|
HC CT ABDOMEN WO CON
|
Facility
|
OP
|
$1,639.04
|
|
|
Service Code
|
CPT 74150
|
| Hospital Charge Code |
35200022
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$1,475.14 |
| Rate for Payer: Aetna American Axle |
$1,065.38
|
| Rate for Payer: Aetna Commercial |
$1,393.18
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,065.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$203.57
|
| Rate for Payer: BCN Commercial |
$203.57
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$1,311.23
|
| Rate for Payer: Cash Price |
$1,311.23
|
| Rate for Payer: Cofinity Advantage |
$1,147.33
|
| Rate for Payer: Cofinity Commercial |
$1,409.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,311.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$1,475.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,147.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,229.28
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,393.18
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,229.28
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$1,393.18
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$1,032.60
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,065.38
|
| Rate for Payer: UHC Core |
$853.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$644.14
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$606.44
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,229.28
|
|
|
HC CT ABDOMEN WO W CON
|
Facility
|
IP
|
$2,502.70
|
|
|
Service Code
|
CPT 74170
|
| Hospital Charge Code |
35200024
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,101.19 |
| Max. Negotiated Rate |
$2,252.43 |
| Rate for Payer: Aetna American Axle |
$1,626.76
|
| Rate for Payer: Aetna Commercial |
$2,127.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,626.76
|
| Rate for Payer: Cash Price |
$2,002.16
|
| Rate for Payer: Cofinity Advantage |
$1,751.89
|
| Rate for Payer: Cofinity Commercial |
$2,152.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,002.16
|
| Rate for Payer: Healthscope Commercial |
$2,252.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,751.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,877.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,127.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,877.03
|
| Rate for Payer: PHP Commercial |
$2,127.30
|
| Rate for Payer: Priority Health SBD |
$1,576.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,101.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,877.03
|
|
|
HC CT ABDOMEN WO W CON
|
Facility
|
OP
|
$2,502.70
|
|
|
Service Code
|
CPT 74170
|
| Hospital Charge Code |
35200024
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$2,252.43 |
| Rate for Payer: Aetna American Axle |
$1,626.76
|
| Rate for Payer: Aetna Commercial |
$2,127.30
|
| Rate for Payer: Aetna Medicare |
$181.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,626.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$486.79
|
| Rate for Payer: BCN Commercial |
$486.79
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$2,002.16
|
| Rate for Payer: Cash Price |
$2,002.16
|
| Rate for Payer: Cofinity Advantage |
$1,751.89
|
| Rate for Payer: Cofinity Commercial |
$2,152.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,002.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$2,252.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,751.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,877.03
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,127.30
|
| Rate for Payer: Nomi Health Commercial |
$524.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,877.03
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$2,127.30
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$565.19
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health SBD |
$1,576.70
|
| Rate for Payer: Priority Health Tiered Network |
$452.15
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,626.76
|
| Rate for Payer: UHC Core |
$1,303.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$983.56
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: UMR Bronson Commercial |
$926.00
|
| Rate for Payer: VA VA |
$174.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,877.03
|
|
|
HC CT ABLATION PROCEDURE
|
Facility
|
IP
|
$1,156.81
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000030
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$509.00 |
| Max. Negotiated Rate |
$1,041.13 |
| Rate for Payer: Aetna American Axle |
$751.93
|
| Rate for Payer: Aetna Commercial |
$983.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$751.93
|
| Rate for Payer: Cash Price |
$925.45
|
| Rate for Payer: Cofinity Advantage |
$809.77
|
| Rate for Payer: Cofinity Commercial |
$994.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$925.45
|
| Rate for Payer: Healthscope Commercial |
$1,041.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$809.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$867.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$983.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$867.61
|
| Rate for Payer: PHP Commercial |
$983.29
|
| Rate for Payer: Priority Health SBD |
$728.79
|
| Rate for Payer: UMR Bronson Commercial |
$509.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$867.61
|
|
|
HC CT ABLATION PROCEDURE
|
Facility
|
OP
|
$1,156.81
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000030
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$428.02 |
| Max. Negotiated Rate |
$1,041.13 |
| Rate for Payer: Aetna American Axle |
$751.93
|
| Rate for Payer: Aetna Commercial |
$983.29
|
| Rate for Payer: Aetna Medicare |
$578.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$751.93
|
| Rate for Payer: BCBS Complete |
$462.72
|
| Rate for Payer: BCBS Trust/PPO |
$747.02
|
| Rate for Payer: BCN Commercial |
$747.02
|
| Rate for Payer: Cash Price |
$925.45
|
| Rate for Payer: Cash Price |
$925.45
|
| Rate for Payer: Cofinity Advantage |
$809.77
|
| Rate for Payer: Cofinity Commercial |
$994.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$925.45
|
| Rate for Payer: Healthscope Commercial |
$1,041.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$809.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$867.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$925.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$983.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$867.61
|
| Rate for Payer: PHP Commercial |
$983.29
|
| Rate for Payer: Priority Health SBD |
$728.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$751.93
|
| Rate for Payer: UHC Core |
$602.70
|
| Rate for Payer: UHC Exchange |
$454.63
|
| Rate for Payer: UMR Bronson Commercial |
$428.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$867.61
|
|
|
HC CTA HEAD/NECK W CONTRAST
|
Facility
|
OP
|
$2,187.00
|
|
|
Service Code
|
CPT 70471
|
| Hospital Charge Code |
35100012
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,968.30 |
| Rate for Payer: Aetna American Axle |
$1,421.55
|
| Rate for Payer: Aetna Commercial |
$1,858.95
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,421.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,749.60
|
| Rate for Payer: Cash Price |
$1,749.60
|
| Rate for Payer: Cofinity Advantage |
$1,530.90
|
| Rate for Payer: Cofinity Commercial |
$1,880.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,749.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$1,968.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,530.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,640.25
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,858.95
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,640.25
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$1,858.95
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$1,377.81
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,421.55
|
| Rate for Payer: UHC Core |
$1,139.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$859.49
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: UMR Bronson Commercial |
$809.19
|
| Rate for Payer: VA VA |
$347.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,640.25
|
|
|
HC CTA HEAD/NECK W CONTRAST
|
Facility
|
IP
|
$2,187.00
|
|
|
Service Code
|
CPT 70471
|
| Hospital Charge Code |
35100012
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$962.28 |
| Max. Negotiated Rate |
$1,968.30 |
| Rate for Payer: Aetna American Axle |
$1,421.55
|
| Rate for Payer: Aetna Commercial |
$1,858.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,421.55
|
| Rate for Payer: Cash Price |
$1,749.60
|
| Rate for Payer: Cofinity Advantage |
$1,530.90
|
| Rate for Payer: Cofinity Commercial |
$1,880.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,749.60
|
| Rate for Payer: Healthscope Commercial |
$1,968.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,530.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,640.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,858.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,640.25
|
| Rate for Payer: PHP Commercial |
$1,858.95
|
| Rate for Payer: Priority Health SBD |
$1,377.81
|
| Rate for Payer: UMR Bronson Commercial |
$962.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,640.25
|
|
|
HC CT ANGIO ABD AND PELVIS
|
Facility
|
OP
|
$3,147.33
|
|
|
Service Code
|
CPT 74174
|
| Hospital Charge Code |
35000034
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$2,832.60 |
| Rate for Payer: Aetna American Axle |
$2,045.76
|
| Rate for Payer: Aetna Commercial |
$2,675.23
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,045.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$695.30
|
| Rate for Payer: BCN Commercial |
$695.30
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$2,517.86
|
| Rate for Payer: Cash Price |
$2,517.86
|
| Rate for Payer: Cofinity Advantage |
$2,203.13
|
| Rate for Payer: Cofinity Commercial |
$2,706.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,517.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$2,832.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,203.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,360.50
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,675.23
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,360.50
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$2,675.23
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$1,982.82
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,045.76
|
| Rate for Payer: UHC Core |
$1,639.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$1,236.90
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: UMR Bronson Commercial |
$1,164.51
|
| Rate for Payer: VA VA |
$347.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,360.50
|
|
|
HC CT ANGIO ABD AND PELVIS
|
Facility
|
IP
|
$3,147.33
|
|
|
Service Code
|
CPT 74174
|
| Hospital Charge Code |
35000034
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,384.83 |
| Max. Negotiated Rate |
$2,832.60 |
| Rate for Payer: Aetna American Axle |
$2,045.76
|
| Rate for Payer: Aetna Commercial |
$2,675.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,045.76
|
| Rate for Payer: Cash Price |
$2,517.86
|
| Rate for Payer: Cofinity Advantage |
$2,203.13
|
| Rate for Payer: Cofinity Commercial |
$2,706.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,517.86
|
| Rate for Payer: Healthscope Commercial |
$2,832.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,203.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,360.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,675.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,360.50
|
| Rate for Payer: PHP Commercial |
$2,675.23
|
| Rate for Payer: Priority Health SBD |
$1,982.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,384.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,360.50
|
|
|
HC CT ANGIO CORONARY DISCONTINUED
|
Facility
|
OP
|
$1,343.28
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000018
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$1,208.95 |
| Rate for Payer: Aetna American Axle |
$873.13
|
| Rate for Payer: Aetna Commercial |
$1,141.79
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$873.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$531.12
|
| Rate for Payer: BCN Commercial |
$531.12
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$1,074.62
|
| Rate for Payer: Cash Price |
$1,074.62
|
| Rate for Payer: Cofinity Advantage |
$940.30
|
| Rate for Payer: Cofinity Commercial |
$1,155.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,074.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$1,208.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$940.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,007.46
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,141.79
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,007.46
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$1,141.79
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$846.27
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$873.13
|
| Rate for Payer: UHC Core |
$699.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$527.91
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: UMR Bronson Commercial |
$497.01
|
| Rate for Payer: VA VA |
$347.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,007.46
|
|
|
HC CT ANGIO CORONARY DISCONTINUED
|
Facility
|
IP
|
$1,343.28
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000018
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$591.04 |
| Max. Negotiated Rate |
$1,208.95 |
| Rate for Payer: Aetna American Axle |
$873.13
|
| Rate for Payer: Aetna Commercial |
$1,141.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$873.13
|
| Rate for Payer: Cash Price |
$1,074.62
|
| Rate for Payer: Cofinity Advantage |
$940.30
|
| Rate for Payer: Cofinity Commercial |
$1,155.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,074.62
|
| Rate for Payer: Healthscope Commercial |
$1,208.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$940.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,007.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,141.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,007.46
|
| Rate for Payer: PHP Commercial |
$1,141.79
|
| Rate for Payer: Priority Health SBD |
$846.27
|
| Rate for Payer: UMR Bronson Commercial |
$591.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,007.46
|
|
|
HC CT AORTA W RUNOFF ANGIO
|
Facility
|
IP
|
$2,199.56
|
|
|
Service Code
|
CPT 75635
|
| Hospital Charge Code |
35000020
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$967.81 |
| Max. Negotiated Rate |
$1,979.60 |
| Rate for Payer: Aetna American Axle |
$1,429.71
|
| Rate for Payer: Aetna Commercial |
$1,869.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,429.71
|
| Rate for Payer: Cash Price |
$1,759.65
|
| Rate for Payer: Cofinity Advantage |
$1,539.69
|
| Rate for Payer: Cofinity Commercial |
$1,891.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,759.65
|
| Rate for Payer: Healthscope Commercial |
$1,979.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,539.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,649.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,869.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,649.67
|
| Rate for Payer: PHP Commercial |
$1,869.63
|
| Rate for Payer: Priority Health SBD |
$1,385.72
|
| Rate for Payer: UMR Bronson Commercial |
$967.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,649.67
|
|
|
HC CT AORTA W RUNOFF ANGIO
|
Facility
|
OP
|
$2,199.56
|
|
|
Service Code
|
CPT 75635
|
| Hospital Charge Code |
35000020
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$1,979.60 |
| Rate for Payer: Aetna American Axle |
$1,429.71
|
| Rate for Payer: Aetna Commercial |
$1,869.63
|
| Rate for Payer: Aetna Medicare |
$181.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,429.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$752.76
|
| Rate for Payer: BCN Commercial |
$752.76
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$1,759.65
|
| Rate for Payer: Cash Price |
$1,759.65
|
| Rate for Payer: Cofinity Advantage |
$1,539.69
|
| Rate for Payer: Cofinity Commercial |
$1,891.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,759.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$1,979.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,539.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,649.67
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,869.63
|
| Rate for Payer: Nomi Health Commercial |
$524.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,649.67
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$1,869.63
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$565.19
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health SBD |
$1,385.72
|
| Rate for Payer: Priority Health Tiered Network |
$452.15
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,429.71
|
| Rate for Payer: UHC Core |
$1,145.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$864.43
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: UMR Bronson Commercial |
$813.84
|
| Rate for Payer: VA VA |
$174.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,649.67
|
|
|
HC CT BONE LENGTH STUDY
|
Facility
|
OP
|
$705.54
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
32000255
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$634.99 |
| Rate for Payer: Aetna American Axle |
$458.60
|
| Rate for Payer: Aetna Commercial |
$599.71
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$79.62
|
| Rate for Payer: BCN Commercial |
$79.62
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$564.43
|
| Rate for Payer: Cash Price |
$564.43
|
| Rate for Payer: Cofinity Advantage |
$493.88
|
| Rate for Payer: Cofinity Commercial |
$606.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$634.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$493.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.15
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.71
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$529.15
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$599.71
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$444.49
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$458.60
|
| Rate for Payer: UHC Core |
$367.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$277.28
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$261.05
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.15
|
|
|
HC CT BONE LENGTH STUDY
|
Facility
|
IP
|
$705.54
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
32000255
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$310.44 |
| Max. Negotiated Rate |
$634.99 |
| Rate for Payer: Aetna American Axle |
$458.60
|
| Rate for Payer: Aetna Commercial |
$599.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.60
|
| Rate for Payer: Cash Price |
$564.43
|
| Rate for Payer: Cofinity Advantage |
$493.88
|
| Rate for Payer: Cofinity Commercial |
$606.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.43
|
| Rate for Payer: Healthscope Commercial |
$634.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$493.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$529.15
|
| Rate for Payer: PHP Commercial |
$599.71
|
| Rate for Payer: Priority Health SBD |
$444.49
|
| Rate for Payer: UMR Bronson Commercial |
$310.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.15
|
|
|
HC CT BRAIN PERF ANAL W CONTRAST WITH CONCURR CT/CTA
|
Facility
|
OP
|
$1,073.00
|
|
|
Service Code
|
CPT 70472
|
| Hospital Charge Code |
35100013
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$397.01 |
| Max. Negotiated Rate |
$965.70 |
| Rate for Payer: Aetna American Axle |
$697.45
|
| Rate for Payer: Aetna Commercial |
$912.05
|
| Rate for Payer: Aetna Medicare |
$536.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$697.45
|
| Rate for Payer: BCBS Complete |
$429.20
|
| Rate for Payer: Cash Price |
$858.40
|
| Rate for Payer: Cofinity Advantage |
$751.10
|
| Rate for Payer: Cofinity Commercial |
$922.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.40
|
| Rate for Payer: Healthscope Commercial |
$965.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$751.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$804.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$858.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$804.75
|
| Rate for Payer: PHP Commercial |
$912.05
|
| Rate for Payer: Priority Health SBD |
$675.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$697.45
|
| Rate for Payer: UHC Core |
$559.03
|
| Rate for Payer: UHC Exchange |
$421.69
|
| Rate for Payer: UMR Bronson Commercial |
$397.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$804.75
|
|
|
HC CT BRAIN PERF ANAL W CONTRAST WITH CONCURR CT/CTA
|
Facility
|
IP
|
$1,073.00
|
|
|
Service Code
|
CPT 70472
|
| Hospital Charge Code |
35100013
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$472.12 |
| Max. Negotiated Rate |
$965.70 |
| Rate for Payer: Aetna American Axle |
$697.45
|
| Rate for Payer: Aetna Commercial |
$912.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$697.45
|
| Rate for Payer: Cash Price |
$858.40
|
| Rate for Payer: Cofinity Advantage |
$751.10
|
| Rate for Payer: Cofinity Commercial |
$922.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.40
|
| Rate for Payer: Healthscope Commercial |
$965.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$751.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$804.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$804.75
|
| Rate for Payer: PHP Commercial |
$912.05
|
| Rate for Payer: Priority Health SBD |
$675.99
|
| Rate for Payer: UMR Bronson Commercial |
$472.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$804.75
|
|
|
HC CT BRAIN PERF ANAL W CONTRAST WO CONCURR CT/CTA
|
Facility
|
OP
|
$1,033.50
|
|
|
Service Code
|
HCPCS 70473
|
| Hospital Charge Code |
35100014
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$930.15 |
| Rate for Payer: Aetna American Axle |
$671.77
|
| Rate for Payer: Aetna Commercial |
$878.48
|
| Rate for Payer: Aetna Medicare |
$181.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$671.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$826.80
|
| Rate for Payer: Cash Price |
$826.80
|
| Rate for Payer: Cofinity Advantage |
$723.45
|
| Rate for Payer: Cofinity Commercial |
$888.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$826.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$930.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$723.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$775.12
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$878.48
|
| Rate for Payer: Nomi Health Commercial |
$524.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$775.12
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$878.48
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$565.19
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health SBD |
$651.11
|
| Rate for Payer: Priority Health Tiered Network |
$452.15
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$671.77
|
| Rate for Payer: UHC Core |
$538.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$406.17
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: UMR Bronson Commercial |
$382.39
|
| Rate for Payer: VA VA |
$174.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$775.12
|
|
|
HC CT BRAIN PERF ANAL W CONTRAST WO CONCURR CT/CTA
|
Facility
|
IP
|
$1,033.50
|
|
|
Service Code
|
HCPCS 70473
|
| Hospital Charge Code |
35100014
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$454.74 |
| Max. Negotiated Rate |
$930.15 |
| Rate for Payer: Aetna American Axle |
$671.77
|
| Rate for Payer: Aetna Commercial |
$878.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$671.77
|
| Rate for Payer: Cash Price |
$826.80
|
| Rate for Payer: Cofinity Advantage |
$723.45
|
| Rate for Payer: Cofinity Commercial |
$888.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$826.80
|
| Rate for Payer: Healthscope Commercial |
$930.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$723.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$775.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$878.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$775.12
|
| Rate for Payer: PHP Commercial |
$878.48
|
| Rate for Payer: Priority Health SBD |
$651.11
|
| Rate for Payer: UMR Bronson Commercial |
$454.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$775.12
|
|
|
HC CT BRAIN PERFUSION
|
Facility
|
IP
|
$1,073.09
|
|
|
Service Code
|
CPT 0042T
|
| Hospital Charge Code |
35100011
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$472.16 |
| Max. Negotiated Rate |
$965.78 |
| Rate for Payer: Aetna American Axle |
$697.51
|
| Rate for Payer: Aetna Commercial |
$912.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$697.51
|
| Rate for Payer: Cash Price |
$858.47
|
| Rate for Payer: Cofinity Advantage |
$751.16
|
| Rate for Payer: Cofinity Commercial |
$922.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.47
|
| Rate for Payer: Healthscope Commercial |
$965.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$751.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$804.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$804.82
|
| Rate for Payer: PHP Commercial |
$912.13
|
| Rate for Payer: Priority Health SBD |
$676.05
|
| Rate for Payer: UMR Bronson Commercial |
$472.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$804.82
|
|
|
HC CT BRAIN PERFUSION
|
Facility
|
OP
|
$1,073.09
|
|
|
Service Code
|
CPT 0042T
|
| Hospital Charge Code |
35100011
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$361.47 |
| Max. Negotiated Rate |
$965.78 |
| Rate for Payer: Aetna American Axle |
$697.51
|
| Rate for Payer: Aetna Commercial |
$912.13
|
| Rate for Payer: Aetna Medicare |
$536.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$697.51
|
| Rate for Payer: BCBS Complete |
$429.24
|
| Rate for Payer: BCBS Trust/PPO |
$361.47
|
| Rate for Payer: BCN Commercial |
$361.47
|
| Rate for Payer: Cash Price |
$858.47
|
| Rate for Payer: Cash Price |
$858.47
|
| Rate for Payer: Cofinity Advantage |
$751.16
|
| Rate for Payer: Cofinity Commercial |
$922.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.47
|
| Rate for Payer: Healthscope Commercial |
$965.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$751.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$804.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$858.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$804.82
|
| Rate for Payer: PHP Commercial |
$912.13
|
| Rate for Payer: Priority Health SBD |
$676.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$697.51
|
| Rate for Payer: UHC Core |
$559.08
|
| Rate for Payer: UHC Exchange |
$421.72
|
| Rate for Payer: UMR Bronson Commercial |
$397.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$804.82
|
|
|
HC CT BRAIN W CON
|
Facility
|
IP
|
$1,655.16
|
|
|
Service Code
|
CPT 70460
|
| Hospital Charge Code |
35100002
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$728.27 |
| Max. Negotiated Rate |
$1,489.64 |
| Rate for Payer: Aetna American Axle |
$1,075.85
|
| Rate for Payer: Aetna Commercial |
$1,406.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,075.85
|
| Rate for Payer: Cash Price |
$1,324.13
|
| Rate for Payer: Cofinity Advantage |
$1,158.61
|
| Rate for Payer: Cofinity Commercial |
$1,423.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,324.13
|
| Rate for Payer: Healthscope Commercial |
$1,489.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,158.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,241.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,406.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,241.37
|
| Rate for Payer: PHP Commercial |
$1,406.89
|
| Rate for Payer: Priority Health SBD |
$1,042.75
|
| Rate for Payer: UMR Bronson Commercial |
$728.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,241.37
|
|
|
HC CT BRAIN W CON
|
Facility
|
OP
|
$1,655.16
|
|
|
Service Code
|
CPT 70460
|
| Hospital Charge Code |
35100002
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$1,489.64 |
| Rate for Payer: Aetna American Axle |
$1,075.85
|
| Rate for Payer: Aetna Commercial |
$1,406.89
|
| Rate for Payer: Aetna Medicare |
$181.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,075.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$240.52
|
| Rate for Payer: BCN Commercial |
$240.52
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$1,324.13
|
| Rate for Payer: Cash Price |
$1,324.13
|
| Rate for Payer: Cofinity Advantage |
$1,158.61
|
| Rate for Payer: Cofinity Commercial |
$1,423.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,324.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$1,489.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,158.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,241.37
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,406.89
|
| Rate for Payer: Nomi Health Commercial |
$524.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,241.37
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$1,406.89
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$565.19
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health SBD |
$1,042.75
|
| Rate for Payer: Priority Health Tiered Network |
$452.15
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,075.85
|
| Rate for Payer: UHC Core |
$862.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$650.48
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: UMR Bronson Commercial |
$612.41
|
| Rate for Payer: VA VA |
$174.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,241.37
|
|
|
HC CT BRAIN WO CON
|
Facility
|
IP
|
$1,544.42
|
|
|
Service Code
|
CPT 70450
|
| Hospital Charge Code |
35100001
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$679.54 |
| Max. Negotiated Rate |
$1,389.98 |
| Rate for Payer: Aetna American Axle |
$1,003.87
|
| Rate for Payer: Aetna Commercial |
$1,312.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,003.87
|
| Rate for Payer: Cash Price |
$1,235.54
|
| Rate for Payer: Cofinity Advantage |
$1,081.09
|
| Rate for Payer: Cofinity Commercial |
$1,328.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,235.54
|
| Rate for Payer: Healthscope Commercial |
$1,389.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,081.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,158.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,312.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,158.32
|
| Rate for Payer: PHP Commercial |
$1,312.76
|
| Rate for Payer: Priority Health SBD |
$972.98
|
| Rate for Payer: UMR Bronson Commercial |
$679.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,158.32
|
|
|
HC CT BRAIN WO CON
|
Facility
|
OP
|
$1,544.42
|
|
|
Service Code
|
CPT 70450
|
| Hospital Charge Code |
35100001
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$1,389.98 |
| Rate for Payer: Aetna American Axle |
$1,003.87
|
| Rate for Payer: Aetna Commercial |
$1,312.76
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,003.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$168.28
|
| Rate for Payer: BCN Commercial |
$168.28
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$1,235.54
|
| Rate for Payer: Cash Price |
$1,235.54
|
| Rate for Payer: Cofinity Advantage |
$1,081.09
|
| Rate for Payer: Cofinity Commercial |
$1,328.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,235.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$1,389.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,081.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,158.32
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,312.76
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,158.32
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$1,312.76
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$972.98
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,003.87
|
| Rate for Payer: UHC Core |
$804.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$606.96
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$571.44
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,158.32
|
|
