|
HC BRACE WRIST HAND OROTHISIS W/NONTORSION JNT(S) CF
|
Facility
|
IP
|
$2,361.71
|
|
|
Service Code
|
HCPCS L3905
|
| Hospital Charge Code |
27400053
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,039.15 |
| Max. Negotiated Rate |
$2,125.54 |
| Rate for Payer: Aetna American Axle |
$1,535.11
|
| Rate for Payer: Aetna Commercial |
$2,007.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,535.11
|
| Rate for Payer: Cash Price |
$1,889.37
|
| Rate for Payer: Cofinity Advantage |
$1,653.20
|
| Rate for Payer: Cofinity Commercial |
$2,031.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,889.37
|
| Rate for Payer: Healthscope Commercial |
$2,125.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,653.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,771.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,007.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,771.28
|
| Rate for Payer: PHP Commercial |
$2,007.45
|
| Rate for Payer: Priority Health SBD |
$1,487.88
|
| Rate for Payer: UMR Bronson Commercial |
$1,039.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,771.28
|
|
|
HC BRACE WRIST/THUMB SPLINT
|
Facility
|
OP
|
$156.10
|
|
|
Service Code
|
HCPCS L3908
|
| Hospital Charge Code |
27400014
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$57.76 |
| Max. Negotiated Rate |
$212.66 |
| Rate for Payer: Aetna American Axle |
$101.47
|
| Rate for Payer: Aetna Commercial |
$132.69
|
| Rate for Payer: Aetna Medicare |
$78.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.47
|
| Rate for Payer: BCBS Complete |
$62.44
|
| Rate for Payer: BCBS Trust/PPO |
$212.66
|
| Rate for Payer: BCN Commercial |
$212.66
|
| Rate for Payer: Cash Price |
$124.88
|
| Rate for Payer: Cash Price |
$124.88
|
| Rate for Payer: Cofinity Advantage |
$109.27
|
| Rate for Payer: Cofinity Commercial |
$134.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.88
|
| Rate for Payer: Healthscope Commercial |
$140.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$109.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$124.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.08
|
| Rate for Payer: PHP Commercial |
$132.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$82.00
|
| Rate for Payer: Priority Health SBD |
$98.34
|
| Rate for Payer: Priority Health Tiered Network |
$65.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.47
|
| Rate for Payer: UHC Core |
$81.33
|
| Rate for Payer: UHC Exchange |
$61.35
|
| Rate for Payer: UMR Bronson Commercial |
$57.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.08
|
|
|
HC BRACE WRIST/THUMB SPLINT
|
Facility
|
IP
|
$156.10
|
|
|
Service Code
|
HCPCS L3908
|
| Hospital Charge Code |
27400014
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$68.68 |
| Max. Negotiated Rate |
$140.49 |
| Rate for Payer: Aetna American Axle |
$101.47
|
| Rate for Payer: Aetna Commercial |
$132.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.47
|
| Rate for Payer: Cash Price |
$124.88
|
| Rate for Payer: Cofinity Advantage |
$109.27
|
| Rate for Payer: Cofinity Commercial |
$134.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.88
|
| Rate for Payer: Healthscope Commercial |
$140.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$109.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.08
|
| Rate for Payer: PHP Commercial |
$132.69
|
| Rate for Payer: Priority Health SBD |
$98.34
|
| Rate for Payer: UMR Bronson Commercial |
$68.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.08
|
|
|
HC BRACHY SOURCE I-125 NSTRD
|
Facility
|
OP
|
$228.69
|
|
|
Service Code
|
HCPCS C2639
|
| Hospital Charge Code |
27800089
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18.69 |
| Max. Negotiated Rate |
$205.82 |
| Rate for Payer: Aetna American Axle |
$148.65
|
| Rate for Payer: Aetna Commercial |
$194.39
|
| Rate for Payer: Aetna Medicare |
$37.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.66
|
| Rate for Payer: BCBS Complete |
$19.62
|
| Rate for Payer: BCBS MAPPO |
$35.73
|
| Rate for Payer: BCN Medicare Advantage |
$35.73
|
| Rate for Payer: Cash Price |
$182.95
|
| Rate for Payer: Cash Price |
$182.95
|
| Rate for Payer: Cofinity Advantage |
$160.08
|
| Rate for Payer: Cofinity Commercial |
$196.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.73
|
| Rate for Payer: Healthscope Commercial |
$205.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$160.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.52
|
| Rate for Payer: Mclaren Medicaid |
$35.73
|
| Rate for Payer: Mclaren Medicare |
$35.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.52
|
| Rate for Payer: Meridian Medicaid |
$37.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$39.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.39
|
| Rate for Payer: Nomi Health Commercial |
$107.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$171.52
|
| Rate for Payer: PACE Medicare |
$33.94
|
| Rate for Payer: PACE SWMI |
$35.73
|
| Rate for Payer: PHP Commercial |
$194.39
|
| Rate for Payer: PHP Medicare Advantage |
$35.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$115.56
|
| Rate for Payer: Priority Health Medicare |
$35.73
|
| Rate for Payer: Priority Health SBD |
$144.07
|
| Rate for Payer: Priority Health Tiered Network |
$92.45
|
| Rate for Payer: Railroad Medicare Medicare |
$35.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.65
|
| Rate for Payer: UHC Core |
$119.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.73
|
| Rate for Payer: UHC Exchange |
$89.88
|
| Rate for Payer: UHC Medicaid |
$18.69
|
| Rate for Payer: UHCCP Medicaid |
$18.69
|
| Rate for Payer: UMR Bronson Commercial |
$84.62
|
| Rate for Payer: VA VA |
$35.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.52
|
|
|
HC BRACHY SOURCE I-125 NSTRD
|
Facility
|
IP
|
$228.69
|
|
|
Service Code
|
HCPCS C2639
|
| Hospital Charge Code |
27800089
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$100.62 |
| Max. Negotiated Rate |
$205.82 |
| Rate for Payer: Aetna American Axle |
$148.65
|
| Rate for Payer: Aetna Commercial |
$194.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.65
|
| Rate for Payer: Cash Price |
$182.95
|
| Rate for Payer: Cofinity Advantage |
$160.08
|
| Rate for Payer: Cofinity Commercial |
$196.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.95
|
| Rate for Payer: Healthscope Commercial |
$205.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$160.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$171.52
|
| Rate for Payer: PHP Commercial |
$194.39
|
| Rate for Payer: Priority Health SBD |
$144.07
|
| Rate for Payer: UMR Bronson Commercial |
$100.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.52
|
|
|
HC BRAVO PROCEDURE
|
Facility
|
IP
|
$1,822.59
|
|
| Hospital Charge Code |
36000091
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$801.94 |
| Max. Negotiated Rate |
$1,640.33 |
| Rate for Payer: Aetna American Axle |
$1,184.68
|
| Rate for Payer: Aetna Commercial |
$1,549.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,184.68
|
| Rate for Payer: Cash Price |
$1,458.07
|
| Rate for Payer: Cofinity Advantage |
$1,275.81
|
| Rate for Payer: Cofinity Commercial |
$1,567.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,458.07
|
| Rate for Payer: Healthscope Commercial |
$1,640.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,275.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,366.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,549.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,366.94
|
| Rate for Payer: PHP Commercial |
$1,549.20
|
| Rate for Payer: Priority Health SBD |
$1,148.23
|
| Rate for Payer: UMR Bronson Commercial |
$801.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,366.94
|
|
|
HC BRAVO PROCEDURE
|
Facility
|
OP
|
$1,822.59
|
|
| Hospital Charge Code |
36000091
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$674.36 |
| Max. Negotiated Rate |
$1,640.33 |
| Rate for Payer: Aetna American Axle |
$1,184.68
|
| Rate for Payer: Aetna Commercial |
$1,549.20
|
| Rate for Payer: Aetna Medicare |
$911.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,184.68
|
| Rate for Payer: BCBS Complete |
$729.04
|
| Rate for Payer: Cash Price |
$1,458.07
|
| Rate for Payer: Cofinity Advantage |
$1,275.81
|
| Rate for Payer: Cofinity Commercial |
$1,567.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,458.07
|
| Rate for Payer: Healthscope Commercial |
$1,640.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,275.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,366.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,458.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,549.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,366.94
|
| Rate for Payer: PHP Commercial |
$1,549.20
|
| Rate for Payer: Priority Health SBD |
$1,148.23
|
| Rate for Payer: UMR Bronson Commercial |
$674.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,366.94
|
|
|
HC BRAZIL NUT IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200076
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC BRAZIL NUT IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200076
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC BREAST BX W CLIP EACH ADDL LESION MR
|
Facility
|
OP
|
$5,282.80
|
|
|
Service Code
|
CPT 19086
|
| Hospital Charge Code |
36100413
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$524.38 |
| Max. Negotiated Rate |
$4,754.52 |
| Rate for Payer: Aetna American Axle |
$3,433.82
|
| Rate for Payer: Aetna Commercial |
$4,490.38
|
| Rate for Payer: Aetna Medicare |
$2,641.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,433.82
|
| Rate for Payer: BCBS Complete |
$2,113.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,919.68
|
| Rate for Payer: BCCCP Commercial |
$524.38
|
| Rate for Payer: BCN Commercial |
$1,919.68
|
| Rate for Payer: Cash Price |
$4,226.24
|
| Rate for Payer: Cash Price |
$4,226.24
|
| Rate for Payer: Cash Price |
$4,226.24
|
| Rate for Payer: Cofinity Advantage |
$3,697.96
|
| Rate for Payer: Cofinity Commercial |
$4,543.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,226.24
|
| Rate for Payer: Healthscope Commercial |
$4,754.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,697.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,962.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,226.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,490.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,962.10
|
| Rate for Payer: PHP Commercial |
$4,490.38
|
| Rate for Payer: Priority Health SBD |
$3,328.16
|
| Rate for Payer: UMR Bronson Commercial |
$1,954.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,962.10
|
|
|
HC BREAST BX W CLIP EACH ADDL LESION MR
|
Facility
|
IP
|
$5,282.80
|
|
|
Service Code
|
CPT 19086
|
| Hospital Charge Code |
36100413
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,324.43 |
| Max. Negotiated Rate |
$4,754.52 |
| Rate for Payer: Aetna American Axle |
$3,433.82
|
| Rate for Payer: Aetna Commercial |
$4,490.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,433.82
|
| Rate for Payer: Cash Price |
$4,226.24
|
| Rate for Payer: Cofinity Advantage |
$3,697.96
|
| Rate for Payer: Cofinity Commercial |
$4,543.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,226.24
|
| Rate for Payer: Healthscope Commercial |
$4,754.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,697.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,962.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,490.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,962.10
|
| Rate for Payer: PHP Commercial |
$4,490.38
|
| Rate for Payer: Priority Health SBD |
$3,328.16
|
| Rate for Payer: UMR Bronson Commercial |
$2,324.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,962.10
|
|
|
HC BREAST BX W CLIP EACH ADDL LESION STEREO
|
Facility
|
OP
|
$3,743.75
|
|
|
Service Code
|
CPT 19082
|
| Hospital Charge Code |
36100409
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$344.68 |
| Max. Negotiated Rate |
$3,369.38 |
| Rate for Payer: Aetna American Axle |
$2,433.44
|
| Rate for Payer: Aetna Commercial |
$3,182.19
|
| Rate for Payer: Aetna Medicare |
$1,871.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,433.44
|
| Rate for Payer: BCBS Complete |
$1,497.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,974.71
|
| Rate for Payer: BCCCP Commercial |
$344.68
|
| Rate for Payer: BCN Commercial |
$1,974.71
|
| Rate for Payer: Cash Price |
$2,995.00
|
| Rate for Payer: Cash Price |
$2,995.00
|
| Rate for Payer: Cash Price |
$2,995.00
|
| Rate for Payer: Cofinity Advantage |
$2,620.62
|
| Rate for Payer: Cofinity Commercial |
$3,219.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,995.00
|
| Rate for Payer: Healthscope Commercial |
$3,369.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,620.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,807.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,995.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,182.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,807.81
|
| Rate for Payer: PHP Commercial |
$3,182.19
|
| Rate for Payer: Priority Health SBD |
$2,358.56
|
| Rate for Payer: UMR Bronson Commercial |
$1,385.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,807.81
|
|
|
HC BREAST BX W CLIP EACH ADDL LESION STEREO
|
Facility
|
IP
|
$3,743.75
|
|
|
Service Code
|
CPT 19082
|
| Hospital Charge Code |
36100409
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,647.25 |
| Max. Negotiated Rate |
$3,369.38 |
| Rate for Payer: Aetna American Axle |
$2,433.44
|
| Rate for Payer: Aetna Commercial |
$3,182.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,433.44
|
| Rate for Payer: Cash Price |
$2,995.00
|
| Rate for Payer: Cofinity Advantage |
$2,620.62
|
| Rate for Payer: Cofinity Commercial |
$3,219.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,995.00
|
| Rate for Payer: Healthscope Commercial |
$3,369.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,620.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,807.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,182.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,807.81
|
| Rate for Payer: PHP Commercial |
$3,182.19
|
| Rate for Payer: Priority Health SBD |
$2,358.56
|
| Rate for Payer: UMR Bronson Commercial |
$1,647.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,807.81
|
|
|
HC BREAST BX W CLIP EACH ADDL LESION US
|
Facility
|
OP
|
$4,126.82
|
|
|
Service Code
|
CPT 19084
|
| Hospital Charge Code |
36100411
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$338.10 |
| Max. Negotiated Rate |
$3,714.14 |
| Rate for Payer: Aetna American Axle |
$2,682.43
|
| Rate for Payer: Aetna Commercial |
$3,507.80
|
| Rate for Payer: Aetna Medicare |
$2,063.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,682.43
|
| Rate for Payer: BCBS Complete |
$1,650.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,814.95
|
| Rate for Payer: BCCCP Commercial |
$338.10
|
| Rate for Payer: BCN Commercial |
$1,814.95
|
| Rate for Payer: Cash Price |
$3,301.46
|
| Rate for Payer: Cash Price |
$3,301.46
|
| Rate for Payer: Cash Price |
$3,301.46
|
| Rate for Payer: Cofinity Advantage |
$2,888.77
|
| Rate for Payer: Cofinity Commercial |
$3,549.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,301.46
|
| Rate for Payer: Healthscope Commercial |
$3,714.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,888.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,095.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,301.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,507.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,095.11
|
| Rate for Payer: PHP Commercial |
$3,507.80
|
| Rate for Payer: Priority Health SBD |
$2,599.90
|
| Rate for Payer: UMR Bronson Commercial |
$1,526.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,095.11
|
|
|
HC BREAST BX W CLIP EACH ADDL LESION US
|
Facility
|
IP
|
$4,126.82
|
|
|
Service Code
|
CPT 19084
|
| Hospital Charge Code |
36100411
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,815.80 |
| Max. Negotiated Rate |
$3,714.14 |
| Rate for Payer: Aetna American Axle |
$2,682.43
|
| Rate for Payer: Aetna Commercial |
$3,507.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,682.43
|
| Rate for Payer: Cash Price |
$3,301.46
|
| Rate for Payer: Cofinity Advantage |
$2,888.77
|
| Rate for Payer: Cofinity Commercial |
$3,549.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,301.46
|
| Rate for Payer: Healthscope Commercial |
$3,714.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,888.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,095.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,507.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,095.11
|
| Rate for Payer: PHP Commercial |
$3,507.80
|
| Rate for Payer: Priority Health SBD |
$2,599.90
|
| Rate for Payer: UMR Bronson Commercial |
$1,815.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,095.11
|
|
|
HC BREAST BX W CLIP FIRST LESION MR
|
Facility
|
OP
|
$3,158.79
|
|
|
Service Code
|
CPT 19085
|
| Hospital Charge Code |
36100412
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$685.36 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna American Axle |
$2,053.21
|
| Rate for Payer: Aetna Commercial |
$2,684.97
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,053.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,731.04
|
| Rate for Payer: BCCCP Commercial |
$685.36
|
| Rate for Payer: BCN Commercial |
$1,731.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$2,527.03
|
| Rate for Payer: Cash Price |
$2,527.03
|
| Rate for Payer: Cash Price |
$2,527.03
|
| Rate for Payer: Cofinity Advantage |
$2,211.15
|
| Rate for Payer: Cofinity Commercial |
$2,716.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,527.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$2,842.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,211.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,369.09
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,684.97
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,369.09
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$2,684.97
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,990.04
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: UMR Bronson Commercial |
$1,168.75
|
| Rate for Payer: VA VA |
$1,645.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,369.09
|
|
|
HC BREAST BX W CLIP FIRST LESION MR
|
Facility
|
IP
|
$3,158.79
|
|
|
Service Code
|
CPT 19085
|
| Hospital Charge Code |
36100412
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,389.87 |
| Max. Negotiated Rate |
$2,842.91 |
| Rate for Payer: Aetna American Axle |
$2,053.21
|
| Rate for Payer: Aetna Commercial |
$2,684.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,053.21
|
| Rate for Payer: Cash Price |
$2,527.03
|
| Rate for Payer: Cofinity Advantage |
$2,211.15
|
| Rate for Payer: Cofinity Commercial |
$2,716.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,527.03
|
| Rate for Payer: Healthscope Commercial |
$2,842.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,211.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,369.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,684.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,369.09
|
| Rate for Payer: PHP Commercial |
$2,684.97
|
| Rate for Payer: Priority Health SBD |
$1,990.04
|
| Rate for Payer: UMR Bronson Commercial |
$1,389.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,369.09
|
|
|
HC BREAST BX W CLIP FIRST LESION STEREO
|
Facility
|
IP
|
$3,815.35
|
|
|
Service Code
|
CPT 19081
|
| Hospital Charge Code |
36100408
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,678.75 |
| Max. Negotiated Rate |
$3,433.82 |
| Rate for Payer: Aetna American Axle |
$2,479.98
|
| Rate for Payer: Aetna Commercial |
$3,243.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,479.98
|
| Rate for Payer: Cash Price |
$3,052.28
|
| Rate for Payer: Cofinity Advantage |
$2,670.74
|
| Rate for Payer: Cofinity Commercial |
$3,281.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,052.28
|
| Rate for Payer: Healthscope Commercial |
$3,433.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,670.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,861.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,243.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,861.51
|
| Rate for Payer: PHP Commercial |
$3,243.05
|
| Rate for Payer: Priority Health SBD |
$2,403.67
|
| Rate for Payer: UMR Bronson Commercial |
$1,678.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,861.51
|
|
|
HC BREAST BX W CLIP FIRST LESION STEREO
|
Facility
|
OP
|
$3,815.35
|
|
|
Service Code
|
CPT 19081
|
| Hospital Charge Code |
36100408
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$456.33 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna American Axle |
$2,479.98
|
| Rate for Payer: Aetna Commercial |
$3,243.05
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,479.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,259.62
|
| Rate for Payer: BCCCP Commercial |
$456.33
|
| Rate for Payer: BCN Commercial |
$1,259.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$3,052.28
|
| Rate for Payer: Cash Price |
$3,052.28
|
| Rate for Payer: Cash Price |
$3,052.28
|
| Rate for Payer: Cofinity Advantage |
$2,670.74
|
| Rate for Payer: Cofinity Commercial |
$3,281.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,052.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$3,433.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,670.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,861.51
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,243.05
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,861.51
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$3,243.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$2,403.67
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: UMR Bronson Commercial |
$1,411.68
|
| Rate for Payer: VA VA |
$1,645.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,861.51
|
|
|
HC BREAST BX W CLIP FIRST LESION US
|
Facility
|
OP
|
$4,208.80
|
|
|
Service Code
|
CPT 19083
|
| Hospital Charge Code |
36100410
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$450.69 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna American Axle |
$2,735.72
|
| Rate for Payer: Aetna Commercial |
$3,577.48
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,735.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,102.22
|
| Rate for Payer: BCCCP Commercial |
$450.69
|
| Rate for Payer: BCN Commercial |
$1,102.22
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$3,367.04
|
| Rate for Payer: Cash Price |
$3,367.04
|
| Rate for Payer: Cash Price |
$3,367.04
|
| Rate for Payer: Cofinity Advantage |
$2,946.16
|
| Rate for Payer: Cofinity Commercial |
$3,619.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,367.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$3,787.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,946.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,156.60
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,577.48
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,156.60
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$3,577.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$2,651.54
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: UMR Bronson Commercial |
$1,557.26
|
| Rate for Payer: VA VA |
$1,645.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,156.60
|
|
|
HC BREAST BX W CLIP FIRST LESION US
|
Facility
|
IP
|
$4,208.80
|
|
|
Service Code
|
CPT 19083
|
| Hospital Charge Code |
36100410
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,851.87 |
| Max. Negotiated Rate |
$3,787.92 |
| Rate for Payer: Aetna American Axle |
$2,735.72
|
| Rate for Payer: Aetna Commercial |
$3,577.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,735.72
|
| Rate for Payer: Cash Price |
$3,367.04
|
| Rate for Payer: Cofinity Advantage |
$2,946.16
|
| Rate for Payer: Cofinity Commercial |
$3,619.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,367.04
|
| Rate for Payer: Healthscope Commercial |
$3,787.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,946.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,156.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,577.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,156.60
|
| Rate for Payer: PHP Commercial |
$3,577.48
|
| Rate for Payer: Priority Health SBD |
$2,651.54
|
| Rate for Payer: UMR Bronson Commercial |
$1,851.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,156.60
|
|
|
HC BREATH HYDROGEN/METHANE TEST
|
Facility
|
OP
|
$370.36
|
|
|
Service Code
|
CPT 91065
|
| Hospital Charge Code |
75000012
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$695.77 |
| Rate for Payer: Aetna American Axle |
$240.73
|
| Rate for Payer: Aetna Commercial |
$314.81
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$236.70
|
| Rate for Payer: BCN Commercial |
$236.70
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$296.29
|
| Rate for Payer: Cash Price |
$296.29
|
| Rate for Payer: Cofinity Advantage |
$259.25
|
| Rate for Payer: Cofinity Commercial |
$318.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$333.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$259.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.77
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.81
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.77
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$314.81
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$233.33
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: UMR Bronson Commercial |
$137.03
|
| Rate for Payer: VA VA |
$215.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.77
|
|
|
HC BREATH HYDROGEN/METHANE TEST
|
Facility
|
IP
|
$370.36
|
|
|
Service Code
|
CPT 91065
|
| Hospital Charge Code |
75000012
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$162.96 |
| Max. Negotiated Rate |
$333.32 |
| Rate for Payer: Aetna American Axle |
$240.73
|
| Rate for Payer: Aetna Commercial |
$314.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.73
|
| Rate for Payer: Cash Price |
$296.29
|
| Rate for Payer: Cofinity Advantage |
$259.25
|
| Rate for Payer: Cofinity Commercial |
$318.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.29
|
| Rate for Payer: Healthscope Commercial |
$333.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$259.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.77
|
| Rate for Payer: PHP Commercial |
$314.81
|
| Rate for Payer: Priority Health SBD |
$233.33
|
| Rate for Payer: UMR Bronson Commercial |
$162.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.77
|
|
|
HC BRIEF EMOTIONAL/BEHAVIORAL ASSESSMENT
|
Facility
|
OP
|
$25.97
|
|
|
Service Code
|
CPT 96127
|
| Hospital Charge Code |
91800002
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$120.34 |
| Rate for Payer: Aetna American Axle |
$16.88
|
| Rate for Payer: Aetna Commercial |
$22.07
|
| Rate for Payer: Aetna Medicare |
$38.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.52
|
| Rate for Payer: BCBS Complete |
$20.44
|
| Rate for Payer: BCBS MAPPO |
$37.22
|
| Rate for Payer: BCBS Trust/PPO |
$18.31
|
| Rate for Payer: BCN Commercial |
$18.31
|
| Rate for Payer: BCN Medicare Advantage |
$37.22
|
| Rate for Payer: Cash Price |
$20.78
|
| Rate for Payer: Cash Price |
$20.78
|
| Rate for Payer: Cofinity Advantage |
$18.18
|
| Rate for Payer: Cofinity Commercial |
$22.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.22
|
| Rate for Payer: Healthscope Commercial |
$23.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.48
|
| Rate for Payer: Mclaren Medicaid |
$37.22
|
| Rate for Payer: Mclaren Medicare |
$37.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.08
|
| Rate for Payer: Meridian Medicaid |
$39.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.07
|
| Rate for Payer: Nomi Health Commercial |
$111.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.48
|
| Rate for Payer: PACE Medicare |
$35.36
|
| Rate for Payer: PACE SWMI |
$37.22
|
| Rate for Payer: PHP Commercial |
$22.07
|
| Rate for Payer: PHP Medicare Advantage |
$37.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$120.34
|
| Rate for Payer: Priority Health Medicare |
$37.22
|
| Rate for Payer: Priority Health SBD |
$16.36
|
| Rate for Payer: Priority Health Tiered Network |
$96.27
|
| Rate for Payer: Railroad Medicare Medicare |
$37.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.88
|
| Rate for Payer: UHC Core |
$13.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.22
|
| Rate for Payer: UHC Exchange |
$10.21
|
| Rate for Payer: UHC Medicaid |
$19.47
|
| Rate for Payer: UHCCP Medicaid |
$19.47
|
| Rate for Payer: UMR Bronson Commercial |
$9.61
|
| Rate for Payer: VA VA |
$37.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.48
|
|
|
HC BRIEF EMOTIONAL/BEHAVIORAL ASSESSMENT
|
Facility
|
IP
|
$25.97
|
|
|
Service Code
|
CPT 96127
|
| Hospital Charge Code |
91800002
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$11.43 |
| Max. Negotiated Rate |
$23.37 |
| Rate for Payer: Aetna American Axle |
$16.88
|
| Rate for Payer: Aetna Commercial |
$22.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.88
|
| Rate for Payer: Cash Price |
$20.78
|
| Rate for Payer: Cofinity Advantage |
$18.18
|
| Rate for Payer: Cofinity Commercial |
$22.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.78
|
| Rate for Payer: Healthscope Commercial |
$23.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.48
|
| Rate for Payer: PHP Commercial |
$22.07
|
| Rate for Payer: Priority Health SBD |
$16.36
|
| Rate for Payer: UMR Bronson Commercial |
$11.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.48
|
|
