|
HC BRONCH CMPTR ASST IMAGE ADD ON
|
Facility
|
OP
|
$263.19
|
|
| Hospital Charge Code |
75000007
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$97.38 |
| Max. Negotiated Rate |
$236.87 |
| Rate for Payer: Aetna American Axle |
$171.07
|
| Rate for Payer: Aetna Commercial |
$223.71
|
| Rate for Payer: Aetna Medicare |
$131.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.07
|
| Rate for Payer: BCBS Complete |
$105.28
|
| Rate for Payer: Cash Price |
$210.55
|
| Rate for Payer: Cofinity Advantage |
$184.23
|
| Rate for Payer: Cofinity Commercial |
$226.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.55
|
| Rate for Payer: Healthscope Commercial |
$236.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$210.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.39
|
| Rate for Payer: PHP Commercial |
$223.71
|
| Rate for Payer: Priority Health SBD |
$165.81
|
| Rate for Payer: UMR Bronson Commercial |
$97.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.39
|
|
|
HC BRONCH CMPTR ASST IMAGE ADD ON
|
Facility
|
IP
|
$263.19
|
|
| Hospital Charge Code |
75000007
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$115.80 |
| Max. Negotiated Rate |
$236.87 |
| Rate for Payer: Aetna American Axle |
$171.07
|
| Rate for Payer: Aetna Commercial |
$223.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.07
|
| Rate for Payer: Cash Price |
$210.55
|
| Rate for Payer: Cofinity Advantage |
$184.23
|
| Rate for Payer: Cofinity Commercial |
$226.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.55
|
| Rate for Payer: Healthscope Commercial |
$236.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.39
|
| Rate for Payer: PHP Commercial |
$223.71
|
| Rate for Payer: Priority Health SBD |
$165.81
|
| Rate for Payer: UMR Bronson Commercial |
$115.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.39
|
|
|
HC BRONCHIAL NAVIGATION
|
Facility
|
IP
|
$3,165.75
|
|
| Hospital Charge Code |
36000102
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,392.93 |
| Max. Negotiated Rate |
$2,849.18 |
| Rate for Payer: Aetna American Axle |
$2,057.74
|
| Rate for Payer: Aetna Commercial |
$2,690.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,057.74
|
| Rate for Payer: Cash Price |
$2,532.60
|
| Rate for Payer: Cofinity Advantage |
$2,216.03
|
| Rate for Payer: Cofinity Commercial |
$2,722.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,532.60
|
| Rate for Payer: Healthscope Commercial |
$2,849.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,216.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,374.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,690.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,374.31
|
| Rate for Payer: PHP Commercial |
$2,690.89
|
| Rate for Payer: Priority Health SBD |
$1,994.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,392.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,374.31
|
|
|
HC BRONCHIAL NAVIGATION
|
Facility
|
OP
|
$3,165.75
|
|
| Hospital Charge Code |
36000102
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,171.33 |
| Max. Negotiated Rate |
$2,849.18 |
| Rate for Payer: Aetna American Axle |
$2,057.74
|
| Rate for Payer: Aetna Commercial |
$2,690.89
|
| Rate for Payer: Aetna Medicare |
$1,582.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,057.74
|
| Rate for Payer: BCBS Complete |
$1,266.30
|
| Rate for Payer: Cash Price |
$2,532.60
|
| Rate for Payer: Cofinity Advantage |
$2,216.03
|
| Rate for Payer: Cofinity Commercial |
$2,722.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,532.60
|
| Rate for Payer: Healthscope Commercial |
$2,849.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,216.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,374.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,532.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,690.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,374.31
|
| Rate for Payer: PHP Commercial |
$2,690.89
|
| Rate for Payer: Priority Health SBD |
$1,994.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,171.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,374.31
|
|
|
HC BRONCHO HYGIENE INITIAL
|
Facility
|
IP
|
$279.24
|
|
|
Service Code
|
CPT 94667
|
| Hospital Charge Code |
41000010
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$122.87 |
| Max. Negotiated Rate |
$251.32 |
| Rate for Payer: Aetna American Axle |
$181.51
|
| Rate for Payer: Aetna Commercial |
$237.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.51
|
| Rate for Payer: Cash Price |
$223.39
|
| Rate for Payer: Cofinity Advantage |
$195.47
|
| Rate for Payer: Cofinity Commercial |
$240.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.39
|
| Rate for Payer: Healthscope Commercial |
$251.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$195.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$209.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$209.43
|
| Rate for Payer: PHP Commercial |
$237.35
|
| Rate for Payer: Priority Health SBD |
$175.92
|
| Rate for Payer: UMR Bronson Commercial |
$122.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$209.43
|
|
|
HC BRONCHO HYGIENE INITIAL
|
Facility
|
OP
|
$279.24
|
|
|
Service Code
|
CPT 94667
|
| Hospital Charge Code |
41000010
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$428.73 |
| Rate for Payer: Aetna American Axle |
$181.51
|
| Rate for Payer: Aetna Commercial |
$237.35
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$104.25
|
| Rate for Payer: BCN Commercial |
$104.25
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$223.39
|
| Rate for Payer: Cash Price |
$223.39
|
| Rate for Payer: Cofinity Advantage |
$195.47
|
| Rate for Payer: Cofinity Commercial |
$240.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$251.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$195.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$209.43
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.35
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$209.43
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$237.35
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$175.92
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.51
|
| Rate for Payer: UHC Core |
$145.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$109.74
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: UMR Bronson Commercial |
$103.32
|
| Rate for Payer: VA VA |
$132.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$209.43
|
|
|
HC BRONCHO HYGIENE SUBS
|
Facility
|
OP
|
$268.38
|
|
|
Service Code
|
CPT 94668
|
| Hospital Charge Code |
41000011
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$428.73 |
| Rate for Payer: Aetna American Axle |
$174.45
|
| Rate for Payer: Aetna Commercial |
$228.12
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$160.62
|
| Rate for Payer: BCN Commercial |
$160.62
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$214.70
|
| Rate for Payer: Cash Price |
$214.70
|
| Rate for Payer: Cofinity Advantage |
$187.87
|
| Rate for Payer: Cofinity Commercial |
$230.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$241.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$187.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.28
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.12
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.28
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$228.12
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$169.08
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.45
|
| Rate for Payer: UHC Core |
$139.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$105.47
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: UMR Bronson Commercial |
$99.30
|
| Rate for Payer: VA VA |
$132.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.28
|
|
|
HC BRONCHO HYGIENE SUBS
|
Facility
|
IP
|
$268.38
|
|
|
Service Code
|
CPT 94668
|
| Hospital Charge Code |
41000011
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$118.09 |
| Max. Negotiated Rate |
$241.54 |
| Rate for Payer: Aetna American Axle |
$174.45
|
| Rate for Payer: Aetna Commercial |
$228.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.45
|
| Rate for Payer: Cash Price |
$214.70
|
| Rate for Payer: Cofinity Advantage |
$187.87
|
| Rate for Payer: Cofinity Commercial |
$230.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.70
|
| Rate for Payer: Healthscope Commercial |
$241.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$187.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.28
|
| Rate for Payer: PHP Commercial |
$228.12
|
| Rate for Payer: Priority Health SBD |
$169.08
|
| Rate for Payer: UMR Bronson Commercial |
$118.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.28
|
|
|
HC BRONCHOSCOPY
|
Facility
|
IP
|
$2,616.10
|
|
| Hospital Charge Code |
36000014
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,151.08 |
| Max. Negotiated Rate |
$2,354.49 |
| Rate for Payer: Aetna American Axle |
$1,700.46
|
| Rate for Payer: Aetna Commercial |
$2,223.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,700.46
|
| Rate for Payer: Cash Price |
$2,092.88
|
| Rate for Payer: Cofinity Advantage |
$1,831.27
|
| Rate for Payer: Cofinity Commercial |
$2,249.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,092.88
|
| Rate for Payer: Healthscope Commercial |
$2,354.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,831.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,962.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,223.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,962.08
|
| Rate for Payer: PHP Commercial |
$2,223.68
|
| Rate for Payer: Priority Health SBD |
$1,648.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,151.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,962.08
|
|
|
HC BRONCHOSCOPY
|
Facility
|
OP
|
$2,616.10
|
|
| Hospital Charge Code |
36000014
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$967.96 |
| Max. Negotiated Rate |
$2,354.49 |
| Rate for Payer: Aetna American Axle |
$1,700.46
|
| Rate for Payer: Aetna Commercial |
$2,223.68
|
| Rate for Payer: Aetna Medicare |
$1,308.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,700.46
|
| Rate for Payer: BCBS Complete |
$1,046.44
|
| Rate for Payer: Cash Price |
$2,092.88
|
| Rate for Payer: Cofinity Advantage |
$1,831.27
|
| Rate for Payer: Cofinity Commercial |
$2,249.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,092.88
|
| Rate for Payer: Healthscope Commercial |
$2,354.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,831.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,962.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,092.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,223.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,962.08
|
| Rate for Payer: PHP Commercial |
$2,223.68
|
| Rate for Payer: Priority Health SBD |
$1,648.14
|
| Rate for Payer: UMR Bronson Commercial |
$967.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,962.08
|
|
|
HC BRONCHOSCOPY W EBUS EXAM
|
Facility
|
IP
|
$3,241.58
|
|
| Hospital Charge Code |
36000015
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,426.30 |
| Max. Negotiated Rate |
$2,917.42 |
| Rate for Payer: Aetna American Axle |
$2,107.03
|
| Rate for Payer: Aetna Commercial |
$2,755.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,107.03
|
| Rate for Payer: Cash Price |
$2,593.26
|
| Rate for Payer: Cofinity Advantage |
$2,269.11
|
| Rate for Payer: Cofinity Commercial |
$2,787.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,593.26
|
| Rate for Payer: Healthscope Commercial |
$2,917.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,269.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,431.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,755.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,431.18
|
| Rate for Payer: PHP Commercial |
$2,755.34
|
| Rate for Payer: Priority Health SBD |
$2,042.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,426.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,431.18
|
|
|
HC BRONCHOSCOPY W EBUS EXAM
|
Facility
|
OP
|
$3,241.58
|
|
| Hospital Charge Code |
36000015
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,199.38 |
| Max. Negotiated Rate |
$2,917.42 |
| Rate for Payer: Aetna American Axle |
$2,107.03
|
| Rate for Payer: Aetna Commercial |
$2,755.34
|
| Rate for Payer: Aetna Medicare |
$1,620.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,107.03
|
| Rate for Payer: BCBS Complete |
$1,296.63
|
| Rate for Payer: Cash Price |
$2,593.26
|
| Rate for Payer: Cofinity Advantage |
$2,269.11
|
| Rate for Payer: Cofinity Commercial |
$2,787.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,593.26
|
| Rate for Payer: Healthscope Commercial |
$2,917.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,269.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,431.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,593.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,755.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,431.18
|
| Rate for Payer: PHP Commercial |
$2,755.34
|
| Rate for Payer: Priority Health SBD |
$2,042.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,199.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,431.18
|
|
|
HC BRONCHOSPASM PROVOCATION (METHACHOLINE CHALLENGE)
|
Facility
|
IP
|
$722.85
|
|
|
Service Code
|
CPT 94070
|
| Hospital Charge Code |
46000003
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$318.05 |
| Max. Negotiated Rate |
$650.57 |
| Rate for Payer: Aetna American Axle |
$469.85
|
| Rate for Payer: Aetna Commercial |
$614.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$469.85
|
| Rate for Payer: Cash Price |
$578.28
|
| Rate for Payer: Cofinity Advantage |
$506.00
|
| Rate for Payer: Cofinity Commercial |
$621.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$578.28
|
| Rate for Payer: Healthscope Commercial |
$650.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$506.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$542.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$614.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$542.14
|
| Rate for Payer: PHP Commercial |
$614.42
|
| Rate for Payer: Priority Health SBD |
$455.40
|
| Rate for Payer: UMR Bronson Commercial |
$318.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$542.14
|
|
|
HC BRONCHOSPASM PROVOCATION (METHACHOLINE CHALLENGE)
|
Facility
|
OP
|
$722.85
|
|
|
Service Code
|
CPT 94070
|
| Hospital Charge Code |
46000003
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$153.56 |
| Max. Negotiated Rate |
$1,202.41 |
| Rate for Payer: Aetna American Axle |
$469.85
|
| Rate for Payer: Aetna Commercial |
$614.42
|
| Rate for Payer: Aetna Medicare |
$386.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$469.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$464.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$464.77
|
| Rate for Payer: BCBS Complete |
$204.20
|
| Rate for Payer: BCBS MAPPO |
$371.82
|
| Rate for Payer: BCBS Trust/PPO |
$153.56
|
| Rate for Payer: BCN Commercial |
$153.56
|
| Rate for Payer: BCN Medicare Advantage |
$371.82
|
| Rate for Payer: Cash Price |
$578.28
|
| Rate for Payer: Cash Price |
$578.28
|
| Rate for Payer: Cofinity Advantage |
$506.00
|
| Rate for Payer: Cofinity Commercial |
$621.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$578.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.82
|
| Rate for Payer: Healthscope Commercial |
$650.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$506.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$542.14
|
| Rate for Payer: Mclaren Medicaid |
$371.82
|
| Rate for Payer: Mclaren Medicare |
$371.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.41
|
| Rate for Payer: Meridian Medicaid |
$390.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$427.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$409.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$614.42
|
| Rate for Payer: Nomi Health Commercial |
$1,115.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$542.14
|
| Rate for Payer: PACE Medicare |
$353.23
|
| Rate for Payer: PACE SWMI |
$371.82
|
| Rate for Payer: PHP Commercial |
$614.42
|
| Rate for Payer: PHP Medicare Advantage |
$371.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,202.41
|
| Rate for Payer: Priority Health Medicare |
$371.82
|
| Rate for Payer: Priority Health SBD |
$455.40
|
| Rate for Payer: Priority Health Tiered Network |
$961.93
|
| Rate for Payer: Railroad Medicare Medicare |
$371.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$469.85
|
| Rate for Payer: UHC Core |
$376.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$371.82
|
| Rate for Payer: UHC Exchange |
$284.08
|
| Rate for Payer: UHC Medicaid |
$194.46
|
| Rate for Payer: UHCCP Medicaid |
$194.46
|
| Rate for Payer: UMR Bronson Commercial |
$267.45
|
| Rate for Payer: VA VA |
$371.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$542.14
|
|
|
HC BRUCELLA ANTIBODY
|
Facility
|
IP
|
$74.91
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200236
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$32.96 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna American Axle |
$48.69
|
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.69
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Advantage |
$52.44
|
| Rate for Payer: Cofinity Commercial |
$64.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.18
|
| Rate for Payer: PHP Commercial |
$63.67
|
| Rate for Payer: Priority Health SBD |
$47.19
|
| Rate for Payer: UMR Bronson Commercial |
$32.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.18
|
|
|
HC BRUCELLA ANTIBODY
|
Facility
|
OP
|
$74.91
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200236
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.67 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna American Axle |
$48.69
|
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: Aetna Medicare |
$9.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.16
|
| Rate for Payer: BCBS Complete |
$4.90
|
| Rate for Payer: BCBS MAPPO |
$8.93
|
| Rate for Payer: BCBS Trust/PPO |
$10.33
|
| Rate for Payer: BCN Commercial |
$10.33
|
| Rate for Payer: BCN Medicare Advantage |
$8.93
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Advantage |
$52.44
|
| Rate for Payer: Cofinity Commercial |
$64.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.93
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.18
|
| Rate for Payer: Mclaren Medicaid |
$8.93
|
| Rate for Payer: Mclaren Medicare |
$8.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.38
|
| Rate for Payer: Meridian Medicaid |
$9.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$13.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.18
|
| Rate for Payer: PACE Medicare |
$8.48
|
| Rate for Payer: PACE SWMI |
$8.93
|
| Rate for Payer: PHP Commercial |
$63.67
|
| Rate for Payer: PHP Medicare Advantage |
$8.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.93
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health SBD |
$47.19
|
| Rate for Payer: Priority Health Tiered Network |
$7.14
|
| Rate for Payer: Railroad Medicare Medicare |
$8.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.40
|
| Rate for Payer: UHC Core |
$13.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.93
|
| Rate for Payer: UHC Exchange |
$13.40
|
| Rate for Payer: UHC Medicaid |
$4.67
|
| Rate for Payer: UHCCP Medicaid |
$4.67
|
| Rate for Payer: UMR Bronson Commercial |
$27.72
|
| Rate for Payer: VA VA |
$8.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.18
|
|
|
HC BRUCELLA ANTIBODY CMPT
|
Facility
|
OP
|
$74.91
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200238
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.67 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna American Axle |
$48.69
|
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: Aetna Medicare |
$9.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.16
|
| Rate for Payer: BCBS Complete |
$4.90
|
| Rate for Payer: BCBS MAPPO |
$8.93
|
| Rate for Payer: BCBS Trust/PPO |
$10.33
|
| Rate for Payer: BCN Commercial |
$10.33
|
| Rate for Payer: BCN Medicare Advantage |
$8.93
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Advantage |
$52.44
|
| Rate for Payer: Cofinity Commercial |
$64.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.93
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.18
|
| Rate for Payer: Mclaren Medicaid |
$8.93
|
| Rate for Payer: Mclaren Medicare |
$8.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.38
|
| Rate for Payer: Meridian Medicaid |
$9.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$13.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.18
|
| Rate for Payer: PACE Medicare |
$8.48
|
| Rate for Payer: PACE SWMI |
$8.93
|
| Rate for Payer: PHP Commercial |
$63.67
|
| Rate for Payer: PHP Medicare Advantage |
$8.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.93
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health SBD |
$47.19
|
| Rate for Payer: Priority Health Tiered Network |
$7.14
|
| Rate for Payer: Railroad Medicare Medicare |
$8.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.40
|
| Rate for Payer: UHC Core |
$13.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.93
|
| Rate for Payer: UHC Exchange |
$13.40
|
| Rate for Payer: UHC Medicaid |
$4.67
|
| Rate for Payer: UHCCP Medicaid |
$4.67
|
| Rate for Payer: UMR Bronson Commercial |
$27.72
|
| Rate for Payer: VA VA |
$8.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.18
|
|
|
HC BRUCELLA ANTIBODY CMPT
|
Facility
|
IP
|
$74.91
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200238
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$32.96 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna American Axle |
$48.69
|
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.69
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Advantage |
$52.44
|
| Rate for Payer: Cofinity Commercial |
$64.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.18
|
| Rate for Payer: PHP Commercial |
$63.67
|
| Rate for Payer: Priority Health SBD |
$47.19
|
| Rate for Payer: UMR Bronson Commercial |
$32.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.18
|
|
|
HC BRUCELLA ANTIBODY CONFIRMATION
|
Facility
|
OP
|
$54.10
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200237
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.67 |
| Max. Negotiated Rate |
$48.69 |
| Rate for Payer: Aetna American Axle |
$35.16
|
| Rate for Payer: Aetna Commercial |
$45.98
|
| Rate for Payer: Aetna Medicare |
$9.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.16
|
| Rate for Payer: BCBS Complete |
$4.90
|
| Rate for Payer: BCBS MAPPO |
$8.93
|
| Rate for Payer: BCBS Trust/PPO |
$10.33
|
| Rate for Payer: BCN Commercial |
$10.33
|
| Rate for Payer: BCN Medicare Advantage |
$8.93
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Advantage |
$37.87
|
| Rate for Payer: Cofinity Commercial |
$46.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.93
|
| Rate for Payer: Healthscope Commercial |
$48.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.58
|
| Rate for Payer: Mclaren Medicaid |
$8.93
|
| Rate for Payer: Mclaren Medicare |
$8.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.38
|
| Rate for Payer: Meridian Medicaid |
$9.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: Nomi Health Commercial |
$13.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.58
|
| Rate for Payer: PACE Medicare |
$8.48
|
| Rate for Payer: PACE SWMI |
$8.93
|
| Rate for Payer: PHP Commercial |
$45.98
|
| Rate for Payer: PHP Medicare Advantage |
$8.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.93
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health SBD |
$34.08
|
| Rate for Payer: Priority Health Tiered Network |
$7.14
|
| Rate for Payer: Railroad Medicare Medicare |
$8.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.40
|
| Rate for Payer: UHC Core |
$13.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.93
|
| Rate for Payer: UHC Exchange |
$13.40
|
| Rate for Payer: UHC Medicaid |
$4.67
|
| Rate for Payer: UHCCP Medicaid |
$4.67
|
| Rate for Payer: UMR Bronson Commercial |
$20.02
|
| Rate for Payer: VA VA |
$8.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.58
|
|
|
HC BRUCELLA ANTIBODY CONFIRMATION
|
Facility
|
IP
|
$54.10
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200237
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.80 |
| Max. Negotiated Rate |
$48.69 |
| Rate for Payer: Aetna American Axle |
$35.16
|
| Rate for Payer: Aetna Commercial |
$45.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.16
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Advantage |
$37.87
|
| Rate for Payer: Cofinity Commercial |
$46.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Healthscope Commercial |
$48.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.58
|
| Rate for Payer: PHP Commercial |
$45.98
|
| Rate for Payer: Priority Health SBD |
$34.08
|
| Rate for Payer: UMR Bronson Commercial |
$23.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.58
|
|
|
HC BUDESONIDE INHALATION SOLUTION
|
Facility
|
IP
|
$29.94
|
|
| Hospital Charge Code |
63700005
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$13.17 |
| Max. Negotiated Rate |
$26.95 |
| Rate for Payer: Aetna American Axle |
$19.46
|
| Rate for Payer: Aetna Commercial |
$25.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.46
|
| Rate for Payer: Cash Price |
$23.95
|
| Rate for Payer: Cofinity Advantage |
$20.96
|
| Rate for Payer: Cofinity Commercial |
$25.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.95
|
| Rate for Payer: Healthscope Commercial |
$26.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.45
|
| Rate for Payer: PHP Commercial |
$25.45
|
| Rate for Payer: Priority Health SBD |
$18.86
|
| Rate for Payer: UMR Bronson Commercial |
$13.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.45
|
|
|
HC BUDESONIDE INHALATION SOLUTION
|
Facility
|
OP
|
$29.94
|
|
| Hospital Charge Code |
63700005
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$26.95 |
| Rate for Payer: Aetna American Axle |
$19.46
|
| Rate for Payer: Aetna Commercial |
$25.45
|
| Rate for Payer: Aetna Medicare |
$14.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.46
|
| Rate for Payer: BCBS Complete |
$11.98
|
| Rate for Payer: Cash Price |
$23.95
|
| Rate for Payer: Cofinity Advantage |
$20.96
|
| Rate for Payer: Cofinity Commercial |
$25.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.95
|
| Rate for Payer: Healthscope Commercial |
$26.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.45
|
| Rate for Payer: PHP Commercial |
$25.45
|
| Rate for Payer: Priority Health SBD |
$18.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.46
|
| Rate for Payer: UHC Core |
$15.60
|
| Rate for Payer: UHC Exchange |
$11.77
|
| Rate for Payer: UMR Bronson Commercial |
$11.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.45
|
|
|
HC BUNDLE OF HIS RECORDING
|
Facility
|
OP
|
$4,101.81
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
48100029
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,517.67 |
| Max. Negotiated Rate |
$25,132.71 |
| Rate for Payer: Aetna American Axle |
$2,666.18
|
| Rate for Payer: Aetna Commercial |
$3,486.54
|
| Rate for Payer: Aetna Medicare |
$8,082.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,666.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,714.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,714.52
|
| Rate for Payer: BCBS Complete |
$4,268.17
|
| Rate for Payer: BCBS MAPPO |
$7,771.62
|
| Rate for Payer: BCBS Trust/PPO |
$20,072.80
|
| Rate for Payer: BCN Commercial |
$20,072.80
|
| Rate for Payer: BCN Medicare Advantage |
$7,771.62
|
| Rate for Payer: Cash Price |
$3,281.45
|
| Rate for Payer: Cash Price |
$3,281.45
|
| Rate for Payer: Cofinity Advantage |
$2,871.27
|
| Rate for Payer: Cofinity Commercial |
$3,527.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,281.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,771.62
|
| Rate for Payer: Healthscope Commercial |
$3,691.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,871.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,076.36
|
| Rate for Payer: Mclaren Medicaid |
$7,771.62
|
| Rate for Payer: Mclaren Medicare |
$7,771.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,160.20
|
| Rate for Payer: Meridian Medicaid |
$8,160.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,937.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,548.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,486.54
|
| Rate for Payer: Nomi Health Commercial |
$23,314.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,076.36
|
| Rate for Payer: PACE Medicare |
$7,383.04
|
| Rate for Payer: PACE SWMI |
$7,771.62
|
| Rate for Payer: PHP Commercial |
$3,486.54
|
| Rate for Payer: PHP Medicare Advantage |
$7,771.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,064.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25,132.71
|
| Rate for Payer: Priority Health Medicare |
$7,771.62
|
| Rate for Payer: Priority Health SBD |
$2,584.14
|
| Rate for Payer: Priority Health Tiered Network |
$20,106.17
|
| Rate for Payer: Railroad Medicare Medicare |
$7,771.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,771.62
|
| Rate for Payer: UHC Medicaid |
$4,064.56
|
| Rate for Payer: UHCCP Medicaid |
$4,064.56
|
| Rate for Payer: UMR Bronson Commercial |
$1,517.67
|
| Rate for Payer: VA VA |
$7,771.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,076.36
|
|
|
HC BUNDLE OF HIS RECORDING
|
Facility
|
IP
|
$4,101.81
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
48100029
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,804.80 |
| Max. Negotiated Rate |
$3,691.63 |
| Rate for Payer: Aetna American Axle |
$2,666.18
|
| Rate for Payer: Aetna Commercial |
$3,486.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,666.18
|
| Rate for Payer: Cash Price |
$3,281.45
|
| Rate for Payer: Cofinity Advantage |
$2,871.27
|
| Rate for Payer: Cofinity Commercial |
$3,527.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,281.45
|
| Rate for Payer: Healthscope Commercial |
$3,691.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,871.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,076.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,486.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,076.36
|
| Rate for Payer: PHP Commercial |
$3,486.54
|
| Rate for Payer: Priority Health SBD |
$2,584.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,804.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,076.36
|
|
|
HC BUPIVACAINE 0.5 MG
|
Facility
|
IP
|
$1.54
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
25000016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$1.39 |
| Rate for Payer: Aetna American Axle |
$1.00
|
| Rate for Payer: Aetna Commercial |
$1.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.00
|
| Rate for Payer: Cash Price |
$1.23
|
| Rate for Payer: Cofinity Advantage |
$1.08
|
| Rate for Payer: Cofinity Commercial |
$1.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.23
|
| Rate for Payer: Healthscope Commercial |
$1.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.16
|
| Rate for Payer: PHP Commercial |
$1.31
|
| Rate for Payer: Priority Health SBD |
$0.97
|
| Rate for Payer: UMR Bronson Commercial |
$0.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.16
|
|
