|
HC HBO TCPO2 ARTERIAL STUDY UNILATERAL OR LIMITED
|
Facility
|
IP
|
$525.25
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100033
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$231.11 |
| Max. Negotiated Rate |
$472.72 |
| Rate for Payer: Aetna American Axle |
$341.41
|
| Rate for Payer: Aetna Commercial |
$446.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.41
|
| Rate for Payer: Cash Price |
$420.20
|
| Rate for Payer: Cofinity Commercial |
$367.68
|
| Rate for Payer: Cofinity Commercial |
$451.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$420.20
|
| Rate for Payer: Healthscope Commercial |
$472.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$367.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$446.46
|
| Rate for Payer: PHP Commercial |
$446.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.68
|
| Rate for Payer: Priority Health SBD |
$330.91
|
| Rate for Payer: UMR Bronson Commercial |
$231.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.94
|
|
|
HC HBO TCPO2 ARTERIAL STUDY UNILATERAL OR LIMITED
|
Facility
|
OP
|
$525.25
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100033
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$587.00 |
| Rate for Payer: Aetna American Axle |
$341.41
|
| Rate for Payer: Aetna Commercial |
$446.46
|
| Rate for Payer: Aetna Medicare |
$118.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.41
|
| 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 |
$351.87
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$420.20
|
| Rate for Payer: Cash Price |
$420.20
|
| Rate for Payer: Cash Price |
$420.20
|
| Rate for Payer: Cofinity Commercial |
$367.68
|
| Rate for Payer: Cofinity Commercial |
$451.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$420.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$472.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$367.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.94
|
| 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 |
$446.46
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$446.46
|
| 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 |
$367.68
|
| 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 |
$330.91
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.97
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.55
|
| Rate for Payer: UHC Exchange |
$80.88
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$194.34
|
| Rate for Payer: VA VA |
$113.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.94
|
|
|
HC HCCORO/CABG ANGIOS ONLY
|
Facility
|
IP
|
$6,358.90
|
|
|
Service Code
|
CPT 93455
|
| Hospital Charge Code |
48100014
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,797.92 |
| Max. Negotiated Rate |
$5,723.01 |
| Rate for Payer: Aetna American Axle |
$4,133.28
|
| Rate for Payer: Aetna Commercial |
$5,405.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,133.28
|
| Rate for Payer: Cash Price |
$5,087.12
|
| Rate for Payer: Cofinity Commercial |
$5,468.65
|
| Rate for Payer: Cofinity Commercial |
$4,451.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,087.12
|
| Rate for Payer: Healthscope Commercial |
$5,723.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,451.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,769.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,405.06
|
| Rate for Payer: PHP Commercial |
$5,405.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,451.23
|
| Rate for Payer: Priority Health SBD |
$4,006.11
|
| Rate for Payer: UMR Bronson Commercial |
$2,797.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,769.18
|
|
|
HC HCCORO/CABG ANGIOS ONLY
|
Facility
|
OP
|
$6,358.90
|
|
|
Service Code
|
CPT 93455
|
| Hospital Charge Code |
48100014
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$975.45 |
| Max. Negotiated Rate |
$9,118.19 |
| Rate for Payer: Aetna American Axle |
$4,133.28
|
| Rate for Payer: Aetna Commercial |
$5,405.06
|
| Rate for Payer: Aetna Medicare |
$3,012.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,133.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,620.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,620.58
|
| Rate for Payer: BCBS Complete |
$1,663.73
|
| Rate for Payer: BCBS MAPPO |
$2,896.46
|
| Rate for Payer: BCBS Trust/PPO |
$3,706.45
|
| Rate for Payer: BCN Medicare Advantage |
$2,896.46
|
| Rate for Payer: Cash Price |
$5,087.12
|
| Rate for Payer: Cash Price |
$5,087.12
|
| Rate for Payer: Cofinity Commercial |
$4,451.23
|
| Rate for Payer: Cofinity Commercial |
$5,468.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,087.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,896.46
|
| Rate for Payer: Healthscope Commercial |
$5,723.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,451.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,769.18
|
| Rate for Payer: Mclaren Medicaid |
$1,584.36
|
| Rate for Payer: Mclaren Medicare |
$2,896.46
|
| Rate for Payer: Meridian Medicaid |
$1,663.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,041.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,330.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,405.06
|
| Rate for Payer: PACE Medicare |
$2,751.64
|
| Rate for Payer: PACE SWMI |
$2,896.46
|
| Rate for Payer: PHP Commercial |
$5,405.06
|
| Rate for Payer: PHP Medicare Advantage |
$2,896.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,584.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,451.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,118.19
|
| Rate for Payer: Priority Health Medicare |
$2,896.46
|
| Rate for Payer: Priority Health Narrow Network |
$7,294.55
|
| Rate for Payer: Priority Health SBD |
$4,006.11
|
| Rate for Payer: Railroad Medicare Medicare |
$2,896.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,073.00
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,896.46
|
| Rate for Payer: UHC Exchange |
$975.45
|
| Rate for Payer: UHC Medicare Advantage |
$2,983.35
|
| Rate for Payer: UMR Bronson Commercial |
$2,352.79
|
| Rate for Payer: VA VA |
$2,896.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,769.18
|
|
|
HC HCG SERUM QUANTITATIVE
|
Facility
|
OP
|
$62.22
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
30100465
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.13 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna American Axle |
$40.44
|
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: Aetna Medicare |
$15.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: BCBS Complete |
$8.64
|
| Rate for Payer: BCBS MAPPO |
$15.05
|
| Rate for Payer: BCBS Trust/PPO |
$13.54
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Cofinity Commercial |
$43.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Mclaren Medicaid |
$8.23
|
| Rate for Payer: Mclaren Medicare |
$15.05
|
| Rate for Payer: Meridian Medicaid |
$8.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.89
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: PHP Medicare Advantage |
$15.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.66
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health Narrow Network |
$6.13
|
| Rate for Payer: Priority Health SBD |
$39.20
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.06
|
| Rate for Payer: UHC Core |
$24.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.05
|
| Rate for Payer: UHC Exchange |
$15.05
|
| Rate for Payer: UHC Medicare Advantage |
$15.50
|
| Rate for Payer: UMR Bronson Commercial |
$23.02
|
| Rate for Payer: VA VA |
$15.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC HCG SERUM QUANTITATIVE
|
Facility
|
IP
|
$62.22
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
30100465
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.38 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna American Axle |
$40.44
|
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.44
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Cofinity Commercial |
$43.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.89
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.55
|
| Rate for Payer: Priority Health SBD |
$39.20
|
| Rate for Payer: UMR Bronson Commercial |
$27.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC HCV GENOTYPE RESOLUTION
|
Facility
|
OP
|
$395.58
|
|
|
Service Code
|
CPT 87902
|
| Hospital Charge Code |
30600262
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$140.83 |
| Max. Negotiated Rate |
$424.66 |
| Rate for Payer: Aetna American Axle |
$257.13
|
| Rate for Payer: Aetna Commercial |
$336.24
|
| Rate for Payer: Aetna Medicare |
$267.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$321.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$321.81
|
| Rate for Payer: BCBS Complete |
$147.88
|
| Rate for Payer: BCBS MAPPO |
$257.45
|
| Rate for Payer: BCBS Trust/PPO |
$231.53
|
| Rate for Payer: BCN Medicare Advantage |
$257.45
|
| Rate for Payer: Cash Price |
$316.46
|
| Rate for Payer: Cash Price |
$316.46
|
| Rate for Payer: Cofinity Commercial |
$276.91
|
| Rate for Payer: Cofinity Commercial |
$340.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.45
|
| Rate for Payer: Healthscope Commercial |
$356.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$276.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$296.68
|
| Rate for Payer: Mclaren Medicaid |
$140.83
|
| Rate for Payer: Mclaren Medicare |
$257.45
|
| Rate for Payer: Meridian Medicaid |
$147.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$270.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$296.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$336.24
|
| Rate for Payer: PACE Medicare |
$244.58
|
| Rate for Payer: PACE SWMI |
$257.45
|
| Rate for Payer: PHP Commercial |
$336.24
|
| Rate for Payer: PHP Medicare Advantage |
$257.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$353.15
|
| Rate for Payer: Priority Health Medicare |
$257.45
|
| Rate for Payer: Priority Health Narrow Network |
$282.52
|
| Rate for Payer: Priority Health SBD |
$249.22
|
| Rate for Payer: Railroad Medicare Medicare |
$257.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.94
|
| Rate for Payer: UHC Core |
$424.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.45
|
| Rate for Payer: UHC Exchange |
$257.45
|
| Rate for Payer: UHC Medicare Advantage |
$265.17
|
| Rate for Payer: UMR Bronson Commercial |
$146.36
|
| Rate for Payer: VA VA |
$257.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$296.68
|
|
|
HC HCV GENOTYPE RESOLUTION
|
Facility
|
IP
|
$395.58
|
|
|
Service Code
|
CPT 87902
|
| Hospital Charge Code |
30600262
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$174.06 |
| Max. Negotiated Rate |
$356.02 |
| Rate for Payer: Aetna American Axle |
$257.13
|
| Rate for Payer: Aetna Commercial |
$336.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.13
|
| Rate for Payer: Cash Price |
$316.46
|
| Rate for Payer: Cofinity Commercial |
$276.91
|
| Rate for Payer: Cofinity Commercial |
$340.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.46
|
| Rate for Payer: Healthscope Commercial |
$356.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$276.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$296.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$336.24
|
| Rate for Payer: PHP Commercial |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.91
|
| Rate for Payer: Priority Health SBD |
$249.22
|
| Rate for Payer: UMR Bronson Commercial |
$174.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$296.68
|
|
|
HC HDL CHOLESTEROL
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
30100282
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.48 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna American Axle |
$19.89
|
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$8.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.24
|
| Rate for Payer: BCBS Complete |
$4.70
|
| Rate for Payer: BCBS MAPPO |
$8.19
|
| Rate for Payer: BCBS Trust/PPO |
$7.36
|
| Rate for Payer: BCN Medicare Advantage |
$8.19
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.19
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Mclaren Medicaid |
$4.48
|
| Rate for Payer: Mclaren Medicare |
$8.19
|
| Rate for Payer: Meridian Medicaid |
$4.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PACE Medicare |
$7.78
|
| Rate for Payer: PACE SWMI |
$8.19
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: PHP Medicare Advantage |
$8.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.24
|
| Rate for Payer: Priority Health Medicare |
$8.19
|
| Rate for Payer: Priority Health Narrow Network |
$8.99
|
| Rate for Payer: Priority Health SBD |
$19.28
|
| Rate for Payer: Railroad Medicare Medicare |
$8.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.83
|
| Rate for Payer: UHC Core |
$13.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.19
|
| Rate for Payer: UHC Exchange |
$8.19
|
| Rate for Payer: UHC Medicare Advantage |
$8.44
|
| Rate for Payer: UMR Bronson Commercial |
$11.32
|
| Rate for Payer: VA VA |
$8.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC HDL CHOLESTEROL
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
30100282
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.46 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna American Axle |
$19.89
|
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health SBD |
$19.28
|
| Rate for Payer: UMR Bronson Commercial |
$13.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC HDL CHOLESTEROL LMPP
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
30100690
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.48 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna American Axle |
$13.26
|
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare |
$8.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.24
|
| Rate for Payer: BCBS Complete |
$4.70
|
| Rate for Payer: BCBS MAPPO |
$8.19
|
| Rate for Payer: BCBS Trust/PPO |
$7.36
|
| Rate for Payer: BCN Medicare Advantage |
$8.19
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Cofinity Commercial |
$14.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.19
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Mclaren Medicaid |
$4.48
|
| Rate for Payer: Mclaren Medicare |
$8.19
|
| Rate for Payer: Meridian Medicaid |
$4.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Medicare |
$7.78
|
| Rate for Payer: PACE SWMI |
$8.19
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: PHP Medicare Advantage |
$8.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.24
|
| Rate for Payer: Priority Health Medicare |
$8.19
|
| Rate for Payer: Priority Health Narrow Network |
$8.99
|
| Rate for Payer: Priority Health SBD |
$12.85
|
| Rate for Payer: Railroad Medicare Medicare |
$8.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.83
|
| Rate for Payer: UHC Core |
$13.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.19
|
| Rate for Payer: UHC Exchange |
$8.19
|
| Rate for Payer: UHC Medicare Advantage |
$8.44
|
| Rate for Payer: UMR Bronson Commercial |
$7.55
|
| Rate for Payer: VA VA |
$8.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC HDL CHOLESTEROL LMPP
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
30100690
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.98 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna American Axle |
$13.26
|
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.26
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$14.28
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health SBD |
$12.85
|
| Rate for Payer: UMR Bronson Commercial |
$8.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC HDR 1 CHANNEL
|
Facility
|
IP
|
$1,950.65
|
|
|
Service Code
|
CPT 77770
|
| Hospital Charge Code |
33300055
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$858.29 |
| Max. Negotiated Rate |
$1,755.58 |
| Rate for Payer: Aetna American Axle |
$1,267.92
|
| Rate for Payer: Aetna American Axle |
$346.45
|
| Rate for Payer: Aetna Commercial |
$453.05
|
| Rate for Payer: Aetna Commercial |
$1,658.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,267.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$346.45
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cash Price |
$1,560.52
|
| Rate for Payer: Cofinity Commercial |
$458.38
|
| Rate for Payer: Cofinity Commercial |
$1,365.46
|
| Rate for Payer: Cofinity Commercial |
$373.10
|
| Rate for Payer: Cofinity Commercial |
$1,677.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$426.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,560.52
|
| Rate for Payer: Healthscope Commercial |
$1,755.58
|
| Rate for Payer: Healthscope Commercial |
$479.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,365.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$373.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,462.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$399.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,658.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$453.05
|
| Rate for Payer: PHP Commercial |
$1,658.05
|
| Rate for Payer: PHP Commercial |
$453.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$373.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,365.46
|
| Rate for Payer: Priority Health SBD |
$1,228.91
|
| Rate for Payer: Priority Health SBD |
$335.79
|
| Rate for Payer: UMR Bronson Commercial |
$858.29
|
| Rate for Payer: UMR Bronson Commercial |
$234.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$399.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,462.99
|
|
|
HC HDR 1 CHANNEL
|
Facility
|
OP
|
$1,950.65
|
|
|
Service Code
|
CPT 77770
|
| Hospital Charge Code |
33300055
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$342.18 |
| Max. Negotiated Rate |
$2,006.26 |
| Rate for Payer: Aetna American Axle |
$1,267.92
|
| Rate for Payer: Aetna American Axle |
$346.45
|
| Rate for Payer: Aetna Commercial |
$453.05
|
| Rate for Payer: Aetna Commercial |
$1,658.05
|
| Rate for Payer: Aetna Medicare |
$662.80
|
| Rate for Payer: Aetna Medicare |
$662.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$346.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,267.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$796.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$796.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$796.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$796.64
|
| Rate for Payer: BCBS Complete |
$366.07
|
| Rate for Payer: BCBS Complete |
$366.07
|
| Rate for Payer: BCBS MAPPO |
$637.31
|
| Rate for Payer: BCBS MAPPO |
$637.31
|
| Rate for Payer: BCBS Trust/PPO |
$737.53
|
| Rate for Payer: BCBS Trust/PPO |
$737.53
|
| Rate for Payer: BCN Medicare Advantage |
$637.31
|
| Rate for Payer: BCN Medicare Advantage |
$637.31
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cash Price |
$1,560.52
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cash Price |
$1,560.52
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cash Price |
$1,560.52
|
| Rate for Payer: Cofinity Commercial |
$373.10
|
| Rate for Payer: Cofinity Commercial |
$458.38
|
| Rate for Payer: Cofinity Commercial |
$1,365.46
|
| Rate for Payer: Cofinity Commercial |
$1,677.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$426.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,560.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$637.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$637.31
|
| Rate for Payer: Healthscope Commercial |
$479.70
|
| Rate for Payer: Healthscope Commercial |
$1,755.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,365.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$373.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$399.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,462.99
|
| Rate for Payer: Mclaren Medicaid |
$348.61
|
| Rate for Payer: Mclaren Medicaid |
$348.61
|
| Rate for Payer: Mclaren Medicare |
$637.31
|
| Rate for Payer: Mclaren Medicare |
$637.31
|
| Rate for Payer: Meridian Medicaid |
$366.07
|
| Rate for Payer: Meridian Medicaid |
$366.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$669.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$669.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$732.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$732.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$453.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,658.05
|
| Rate for Payer: PACE Medicare |
$605.44
|
| Rate for Payer: PACE Medicare |
$605.44
|
| Rate for Payer: PACE SWMI |
$637.31
|
| Rate for Payer: PACE SWMI |
$637.31
|
| Rate for Payer: PHP Commercial |
$453.05
|
| Rate for Payer: PHP Commercial |
$1,658.05
|
| Rate for Payer: PHP Medicare Advantage |
$637.31
|
| Rate for Payer: PHP Medicare Advantage |
$637.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$373.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,365.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,006.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,006.26
|
| Rate for Payer: Priority Health Medicare |
$637.31
|
| Rate for Payer: Priority Health Medicare |
$637.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,605.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,605.01
|
| Rate for Payer: Priority Health SBD |
$335.79
|
| Rate for Payer: Priority Health SBD |
$1,228.91
|
| Rate for Payer: Railroad Medicare Medicare |
$637.31
|
| Rate for Payer: Railroad Medicare Medicare |
$637.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$376.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$376.40
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$637.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$637.31
|
| Rate for Payer: UHC Exchange |
$342.18
|
| Rate for Payer: UHC Exchange |
$342.18
|
| Rate for Payer: UHC Medicare Advantage |
$656.43
|
| Rate for Payer: UHC Medicare Advantage |
$656.43
|
| Rate for Payer: UMR Bronson Commercial |
$721.74
|
| Rate for Payer: UMR Bronson Commercial |
$197.21
|
| Rate for Payer: VA VA |
$637.31
|
| Rate for Payer: VA VA |
$637.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,462.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$399.75
|
|
|
HC HDR 2-12 CHANNELS
|
Facility
|
OP
|
$1,828.00
|
|
|
Service Code
|
CPT 77771
|
| Hospital Charge Code |
33300056
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$348.61 |
| Max. Negotiated Rate |
$2,006.26 |
| Rate for Payer: Aetna American Axle |
$1,188.20
|
| Rate for Payer: Aetna American Axle |
$1,408.37
|
| Rate for Payer: Aetna Commercial |
$1,553.80
|
| Rate for Payer: Aetna Commercial |
$1,841.71
|
| Rate for Payer: Aetna Medicare |
$662.80
|
| Rate for Payer: Aetna Medicare |
$662.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,408.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,188.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$796.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$796.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$796.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$796.64
|
| Rate for Payer: BCBS Complete |
$366.07
|
| Rate for Payer: BCBS Complete |
$366.07
|
| Rate for Payer: BCBS MAPPO |
$637.31
|
| Rate for Payer: BCBS MAPPO |
$637.31
|
| Rate for Payer: BCBS Trust/PPO |
$737.53
|
| Rate for Payer: BCBS Trust/PPO |
$737.53
|
| Rate for Payer: BCN Medicare Advantage |
$637.31
|
| Rate for Payer: BCN Medicare Advantage |
$637.31
|
| Rate for Payer: Cash Price |
$1,733.38
|
| Rate for Payer: Cash Price |
$1,733.38
|
| Rate for Payer: Cash Price |
$1,462.40
|
| Rate for Payer: Cash Price |
$1,462.40
|
| Rate for Payer: Cash Price |
$1,462.40
|
| Rate for Payer: Cash Price |
$1,733.38
|
| Rate for Payer: Cofinity Commercial |
$1,279.60
|
| Rate for Payer: Cofinity Commercial |
$1,863.38
|
| Rate for Payer: Cofinity Commercial |
$1,516.70
|
| Rate for Payer: Cofinity Commercial |
$1,572.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,733.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,462.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$637.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$637.31
|
| Rate for Payer: Healthscope Commercial |
$1,645.20
|
| Rate for Payer: Healthscope Commercial |
$1,950.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,279.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,516.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,625.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,371.00
|
| Rate for Payer: Mclaren Medicaid |
$348.61
|
| Rate for Payer: Mclaren Medicaid |
$348.61
|
| Rate for Payer: Mclaren Medicare |
$637.31
|
| Rate for Payer: Mclaren Medicare |
$637.31
|
| Rate for Payer: Meridian Medicaid |
$366.07
|
| Rate for Payer: Meridian Medicaid |
$366.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$669.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$669.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$732.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$732.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,553.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,841.71
|
| Rate for Payer: PACE Medicare |
$605.44
|
| Rate for Payer: PACE Medicare |
$605.44
|
| Rate for Payer: PACE SWMI |
$637.31
|
| Rate for Payer: PACE SWMI |
$637.31
|
| Rate for Payer: PHP Commercial |
$1,553.80
|
| Rate for Payer: PHP Commercial |
$1,841.71
|
| Rate for Payer: PHP Medicare Advantage |
$637.31
|
| Rate for Payer: PHP Medicare Advantage |
$637.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,516.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,279.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,006.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,006.26
|
| Rate for Payer: Priority Health Medicare |
$637.31
|
| Rate for Payer: Priority Health Medicare |
$637.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,605.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,605.01
|
| Rate for Payer: Priority Health SBD |
$1,365.03
|
| Rate for Payer: Priority Health SBD |
$1,151.64
|
| Rate for Payer: Railroad Medicare Medicare |
$637.31
|
| Rate for Payer: Railroad Medicare Medicare |
$637.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$654.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$654.46
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$637.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$637.31
|
| Rate for Payer: UHC Exchange |
$594.96
|
| Rate for Payer: UHC Exchange |
$594.96
|
| Rate for Payer: UHC Medicare Advantage |
$656.43
|
| Rate for Payer: UHC Medicare Advantage |
$656.43
|
| Rate for Payer: UMR Bronson Commercial |
$801.69
|
| Rate for Payer: UMR Bronson Commercial |
$676.36
|
| Rate for Payer: VA VA |
$637.31
|
| Rate for Payer: VA VA |
$637.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,625.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,371.00
|
|
|
HC HDR 2-12 CHANNELS
|
Facility
|
IP
|
$1,828.00
|
|
|
Service Code
|
CPT 77771
|
| Hospital Charge Code |
33300056
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$804.32 |
| Max. Negotiated Rate |
$1,645.20 |
| Rate for Payer: Aetna American Axle |
$1,188.20
|
| Rate for Payer: Aetna American Axle |
$1,408.37
|
| Rate for Payer: Aetna Commercial |
$1,841.71
|
| Rate for Payer: Aetna Commercial |
$1,553.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,408.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,188.20
|
| Rate for Payer: Cash Price |
$1,462.40
|
| Rate for Payer: Cash Price |
$1,733.38
|
| Rate for Payer: Cofinity Commercial |
$1,516.70
|
| Rate for Payer: Cofinity Commercial |
$1,572.08
|
| Rate for Payer: Cofinity Commercial |
$1,863.38
|
| Rate for Payer: Cofinity Commercial |
$1,279.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,462.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,733.38
|
| Rate for Payer: Healthscope Commercial |
$1,950.05
|
| Rate for Payer: Healthscope Commercial |
$1,645.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,279.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,516.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,625.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,371.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,553.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,841.71
|
| Rate for Payer: PHP Commercial |
$1,553.80
|
| Rate for Payer: PHP Commercial |
$1,841.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,279.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,516.70
|
| Rate for Payer: Priority Health SBD |
$1,151.64
|
| Rate for Payer: Priority Health SBD |
$1,365.03
|
| Rate for Payer: UMR Bronson Commercial |
$804.32
|
| Rate for Payer: UMR Bronson Commercial |
$953.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,625.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,371.00
|
|
|
HC HDR IR 192 BRACHY SOURCE NSTRD
|
Facility
|
OP
|
$551.38
|
|
|
Service Code
|
HCPCS C1717
|
| Hospital Charge Code |
27800090
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$177.06 |
| Max. Negotiated Rate |
$1,019.03 |
| Rate for Payer: Aetna American Axle |
$358.40
|
| Rate for Payer: Aetna Commercial |
$468.67
|
| Rate for Payer: Aetna Medicare |
$336.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$358.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$404.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$404.62
|
| Rate for Payer: BCBS Complete |
$185.93
|
| Rate for Payer: BCBS MAPPO |
$323.70
|
| Rate for Payer: BCN Medicare Advantage |
$323.70
|
| Rate for Payer: Cash Price |
$441.10
|
| Rate for Payer: Cash Price |
$441.10
|
| Rate for Payer: Cofinity Commercial |
$474.19
|
| Rate for Payer: Cofinity Commercial |
$385.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$441.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.70
|
| Rate for Payer: Healthscope Commercial |
$496.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$385.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$413.54
|
| Rate for Payer: Mclaren Medicaid |
$177.06
|
| Rate for Payer: Mclaren Medicare |
$323.70
|
| Rate for Payer: Meridian Medicaid |
$185.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$339.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$372.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$468.67
|
| Rate for Payer: PACE Medicare |
$307.52
|
| Rate for Payer: PACE SWMI |
$323.70
|
| Rate for Payer: PHP Commercial |
$468.67
|
| Rate for Payer: PHP Medicare Advantage |
$323.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$177.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$385.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,019.03
|
| Rate for Payer: Priority Health Medicare |
$323.70
|
| Rate for Payer: Priority Health Narrow Network |
$815.22
|
| Rate for Payer: Priority Health SBD |
$347.37
|
| Rate for Payer: Railroad Medicare Medicare |
$323.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$907.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$323.70
|
| Rate for Payer: UHC Exchange |
$618.62
|
| Rate for Payer: UHC Medicare Advantage |
$333.41
|
| Rate for Payer: UMR Bronson Commercial |
$204.01
|
| Rate for Payer: VA VA |
$323.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$413.54
|
|
|
HC HDR IR 192 BRACHY SOURCE NSTRD
|
Facility
|
IP
|
$551.38
|
|
|
Service Code
|
HCPCS C1717
|
| Hospital Charge Code |
27800090
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$242.61 |
| Max. Negotiated Rate |
$496.24 |
| Rate for Payer: Aetna American Axle |
$358.40
|
| Rate for Payer: Aetna Commercial |
$468.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$358.40
|
| Rate for Payer: Cash Price |
$441.10
|
| Rate for Payer: Cofinity Commercial |
$385.97
|
| Rate for Payer: Cofinity Commercial |
$474.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$441.10
|
| Rate for Payer: Healthscope Commercial |
$496.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$385.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$413.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$468.67
|
| Rate for Payer: PHP Commercial |
$468.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$385.97
|
| Rate for Payer: Priority Health SBD |
$347.37
|
| Rate for Payer: UMR Bronson Commercial |
$242.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$413.54
|
|
|
HC HDR OVER 12 CHANNELS
|
Facility
|
IP
|
$2,391.07
|
|
|
Service Code
|
CPT 77772
|
| Hospital Charge Code |
33300057
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,052.07 |
| Max. Negotiated Rate |
$2,151.96 |
| Rate for Payer: Aetna American Axle |
$1,554.20
|
| Rate for Payer: Aetna American Axle |
$1,742.00
|
| Rate for Payer: Aetna Commercial |
$2,278.00
|
| Rate for Payer: Aetna Commercial |
$2,032.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,742.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,554.20
|
| Rate for Payer: Cash Price |
$2,144.00
|
| Rate for Payer: Cash Price |
$1,912.86
|
| Rate for Payer: Cofinity Commercial |
$1,673.75
|
| Rate for Payer: Cofinity Commercial |
$1,876.00
|
| Rate for Payer: Cofinity Commercial |
$2,304.80
|
| Rate for Payer: Cofinity Commercial |
$2,056.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,912.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,144.00
|
| Rate for Payer: Healthscope Commercial |
$2,412.00
|
| Rate for Payer: Healthscope Commercial |
$2,151.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,876.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,673.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,010.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,793.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,032.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,278.00
|
| Rate for Payer: PHP Commercial |
$2,032.41
|
| Rate for Payer: PHP Commercial |
$2,278.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,673.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,876.00
|
| Rate for Payer: Priority Health SBD |
$1,688.40
|
| Rate for Payer: Priority Health SBD |
$1,506.37
|
| Rate for Payer: UMR Bronson Commercial |
$1,052.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,179.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,010.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,793.30
|
|
|
HC HDR OVER 12 CHANNELS
|
Facility
|
OP
|
$2,391.07
|
|
|
Service Code
|
CPT 77772
|
| Hospital Charge Code |
33300057
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$348.61 |
| Max. Negotiated Rate |
$2,151.96 |
| Rate for Payer: Aetna American Axle |
$1,554.20
|
| Rate for Payer: Aetna American Axle |
$1,742.00
|
| Rate for Payer: Aetna Commercial |
$2,278.00
|
| Rate for Payer: Aetna Commercial |
$2,032.41
|
| Rate for Payer: Aetna Medicare |
$662.80
|
| Rate for Payer: Aetna Medicare |
$662.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,742.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,554.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$796.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$796.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$796.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$796.64
|
| Rate for Payer: BCBS Complete |
$366.07
|
| Rate for Payer: BCBS Complete |
$366.07
|
| Rate for Payer: BCBS MAPPO |
$637.31
|
| Rate for Payer: BCBS MAPPO |
$637.31
|
| Rate for Payer: BCBS Trust/PPO |
$737.53
|
| Rate for Payer: BCBS Trust/PPO |
$737.53
|
| Rate for Payer: BCN Medicare Advantage |
$637.31
|
| Rate for Payer: BCN Medicare Advantage |
$637.31
|
| Rate for Payer: Cash Price |
$2,144.00
|
| Rate for Payer: Cash Price |
$2,144.00
|
| Rate for Payer: Cash Price |
$1,912.86
|
| Rate for Payer: Cash Price |
$1,912.86
|
| Rate for Payer: Cash Price |
$2,144.00
|
| Rate for Payer: Cash Price |
$1,912.86
|
| Rate for Payer: Cofinity Commercial |
$2,056.32
|
| Rate for Payer: Cofinity Commercial |
$1,673.75
|
| Rate for Payer: Cofinity Commercial |
$2,304.80
|
| Rate for Payer: Cofinity Commercial |
$1,876.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,144.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,912.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$637.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$637.31
|
| Rate for Payer: Healthscope Commercial |
$2,412.00
|
| Rate for Payer: Healthscope Commercial |
$2,151.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,876.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,673.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,010.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,793.30
|
| Rate for Payer: Mclaren Medicaid |
$348.61
|
| Rate for Payer: Mclaren Medicaid |
$348.61
|
| Rate for Payer: Mclaren Medicare |
$637.31
|
| Rate for Payer: Mclaren Medicare |
$637.31
|
| Rate for Payer: Meridian Medicaid |
$366.07
|
| Rate for Payer: Meridian Medicaid |
$366.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$669.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$669.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$732.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$732.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,278.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,032.41
|
| Rate for Payer: PACE Medicare |
$605.44
|
| Rate for Payer: PACE Medicare |
$605.44
|
| Rate for Payer: PACE SWMI |
$637.31
|
| Rate for Payer: PACE SWMI |
$637.31
|
| Rate for Payer: PHP Commercial |
$2,278.00
|
| Rate for Payer: PHP Commercial |
$2,032.41
|
| Rate for Payer: PHP Medicare Advantage |
$637.31
|
| Rate for Payer: PHP Medicare Advantage |
$637.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,673.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,876.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,006.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,006.26
|
| Rate for Payer: Priority Health Medicare |
$637.31
|
| Rate for Payer: Priority Health Medicare |
$637.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,605.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,605.01
|
| Rate for Payer: Priority Health SBD |
$1,506.37
|
| Rate for Payer: Priority Health SBD |
$1,688.40
|
| Rate for Payer: Railroad Medicare Medicare |
$637.31
|
| Rate for Payer: Railroad Medicare Medicare |
$637.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$977.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$977.18
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$637.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$637.31
|
| Rate for Payer: UHC Exchange |
$888.35
|
| Rate for Payer: UHC Exchange |
$888.35
|
| Rate for Payer: UHC Medicare Advantage |
$656.43
|
| Rate for Payer: UHC Medicare Advantage |
$656.43
|
| Rate for Payer: UMR Bronson Commercial |
$991.60
|
| Rate for Payer: UMR Bronson Commercial |
$884.70
|
| Rate for Payer: VA VA |
$637.31
|
| Rate for Payer: VA VA |
$637.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,793.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,010.00
|
|
|
HC HDR SKIN SURFACE 1 CHANNEL
|
Facility
|
OP
|
$472.31
|
|
|
Service Code
|
CPT 77767
|
| Hospital Charge Code |
33300053
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$130.67 |
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$307.00
|
| Rate for Payer: Aetna Commercial |
$401.46
|
| Rate for Payer: Aetna Medicare |
$248.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$298.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$298.60
|
| Rate for Payer: BCBS Complete |
$137.21
|
| Rate for Payer: BCBS MAPPO |
$238.88
|
| Rate for Payer: BCBS Trust/PPO |
$204.21
|
| Rate for Payer: BCN Medicare Advantage |
$238.88
|
| Rate for Payer: Cash Price |
$377.85
|
| Rate for Payer: Cash Price |
$377.85
|
| Rate for Payer: Cash Price |
$377.85
|
| Rate for Payer: Cofinity Commercial |
$330.62
|
| Rate for Payer: Cofinity Commercial |
$406.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$377.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.88
|
| Rate for Payer: Healthscope Commercial |
$425.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$330.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.23
|
| Rate for Payer: Mclaren Medicaid |
$130.67
|
| Rate for Payer: Mclaren Medicare |
$238.88
|
| Rate for Payer: Meridian Medicaid |
$137.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$250.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$401.46
|
| Rate for Payer: PACE Medicare |
$226.94
|
| Rate for Payer: PACE SWMI |
$238.88
|
| Rate for Payer: PHP Commercial |
$401.46
|
| Rate for Payer: PHP Medicare Advantage |
$238.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$752.03
|
| Rate for Payer: Priority Health Medicare |
$238.88
|
| Rate for Payer: Priority Health Narrow Network |
$601.62
|
| Rate for Payer: Priority Health SBD |
$297.56
|
| Rate for Payer: Railroad Medicare Medicare |
$238.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.14
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.88
|
| Rate for Payer: UHC Exchange |
$245.58
|
| Rate for Payer: UHC Medicare Advantage |
$246.05
|
| Rate for Payer: UMR Bronson Commercial |
$174.75
|
| Rate for Payer: VA VA |
$238.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.23
|
|
|
HC HDR SKIN SURFACE 1 CHANNEL
|
Facility
|
IP
|
$472.31
|
|
|
Service Code
|
CPT 77767
|
| Hospital Charge Code |
33300053
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$207.82 |
| Max. Negotiated Rate |
$425.08 |
| Rate for Payer: Aetna American Axle |
$307.00
|
| Rate for Payer: Aetna Commercial |
$401.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.00
|
| Rate for Payer: Cash Price |
$377.85
|
| Rate for Payer: Cofinity Commercial |
$330.62
|
| Rate for Payer: Cofinity Commercial |
$406.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$377.85
|
| Rate for Payer: Healthscope Commercial |
$425.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$330.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$401.46
|
| Rate for Payer: PHP Commercial |
$401.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.62
|
| Rate for Payer: Priority Health SBD |
$297.56
|
| Rate for Payer: UMR Bronson Commercial |
$207.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.23
|
|
|
HC HDR SKIN SURFACE 2 OR MORE CHANNELS
|
Facility
|
OP
|
$531.36
|
|
|
Service Code
|
CPT 77768
|
| Hospital Charge Code |
33300054
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$130.67 |
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$345.38
|
| Rate for Payer: Aetna Commercial |
$451.66
|
| Rate for Payer: Aetna Medicare |
$248.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$298.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$298.60
|
| Rate for Payer: BCBS Complete |
$137.21
|
| Rate for Payer: BCBS MAPPO |
$238.88
|
| Rate for Payer: BCBS Trust/PPO |
$204.21
|
| Rate for Payer: BCN Medicare Advantage |
$238.88
|
| Rate for Payer: Cash Price |
$425.09
|
| Rate for Payer: Cash Price |
$425.09
|
| Rate for Payer: Cash Price |
$425.09
|
| Rate for Payer: Cofinity Commercial |
$371.95
|
| Rate for Payer: Cofinity Commercial |
$456.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.88
|
| Rate for Payer: Healthscope Commercial |
$478.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$371.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$398.52
|
| Rate for Payer: Mclaren Medicaid |
$130.67
|
| Rate for Payer: Mclaren Medicare |
$238.88
|
| Rate for Payer: Meridian Medicaid |
$137.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$250.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$451.66
|
| Rate for Payer: PACE Medicare |
$226.94
|
| Rate for Payer: PACE SWMI |
$238.88
|
| Rate for Payer: PHP Commercial |
$451.66
|
| Rate for Payer: PHP Medicare Advantage |
$238.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$371.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$752.03
|
| Rate for Payer: Priority Health Medicare |
$238.88
|
| Rate for Payer: Priority Health Narrow Network |
$601.62
|
| Rate for Payer: Priority Health SBD |
$334.76
|
| Rate for Payer: Railroad Medicare Medicare |
$238.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$395.85
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.88
|
| Rate for Payer: UHC Exchange |
$359.86
|
| Rate for Payer: UHC Medicare Advantage |
$246.05
|
| Rate for Payer: UMR Bronson Commercial |
$196.60
|
| Rate for Payer: VA VA |
$238.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$398.52
|
|
|
HC HDR SKIN SURFACE 2 OR MORE CHANNELS
|
Facility
|
IP
|
$531.36
|
|
|
Service Code
|
CPT 77768
|
| Hospital Charge Code |
33300054
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$233.80 |
| Max. Negotiated Rate |
$478.22 |
| Rate for Payer: Aetna American Axle |
$345.38
|
| Rate for Payer: Aetna Commercial |
$451.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.38
|
| Rate for Payer: Cash Price |
$425.09
|
| Rate for Payer: Cofinity Commercial |
$456.97
|
| Rate for Payer: Cofinity Commercial |
$371.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.09
|
| Rate for Payer: Healthscope Commercial |
$478.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$371.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$398.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$451.66
|
| Rate for Payer: PHP Commercial |
$451.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$371.95
|
| Rate for Payer: Priority Health SBD |
$334.76
|
| Rate for Payer: UMR Bronson Commercial |
$233.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$398.52
|
|
|
HC HEALTH & BEHAV ASSESS OR REASSESS
|
Facility
|
IP
|
$120.36
|
|
|
Service Code
|
CPT 96156
|
| Hospital Charge Code |
91400009
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$52.96 |
| Max. Negotiated Rate |
$108.32 |
| Rate for Payer: Aetna American Axle |
$78.23
|
| Rate for Payer: Aetna Commercial |
$102.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.23
|
| Rate for Payer: Cash Price |
$96.29
|
| Rate for Payer: Cofinity Commercial |
$103.51
|
| Rate for Payer: Cofinity Commercial |
$84.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.29
|
| Rate for Payer: Healthscope Commercial |
$108.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.31
|
| Rate for Payer: PHP Commercial |
$102.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.25
|
| Rate for Payer: Priority Health SBD |
$75.83
|
| Rate for Payer: UMR Bronson Commercial |
$52.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.27
|
|
