|
HC EP UPPER/LOWER EXT. SOMATOSENSORY
|
Facility
|
IP
|
$2,457.76
|
|
|
Service Code
|
CPT 95938
|
| Hospital Charge Code |
92200025
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$1,081.41 |
| Max. Negotiated Rate |
$2,211.98 |
| Rate for Payer: Aetna American Axle |
$1,597.54
|
| Rate for Payer: Aetna Commercial |
$2,089.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,597.54
|
| Rate for Payer: Cash Price |
$1,966.21
|
| Rate for Payer: Cofinity Commercial |
$2,113.67
|
| Rate for Payer: Cofinity Commercial |
$1,720.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,966.21
|
| Rate for Payer: Healthscope Commercial |
$2,211.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,720.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,843.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,089.10
|
| Rate for Payer: PHP Commercial |
$2,089.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,720.43
|
| Rate for Payer: Priority Health SBD |
$1,548.39
|
| Rate for Payer: UMR Bronson Commercial |
$1,081.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,843.32
|
|
|
HC EP UPPER/LOWER EXT. SOMATOSENSORY
|
Facility
|
OP
|
$2,457.76
|
|
|
Service Code
|
CPT 95938
|
| Hospital Charge Code |
92200025
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$260.60 |
| Max. Negotiated Rate |
$2,211.98 |
| Rate for Payer: Aetna American Axle |
$1,597.54
|
| Rate for Payer: Aetna Commercial |
$2,089.10
|
| Rate for Payer: Aetna Medicare |
$495.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,597.54
|
| 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 |
$1,601.87
|
| Rate for Payer: BCN Medicare Advantage |
$476.42
|
| Rate for Payer: Cash Price |
$1,966.21
|
| Rate for Payer: Cash Price |
$1,966.21
|
| Rate for Payer: Cash Price |
$1,966.21
|
| Rate for Payer: Cofinity Commercial |
$2,113.67
|
| Rate for Payer: Cofinity Commercial |
$1,720.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,966.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.42
|
| Rate for Payer: Healthscope Commercial |
$2,211.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,720.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,843.32
|
| 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 |
$2,089.10
|
| Rate for Payer: PACE Medicare |
$452.60
|
| Rate for Payer: PACE SWMI |
$476.42
|
| Rate for Payer: PHP Commercial |
$2,089.10
|
| 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 |
$1,720.43
|
| 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 |
$1,548.39
|
| Rate for Payer: Railroad Medicare Medicare |
$476.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$405.21
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$476.42
|
| Rate for Payer: UHC Exchange |
$368.37
|
| Rate for Payer: UHC Medicare Advantage |
$490.71
|
| Rate for Payer: UMR Bronson Commercial |
$909.37
|
| Rate for Payer: VA VA |
$476.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,843.32
|
|
|
HC EP VISUAL
|
Facility
|
OP
|
$770.51
|
|
|
Service Code
|
CPT 95930
|
| Hospital Charge Code |
92200018
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$66.14 |
| Max. Negotiated Rate |
$878.32 |
| Rate for Payer: Aetna American Axle |
$500.83
|
| Rate for Payer: Aetna Commercial |
$654.93
|
| Rate for Payer: Aetna Medicare |
$290.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$500.83
|
| 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 |
$241.30
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$616.41
|
| Rate for Payer: Cash Price |
$616.41
|
| Rate for Payer: Cash Price |
$616.41
|
| Rate for Payer: Cofinity Commercial |
$539.36
|
| Rate for Payer: Cofinity Commercial |
$662.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$616.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$693.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$539.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$577.88
|
| 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 |
$654.93
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$654.93
|
| 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 |
$539.36
|
| 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 |
$485.42
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.75
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.00
|
| Rate for Payer: UHC Exchange |
$66.14
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: UMR Bronson Commercial |
$285.09
|
| Rate for Payer: VA VA |
$279.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$577.88
|
|
|
HC EP VISUAL
|
Facility
|
IP
|
$770.51
|
|
|
Service Code
|
CPT 95930
|
| Hospital Charge Code |
92200018
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$339.02 |
| Max. Negotiated Rate |
$693.46 |
| Rate for Payer: Aetna American Axle |
$500.83
|
| Rate for Payer: Aetna Commercial |
$654.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$500.83
|
| Rate for Payer: Cash Price |
$616.41
|
| Rate for Payer: Cofinity Commercial |
$662.64
|
| Rate for Payer: Cofinity Commercial |
$539.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$616.41
|
| Rate for Payer: Healthscope Commercial |
$693.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$539.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$577.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$654.93
|
| Rate for Payer: PHP Commercial |
$654.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$539.36
|
| Rate for Payer: Priority Health SBD |
$485.42
|
| Rate for Payer: UMR Bronson Commercial |
$339.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$577.88
|
|
|
HC ERBE IRRIGATION
|
Facility
|
IP
|
$309.64
|
|
| Hospital Charge Code |
27000070
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$136.24 |
| Max. Negotiated Rate |
$278.68 |
| Rate for Payer: Aetna American Axle |
$201.27
|
| Rate for Payer: Aetna Commercial |
$263.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.27
|
| Rate for Payer: Cash Price |
$247.71
|
| Rate for Payer: Cofinity Commercial |
$216.75
|
| Rate for Payer: Cofinity Commercial |
$266.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.71
|
| Rate for Payer: Healthscope Commercial |
$278.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$216.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$263.19
|
| Rate for Payer: PHP Commercial |
$263.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.75
|
| Rate for Payer: Priority Health SBD |
$195.07
|
| Rate for Payer: UMR Bronson Commercial |
$136.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.23
|
|
|
HC ERBE IRRIGATION
|
Facility
|
OP
|
$309.64
|
|
| Hospital Charge Code |
27000070
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$114.57 |
| Max. Negotiated Rate |
$278.68 |
| Rate for Payer: Aetna American Axle |
$201.27
|
| Rate for Payer: Aetna Commercial |
$263.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.27
|
| Rate for Payer: BCBS Complete |
$123.86
|
| Rate for Payer: Cash Price |
$247.71
|
| Rate for Payer: Cofinity Commercial |
$216.75
|
| Rate for Payer: Cofinity Commercial |
$266.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.71
|
| Rate for Payer: Healthscope Commercial |
$278.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$216.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$263.19
|
| Rate for Payer: PHP Commercial |
$263.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.75
|
| Rate for Payer: Priority Health SBD |
$195.07
|
| Rate for Payer: UMR Bronson Commercial |
$114.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.23
|
|
|
HC ER BURN CARE
|
Facility
|
OP
|
$396.15
|
|
| Hospital Charge Code |
45000038
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$146.58 |
| Max. Negotiated Rate |
$356.54 |
| Rate for Payer: Aetna American Axle |
$257.50
|
| Rate for Payer: Aetna Commercial |
$336.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.50
|
| Rate for Payer: BCBS Complete |
$158.46
|
| Rate for Payer: Cash Price |
$316.92
|
| Rate for Payer: Cofinity Commercial |
$277.30
|
| Rate for Payer: Cofinity Commercial |
$340.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.92
|
| Rate for Payer: Healthscope Commercial |
$356.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$277.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$336.73
|
| Rate for Payer: PHP Commercial |
$336.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$277.30
|
| Rate for Payer: Priority Health SBD |
$249.57
|
| Rate for Payer: UMR Bronson Commercial |
$146.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.11
|
|
|
HC ER BURN CARE
|
Facility
|
IP
|
$396.15
|
|
| Hospital Charge Code |
45000038
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$174.31 |
| Max. Negotiated Rate |
$356.54 |
| Rate for Payer: Aetna American Axle |
$257.50
|
| Rate for Payer: Aetna Commercial |
$336.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.50
|
| Rate for Payer: Cash Price |
$316.92
|
| Rate for Payer: Cofinity Commercial |
$277.30
|
| Rate for Payer: Cofinity Commercial |
$340.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.92
|
| Rate for Payer: Healthscope Commercial |
$356.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$277.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$336.73
|
| Rate for Payer: PHP Commercial |
$336.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$277.30
|
| Rate for Payer: Priority Health SBD |
$249.57
|
| Rate for Payer: UMR Bronson Commercial |
$174.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.11
|
|
|
HC ERCP
|
Facility
|
IP
|
$3,330.35
|
|
| Hospital Charge Code |
36000039
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,465.35 |
| Max. Negotiated Rate |
$2,997.32 |
| Rate for Payer: Aetna American Axle |
$2,164.73
|
| Rate for Payer: Aetna Commercial |
$2,830.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,164.73
|
| Rate for Payer: Cash Price |
$2,664.28
|
| Rate for Payer: Cofinity Commercial |
$2,864.10
|
| Rate for Payer: Cofinity Commercial |
$2,331.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,664.28
|
| Rate for Payer: Healthscope Commercial |
$2,997.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,331.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,497.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,830.80
|
| Rate for Payer: PHP Commercial |
$2,830.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,331.24
|
| Rate for Payer: Priority Health SBD |
$2,098.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,465.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,497.76
|
|
|
HC ERCP
|
Facility
|
OP
|
$3,330.35
|
|
| Hospital Charge Code |
36000039
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,232.23 |
| Max. Negotiated Rate |
$2,997.32 |
| Rate for Payer: Aetna American Axle |
$2,164.73
|
| Rate for Payer: Aetna Commercial |
$2,830.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,164.73
|
| Rate for Payer: BCBS Complete |
$1,332.14
|
| Rate for Payer: Cash Price |
$2,664.28
|
| Rate for Payer: Cofinity Commercial |
$2,331.24
|
| Rate for Payer: Cofinity Commercial |
$2,864.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,664.28
|
| Rate for Payer: Healthscope Commercial |
$2,997.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,331.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,497.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,830.80
|
| Rate for Payer: PHP Commercial |
$2,830.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,331.24
|
| Rate for Payer: Priority Health SBD |
$2,098.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,232.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,497.76
|
|
|
HC ERCP SPHINCTEROTOMY
|
Facility
|
OP
|
$3,966.57
|
|
| Hospital Charge Code |
36000040
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,467.63 |
| Max. Negotiated Rate |
$3,569.91 |
| Rate for Payer: Aetna American Axle |
$2,578.27
|
| Rate for Payer: Aetna Commercial |
$3,371.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,578.27
|
| Rate for Payer: BCBS Complete |
$1,586.63
|
| Rate for Payer: Cash Price |
$3,173.26
|
| Rate for Payer: Cofinity Commercial |
$2,776.60
|
| Rate for Payer: Cofinity Commercial |
$3,411.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,173.26
|
| Rate for Payer: Healthscope Commercial |
$3,569.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,776.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,974.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,371.58
|
| Rate for Payer: PHP Commercial |
$3,371.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,776.60
|
| Rate for Payer: Priority Health SBD |
$2,498.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,467.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,974.93
|
|
|
HC ERCP SPHINCTEROTOMY
|
Facility
|
IP
|
$3,966.57
|
|
| Hospital Charge Code |
36000040
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,745.29 |
| Max. Negotiated Rate |
$3,569.91 |
| Rate for Payer: Aetna American Axle |
$2,578.27
|
| Rate for Payer: Aetna Commercial |
$3,371.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,578.27
|
| Rate for Payer: Cash Price |
$3,173.26
|
| Rate for Payer: Cofinity Commercial |
$2,776.60
|
| Rate for Payer: Cofinity Commercial |
$3,411.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,173.26
|
| Rate for Payer: Healthscope Commercial |
$3,569.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,776.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,974.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,371.58
|
| Rate for Payer: PHP Commercial |
$3,371.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,776.60
|
| Rate for Payer: Priority Health SBD |
$2,498.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,745.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,974.93
|
|
|
HC ER CRITICAL CARE EA ADDL 30 MIN
|
Facility
|
IP
|
$746.13
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
45000081
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$328.30 |
| Max. Negotiated Rate |
$671.52 |
| Rate for Payer: Aetna American Axle |
$484.98
|
| Rate for Payer: Aetna Commercial |
$634.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$484.98
|
| Rate for Payer: Cash Price |
$596.90
|
| Rate for Payer: Cofinity Commercial |
$522.29
|
| Rate for Payer: Cofinity Commercial |
$641.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.90
|
| Rate for Payer: Healthscope Commercial |
$671.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$522.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$559.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$634.21
|
| Rate for Payer: PHP Commercial |
$634.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.29
|
| Rate for Payer: Priority Health SBD |
$470.06
|
| Rate for Payer: UMR Bronson Commercial |
$328.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$559.60
|
|
|
HC ER CRITICAL CARE EA ADDL 30 MIN
|
Facility
|
OP
|
$746.13
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
45000081
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$104.13 |
| Max. Negotiated Rate |
$1,971.13 |
| Rate for Payer: Aetna American Axle |
$484.98
|
| Rate for Payer: Aetna Commercial |
$634.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$484.98
|
| Rate for Payer: BCBS Complete |
$298.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,971.13
|
| Rate for Payer: Cash Price |
$596.90
|
| Rate for Payer: Cash Price |
$596.90
|
| Rate for Payer: Cofinity Commercial |
$641.67
|
| Rate for Payer: Cofinity Commercial |
$522.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.90
|
| Rate for Payer: Healthscope Commercial |
$671.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$522.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$559.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$634.21
|
| Rate for Payer: PHP Commercial |
$634.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.29
|
| Rate for Payer: Priority Health SBD |
$470.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.54
|
| Rate for Payer: UHC Exchange |
$104.13
|
| Rate for Payer: UMR Bronson Commercial |
$276.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$559.60
|
|
|
HC ER CRITICAL CARE INITIAL 30-74 MIN
|
Facility
|
OP
|
$3,366.24
|
|
|
Service Code
|
CPT 99291
|
| Hospital Charge Code |
45000026
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$206.62 |
| Max. Negotiated Rate |
$3,029.62 |
| Rate for Payer: Aetna American Axle |
$2,188.06
|
| Rate for Payer: Aetna Commercial |
$2,861.30
|
| Rate for Payer: Aetna Medicare |
$820.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,188.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$985.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$985.96
|
| Rate for Payer: BCBS Complete |
$453.07
|
| Rate for Payer: BCBS MAPPO |
$788.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,901.89
|
| Rate for Payer: BCN Medicare Advantage |
$788.77
|
| Rate for Payer: Cash Price |
$2,692.99
|
| Rate for Payer: Cash Price |
$2,692.99
|
| Rate for Payer: Cash Price |
$2,692.99
|
| Rate for Payer: Cofinity Commercial |
$2,894.97
|
| Rate for Payer: Cofinity Commercial |
$2,356.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,692.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$788.77
|
| Rate for Payer: Healthscope Commercial |
$3,029.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,356.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,524.68
|
| Rate for Payer: Mclaren Medicaid |
$431.46
|
| Rate for Payer: Mclaren Medicare |
$788.77
|
| Rate for Payer: Meridian Medicaid |
$453.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$828.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$907.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,861.30
|
| Rate for Payer: PACE Medicare |
$749.33
|
| Rate for Payer: PACE SWMI |
$788.77
|
| Rate for Payer: PHP Commercial |
$2,861.30
|
| Rate for Payer: PHP Medicare Advantage |
$788.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,356.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,483.07
|
| Rate for Payer: Priority Health Medicare |
$788.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,986.46
|
| Rate for Payer: Priority Health SBD |
$2,120.73
|
| Rate for Payer: Railroad Medicare Medicare |
$788.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.28
|
| Rate for Payer: UHC Core |
$2,234.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$788.77
|
| Rate for Payer: UHC Exchange |
$206.62
|
| Rate for Payer: UHC Medicare Advantage |
$812.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,245.51
|
| Rate for Payer: VA VA |
$788.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,524.68
|
|
|
HC ER CRITICAL CARE INITIAL 30-74 MIN
|
Facility
|
IP
|
$3,366.24
|
|
|
Service Code
|
CPT 99291
|
| Hospital Charge Code |
45000026
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,481.15 |
| Max. Negotiated Rate |
$3,029.62 |
| Rate for Payer: Aetna American Axle |
$2,188.06
|
| Rate for Payer: Aetna Commercial |
$2,861.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,188.06
|
| Rate for Payer: Cash Price |
$2,692.99
|
| Rate for Payer: Cofinity Commercial |
$2,356.37
|
| Rate for Payer: Cofinity Commercial |
$2,894.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,692.99
|
| Rate for Payer: Healthscope Commercial |
$3,029.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,356.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,524.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,861.30
|
| Rate for Payer: PHP Commercial |
$2,861.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,356.37
|
| Rate for Payer: Priority Health SBD |
$2,120.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,481.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,524.68
|
|
|
HC ER LEVEL FIVE 99285
|
Facility
|
OP
|
$2,007.51
|
|
|
Service Code
|
CPT 99285
|
| Hospital Charge Code |
45000025
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$170.27 |
| Max. Negotiated Rate |
$2,017.00 |
| Rate for Payer: Aetna American Axle |
$1,304.88
|
| Rate for Payer: Aetna Commercial |
$1,706.38
|
| Rate for Payer: Aetna Medicare |
$593.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,304.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$713.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$713.68
|
| Rate for Payer: BCBS Complete |
$327.95
|
| Rate for Payer: BCBS MAPPO |
$570.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,134.23
|
| Rate for Payer: BCN Medicare Advantage |
$570.94
|
| Rate for Payer: Cash Price |
$1,606.01
|
| Rate for Payer: Cash Price |
$1,606.01
|
| Rate for Payer: Cash Price |
$1,606.01
|
| Rate for Payer: Cofinity Commercial |
$1,726.46
|
| Rate for Payer: Cofinity Commercial |
$1,405.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,606.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$570.94
|
| Rate for Payer: Healthscope Commercial |
$1,806.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,405.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,505.63
|
| Rate for Payer: Mclaren Medicaid |
$312.30
|
| Rate for Payer: Mclaren Medicare |
$570.94
|
| Rate for Payer: Meridian Medicaid |
$327.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$599.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$656.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,706.38
|
| Rate for Payer: PACE Medicare |
$542.39
|
| Rate for Payer: PACE SWMI |
$570.94
|
| Rate for Payer: PHP Commercial |
$1,706.38
|
| Rate for Payer: PHP Medicare Advantage |
$570.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$312.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,405.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,797.33
|
| Rate for Payer: Priority Health Medicare |
$570.94
|
| Rate for Payer: Priority Health Narrow Network |
$1,437.86
|
| Rate for Payer: Priority Health SBD |
$1,264.73
|
| Rate for Payer: Railroad Medicare Medicare |
$570.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.30
|
| Rate for Payer: UHC Core |
$2,017.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$570.94
|
| Rate for Payer: UHC Exchange |
$170.27
|
| Rate for Payer: UHC Medicare Advantage |
$588.07
|
| Rate for Payer: UMR Bronson Commercial |
$742.78
|
| Rate for Payer: VA VA |
$570.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,505.63
|
|
|
HC ER LEVEL FIVE 99285
|
Facility
|
IP
|
$2,007.51
|
|
|
Service Code
|
CPT 99285
|
| Hospital Charge Code |
45000025
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$883.30 |
| Max. Negotiated Rate |
$1,806.76 |
| Rate for Payer: Aetna American Axle |
$1,304.88
|
| Rate for Payer: Aetna Commercial |
$1,706.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,304.88
|
| Rate for Payer: Cash Price |
$1,606.01
|
| Rate for Payer: Cofinity Commercial |
$1,405.26
|
| Rate for Payer: Cofinity Commercial |
$1,726.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,606.01
|
| Rate for Payer: Healthscope Commercial |
$1,806.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,405.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,505.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,706.38
|
| Rate for Payer: PHP Commercial |
$1,706.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,405.26
|
| Rate for Payer: Priority Health SBD |
$1,264.73
|
| Rate for Payer: UMR Bronson Commercial |
$883.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,505.63
|
|
|
HC ER LEVEL FOUR 99284
|
Facility
|
IP
|
$1,391.19
|
|
|
Service Code
|
CPT 99284
|
| Hospital Charge Code |
45000024
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$612.12 |
| Max. Negotiated Rate |
$1,252.07 |
| Rate for Payer: Aetna American Axle |
$904.27
|
| Rate for Payer: Aetna Commercial |
$1,182.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$904.27
|
| Rate for Payer: Cash Price |
$1,112.95
|
| Rate for Payer: Cofinity Commercial |
$1,196.42
|
| Rate for Payer: Cofinity Commercial |
$973.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,112.95
|
| Rate for Payer: Healthscope Commercial |
$1,252.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$973.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,043.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,182.51
|
| Rate for Payer: PHP Commercial |
$1,182.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$973.83
|
| Rate for Payer: Priority Health SBD |
$876.45
|
| Rate for Payer: UMR Bronson Commercial |
$612.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,043.39
|
|
|
HC ER LEVEL FOUR 99284
|
Facility
|
OP
|
$1,391.19
|
|
|
Service Code
|
CPT 99284
|
| Hospital Charge Code |
45000024
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$117.55 |
| Max. Negotiated Rate |
$1,869.00 |
| Rate for Payer: Aetna American Axle |
$904.27
|
| Rate for Payer: Aetna Commercial |
$1,182.51
|
| Rate for Payer: Aetna Medicare |
$409.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$904.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.11
|
| Rate for Payer: BCBS Complete |
$226.14
|
| Rate for Payer: BCBS MAPPO |
$393.69
|
| Rate for Payer: BCBS Trust/PPO |
$786.02
|
| Rate for Payer: BCN Medicare Advantage |
$393.69
|
| Rate for Payer: Cash Price |
$1,112.95
|
| Rate for Payer: Cash Price |
$1,112.95
|
| Rate for Payer: Cash Price |
$1,112.95
|
| Rate for Payer: Cofinity Commercial |
$1,196.42
|
| Rate for Payer: Cofinity Commercial |
$973.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,112.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.69
|
| Rate for Payer: Healthscope Commercial |
$1,252.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$973.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,043.39
|
| Rate for Payer: Mclaren Medicaid |
$215.35
|
| Rate for Payer: Mclaren Medicare |
$393.69
|
| Rate for Payer: Meridian Medicaid |
$226.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$413.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,182.51
|
| Rate for Payer: PACE Medicare |
$374.01
|
| Rate for Payer: PACE SWMI |
$393.69
|
| Rate for Payer: PHP Commercial |
$1,182.51
|
| Rate for Payer: PHP Medicare Advantage |
$393.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$973.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,239.37
|
| Rate for Payer: Priority Health Medicare |
$393.69
|
| Rate for Payer: Priority Health Narrow Network |
$991.50
|
| Rate for Payer: Priority Health SBD |
$876.45
|
| Rate for Payer: Railroad Medicare Medicare |
$393.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.30
|
| Rate for Payer: UHC Core |
$1,869.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.69
|
| Rate for Payer: UHC Exchange |
$117.55
|
| Rate for Payer: UHC Medicare Advantage |
$405.50
|
| Rate for Payer: UMR Bronson Commercial |
$514.74
|
| Rate for Payer: VA VA |
$393.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,043.39
|
|
|
HC ER LEVEL ONE 99281
|
Facility
|
OP
|
$252.31
|
|
|
Service Code
|
CPT 99281
|
| Hospital Charge Code |
45000020
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$11.13 |
| Max. Negotiated Rate |
$516.00 |
| Rate for Payer: Aetna American Axle |
$164.00
|
| Rate for Payer: Aetna Commercial |
$214.46
|
| Rate for Payer: Aetna Medicare |
$82.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.65
|
| Rate for Payer: BCBS Complete |
$45.33
|
| Rate for Payer: BCBS MAPPO |
$78.92
|
| Rate for Payer: BCBS Trust/PPO |
$142.55
|
| Rate for Payer: BCN Medicare Advantage |
$78.92
|
| Rate for Payer: Cash Price |
$201.85
|
| Rate for Payer: Cash Price |
$201.85
|
| Rate for Payer: Cash Price |
$201.85
|
| Rate for Payer: Cofinity Commercial |
$176.62
|
| Rate for Payer: Cofinity Commercial |
$216.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.92
|
| Rate for Payer: Healthscope Commercial |
$227.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$176.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.23
|
| Rate for Payer: Mclaren Medicaid |
$43.17
|
| Rate for Payer: Mclaren Medicare |
$78.92
|
| Rate for Payer: Meridian Medicaid |
$45.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$82.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$214.46
|
| Rate for Payer: PACE Medicare |
$74.97
|
| Rate for Payer: PACE SWMI |
$78.92
|
| Rate for Payer: PHP Commercial |
$214.46
|
| Rate for Payer: PHP Medicare Advantage |
$78.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.42
|
| Rate for Payer: Priority Health Medicare |
$78.92
|
| Rate for Payer: Priority Health Narrow Network |
$198.74
|
| Rate for Payer: Priority Health SBD |
$158.96
|
| Rate for Payer: Railroad Medicare Medicare |
$78.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.24
|
| Rate for Payer: UHC Core |
$516.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.92
|
| Rate for Payer: UHC Exchange |
$11.13
|
| Rate for Payer: UHC Medicare Advantage |
$81.29
|
| Rate for Payer: UMR Bronson Commercial |
$93.35
|
| Rate for Payer: VA VA |
$78.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.23
|
|
|
HC ER LEVEL ONE 99281
|
Facility
|
IP
|
$252.31
|
|
|
Service Code
|
CPT 99281
|
| Hospital Charge Code |
45000020
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$111.02 |
| Max. Negotiated Rate |
$227.08 |
| Rate for Payer: Aetna American Axle |
$164.00
|
| Rate for Payer: Aetna Commercial |
$214.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.00
|
| Rate for Payer: Cash Price |
$201.85
|
| Rate for Payer: Cofinity Commercial |
$176.62
|
| Rate for Payer: Cofinity Commercial |
$216.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.85
|
| Rate for Payer: Healthscope Commercial |
$227.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$176.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$214.46
|
| Rate for Payer: PHP Commercial |
$214.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.62
|
| Rate for Payer: Priority Health SBD |
$158.96
|
| Rate for Payer: UMR Bronson Commercial |
$111.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.23
|
|
|
HC ER LEVEL THREE 99283
|
Facility
|
OP
|
$885.90
|
|
|
Service Code
|
CPT 99283
|
| Hospital Charge Code |
45000022
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$69.09 |
| Max. Negotiated Rate |
$1,462.00 |
| Rate for Payer: Aetna American Axle |
$575.84
|
| Rate for Payer: Aetna Commercial |
$753.02
|
| Rate for Payer: Aetna Medicare |
$263.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$575.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$317.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$317.01
|
| Rate for Payer: BCBS Complete |
$145.67
|
| Rate for Payer: BCBS MAPPO |
$253.61
|
| Rate for Payer: BCBS Trust/PPO |
$458.14
|
| Rate for Payer: BCN Medicare Advantage |
$253.61
|
| Rate for Payer: Cash Price |
$708.72
|
| Rate for Payer: Cash Price |
$708.72
|
| Rate for Payer: Cash Price |
$708.72
|
| Rate for Payer: Cofinity Commercial |
$620.13
|
| Rate for Payer: Cofinity Commercial |
$761.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$708.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$253.61
|
| Rate for Payer: Healthscope Commercial |
$797.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$620.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$664.42
|
| Rate for Payer: Mclaren Medicaid |
$138.72
|
| Rate for Payer: Mclaren Medicare |
$253.61
|
| Rate for Payer: Meridian Medicaid |
$145.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$266.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$291.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$753.02
|
| Rate for Payer: PACE Medicare |
$240.93
|
| Rate for Payer: PACE SWMI |
$253.61
|
| Rate for Payer: PHP Commercial |
$753.02
|
| Rate for Payer: PHP Medicare Advantage |
$253.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$620.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$798.40
|
| Rate for Payer: Priority Health Medicare |
$253.61
|
| Rate for Payer: Priority Health Narrow Network |
$638.72
|
| Rate for Payer: Priority Health SBD |
$558.12
|
| Rate for Payer: Railroad Medicare Medicare |
$253.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.00
|
| Rate for Payer: UHC Core |
$1,462.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$253.61
|
| Rate for Payer: UHC Exchange |
$69.09
|
| Rate for Payer: UHC Medicare Advantage |
$261.22
|
| Rate for Payer: UMR Bronson Commercial |
$327.78
|
| Rate for Payer: VA VA |
$253.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$664.42
|
|
|
HC ER LEVEL THREE 99283
|
Facility
|
IP
|
$885.90
|
|
|
Service Code
|
CPT 99283
|
| Hospital Charge Code |
45000022
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$389.80 |
| Max. Negotiated Rate |
$797.31 |
| Rate for Payer: Aetna American Axle |
$575.84
|
| Rate for Payer: Aetna Commercial |
$753.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$575.84
|
| Rate for Payer: Cash Price |
$708.72
|
| Rate for Payer: Cofinity Commercial |
$620.13
|
| Rate for Payer: Cofinity Commercial |
$761.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$708.72
|
| Rate for Payer: Healthscope Commercial |
$797.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$620.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$664.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$753.02
|
| Rate for Payer: PHP Commercial |
$753.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$620.13
|
| Rate for Payer: Priority Health SBD |
$558.12
|
| Rate for Payer: UMR Bronson Commercial |
$389.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$664.42
|
|
|
HC ER LEVEL TWO 99282
|
Facility
|
OP
|
$502.02
|
|
|
Service Code
|
CPT 99282
|
| Hospital Charge Code |
45000021
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$40.60 |
| Max. Negotiated Rate |
$1,004.00 |
| Rate for Payer: Aetna American Axle |
$326.31
|
| Rate for Payer: Aetna Commercial |
$426.72
|
| Rate for Payer: Aetna Medicare |
$151.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$326.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$181.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$181.72
|
| Rate for Payer: BCBS Complete |
$83.51
|
| Rate for Payer: BCBS MAPPO |
$145.38
|
| Rate for Payer: BCBS Trust/PPO |
$272.90
|
| Rate for Payer: BCN Medicare Advantage |
$145.38
|
| Rate for Payer: Cash Price |
$401.62
|
| Rate for Payer: Cash Price |
$401.62
|
| Rate for Payer: Cash Price |
$401.62
|
| Rate for Payer: Cofinity Commercial |
$351.41
|
| Rate for Payer: Cofinity Commercial |
$431.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$401.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.38
|
| Rate for Payer: Healthscope Commercial |
$451.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$351.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$376.52
|
| Rate for Payer: Mclaren Medicaid |
$79.52
|
| Rate for Payer: Mclaren Medicare |
$145.38
|
| Rate for Payer: Meridian Medicaid |
$83.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$152.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$167.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$426.72
|
| Rate for Payer: PACE Medicare |
$138.11
|
| Rate for Payer: PACE SWMI |
$145.38
|
| Rate for Payer: PHP Commercial |
$426.72
|
| Rate for Payer: PHP Medicare Advantage |
$145.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$351.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$457.65
|
| Rate for Payer: Priority Health Medicare |
$145.38
|
| Rate for Payer: Priority Health Narrow Network |
$366.12
|
| Rate for Payer: Priority Health SBD |
$316.27
|
| Rate for Payer: Railroad Medicare Medicare |
$145.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.66
|
| Rate for Payer: UHC Core |
$1,004.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.38
|
| Rate for Payer: UHC Exchange |
$40.60
|
| Rate for Payer: UHC Medicare Advantage |
$149.74
|
| Rate for Payer: UMR Bronson Commercial |
$185.75
|
| Rate for Payer: VA VA |
$145.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$376.52
|
|
