rate for Payer: UMR Bronson Commercial |
$296.20
|
Rate for Payer: VA VA |
$279.00
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.40
|
|
HC EMG NEEDLE EXAM CRANIAL BILAT NCS
|
Facility
|
IP
|
$800.53
|
|
Service Code
|
CPT 95868
|
Hospital Charge Code |
92200007
|
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
|
|
HC EMG NEEDLE EXAM CRANIAL UNILAT WO NCS
|
Facility
|
OP
|
$720.52
|
|
Service Code
|
CPT 95867
|
Hospital Charge Code |
92200006
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$104.45 |
Max. Negotiated Rate |
$878.32 |
Rate for Payer: Aetna American Axle |
$468.34
|
Rate for Payer: Aetna Commercial |
$612.44
|
Rate for Payer: Aetna Medicare |
$290.16
|
Rate for Payer: Aetna New Business (MI Preferred) |
$468.34
|
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 |
$331.76
|
Rate for Payer: BCN Medicare Advantage |
$279.00
|
Rate for Payer: Cash Price |
$576.42
|
Rate for Payer: Cash Price |
$576.42
|
Rate for Payer: Cash Price |
$576.42
|
Rate for Payer: Cofinity Commercial |
$504.36
|
Rate for Payer: Cofinity Commercial |
$619.65
|
Rate for Payer: Encore Health Key Benefits Commercial |
$576.42
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
Rate for Payer: Healthscope Commercial |
$648.47
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$504.36
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$540.39
|
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 |
$612.44
|
Rate for Payer: PACE Medicare |
$265.05
|
Rate for Payer: PACE SWMI |
$279.00
|
Rate for Payer: PHP Commercial |
$612.44
|
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 |
$504.36
|
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 |
$453.93
|
Rate for Payer: Railroad Medicare Medicare |
$279.00
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$114.90
|
Rate for Payer: UHC Core |
$522.00
|
Rate for Payer: UHC Dual Complete DSNP |
$279.00
|
Rate for Payer: UHC Exchange |
$104.45
|
Rate for Payer: UHC Medicare Advantage |
$287.37
|
Rate for Payer: UMR Bronson Commercial |
$266.59
|
Rate for Payer: VA VA |
$279.00
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$540.39
|
|
HC EMG NEEDLE EXAM CRANIAL UNILAT WO NCS
|
Facility
|
IP
|
$720.52
|
|
Service Code
|
CPT 95867
|
Hospital Charge Code |
92200006
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$317.03 |
Max. Negotiated Rate |
$648.47 |
Rate for Payer: Aetna American Axle |
$468.34
|
Rate for Payer: Aetna Commercial |
$612.44
|
Rate for Payer: Aetna New Business (MI Preferred) |
$468.34
|
Rate for Payer: Cash Price |
$576.42
|
Rate for Payer: Cofinity Commercial |
$504.36
|
Rate for Payer: Cofinity Commercial |
$619.65
|
Rate for Payer: Encore Health Key Benefits Commercial |
$576.42
|
Rate for Payer: Healthscope Commercial |
$648.47
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$504.36
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$540.39
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$612.44
|
Rate for Payer: PHP Commercial |
$612.44
|
Rate for Payer: Priority Health Cigna Priority Health |
$504.36
|
Rate for Payer: Priority Health SBD |
$453.93
|
Rate for Payer: UMR Bronson Commercial |
$317.03
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$540.39
|
|
HC EMG NEEDLE EXAM WITH NCS LIMITED
|
Facility
|
IP
|
$367.63
|
|
Service Code
|
CPT 95885
|
Hospital Charge Code |
92200022
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$161.76 |
Max. Negotiated Rate |
$330.87 |
Rate for Payer: Aetna American Axle |
$238.96
|
Rate for Payer: Aetna Commercial |
$312.49
|
Rate for Payer: Aetna New Business (MI Preferred) |
$238.96
|
Rate for Payer: Cash Price |
$294.10
|
Rate for Payer: Cofinity Commercial |
$257.34
|
Rate for Payer: Cofinity Commercial |
$316.16
|
Rate for Payer: Encore Health Key Benefits Commercial |
$294.10
|
Rate for Payer: Healthscope Commercial |
$330.87
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$257.34
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$275.72
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$312.49
|
Rate for Payer: PHP Commercial |
$312.49
|
Rate for Payer: Priority Health Cigna Priority Health |
$257.34
|
Rate for Payer: Priority Health SBD |
$231.61
|
Rate for Payer: UMR Bronson Commercial |
$161.76
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$275.72
|
|
HC EMG NEEDLE EXAM WITH NCS LIMITED
|
Facility
|
OP
|
$367.63
|
|
Service Code
|
CPT 95885
|
Hospital Charge Code |
92200022
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$60.58 |
Max. Negotiated Rate |
$522.00 |
Rate for Payer: Aetna American Axle |
$238.96
|
Rate for Payer: Aetna Commercial |
$312.49
|
Rate for Payer: Aetna New Business (MI Preferred) |
$238.96
|
Rate for Payer: BCBS Complete |
$147.05
|
Rate for Payer: BCBS Trust/PPO |
$221.19
|
Rate for Payer: Cash Price |
$294.10
|
Rate for Payer: Cash Price |
$294.10
|
Rate for Payer: Cash Price |
$294.10
|
Rate for Payer: Cofinity Commercial |
$316.16
|
Rate for Payer: Cofinity Commercial |
$257.34
|
Rate for Payer: Encore Health Key Benefits Commercial |
$294.10
|
Rate for Payer: Healthscope Commercial |
$330.87
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$257.34
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$275.72
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$312.49
|
Rate for Payer: PHP Commercial |
$312.49
|
Rate for Payer: Priority Health Cigna Priority Health |
$257.34
|
Rate for Payer: Priority Health SBD |
$231.61
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$66.64
|
Rate for Payer: UHC Core |
$522.00
|
Rate for Payer: UHC Exchange |
$60.58
|
Rate for Payer: UMR Bronson Commercial |
$136.02
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$275.72
|
|
HC EMG NEEDLE EXAM WITH NCV COMPLETE
|
Facility
|
OP
|
$445.19
|
|
Service Code
|
CPT 95886
|
Hospital Charge Code |
92200023
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$94.30 |
Max. Negotiated Rate |
$522.00 |
Rate for Payer: Aetna American Axle |
$289.37
|
Rate for Payer: Aetna Commercial |
$378.41
|
Rate for Payer: Aetna New Business (MI Preferred) |
$289.37
|
Rate for Payer: BCBS Complete |
$178.08
|
Rate for Payer: BCBS Trust/PPO |
$264.74
|
Rate for Payer: Cash Price |
$356.15
|
Rate for Payer: Cash Price |
$356.15
|
Rate for Payer: Cash Price |
$356.15
|
Rate for Payer: Cofinity Commercial |
$311.63
|
Rate for Payer: Cofinity Commercial |
$382.86
|
Rate for Payer: Encore Health Key Benefits Commercial |
$356.15
|
Rate for Payer: Healthscope Commercial |
$400.67
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$311.63
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$333.89
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$378.41
|
Rate for Payer: PHP Commercial |
$378.41
|
Rate for Payer: Priority Health Cigna Priority Health |
$311.63
|
Rate for Payer: Priority Health SBD |
$280.47
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$103.73
|
Rate for Payer: UHC Core |
$522.00
|
Rate for Payer: UHC Exchange |
$94.30
|
Rate for Payer: UMR Bronson Commercial |
$164.72
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$333.89
|
|
HC EMG NEEDLE EXAM WITH NCV COMPLETE
|
Facility
|
IP
|
$445.19
|
|
Service Code
|
CPT 95886
|
Hospital Charge Code |
92200023
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$195.88 |
Max. Negotiated Rate |
$400.67 |
Rate for Payer: Aetna American Axle |
$289.37
|
Rate for Payer: Aetna Commercial |
$378.41
|
Rate for Payer: Aetna New Business (MI Preferred) |
$289.37
|
Rate for Payer: Cash Price |
$356.15
|
Rate for Payer: Cofinity Commercial |
$311.63
|
Rate for Payer: Cofinity Commercial |
$382.86
|
Rate for Payer: Encore Health Key Benefits Commercial |
$356.15
|
Rate for Payer: Healthscope Commercial |
$400.67
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$311.63
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$333.89
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$378.41
|
Rate for Payer: PHP Commercial |
$378.41
|
Rate for Payer: Priority Health Cigna Priority Health |
$311.63
|
Rate for Payer: Priority Health SBD |
$280.47
|
Rate for Payer: UMR Bronson Commercial |
$195.88
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$333.89
|
|
HC EMG NEEDLE FROM LARYNX
|
Facility
|
IP
|
$390.33
|
|
Service Code
|
CPT 95865
|
Hospital Charge Code |
92200005
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$171.75 |
Max. Negotiated Rate |
$351.30 |
Rate for Payer: Aetna American Axle |
$253.71
|
Rate for Payer: Aetna Commercial |
$331.78
|
Rate for Payer: Aetna New Business (MI Preferred) |
$253.71
|
Rate for Payer: Cash Price |
$312.26
|
Rate for Payer: Cofinity Commercial |
$273.23
|
Rate for Payer: Cofinity Commercial |
$335.68
|
Rate for Payer: Encore Health Key Benefits Commercial |
$312.26
|
Rate for Payer: Healthscope Commercial |
$351.30
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$273.23
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.75
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$331.78
|
Rate for Payer: PHP Commercial |
$331.78
|
Rate for Payer: Priority Health Cigna Priority Health |
$273.23
|
Rate for Payer: Priority Health SBD |
$245.91
|
Rate for Payer: UMR Bronson Commercial |
$171.75
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.75
|
|
HC EMG NEEDLE FROM LARYNX
|
Facility
|
OP
|
$390.33
|
|
Service Code
|
CPT 95865
|
Hospital Charge Code |
92200005
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$62.11 |
Max. Negotiated Rate |
$522.00 |
Rate for Payer: Aetna American Axle |
$253.71
|
Rate for Payer: Aetna Commercial |
$331.78
|
Rate for Payer: Aetna Medicare |
$118.09
|
Rate for Payer: Aetna New Business (MI Preferred) |
$253.71
|
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 |
$345.18
|
Rate for Payer: BCN Medicare Advantage |
$113.55
|
Rate for Payer: Cash Price |
$312.26
|
Rate for Payer: Cash Price |
$312.26
|
Rate for Payer: Cash Price |
$312.26
|
Rate for Payer: Cofinity Commercial |
$335.68
|
Rate for Payer: Cofinity Commercial |
$273.23
|
Rate for Payer: Encore Health Key Benefits Commercial |
$312.26
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
Rate for Payer: Healthscope Commercial |
$351.30
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$273.23
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.75
|
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 |
$331.78
|
Rate for Payer: PACE Medicare |
$107.87
|
Rate for Payer: PACE SWMI |
$113.55
|
Rate for Payer: PHP Commercial |
$331.78
|
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 |
$273.23
|
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 |
$245.91
|
Rate for Payer: Railroad Medicare Medicare |
$113.55
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$160.64
|
Rate for Payer: UHC Core |
$522.00
|
Rate for Payer: UHC Dual Complete DSNP |
$113.55
|
Rate for Payer: UHC Exchange |
$146.04
|
Rate for Payer: UHC Medicare Advantage |
$116.96
|
Rate for Payer: UMR Bronson Commercial |
$144.42
|
Rate for Payer: VA VA |
$113.55
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.75
|
|
HC EMG REPETITIVE STIMULATION
|
Facility
|
OP
|
$430.40
|
|
Service Code
|
CPT 95937
|
Hospital Charge Code |
92200021
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$75.95 |
Max. Negotiated Rate |
$522.00 |
Rate for Payer: Aetna American Axle |
$279.76
|
Rate for Payer: Aetna Commercial |
$365.84
|
Rate for Payer: Aetna Medicare |
$144.40
|
Rate for Payer: Aetna New Business (MI Preferred) |
$279.76
|
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 |
$358.59
|
Rate for Payer: BCN Medicare Advantage |
$138.85
|
Rate for Payer: Cash Price |
$344.32
|
Rate for Payer: Cash Price |
$344.32
|
Rate for Payer: Cash Price |
$344.32
|
Rate for Payer: Cofinity Commercial |
$301.28
|
Rate for Payer: Cofinity Commercial |
$370.14
|
Rate for Payer: Encore Health Key Benefits Commercial |
$344.32
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
Rate for Payer: Healthscope Commercial |
$387.36
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$301.28
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.80
|
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 |
$365.84
|
Rate for Payer: PACE Medicare |
$131.91
|
Rate for Payer: PACE SWMI |
$138.85
|
Rate for Payer: PHP Commercial |
$365.84
|
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 |
$301.28
|
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 |
$271.15
|
Rate for Payer: Railroad Medicare Medicare |
$138.85
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$112.38
|
Rate for Payer: UHC Core |
$522.00
|
Rate for Payer: UHC Dual Complete DSNP |
$138.85
|
Rate for Payer: UHC Exchange |
$102.16
|
Rate for Payer: UHC Medicare Advantage |
$143.02
|
Rate for Payer: UMR Bronson Commercial |
$159.25
|
Rate for Payer: VA VA |
$138.85
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.80
|
|
HC EMG REPETITIVE STIMULATION
|
Facility
|
IP
|
$430.40
|
|
Service Code
|
CPT 95937
|
Hospital Charge Code |
92200021
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$189.38 |
Max. Negotiated Rate |
$387.36 |
Rate for Payer: Aetna American Axle |
$279.76
|
Rate for Payer: Aetna Commercial |
$365.84
|
Rate for Payer: Aetna New Business (MI Preferred) |
$279.76
|
Rate for Payer: Cash Price |
$344.32
|
Rate for Payer: Cofinity Commercial |
$301.28
|
Rate for Payer: Cofinity Commercial |
$370.14
|
Rate for Payer: Encore Health Key Benefits Commercial |
$344.32
|
Rate for Payer: Healthscope Commercial |
$387.36
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$301.28
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.80
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.84
|
Rate for Payer: PHP Commercial |
$365.84
|
Rate for Payer: Priority Health Cigna Priority Health |
$301.28
|
Rate for Payer: Priority Health SBD |
$271.15
|
Rate for Payer: UMR Bronson Commercial |
$189.38
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.80
|
|
HC EMG SINGLE FIBER
|
Facility
|
OP
|
$450.54
|
|
Service Code
|
CPT 95872
|
Hospital Charge Code |
92200010
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$75.95 |
Max. Negotiated Rate |
$522.00 |
Rate for Payer: Aetna American Axle |
$292.85
|
Rate for Payer: Aetna Commercial |
$382.96
|
Rate for Payer: Aetna Medicare |
$144.40
|
Rate for Payer: Aetna New Business (MI Preferred) |
$292.85
|
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 |
$249.68
|
Rate for Payer: BCN Medicare Advantage |
$138.85
|
Rate for Payer: Cash Price |
$360.43
|
Rate for Payer: Cash Price |
$360.43
|
Rate for Payer: Cash Price |
$360.43
|
Rate for Payer: Cofinity Commercial |
$315.38
|
Rate for Payer: Cofinity Commercial |
$387.46
|
Rate for Payer: Encore Health Key Benefits Commercial |
$360.43
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
Rate for Payer: Healthscope Commercial |
$405.49
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$315.38
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.90
|
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 |
$382.96
|
Rate for Payer: PACE Medicare |
$131.91
|
Rate for Payer: PACE SWMI |
$138.85
|
Rate for Payer: PHP Commercial |
$382.96
|
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 |
$315.38
|
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 |
$283.84
|
Rate for Payer: Railroad Medicare Medicare |
$138.85
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$202.78
|
Rate for Payer: UHC Core |
$522.00
|
Rate for Payer: UHC Dual Complete DSNP |
$138.85
|
Rate for Payer: UHC Exchange |
$184.35
|
Rate for Payer: UHC Medicare Advantage |
$143.02
|
Rate for Payer: UMR Bronson Commercial |
$166.70
|
Rate for Payer: VA VA |
$138.85
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.90
|
|
HC EMG SINGLE FIBER
|
Facility
|
IP
|
$450.54
|
|
Service Code
|
CPT 95872
|
Hospital Charge Code |
92200010
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$198.24 |
Max. Negotiated Rate |
$405.49 |
Rate for Payer: Aetna American Axle |
$292.85
|
Rate for Payer: Aetna Commercial |
$382.96
|
Rate for Payer: Aetna New Business (MI Preferred) |
$292.85
|
Rate for Payer: Cash Price |
$360.43
|
Rate for Payer: Cofinity Commercial |
$315.38
|
Rate for Payer: Cofinity Commercial |
$387.46
|
Rate for Payer: Encore Health Key Benefits Commercial |
$360.43
|
Rate for Payer: Healthscope Commercial |
$405.49
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$315.38
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.90
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$382.96
|
Rate for Payer: PHP Commercial |
$382.96
|
Rate for Payer: Priority Health Cigna Priority Health |
$315.38
|
Rate for Payer: Priority Health SBD |
$283.84
|
Rate for Payer: UMR Bronson Commercial |
$198.24
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.90
|
|
HC EMG SURFACE FROM LARYNX
|
Facility
|
OP
|
$272.42
|
|
Service Code
|
CPT 95999
|
Hospital Charge Code |
92000010
|
Hospital Revenue Code
|
920
|
Min. Negotiated Rate |
$75.95 |
Max. Negotiated Rate |
$461.26 |
Rate for Payer: Aetna American Axle |
$177.07
|
Rate for Payer: Aetna Commercial |
$231.56
|
Rate for Payer: Aetna Medicare |
$144.40
|
Rate for Payer: Aetna New Business (MI Preferred) |
$177.07
|
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 |
$217.94
|
Rate for Payer: Cash Price |
$217.94
|
Rate for Payer: Cash Price |
$217.94
|
Rate for Payer: Cofinity Commercial |
$190.69
|
Rate for Payer: Cofinity Commercial |
$234.28
|
Rate for Payer: Encore Health Key Benefits Commercial |
$217.94
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
Rate for Payer: Healthscope Commercial |
$245.18
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$190.69
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.32
|
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 |
$231.56
|
Rate for Payer: PACE Medicare |
$131.91
|
Rate for Payer: PACE SWMI |
$138.85
|
Rate for Payer: PHP Commercial |
$231.56
|
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 |
$190.69
|
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 |
$171.62
|
Rate for Payer: Railroad Medicare Medicare |
$138.85
|
Rate for Payer: UHC Core |
$294.00
|
Rate for Payer: UHC Dual Complete DSNP |
$138.85
|
Rate for Payer: UHC Medicare Advantage |
$143.02
|
Rate for Payer: UMR Bronson Commercial |
$100.80
|
Rate for Payer: VA VA |
$138.85
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.32
|
|
HC EMG SURFACE FROM LARYNX
|
Facility
|
IP
|
$272.42
|
|
Service Code
|
CPT 95999
|
Hospital Charge Code |
92000010
|
Hospital Revenue Code
|
920
|
Min. Negotiated Rate |
$119.86 |
Max. Negotiated Rate |
$245.18 |
Rate for Payer: Aetna American Axle |
$177.07
|
Rate for Payer: Aetna Commercial |
$231.56
|
Rate for Payer: Aetna New Business (MI Preferred) |
$177.07
|
Rate for Payer: Cash Price |
$217.94
|
Rate for Payer: Cofinity Commercial |
$190.69
|
Rate for Payer: Cofinity Commercial |
$234.28
|
Rate for Payer: Encore Health Key Benefits Commercial |
$217.94
|
Rate for Payer: Healthscope Commercial |
$245.18
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$190.69
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.32
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$231.56
|
Rate for Payer: PHP Commercial |
$231.56
|
Rate for Payer: Priority Health Cigna Priority Health |
$190.69
|
Rate for Payer: Priority Health SBD |
$171.62
|
Rate for Payer: UMR Bronson Commercial |
$119.86
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.32
|
|
HC EMG THORACIC PSP. NEEDLE EXAM
|
Facility
|
IP
|
$514.90
|
|
Service Code
|
CPT 95869
|
Hospital Charge Code |
92200008
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$226.56 |
Max. Negotiated Rate |
$463.41 |
Rate for Payer: Aetna American Axle |
$334.68
|
Rate for Payer: Aetna Commercial |
$437.66
|
Rate for Payer: Aetna New Business (MI Preferred) |
$334.68
|
Rate for Payer: Cash Price |
$411.92
|
Rate for Payer: Cofinity Commercial |
$442.81
|
Rate for Payer: Cofinity Commercial |
$360.43
|
Rate for Payer: Encore Health Key Benefits Commercial |
$411.92
|
Rate for Payer: Healthscope Commercial |
$463.41
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$360.43
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$386.18
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$437.66
|
Rate for Payer: PHP Commercial |
$437.66
|
Rate for Payer: Priority Health Cigna Priority Health |
$360.43
|
Rate for Payer: Priority Health SBD |
$324.39
|
Rate for Payer: UMR Bronson Commercial |
$226.56
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$386.18
|
|
HC EMG THORACIC PSP. NEEDLE EXAM
|
Facility
|
OP
|
$514.90
|
|
Service Code
|
CPT 95869
|
Hospital Charge Code |
92200008
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$93.32 |
Max. Negotiated Rate |
$878.32 |
Rate for Payer: Aetna American Axle |
$334.68
|
Rate for Payer: Aetna Commercial |
$437.66
|
Rate for Payer: Aetna Medicare |
$290.16
|
Rate for Payer: Aetna New Business (MI Preferred) |
$334.68
|
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 |
$383.71
|
Rate for Payer: BCN Medicare Advantage |
$279.00
|
Rate for Payer: Cash Price |
$411.92
|
Rate for Payer: Cash Price |
$411.92
|
Rate for Payer: Cash Price |
$411.92
|
Rate for Payer: Cofinity Commercial |
$360.43
|
Rate for Payer: Cofinity Commercial |
$442.81
|
Rate for Payer: Encore Health Key Benefits Commercial |
$411.92
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
Rate for Payer: Healthscope Commercial |
$463.41
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$360.43
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$386.18
|
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 |
$437.66
|
Rate for Payer: PACE Medicare |
$265.05
|
Rate for Payer: PACE SWMI |
$279.00
|
Rate for Payer: PHP Commercial |
$437.66
|
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 |
$360.43
|
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 |
$324.39
|
Rate for Payer: Railroad Medicare Medicare |
$279.00
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$102.65
|
Rate for Payer: UHC Core |
$522.00
|
Rate for Payer: UHC Dual Complete DSNP |
$279.00
|
Rate for Payer: UHC Exchange |
$93.32
|
Rate for Payer: UHC Medicare Advantage |
$287.37
|
Rate for Payer: UMR Bronson Commercial |
$190.51
|
Rate for Payer: VA VA |
$279.00
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$386.18
|
|
HC EMR RENAL BIOPSY (BILL ONLY)
|
Facility
|
OP
|
$573.00
|
|
Service Code
|
CPT 88348
|
Hospital Charge Code |
31200008
|
Hospital Revenue Code
|
312
|
Min. Negotiated Rate |
$188.46 |
Max. Negotiated Rate |
$2,406.16 |
Rate for Payer: Aetna American Axle |
$372.45
|
Rate for Payer: Aetna Commercial |
$487.05
|
Rate for Payer: Aetna Medicare |
$794.90
|
Rate for Payer: Aetna New Business (MI Preferred) |
$372.45
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$955.41
|
Rate for Payer: Amish Plain Church Group Commercial |
$955.41
|
Rate for Payer: BCBS Complete |
$439.03
|
Rate for Payer: BCBS MAPPO |
$764.33
|
Rate for Payer: BCBS Trust/PPO |
$563.48
|
Rate for Payer: BCN Medicare Advantage |
$764.33
|
Rate for Payer: Cash Price |
$458.40
|
Rate for Payer: Cash Price |
$458.40
|
Rate for Payer: Cofinity Commercial |
$401.10
|
Rate for Payer: Cofinity Commercial |
$492.78
|
Rate for Payer: Encore Health Key Benefits Commercial |
$458.40
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$764.33
|
Rate for Payer: Healthscope Commercial |
$515.70
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$401.10
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$429.75
|
Rate for Payer: Mclaren Medicaid |
$418.09
|
Rate for Payer: Mclaren Medicare |
$764.33
|
Rate for Payer: Meridian Medicaid |
$439.03
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$802.55
|
Rate for Payer: MI Amish Medical Board Commercial |
$878.98
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$487.05
|
Rate for Payer: PACE Medicare |
$726.11
|
Rate for Payer: PACE SWMI |
$764.33
|
Rate for Payer: PHP Commercial |
$487.05
|
Rate for Payer: PHP Medicare Advantage |
$764.33
|
Rate for Payer: Priority Health Choice Medicaid |
$418.09
|
Rate for Payer: Priority Health Cigna Priority Health |
$401.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,406.16
|
Rate for Payer: Priority Health Medicare |
$764.33
|
Rate for Payer: Priority Health Narrow Network |
$1,924.93
|
Rate for Payer: Priority Health SBD |
$360.99
|
Rate for Payer: Railroad Medicare Medicare |
$764.33
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$523.35
|
Rate for Payer: UHC Core |
$188.46
|
Rate for Payer: UHC Dual Complete DSNP |
$764.33
|
Rate for Payer: UHC Exchange |
$475.77
|
Rate for Payer: UHC Medicare Advantage |
$787.26
|
Rate for Payer: UMR Bronson Commercial |
$212.01
|
Rate for Payer: VA VA |
$764.33
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$429.75
|
|
HC EMR RENAL BIOPSY (BILL ONLY)
|
Facility
|
IP
|
$573.00
|
|
Service Code
|
CPT 88348
|
Hospital Charge Code |
31200008
|
Hospital Revenue Code
|
312
|
Min. Negotiated Rate |
$252.12 |
Max. Negotiated Rate |
$515.70 |
Rate for Payer: Aetna American Axle |
$372.45
|
Rate for Payer: Aetna Commercial |
$487.05
|
Rate for Payer: Aetna New Business (MI Preferred) |
$372.45
|
Rate for Payer: Cash Price |
$458.40
|
Rate for Payer: Cofinity Commercial |
$492.78
|
Rate for Payer: Cofinity Commercial |
$401.10
|
Rate for Payer: Encore Health Key Benefits Commercial |
$458.40
|
Rate for Payer: Healthscope Commercial |
$515.70
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$401.10
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$429.75
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$487.05
|
Rate for Payer: PHP Commercial |
$487.05
|
Rate for Payer: Priority Health Cigna Priority Health |
$401.10
|
Rate for Payer: Priority Health SBD |
$360.99
|
Rate for Payer: UMR Bronson Commercial |
$252.12
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$429.75
|
|
HC ENA EXTRACTABLE NUCLEAR AB PANEL
|
Facility
|
OP
|
$32.45
|
|
Service Code
|
CPT 86235
|
Hospital Charge Code |
30200170
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$9.81 |
Max. Negotiated Rate |
$29.58 |
Rate for Payer: Aetna American Axle |
$21.09
|
Rate for Payer: Aetna Commercial |
$27.58
|
Rate for Payer: Aetna Medicare |
$18.65
|
Rate for Payer: Aetna New Business (MI Preferred) |
$21.09
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
Rate for Payer: BCBS Complete |
$10.30
|
Rate for Payer: BCBS MAPPO |
$17.93
|
Rate for Payer: BCBS Trust/PPO |
$16.13
|
Rate for Payer: BCN Medicare Advantage |
$17.93
|
Rate for Payer: Cash Price |
$25.96
|
Rate for Payer: Cash Price |
$25.96
|
Rate for Payer: Cofinity Commercial |
$22.72
|
Rate for Payer: Cofinity Commercial |
$27.91
|
Rate for Payer: Encore Health Key Benefits Commercial |
$25.96
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
Rate for Payer: Healthscope Commercial |
$29.20
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.72
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.34
|
Rate for Payer: Mclaren Medicaid |
$9.81
|
Rate for Payer: Mclaren Medicare |
$17.93
|
Rate for Payer: Meridian Medicaid |
$10.30
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.83
|
Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.58
|
Rate for Payer: PACE Medicare |
$17.03
|
Rate for Payer: PACE SWMI |
$17.93
|
Rate for Payer: PHP Commercial |
$27.58
|
Rate for Payer: PHP Medicare Advantage |
$17.93
|
Rate for Payer: Priority Health Choice Medicaid |
$9.81
|
Rate for Payer: Priority Health Cigna Priority Health |
$22.72
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.91
|
Rate for Payer: Priority Health Medicare |
$17.93
|
Rate for Payer: Priority Health Narrow Network |
$15.93
|
Rate for Payer: Priority Health SBD |
$20.44
|
Rate for Payer: Railroad Medicare Medicare |
$17.93
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$21.52
|
Rate for Payer: UHC Core |
$29.58
|
Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
Rate for Payer: UHC Exchange |
$17.93
|
Rate for Payer: UHC Medicare Advantage |
$18.47
|
Rate for Payer: UMR Bronson Commercial |
$12.01
|
Rate for Payer: VA VA |
$17.93
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.34
|
|
HC ENA EXTRACTABLE NUCLEAR AB PANEL
|
Facility
|
IP
|
$32.45
|
|
Service Code
|
CPT 86235
|
Hospital Charge Code |
30200170
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$14.28 |
Max. Negotiated Rate |
$29.20 |
Rate for Payer: Aetna American Axle |
$21.09
|
Rate for Payer: Aetna Commercial |
$27.58
|
Rate for Payer: Aetna New Business (MI Preferred) |
$21.09
|
Rate for Payer: Cash Price |
$25.96
|
Rate for Payer: Cofinity Commercial |
$22.72
|
Rate for Payer: Cofinity Commercial |
$27.91
|
Rate for Payer: Encore Health Key Benefits Commercial |
$25.96
|
Rate for Payer: Healthscope Commercial |
$29.20
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.72
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.34
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.58
|
Rate for Payer: PHP Commercial |
$27.58
|
Rate for Payer: Priority Health Cigna Priority Health |
$22.72
|
Rate for Payer: Priority Health SBD |
$20.44
|
Rate for Payer: UMR Bronson Commercial |
$14.28
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.34
|
|
HC ENA EXTRACTABLE NUCLEAR AB SCREEN
|
Facility
|
OP
|
$34.48
|
|
Service Code
|
CPT 86235
|
Hospital Charge Code |
30200169
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$9.81 |
Max. Negotiated Rate |
$31.03 |
Rate for Payer: Aetna American Axle |
$22.41
|
Rate for Payer: Aetna Commercial |
$29.31
|
Rate for Payer: Aetna Medicare |
$18.65
|
Rate for Payer: Aetna New Business (MI Preferred) |
$22.41
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
Rate for Payer: BCBS Complete |
$10.30
|
Rate for Payer: BCBS MAPPO |
$17.93
|
Rate for Payer: BCBS Trust/PPO |
$16.13
|
Rate for Payer: BCN Medicare Advantage |
$17.93
|
Rate for Payer: Cash Price |
$27.58
|
Rate for Payer: Cash Price |
$27.58
|
Rate for Payer: Cofinity Commercial |
$24.14
|
Rate for Payer: Cofinity Commercial |
$29.65
|
Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
Rate for Payer: Healthscope Commercial |
$31.03
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.14
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
Rate for Payer: Mclaren Medicaid |
$9.81
|
Rate for Payer: Mclaren Medicare |
$17.93
|
Rate for Payer: Meridian Medicaid |
$10.30
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.83
|
Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
Rate for Payer: PACE Medicare |
$17.03
|
Rate for Payer: PACE SWMI |
$17.93
|
Rate for Payer: PHP Commercial |
$29.31
|
Rate for Payer: PHP Medicare Advantage |
$17.93
|
Rate for Payer: Priority Health Choice Medicaid |
$9.81
|
Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.91
|
Rate for Payer: Priority Health Medicare |
$17.93
|
Rate for Payer: Priority Health Narrow Network |
$15.93
|
Rate for Payer: Priority Health SBD |
$21.72
|
Rate for Payer: Railroad Medicare Medicare |
$17.93
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$21.52
|
Rate for Payer: UHC Core |
$29.58
|
Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
Rate for Payer: UHC Exchange |
$17.93
|
Rate for Payer: UHC Medicare Advantage |
$18.47
|
Rate for Payer: UMR Bronson Commercial |
$12.76
|
Rate for Payer: VA VA |
$17.93
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
HC ENA EXTRACTABLE NUCLEAR AB SCREEN
|
Facility
|
IP
|
$34.48
|
|
Service Code
|
CPT 86235
|
Hospital Charge Code |
30200169
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$15.17 |
Max. Negotiated Rate |
$31.03 |
Rate for Payer: Aetna American Axle |
$22.41
|
Rate for Payer: Aetna Commercial |
$29.31
|
Rate for Payer: Aetna New Business (MI Preferred) |
$22.41
|
Rate for Payer: Cash Price |
$27.58
|
Rate for Payer: Cofinity Commercial |
$24.14
|
Rate for Payer: Cofinity Commercial |
$29.65
|
Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
Rate for Payer: Healthscope Commercial |
$31.03
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.14
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
Rate for Payer: PHP Commercial |
$29.31
|
Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
Rate for Payer: Priority Health SBD |
$21.72
|
Rate for Payer: UMR Bronson Commercial |
$15.17
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|