|
HC ATHERECTOMY RENAL ARTERY
|
Facility
|
IP
|
$12,970.49
|
|
|
Service Code
|
CPT 0234T
|
| Hospital Charge Code |
36100304
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,707.02 |
| Max. Negotiated Rate |
$11,673.44 |
| Rate for Payer: Aetna American Axle |
$8,430.82
|
| Rate for Payer: Aetna Commercial |
$11,024.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,430.82
|
| Rate for Payer: Cash Price |
$10,376.39
|
| Rate for Payer: Cofinity Commercial |
$11,154.62
|
| Rate for Payer: Cofinity Commercial |
$9,079.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,079.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,376.39
|
| Rate for Payer: Healthscope Commercial |
$11,673.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,079.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,727.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,024.92
|
| Rate for Payer: PHP Commercial |
$11,024.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,430.82
|
| Rate for Payer: Priority Health SBD |
$8,171.41
|
| Rate for Payer: UMR Bronson Commercial |
$5,707.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,727.87
|
|
|
HC ATHERECT VISCERAL EACH VESS
|
Facility
|
IP
|
$12,970.49
|
|
|
Service Code
|
CPT 0235T
|
| Hospital Charge Code |
36100303
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,707.02 |
| Max. Negotiated Rate |
$11,673.44 |
| Rate for Payer: Aetna American Axle |
$8,430.82
|
| Rate for Payer: Aetna Commercial |
$11,024.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,430.82
|
| Rate for Payer: Cash Price |
$10,376.39
|
| Rate for Payer: Cofinity Commercial |
$11,154.62
|
| Rate for Payer: Cofinity Commercial |
$9,079.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,079.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,376.39
|
| Rate for Payer: Healthscope Commercial |
$11,673.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,079.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,727.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,024.92
|
| Rate for Payer: PHP Commercial |
$11,024.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,430.82
|
| Rate for Payer: Priority Health SBD |
$8,171.41
|
| Rate for Payer: UMR Bronson Commercial |
$5,707.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,727.87
|
|
|
HC ATHERECT VISCERAL EACH VESS
|
Facility
|
OP
|
$12,970.49
|
|
|
Service Code
|
CPT 0235T
|
| Hospital Charge Code |
36100303
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$522.51 |
| Max. Negotiated Rate |
$11,673.44 |
| Rate for Payer: Aetna American Axle |
$8,430.82
|
| Rate for Payer: Aetna Commercial |
$11,024.92
|
| Rate for Payer: Aetna Medicare |
$6,485.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,430.82
|
| Rate for Payer: BCBS Complete |
$5,188.20
|
| Rate for Payer: BCBS Trust/PPO |
$522.51
|
| Rate for Payer: BCN Commercial |
$522.51
|
| Rate for Payer: Cash Price |
$10,376.39
|
| Rate for Payer: Cash Price |
$10,376.39
|
| Rate for Payer: Cash Price |
$10,376.39
|
| Rate for Payer: Cofinity Commercial |
$9,079.34
|
| Rate for Payer: Cofinity Commercial |
$11,154.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,079.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,376.39
|
| Rate for Payer: Healthscope Commercial |
$11,673.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,079.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,727.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,024.92
|
| Rate for Payer: PHP Commercial |
$11,024.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,430.82
|
| Rate for Payer: Priority Health SBD |
$8,171.41
|
| Rate for Payer: UHC Core |
$1,879.00
|
| Rate for Payer: UMR Bronson Commercial |
$4,799.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,727.87
|
|
|
HC ATS NON OPEN HEART
|
Facility
|
OP
|
$2,250.45
|
|
| Hospital Charge Code |
27000088
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$832.67 |
| Max. Negotiated Rate |
$2,025.40 |
| Rate for Payer: Aetna American Axle |
$1,462.79
|
| Rate for Payer: Aetna Commercial |
$1,912.88
|
| Rate for Payer: Aetna Medicare |
$1,125.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,462.79
|
| Rate for Payer: BCBS Complete |
$900.18
|
| Rate for Payer: Cash Price |
$1,800.36
|
| Rate for Payer: Cofinity Commercial |
$1,575.32
|
| Rate for Payer: Cofinity Commercial |
$1,935.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,575.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,800.36
|
| Rate for Payer: Healthscope Commercial |
$2,025.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,575.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,687.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,912.88
|
| Rate for Payer: PHP Commercial |
$1,912.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,462.79
|
| Rate for Payer: Priority Health SBD |
$1,417.78
|
| Rate for Payer: UMR Bronson Commercial |
$832.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,687.84
|
|
|
HC ATS NON OPEN HEART
|
Facility
|
IP
|
$2,250.45
|
|
| Hospital Charge Code |
27000088
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$990.20 |
| Max. Negotiated Rate |
$2,025.40 |
| Rate for Payer: Aetna American Axle |
$1,462.79
|
| Rate for Payer: Aetna Commercial |
$1,912.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,462.79
|
| Rate for Payer: Cash Price |
$1,800.36
|
| Rate for Payer: Cofinity Commercial |
$1,575.32
|
| Rate for Payer: Cofinity Commercial |
$1,935.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,575.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,800.36
|
| Rate for Payer: Healthscope Commercial |
$2,025.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,575.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,687.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,912.88
|
| Rate for Payer: PHP Commercial |
$1,912.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,462.79
|
| Rate for Payer: Priority Health SBD |
$1,417.78
|
| Rate for Payer: UMR Bronson Commercial |
$990.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,687.84
|
|
|
HC ATS STAND BY HR
|
Facility
|
OP
|
$1,537.13
|
|
| Hospital Charge Code |
27000089
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$568.74 |
| Max. Negotiated Rate |
$1,383.42 |
| Rate for Payer: Aetna American Axle |
$999.13
|
| Rate for Payer: Aetna Commercial |
$1,306.56
|
| Rate for Payer: Aetna Medicare |
$768.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$999.13
|
| Rate for Payer: BCBS Complete |
$614.85
|
| Rate for Payer: Cash Price |
$1,229.70
|
| Rate for Payer: Cofinity Commercial |
$1,075.99
|
| Rate for Payer: Cofinity Commercial |
$1,321.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,075.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.70
|
| Rate for Payer: Healthscope Commercial |
$1,383.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,075.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.56
|
| Rate for Payer: PHP Commercial |
$1,306.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$999.13
|
| Rate for Payer: Priority Health SBD |
$968.39
|
| Rate for Payer: UMR Bronson Commercial |
$568.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.85
|
|
|
HC ATS STAND BY HR
|
Facility
|
IP
|
$1,537.13
|
|
| Hospital Charge Code |
27000089
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$676.34 |
| Max. Negotiated Rate |
$1,383.42 |
| Rate for Payer: Aetna American Axle |
$999.13
|
| Rate for Payer: Aetna Commercial |
$1,306.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$999.13
|
| Rate for Payer: Cash Price |
$1,229.70
|
| Rate for Payer: Cofinity Commercial |
$1,075.99
|
| Rate for Payer: Cofinity Commercial |
$1,321.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,075.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.70
|
| Rate for Payer: Healthscope Commercial |
$1,383.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,075.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.56
|
| Rate for Payer: PHP Commercial |
$1,306.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$999.13
|
| Rate for Payer: Priority Health SBD |
$968.39
|
| Rate for Payer: UMR Bronson Commercial |
$676.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.85
|
|
|
HC ATYPICAL PNEUMO EVAL C PNEUM
|
Facility
|
OP
|
$15.61
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200240
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.78 |
| Max. Negotiated Rate |
$35.46 |
| Rate for Payer: Aetna American Axle |
$10.15
|
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna Medicare |
$12.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.78
|
| Rate for Payer: BCBS Complete |
$6.65
|
| Rate for Payer: BCBS MAPPO |
$11.82
|
| Rate for Payer: BCBS Trust/PPO |
$11.39
|
| Rate for Payer: BCN Commercial |
$11.39
|
| Rate for Payer: BCN Medicare Advantage |
$11.82
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Cofinity Commercial |
$10.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.82
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Mclaren Medicaid |
$6.34
|
| Rate for Payer: Mclaren Medicare |
$11.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.41
|
| Rate for Payer: Meridian Medicaid |
$6.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$35.46
|
| Rate for Payer: PACE Medicare |
$11.23
|
| Rate for Payer: PACE SWMI |
$11.82
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: PHP Medicare Advantage |
$11.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.17
|
| Rate for Payer: Priority Health Medicare |
$11.82
|
| Rate for Payer: Priority Health Narrow Network |
$9.74
|
| Rate for Payer: Priority Health SBD |
$9.83
|
| Rate for Payer: Railroad Medicare Medicare |
$11.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.82
|
| Rate for Payer: UHC Exchange |
$11.82
|
| Rate for Payer: UHC Medicare Advantage |
$11.82
|
| Rate for Payer: UHCCP Medicaid |
$6.34
|
| Rate for Payer: UMR Bronson Commercial |
$5.78
|
| Rate for Payer: VA VA |
$11.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC ATYPICAL PNEUMO EVAL C PNEUM
|
Facility
|
IP
|
$15.61
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200240
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.87 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna American Axle |
$10.15
|
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.15
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$10.93
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health SBD |
$9.83
|
| Rate for Payer: UMR Bronson Commercial |
$6.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC ATYPICAL PNEUMO EVAL C PNEUM IGM
|
Facility
|
IP
|
$15.61
|
|
|
Service Code
|
CPT 86632
|
| Hospital Charge Code |
30200243
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.87 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna American Axle |
$10.15
|
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.15
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$10.93
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health SBD |
$9.83
|
| Rate for Payer: UMR Bronson Commercial |
$6.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC ATYPICAL PNEUMO EVAL C PNEUM IGM
|
Facility
|
OP
|
$15.61
|
|
|
Service Code
|
CPT 86632
|
| Hospital Charge Code |
30200243
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.78 |
| Max. Negotiated Rate |
$38.04 |
| Rate for Payer: Aetna American Axle |
$10.15
|
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna Medicare |
$13.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.85
|
| Rate for Payer: BCBS Complete |
$7.14
|
| Rate for Payer: BCBS MAPPO |
$12.68
|
| Rate for Payer: BCBS Trust/PPO |
$12.22
|
| Rate for Payer: BCN Commercial |
$12.22
|
| Rate for Payer: BCN Medicare Advantage |
$12.68
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Cofinity Commercial |
$10.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.68
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Mclaren Medicaid |
$6.80
|
| Rate for Payer: Mclaren Medicare |
$12.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.31
|
| Rate for Payer: Meridian Medicaid |
$7.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$38.04
|
| Rate for Payer: PACE Medicare |
$12.05
|
| Rate for Payer: PACE SWMI |
$12.68
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: PHP Medicare Advantage |
$12.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.05
|
| Rate for Payer: Priority Health Medicare |
$12.68
|
| Rate for Payer: Priority Health Narrow Network |
$10.44
|
| Rate for Payer: Priority Health SBD |
$9.83
|
| Rate for Payer: Railroad Medicare Medicare |
$12.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.68
|
| Rate for Payer: UHC Exchange |
$12.68
|
| Rate for Payer: UHC Medicare Advantage |
$12.68
|
| Rate for Payer: UHCCP Medicaid |
$6.80
|
| Rate for Payer: UMR Bronson Commercial |
$5.78
|
| Rate for Payer: VA VA |
$12.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC ATYPICAL PNEUMO EVAL L PNEUM
|
Facility
|
IP
|
$21.85
|
|
|
Service Code
|
CPT 86713
|
| Hospital Charge Code |
30200302
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$19.66 |
| Rate for Payer: Aetna American Axle |
$14.20
|
| Rate for Payer: Aetna Commercial |
$18.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.20
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$15.30
|
| Rate for Payer: Cofinity Commercial |
$18.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: PHP Commercial |
$18.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.20
|
| Rate for Payer: Priority Health SBD |
$13.77
|
| Rate for Payer: UMR Bronson Commercial |
$9.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.39
|
|
|
HC ATYPICAL PNEUMO EVAL L PNEUM
|
Facility
|
OP
|
$21.85
|
|
|
Service Code
|
CPT 86713
|
| Hospital Charge Code |
30200302
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna American Axle |
$14.20
|
| Rate for Payer: Aetna Commercial |
$18.57
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: BCBS Complete |
$8.61
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$14.75
|
| Rate for Payer: BCN Commercial |
$14.75
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$18.79
|
| Rate for Payer: Cofinity Commercial |
$15.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.39
|
| Rate for Payer: Mclaren Medicaid |
$8.20
|
| Rate for Payer: Mclaren Medicare |
$15.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: Meridian Medicaid |
$8.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$22.95
|
| Rate for Payer: PACE Medicare |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$18.57
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.30
|
| Rate for Payer: Priority Health Medicare |
$15.30
|
| Rate for Payer: Priority Health Narrow Network |
$12.24
|
| Rate for Payer: Priority Health SBD |
$13.77
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.30
|
| Rate for Payer: UHC Exchange |
$15.30
|
| Rate for Payer: UHC Medicare Advantage |
$15.30
|
| Rate for Payer: UHCCP Medicaid |
$8.20
|
| Rate for Payer: UMR Bronson Commercial |
$8.08
|
| Rate for Payer: VA VA |
$15.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.39
|
|
|
HC ATYPICAL PNEUMO EVAL M PNEUM
|
Facility
|
OP
|
$14.57
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200308
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$19.86 |
| Rate for Payer: Aetna American Axle |
$9.47
|
| Rate for Payer: Aetna Commercial |
$12.38
|
| Rate for Payer: Aetna Medicare |
$13.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: BCBS Complete |
$7.45
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$12.76
|
| Rate for Payer: BCN Commercial |
$12.76
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$11.66
|
| Rate for Payer: Cash Price |
$11.66
|
| Rate for Payer: Cofinity Commercial |
$12.53
|
| Rate for Payer: Cofinity Commercial |
$10.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$13.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.93
|
| Rate for Payer: Mclaren Medicaid |
$7.10
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: Meridian Medicaid |
$7.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.38
|
| Rate for Payer: Nomi Health Commercial |
$19.86
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$12.38
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.62
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health Narrow Network |
$10.90
|
| Rate for Payer: Priority Health SBD |
$9.18
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.24
|
| Rate for Payer: UHC Exchange |
$13.24
|
| Rate for Payer: UHC Medicare Advantage |
$13.24
|
| Rate for Payer: UHCCP Medicaid |
$7.10
|
| Rate for Payer: UMR Bronson Commercial |
$5.39
|
| Rate for Payer: VA VA |
$13.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.93
|
|
|
HC ATYPICAL PNEUMO EVAL M PNEUM
|
Facility
|
IP
|
$14.57
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200308
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.41 |
| Max. Negotiated Rate |
$13.11 |
| Rate for Payer: Aetna American Axle |
$9.47
|
| Rate for Payer: Aetna Commercial |
$12.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.47
|
| Rate for Payer: Cash Price |
$11.66
|
| Rate for Payer: Cofinity Commercial |
$10.20
|
| Rate for Payer: Cofinity Commercial |
$12.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.66
|
| Rate for Payer: Healthscope Commercial |
$13.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.38
|
| Rate for Payer: PHP Commercial |
$12.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.47
|
| Rate for Payer: Priority Health SBD |
$9.18
|
| Rate for Payer: UMR Bronson Commercial |
$6.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.93
|
|
|
HC ATYPICAL PNEUMO EVALUATION
|
Facility
|
OP
|
$15.61
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200241
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.78 |
| Max. Negotiated Rate |
$35.46 |
| Rate for Payer: Aetna American Axle |
$10.15
|
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna Medicare |
$12.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.78
|
| Rate for Payer: BCBS Complete |
$6.65
|
| Rate for Payer: BCBS MAPPO |
$11.82
|
| Rate for Payer: BCBS Trust/PPO |
$11.39
|
| Rate for Payer: BCN Commercial |
$11.39
|
| Rate for Payer: BCN Medicare Advantage |
$11.82
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Cofinity Commercial |
$10.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.82
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Mclaren Medicaid |
$6.34
|
| Rate for Payer: Mclaren Medicare |
$11.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.41
|
| Rate for Payer: Meridian Medicaid |
$6.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$35.46
|
| Rate for Payer: PACE Medicare |
$11.23
|
| Rate for Payer: PACE SWMI |
$11.82
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: PHP Medicare Advantage |
$11.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.17
|
| Rate for Payer: Priority Health Medicare |
$11.82
|
| Rate for Payer: Priority Health Narrow Network |
$9.74
|
| Rate for Payer: Priority Health SBD |
$9.83
|
| Rate for Payer: Railroad Medicare Medicare |
$11.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.82
|
| Rate for Payer: UHC Exchange |
$11.82
|
| Rate for Payer: UHC Medicare Advantage |
$11.82
|
| Rate for Payer: UHCCP Medicaid |
$6.34
|
| Rate for Payer: UMR Bronson Commercial |
$5.78
|
| Rate for Payer: VA VA |
$11.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC ATYPICAL PNEUMO EVALUATION
|
Facility
|
IP
|
$15.61
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200241
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.87 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna American Axle |
$10.15
|
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.15
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$10.93
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health SBD |
$9.83
|
| Rate for Payer: UMR Bronson Commercial |
$6.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC AUDIOMETRY AIR AND BONE
|
Facility
|
OP
|
$212.17
|
|
|
Service Code
|
CPT 92553
|
| Hospital Charge Code |
47100010
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$41.25 |
| Max. Negotiated Rate |
$481.80 |
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: Aetna American Axle |
$137.91
|
| Rate for Payer: Aetna Commercial |
$180.34
|
| Rate for Payer: Aetna Medicare |
$159.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$193.11
|
| Rate for Payer: BCN Commercial |
$193.11
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$169.74
|
| Rate for Payer: Cash Price |
$169.74
|
| Rate for Payer: Cash Price |
$169.74
|
| Rate for Payer: Cofinity Commercial |
$148.52
|
| Rate for Payer: Cofinity Commercial |
$182.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$148.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$190.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$148.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.13
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.34
|
| Rate for Payer: Nomi Health Commercial |
$459.90
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$180.34
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$481.80
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$385.44
|
| Rate for Payer: Priority Health SBD |
$133.67
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$41.25
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$82.17
|
| Rate for Payer: UMR Bronson Commercial |
$78.50
|
| Rate for Payer: VA VA |
$153.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.13
|
|
|
HC AUDIOMETRY AIR AND BONE
|
Facility
|
IP
|
$212.17
|
|
|
Service Code
|
CPT 92553
|
| Hospital Charge Code |
47100010
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$93.35 |
| Max. Negotiated Rate |
$190.95 |
| Rate for Payer: Aetna American Axle |
$137.91
|
| Rate for Payer: Aetna Commercial |
$180.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.91
|
| Rate for Payer: Cash Price |
$169.74
|
| Rate for Payer: Cofinity Commercial |
$148.52
|
| Rate for Payer: Cofinity Commercial |
$182.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$148.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.74
|
| Rate for Payer: Healthscope Commercial |
$190.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$148.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.34
|
| Rate for Payer: PHP Commercial |
$180.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.91
|
| Rate for Payer: Priority Health SBD |
$133.67
|
| Rate for Payer: UMR Bronson Commercial |
$93.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.13
|
|
|
HC AUDITORY EVOKED POTENTIAL SCREENING
|
Facility
|
IP
|
$256.13
|
|
|
Service Code
|
CPT 92650
|
| Hospital Charge Code |
47100015
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$112.70 |
| Max. Negotiated Rate |
$230.52 |
| Rate for Payer: Aetna American Axle |
$166.48
|
| Rate for Payer: Aetna Commercial |
$217.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.48
|
| Rate for Payer: Cash Price |
$204.90
|
| Rate for Payer: Cofinity Commercial |
$179.29
|
| Rate for Payer: Cofinity Commercial |
$220.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$179.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.90
|
| Rate for Payer: Healthscope Commercial |
$230.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$179.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$192.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.71
|
| Rate for Payer: PHP Commercial |
$217.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.48
|
| Rate for Payer: Priority Health SBD |
$161.36
|
| Rate for Payer: UMR Bronson Commercial |
$112.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$192.10
|
|
|
HC AUDITORY EVOKED POTENTIAL SCREENING
|
Facility
|
OP
|
$256.13
|
|
|
Service Code
|
CPT 92650
|
| Hospital Charge Code |
47100015
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$23.17 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$166.48
|
| Rate for Payer: Aetna Commercial |
$217.71
|
| Rate for Payer: Aetna Medicare |
$128.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.48
|
| Rate for Payer: BCBS Complete |
$102.45
|
| Rate for Payer: BCBS Trust/PPO |
$76.11
|
| Rate for Payer: BCN Commercial |
$76.11
|
| Rate for Payer: Cash Price |
$204.90
|
| Rate for Payer: Cash Price |
$204.90
|
| Rate for Payer: Cash Price |
$204.90
|
| Rate for Payer: Cofinity Commercial |
$220.27
|
| Rate for Payer: Cofinity Commercial |
$179.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$179.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.90
|
| Rate for Payer: Healthscope Commercial |
$230.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$179.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$192.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.71
|
| Rate for Payer: PHP Commercial |
$217.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.96
|
| Rate for Payer: Priority Health Narrow Network |
$23.17
|
| Rate for Payer: Priority Health SBD |
$161.36
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$94.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$192.10
|
|
|
HC AUDITORY EVOK POT NEURODIAGNOSTIC W I&R
|
Facility
|
OP
|
$687.84
|
|
|
Service Code
|
CPT 92653
|
| Hospital Charge Code |
47000001
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$77.85 |
| Max. Negotiated Rate |
$958.92 |
| Rate for Payer: Aetna American Axle |
$447.10
|
| Rate for Payer: Aetna Commercial |
$584.66
|
| Rate for Payer: Aetna Medicare |
$317.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.38
|
| Rate for Payer: BCBS Complete |
$171.71
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCBS Trust/PPO |
$194.51
|
| Rate for Payer: BCN Commercial |
$194.51
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| Rate for Payer: Cash Price |
$550.27
|
| Rate for Payer: Cash Price |
$550.27
|
| Rate for Payer: Cash Price |
$550.27
|
| Rate for Payer: Cofinity Commercial |
$481.49
|
| Rate for Payer: Cofinity Commercial |
$591.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$481.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$619.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$481.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$515.88
|
| Rate for Payer: Mclaren Medicaid |
$163.53
|
| Rate for Payer: Mclaren Medicare |
$305.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.36
|
| Rate for Payer: Meridian Medicaid |
$171.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$584.66
|
| Rate for Payer: Nomi Health Commercial |
$915.30
|
| Rate for Payer: PACE Medicare |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$584.66
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$958.92
|
| Rate for Payer: Priority Health Medicare |
$305.10
|
| Rate for Payer: Priority Health Narrow Network |
$767.14
|
| Rate for Payer: Priority Health SBD |
$433.34
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.64
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.10
|
| Rate for Payer: UHC Exchange |
$77.85
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$163.53
|
| Rate for Payer: UMR Bronson Commercial |
$254.50
|
| Rate for Payer: VA VA |
$305.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$515.88
|
|
|
HC AUDITORY EVOK POT NEURODIAGNOSTIC W I&R
|
Facility
|
IP
|
$687.84
|
|
|
Service Code
|
CPT 92653
|
| Hospital Charge Code |
47000001
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$302.65 |
| Max. Negotiated Rate |
$619.06 |
| Rate for Payer: Aetna American Axle |
$447.10
|
| Rate for Payer: Aetna Commercial |
$584.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.10
|
| Rate for Payer: Cash Price |
$550.27
|
| Rate for Payer: Cofinity Commercial |
$481.49
|
| Rate for Payer: Cofinity Commercial |
$591.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$481.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.27
|
| Rate for Payer: Healthscope Commercial |
$619.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$481.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$515.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$584.66
|
| Rate for Payer: PHP Commercial |
$584.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.10
|
| Rate for Payer: Priority Health SBD |
$433.34
|
| Rate for Payer: UMR Bronson Commercial |
$302.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$515.88
|
|
|
HC AUDITORY EVOK POT THRESHOLD MULTI FREQ
|
Facility
|
OP
|
$687.84
|
|
|
Service Code
|
CPT 92652
|
| Hospital Charge Code |
47000002
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$105.29 |
| Max. Negotiated Rate |
$958.92 |
| Rate for Payer: Aetna American Axle |
$447.10
|
| Rate for Payer: Aetna Commercial |
$584.66
|
| Rate for Payer: Aetna Medicare |
$317.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.38
|
| Rate for Payer: BCBS Complete |
$171.71
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCBS Trust/PPO |
$250.88
|
| Rate for Payer: BCN Commercial |
$250.88
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| Rate for Payer: Cash Price |
$550.27
|
| Rate for Payer: Cash Price |
$550.27
|
| Rate for Payer: Cash Price |
$550.27
|
| Rate for Payer: Cofinity Commercial |
$481.49
|
| Rate for Payer: Cofinity Commercial |
$591.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$481.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$619.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$481.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$515.88
|
| Rate for Payer: Mclaren Medicaid |
$163.53
|
| Rate for Payer: Mclaren Medicare |
$305.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.36
|
| Rate for Payer: Meridian Medicaid |
$171.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$584.66
|
| Rate for Payer: Nomi Health Commercial |
$915.30
|
| Rate for Payer: PACE Medicare |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$584.66
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$958.92
|
| Rate for Payer: Priority Health Medicare |
$305.10
|
| Rate for Payer: Priority Health Narrow Network |
$767.14
|
| Rate for Payer: Priority Health SBD |
$433.34
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.82
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.10
|
| Rate for Payer: UHC Exchange |
$105.29
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$163.53
|
| Rate for Payer: UMR Bronson Commercial |
$254.50
|
| Rate for Payer: VA VA |
$305.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$515.88
|
|
|
HC AUDITORY EVOK POT THRESHOLD MULTI FREQ
|
Facility
|
IP
|
$687.84
|
|
|
Service Code
|
CPT 92652
|
| Hospital Charge Code |
47000002
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$302.65 |
| Max. Negotiated Rate |
$619.06 |
| Rate for Payer: Aetna American Axle |
$447.10
|
| Rate for Payer: Aetna Commercial |
$584.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.10
|
| Rate for Payer: Cash Price |
$550.27
|
| Rate for Payer: Cofinity Commercial |
$481.49
|
| Rate for Payer: Cofinity Commercial |
$591.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$481.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.27
|
| Rate for Payer: Healthscope Commercial |
$619.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$481.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$515.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$584.66
|
| Rate for Payer: PHP Commercial |
$584.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.10
|
| Rate for Payer: Priority Health SBD |
$433.34
|
| Rate for Payer: UMR Bronson Commercial |
$302.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$515.88
|
|
