|
HC AUD VERTICAL ELECTRODE USE
|
Facility
|
IP
|
$55.11
|
|
|
Service Code
|
CPT 92547
|
| Hospital Charge Code |
47100004
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$24.25 |
| Max. Negotiated Rate |
$49.60 |
| Rate for Payer: Aetna American Axle |
$35.82
|
| Rate for Payer: Aetna Commercial |
$46.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.82
|
| Rate for Payer: Cash Price |
$44.09
|
| Rate for Payer: Cofinity Commercial |
$38.58
|
| Rate for Payer: Cofinity Commercial |
$47.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.09
|
| Rate for Payer: Healthscope Commercial |
$49.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.84
|
| Rate for Payer: PHP Commercial |
$46.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.82
|
| Rate for Payer: Priority Health SBD |
$34.72
|
| Rate for Payer: UMR Bronson Commercial |
$24.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.33
|
|
|
HC AUD VERTICAL ELECTRODE USE
|
Facility
|
OP
|
$55.11
|
|
|
Service Code
|
CPT 92547
|
| Hospital Charge Code |
47100004
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$20.39 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$35.82
|
| Rate for Payer: Aetna Commercial |
$46.84
|
| Rate for Payer: Aetna Medicare |
$27.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.82
|
| Rate for Payer: BCBS Complete |
$22.04
|
| Rate for Payer: Cash Price |
$44.09
|
| Rate for Payer: Cash Price |
$44.09
|
| Rate for Payer: Cofinity Commercial |
$47.39
|
| Rate for Payer: Cofinity Commercial |
$38.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.09
|
| Rate for Payer: Healthscope Commercial |
$49.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.84
|
| Rate for Payer: PHP Commercial |
$46.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.82
|
| Rate for Payer: Priority Health SBD |
$34.72
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$20.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.33
|
|
|
HC AUD VESTIBULAR EVAL BASIC
|
Facility
|
IP
|
$463.45
|
|
|
Service Code
|
CPT 92540
|
| Hospital Charge Code |
47100005
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$203.92 |
| Max. Negotiated Rate |
$417.11 |
| Rate for Payer: Aetna American Axle |
$301.24
|
| Rate for Payer: Aetna Commercial |
$393.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.24
|
| Rate for Payer: Cash Price |
$370.76
|
| Rate for Payer: Cofinity Commercial |
$324.42
|
| Rate for Payer: Cofinity Commercial |
$398.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$324.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.76
|
| Rate for Payer: Healthscope Commercial |
$417.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$324.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.93
|
| Rate for Payer: PHP Commercial |
$393.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.24
|
| Rate for Payer: Priority Health SBD |
$291.97
|
| Rate for Payer: UMR Bronson Commercial |
$203.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.59
|
|
|
HC AUD VESTIBULAR EVAL BASIC
|
Facility
|
OP
|
$463.45
|
|
|
Service Code
|
CPT 92540
|
| Hospital Charge Code |
47100005
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$429.53 |
| Rate for Payer: Aetna American Axle |
$301.24
|
| Rate for Payer: Aetna Commercial |
$393.93
|
| Rate for Payer: Aetna Medicare |
$158.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$370.76
|
| Rate for Payer: Cash Price |
$370.76
|
| Rate for Payer: Cash Price |
$370.76
|
| Rate for Payer: Cofinity Commercial |
$324.42
|
| Rate for Payer: Cofinity Commercial |
$398.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$324.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$417.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$324.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.59
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.93
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$393.93
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.24
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health SBD |
$291.97
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.53
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$291.61
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$81.79
|
| Rate for Payer: UMR Bronson Commercial |
$171.48
|
| Rate for Payer: VA VA |
$152.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.59
|
|
|
HC AUTOLOGOUS UNIT
|
Facility
|
OP
|
$825.28
|
|
|
Service Code
|
HCPCS P9021
|
| Hospital Charge Code |
39000040
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$75.44 |
| Max. Negotiated Rate |
$742.75 |
| Rate for Payer: Aetna American Axle |
$536.43
|
| Rate for Payer: Aetna Commercial |
$701.49
|
| Rate for Payer: Aetna Medicare |
$146.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$536.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.94
|
| Rate for Payer: BCBS Complete |
$79.21
|
| Rate for Payer: BCBS MAPPO |
$140.75
|
| Rate for Payer: BCN Medicare Advantage |
$140.75
|
| Rate for Payer: Cash Price |
$660.22
|
| Rate for Payer: Cash Price |
$660.22
|
| Rate for Payer: Cash Price |
$660.22
|
| Rate for Payer: Cofinity Commercial |
$577.70
|
| Rate for Payer: Cofinity Commercial |
$709.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$577.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.75
|
| Rate for Payer: Healthscope Commercial |
$742.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$577.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$618.96
|
| Rate for Payer: Mclaren Medicaid |
$75.44
|
| Rate for Payer: Mclaren Medicare |
$140.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.79
|
| Rate for Payer: Meridian Medicaid |
$79.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.49
|
| Rate for Payer: PACE Medicare |
$133.71
|
| Rate for Payer: PACE SWMI |
$140.75
|
| Rate for Payer: PHP Commercial |
$701.49
|
| Rate for Payer: PHP Medicare Advantage |
$140.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.43
|
| Rate for Payer: Priority Health Medicare |
$140.75
|
| Rate for Payer: Priority Health SBD |
$519.93
|
| Rate for Payer: Railroad Medicare Medicare |
$140.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.20
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.75
|
| Rate for Payer: UHC Exchange |
$268.99
|
| Rate for Payer: UHC Medicare Advantage |
$140.75
|
| Rate for Payer: UHCCP Medicaid |
$75.44
|
| Rate for Payer: UMR Bronson Commercial |
$305.35
|
| Rate for Payer: VA VA |
$140.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$618.96
|
|
|
HC AUTOLOGOUS UNIT
|
Facility
|
IP
|
$825.28
|
|
|
Service Code
|
HCPCS P9021
|
| Hospital Charge Code |
39000040
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$363.12 |
| Max. Negotiated Rate |
$742.75 |
| Rate for Payer: Aetna American Axle |
$536.43
|
| Rate for Payer: Aetna Commercial |
$701.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$536.43
|
| Rate for Payer: Cash Price |
$660.22
|
| Rate for Payer: Cofinity Commercial |
$577.70
|
| Rate for Payer: Cofinity Commercial |
$709.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$577.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.22
|
| Rate for Payer: Healthscope Commercial |
$742.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$577.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$618.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.49
|
| Rate for Payer: PHP Commercial |
$701.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.43
|
| Rate for Payer: Priority Health SBD |
$519.93
|
| Rate for Payer: UMR Bronson Commercial |
$363.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$618.96
|
|
|
HC AUTONOMIC FUNC ADRENERGIC
|
Facility
|
OP
|
$181.53
|
|
|
Service Code
|
CPT 95922
|
| Hospital Charge Code |
92000007
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$67.17 |
| Max. Negotiated Rate |
$353.86 |
| Rate for Payer: Aetna American Axle |
$117.99
|
| Rate for Payer: Aetna Commercial |
$154.30
|
| Rate for Payer: Aetna Medicare |
$130.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$145.22
|
| Rate for Payer: Cash Price |
$145.22
|
| Rate for Payer: Cash Price |
$145.22
|
| Rate for Payer: Cofinity Commercial |
$127.07
|
| Rate for Payer: Cofinity Commercial |
$156.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$127.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$163.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$127.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.15
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.30
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$154.30
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.99
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health SBD |
$114.36
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.86
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$240.24
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: UMR Bronson Commercial |
$67.17
|
| Rate for Payer: VA VA |
$125.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.15
|
|
|
HC AUTONOMIC FUNC ADRENERGIC
|
Facility
|
IP
|
$181.53
|
|
|
Service Code
|
CPT 95922
|
| Hospital Charge Code |
92000007
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$79.87 |
| Max. Negotiated Rate |
$163.38 |
| Rate for Payer: Aetna American Axle |
$117.99
|
| Rate for Payer: Aetna Commercial |
$154.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.99
|
| Rate for Payer: Cash Price |
$145.22
|
| Rate for Payer: Cofinity Commercial |
$127.07
|
| Rate for Payer: Cofinity Commercial |
$156.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$127.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.22
|
| Rate for Payer: Healthscope Commercial |
$163.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$127.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.30
|
| Rate for Payer: PHP Commercial |
$154.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.99
|
| Rate for Payer: Priority Health SBD |
$114.36
|
| Rate for Payer: UMR Bronson Commercial |
$79.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.15
|
|
|
HC AUTONOMIC FUNC CARDIO INNERVAT
|
Facility
|
IP
|
$363.05
|
|
|
Service Code
|
CPT 95921
|
| Hospital Charge Code |
92000006
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$159.74 |
| Max. Negotiated Rate |
$326.75 |
| Rate for Payer: Aetna American Axle |
$235.98
|
| Rate for Payer: Aetna Commercial |
$308.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.98
|
| Rate for Payer: Cash Price |
$290.44
|
| Rate for Payer: Cofinity Commercial |
$254.13
|
| Rate for Payer: Cofinity Commercial |
$312.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$254.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.44
|
| Rate for Payer: Healthscope Commercial |
$326.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$254.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$272.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$308.59
|
| Rate for Payer: PHP Commercial |
$308.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.98
|
| Rate for Payer: Priority Health SBD |
$228.72
|
| Rate for Payer: UMR Bronson Commercial |
$159.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$272.29
|
|
|
HC AUTONOMIC FUNC CARDIO INNERVAT
|
Facility
|
OP
|
$363.05
|
|
|
Service Code
|
CPT 95921
|
| Hospital Charge Code |
92000006
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$429.53 |
| Rate for Payer: Aetna American Axle |
$235.98
|
| Rate for Payer: Aetna Commercial |
$308.59
|
| Rate for Payer: Aetna Medicare |
$158.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$290.44
|
| Rate for Payer: Cash Price |
$290.44
|
| Rate for Payer: Cash Price |
$290.44
|
| Rate for Payer: Cofinity Commercial |
$254.13
|
| Rate for Payer: Cofinity Commercial |
$312.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$254.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$326.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$254.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$272.29
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$308.59
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$308.59
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.98
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health SBD |
$228.72
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.53
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$291.61
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$81.79
|
| Rate for Payer: UMR Bronson Commercial |
$134.33
|
| Rate for Payer: VA VA |
$152.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$272.29
|
|
|
HC AUTONOMIC FUNC QSART
|
Facility
|
IP
|
$363.05
|
|
|
Service Code
|
CPT 95923
|
| Hospital Charge Code |
92000008
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$159.74 |
| Max. Negotiated Rate |
$326.75 |
| Rate for Payer: Aetna American Axle |
$235.98
|
| Rate for Payer: Aetna Commercial |
$308.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.98
|
| Rate for Payer: Cash Price |
$290.44
|
| Rate for Payer: Cofinity Commercial |
$254.13
|
| Rate for Payer: Cofinity Commercial |
$312.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$254.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.44
|
| Rate for Payer: Healthscope Commercial |
$326.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$254.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$272.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$308.59
|
| Rate for Payer: PHP Commercial |
$308.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.98
|
| Rate for Payer: Priority Health SBD |
$228.72
|
| Rate for Payer: UMR Bronson Commercial |
$159.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$272.29
|
|
|
HC AUTONOMIC FUNC QSART
|
Facility
|
OP
|
$363.05
|
|
|
Service Code
|
CPT 95923
|
| Hospital Charge Code |
92000008
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$353.86 |
| Rate for Payer: Aetna American Axle |
$235.98
|
| Rate for Payer: Aetna Commercial |
$308.59
|
| Rate for Payer: Aetna Medicare |
$130.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$290.44
|
| Rate for Payer: Cash Price |
$290.44
|
| Rate for Payer: Cash Price |
$290.44
|
| Rate for Payer: Cofinity Commercial |
$254.13
|
| Rate for Payer: Cofinity Commercial |
$312.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$254.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$326.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$254.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$272.29
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$308.59
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$308.59
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.98
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health SBD |
$228.72
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.86
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$240.24
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: UMR Bronson Commercial |
$134.33
|
| Rate for Payer: VA VA |
$125.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$272.29
|
|
|
HC AUTONOMIC W/O QSART
|
Facility
|
OP
|
$518.64
|
|
|
Service Code
|
CPT 95924
|
| Hospital Charge Code |
92000012
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$162.78 |
| Max. Negotiated Rate |
$854.89 |
| Rate for Payer: Aetna American Axle |
$337.12
|
| Rate for Payer: Aetna Commercial |
$440.84
|
| Rate for Payer: Aetna Medicare |
$315.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$337.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.62
|
| Rate for Payer: BCBS Complete |
$170.92
|
| Rate for Payer: BCBS MAPPO |
$303.70
|
| Rate for Payer: BCN Medicare Advantage |
$303.70
|
| Rate for Payer: Cash Price |
$414.91
|
| Rate for Payer: Cash Price |
$414.91
|
| Rate for Payer: Cash Price |
$414.91
|
| Rate for Payer: Cofinity Commercial |
$363.05
|
| Rate for Payer: Cofinity Commercial |
$446.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$363.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$414.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.70
|
| Rate for Payer: Healthscope Commercial |
$466.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$363.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$388.98
|
| Rate for Payer: Mclaren Medicaid |
$162.78
|
| Rate for Payer: Mclaren Medicare |
$303.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.88
|
| Rate for Payer: Meridian Medicaid |
$170.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$440.84
|
| Rate for Payer: PACE Medicare |
$288.51
|
| Rate for Payer: PACE SWMI |
$303.70
|
| Rate for Payer: PHP Commercial |
$440.84
|
| Rate for Payer: PHP Medicare Advantage |
$303.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$337.12
|
| Rate for Payer: Priority Health Medicare |
$303.70
|
| Rate for Payer: Priority Health SBD |
$326.74
|
| Rate for Payer: Railroad Medicare Medicare |
$303.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.89
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.70
|
| Rate for Payer: UHC Exchange |
$580.40
|
| Rate for Payer: UHC Medicare Advantage |
$303.70
|
| Rate for Payer: UHCCP Medicaid |
$162.78
|
| Rate for Payer: UMR Bronson Commercial |
$191.90
|
| Rate for Payer: VA VA |
$303.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$388.98
|
|
|
HC AUTONOMIC W/O QSART
|
Facility
|
IP
|
$518.64
|
|
|
Service Code
|
CPT 95924
|
| Hospital Charge Code |
92000012
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$228.20 |
| Max. Negotiated Rate |
$466.78 |
| Rate for Payer: Aetna American Axle |
$337.12
|
| Rate for Payer: Aetna Commercial |
$440.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$337.12
|
| Rate for Payer: Cash Price |
$414.91
|
| Rate for Payer: Cofinity Commercial |
$363.05
|
| Rate for Payer: Cofinity Commercial |
$446.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$363.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$414.91
|
| Rate for Payer: Healthscope Commercial |
$466.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$363.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$388.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$440.84
|
| Rate for Payer: PHP Commercial |
$440.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$337.12
|
| Rate for Payer: Priority Health SBD |
$326.74
|
| Rate for Payer: UMR Bronson Commercial |
$228.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$388.98
|
|
|
HC AVULSION OF NAIL PLATE
|
Facility
|
OP
|
$319.94
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
76100045
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$545.50 |
| Rate for Payer: Aetna American Axle |
$207.96
|
| Rate for Payer: Aetna Commercial |
$271.95
|
| Rate for Payer: Aetna Medicare |
$201.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$255.95
|
| Rate for Payer: Cash Price |
$255.95
|
| Rate for Payer: Cofinity Commercial |
$275.15
|
| Rate for Payer: Cofinity Commercial |
$223.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$223.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$255.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$287.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$223.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$239.96
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$271.95
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$271.95
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.96
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health SBD |
$201.56
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$370.35
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: UMR Bronson Commercial |
$118.38
|
| Rate for Payer: VA VA |
$193.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$239.96
|
|
|
HC AVULSION OF NAIL PLATE
|
Facility
|
IP
|
$319.94
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
76100045
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$140.77 |
| Max. Negotiated Rate |
$287.95 |
| Rate for Payer: Aetna American Axle |
$207.96
|
| Rate for Payer: Aetna Commercial |
$271.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.96
|
| Rate for Payer: Cash Price |
$255.95
|
| Rate for Payer: Cofinity Commercial |
$223.96
|
| Rate for Payer: Cofinity Commercial |
$275.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$223.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$255.95
|
| Rate for Payer: Healthscope Commercial |
$287.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$223.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$239.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$271.95
|
| Rate for Payer: PHP Commercial |
$271.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.96
|
| Rate for Payer: Priority Health SBD |
$201.56
|
| Rate for Payer: UMR Bronson Commercial |
$140.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$239.96
|
|
|
HC BACITRACIN 1 OZ
|
Facility
|
OP
|
$8.13
|
|
| Hospital Charge Code |
27100006
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.01 |
| Max. Negotiated Rate |
$7.32 |
| Rate for Payer: Aetna American Axle |
$5.28
|
| Rate for Payer: Aetna Commercial |
$6.91
|
| Rate for Payer: Aetna Medicare |
$4.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.28
|
| Rate for Payer: BCBS Complete |
$3.25
|
| Rate for Payer: Cash Price |
$6.50
|
| Rate for Payer: Cofinity Commercial |
$5.69
|
| Rate for Payer: Cofinity Commercial |
$6.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$5.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.50
|
| Rate for Payer: Healthscope Commercial |
$7.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.91
|
| Rate for Payer: PHP Commercial |
$6.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.28
|
| Rate for Payer: Priority Health SBD |
$5.12
|
| Rate for Payer: UMR Bronson Commercial |
$3.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.10
|
|
|
HC BACITRACIN 1 OZ
|
Facility
|
IP
|
$8.13
|
|
| Hospital Charge Code |
27100006
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.58 |
| Max. Negotiated Rate |
$7.32 |
| Rate for Payer: Aetna American Axle |
$5.28
|
| Rate for Payer: Aetna Commercial |
$6.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.28
|
| Rate for Payer: Cash Price |
$6.50
|
| Rate for Payer: Cofinity Commercial |
$5.69
|
| Rate for Payer: Cofinity Commercial |
$6.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$5.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.50
|
| Rate for Payer: Healthscope Commercial |
$7.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.91
|
| Rate for Payer: PHP Commercial |
$6.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.28
|
| Rate for Payer: Priority Health SBD |
$5.12
|
| Rate for Payer: UMR Bronson Commercial |
$3.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.10
|
|
|
HC BACITRACIN 4 OZ
|
Facility
|
OP
|
$30.98
|
|
| Hospital Charge Code |
27100007
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.46 |
| Max. Negotiated Rate |
$27.88 |
| Rate for Payer: Aetna American Axle |
$20.14
|
| Rate for Payer: Aetna Commercial |
$26.33
|
| Rate for Payer: Aetna Medicare |
$15.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.14
|
| Rate for Payer: BCBS Complete |
$12.39
|
| Rate for Payer: Cash Price |
$24.78
|
| Rate for Payer: Cofinity Commercial |
$21.69
|
| Rate for Payer: Cofinity Commercial |
$26.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.78
|
| Rate for Payer: Healthscope Commercial |
$27.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.33
|
| Rate for Payer: PHP Commercial |
$26.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.14
|
| Rate for Payer: Priority Health SBD |
$19.52
|
| Rate for Payer: UMR Bronson Commercial |
$11.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.23
|
|
|
HC BACITRACIN 4 OZ
|
Facility
|
IP
|
$30.98
|
|
| Hospital Charge Code |
27100007
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$27.88 |
| Rate for Payer: Aetna American Axle |
$20.14
|
| Rate for Payer: Aetna Commercial |
$26.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.14
|
| Rate for Payer: Cash Price |
$24.78
|
| Rate for Payer: Cofinity Commercial |
$21.69
|
| Rate for Payer: Cofinity Commercial |
$26.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.78
|
| Rate for Payer: Healthscope Commercial |
$27.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.33
|
| Rate for Payer: PHP Commercial |
$26.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.14
|
| Rate for Payer: Priority Health SBD |
$19.52
|
| Rate for Payer: UMR Bronson Commercial |
$13.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.23
|
|
|
HC BACK SCREEN
|
Facility
|
IP
|
$52.02
|
|
| Hospital Charge Code |
42000047
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$22.89 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: UMR Bronson Commercial |
$22.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC BACK SCREEN
|
Facility
|
OP
|
$52.02
|
|
| Hospital Charge Code |
42000047
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.25 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$26.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: BCBS Complete |
$20.81
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$19.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC BACK SCREEN, VBISD
|
Facility
|
OP
|
$68.34
|
|
| Hospital Charge Code |
43000014
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$25.29 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$44.42
|
| Rate for Payer: Aetna Commercial |
$58.09
|
| Rate for Payer: Aetna Medicare |
$34.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.42
|
| Rate for Payer: BCBS Complete |
$27.34
|
| Rate for Payer: Cash Price |
$54.67
|
| Rate for Payer: Cash Price |
$54.67
|
| Rate for Payer: Cofinity Commercial |
$58.77
|
| Rate for Payer: Cofinity Commercial |
$47.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.67
|
| Rate for Payer: Healthscope Commercial |
$61.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.09
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$58.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.42
|
| Rate for Payer: Priority Health SBD |
$43.05
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$25.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.26
|
|
|
HC BACK SCREEN, VBISD
|
Facility
|
IP
|
$68.34
|
|
| Hospital Charge Code |
43000014
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$30.07 |
| Max. Negotiated Rate |
$61.51 |
| Rate for Payer: Aetna American Axle |
$44.42
|
| Rate for Payer: Aetna Commercial |
$58.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.42
|
| Rate for Payer: Cash Price |
$54.67
|
| Rate for Payer: Cofinity Commercial |
$47.84
|
| Rate for Payer: Cofinity Commercial |
$58.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.67
|
| Rate for Payer: Healthscope Commercial |
$61.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.09
|
| Rate for Payer: PHP Commercial |
$58.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.42
|
| Rate for Payer: Priority Health SBD |
$43.05
|
| Rate for Payer: UMR Bronson Commercial |
$30.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.26
|
|
|
HC BACTERIAL VAGINOSIS PANEL
|
Facility
|
OP
|
$153.00
|
|
|
Service Code
|
CPT 0352U
|
| Hospital Charge Code |
30600337
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$56.61 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Aetna American Axle |
$99.45
|
| Rate for Payer: Aetna Commercial |
$130.05
|
| Rate for Payer: Aetna Medicare |
$76.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.45
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$107.10
|
| Rate for Payer: Cofinity Commercial |
$131.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.40
|
| Rate for Payer: Healthscope Commercial |
$137.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.05
|
| Rate for Payer: PHP Commercial |
$130.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health SBD |
$96.39
|
| Rate for Payer: UMR Bronson Commercial |
$56.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.75
|
|
