|
HC EEG W/O VID 2-12 HRS CONT MNTR
|
Facility
|
OP
|
$1,679.41
|
|
|
Service Code
|
CPT 95707
|
| Hospital Charge Code |
74000029
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$1,511.47 |
| Rate for Payer: Aetna American Axle |
$1,091.62
|
| Rate for Payer: Aetna Commercial |
$1,427.50
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,091.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$823.75
|
| Rate for Payer: BCN Commercial |
$823.75
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$1,343.53
|
| Rate for Payer: Cash Price |
$1,343.53
|
| Rate for Payer: Cofinity Advantage |
$1,175.59
|
| Rate for Payer: Cofinity Commercial |
$1,444.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,343.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$1,511.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,175.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,259.56
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,427.50
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,259.56
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$1,427.50
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$1,058.03
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,091.62
|
| Rate for Payer: UHC Core |
$874.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$660.01
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: UMR Bronson Commercial |
$621.38
|
| Rate for Payer: VA VA |
$215.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,259.56
|
|
|
HC EEG W/O VID 2-12 HRS INTMT MNTR
|
Facility
|
IP
|
$1,679.22
|
|
|
Service Code
|
CPT 95706
|
| Hospital Charge Code |
74000028
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$738.86 |
| Max. Negotiated Rate |
$1,511.30 |
| Rate for Payer: Aetna American Axle |
$1,091.49
|
| Rate for Payer: Aetna Commercial |
$1,427.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,091.49
|
| Rate for Payer: Cash Price |
$1,343.38
|
| Rate for Payer: Cofinity Advantage |
$1,175.45
|
| Rate for Payer: Cofinity Commercial |
$1,444.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,343.38
|
| Rate for Payer: Healthscope Commercial |
$1,511.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,175.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,259.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,427.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,259.41
|
| Rate for Payer: PHP Commercial |
$1,427.34
|
| Rate for Payer: Priority Health SBD |
$1,057.91
|
| Rate for Payer: UMR Bronson Commercial |
$738.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,259.41
|
|
|
HC EEG W/O VID 2-12 HRS INTMT MNTR
|
Facility
|
OP
|
$1,679.22
|
|
|
Service Code
|
CPT 95706
|
| Hospital Charge Code |
74000028
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$1,511.30 |
| Rate for Payer: Aetna American Axle |
$1,091.49
|
| Rate for Payer: Aetna Commercial |
$1,427.34
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,091.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$823.75
|
| Rate for Payer: BCN Commercial |
$823.75
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$1,343.38
|
| Rate for Payer: Cash Price |
$1,343.38
|
| Rate for Payer: Cofinity Advantage |
$1,175.45
|
| Rate for Payer: Cofinity Commercial |
$1,444.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,343.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$1,511.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,175.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,259.41
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,427.34
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,259.41
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$1,427.34
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$1,057.91
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,091.49
|
| Rate for Payer: UHC Core |
$874.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$659.93
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: UMR Bronson Commercial |
$621.31
|
| Rate for Payer: VA VA |
$215.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,259.41
|
|
|
HC EEG W/O VID 2-12 HR UNMNTR
|
Facility
|
OP
|
$1,041.69
|
|
|
Service Code
|
CPT 95705
|
| Hospital Charge Code |
74000020
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$937.52 |
| Rate for Payer: Aetna American Axle |
$677.10
|
| Rate for Payer: Aetna Commercial |
$885.44
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$677.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$823.75
|
| Rate for Payer: BCN Commercial |
$823.75
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$833.35
|
| Rate for Payer: Cash Price |
$833.35
|
| Rate for Payer: Cofinity Advantage |
$729.18
|
| Rate for Payer: Cofinity Commercial |
$895.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$833.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$937.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$729.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$781.27
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$885.44
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$781.27
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$885.44
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$656.26
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$677.10
|
| Rate for Payer: UHC Core |
$542.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$409.38
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: UMR Bronson Commercial |
$385.43
|
| Rate for Payer: VA VA |
$215.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$781.27
|
|
|
HC EEG W/O VID 2-12 HR UNMNTR
|
Facility
|
IP
|
$1,041.69
|
|
|
Service Code
|
CPT 95705
|
| Hospital Charge Code |
74000020
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$458.34 |
| Max. Negotiated Rate |
$937.52 |
| Rate for Payer: Aetna American Axle |
$677.10
|
| Rate for Payer: Aetna Commercial |
$885.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$677.10
|
| Rate for Payer: Cash Price |
$833.35
|
| Rate for Payer: Cofinity Advantage |
$729.18
|
| Rate for Payer: Cofinity Commercial |
$895.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$833.35
|
| Rate for Payer: Healthscope Commercial |
$937.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$729.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$781.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$885.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$781.27
|
| Rate for Payer: PHP Commercial |
$885.44
|
| Rate for Payer: Priority Health SBD |
$656.26
|
| Rate for Payer: UMR Bronson Commercial |
$458.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$781.27
|
|
|
HC EEG W/O VID EA 12-26 HR UNMNTR
|
Facility
|
OP
|
$1,998.65
|
|
|
Service Code
|
CPT 95708
|
| Hospital Charge Code |
74000021
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$194.46 |
| Max. Negotiated Rate |
$1,798.79 |
| Rate for Payer: Aetna American Axle |
$1,299.12
|
| Rate for Payer: Aetna Commercial |
$1,698.85
|
| Rate for Payer: Aetna Medicare |
$386.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,299.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$464.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$464.77
|
| Rate for Payer: BCBS Complete |
$204.20
|
| Rate for Payer: BCBS MAPPO |
$371.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,403.60
|
| Rate for Payer: BCN Commercial |
$1,403.60
|
| Rate for Payer: BCN Medicare Advantage |
$371.82
|
| Rate for Payer: Cash Price |
$1,598.92
|
| Rate for Payer: Cash Price |
$1,598.92
|
| Rate for Payer: Cofinity Advantage |
$1,399.06
|
| Rate for Payer: Cofinity Commercial |
$1,718.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,598.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.82
|
| Rate for Payer: Healthscope Commercial |
$1,798.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,399.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,498.99
|
| Rate for Payer: Mclaren Medicaid |
$371.82
|
| Rate for Payer: Mclaren Medicare |
$371.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.41
|
| Rate for Payer: Meridian Medicaid |
$390.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$427.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$409.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,698.85
|
| Rate for Payer: Nomi Health Commercial |
$1,115.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,498.99
|
| Rate for Payer: PACE Medicare |
$353.23
|
| Rate for Payer: PACE SWMI |
$371.82
|
| Rate for Payer: PHP Commercial |
$1,698.85
|
| Rate for Payer: PHP Medicare Advantage |
$371.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,202.41
|
| Rate for Payer: Priority Health Medicare |
$371.82
|
| Rate for Payer: Priority Health SBD |
$1,259.15
|
| Rate for Payer: Priority Health Tiered Network |
$961.93
|
| Rate for Payer: Railroad Medicare Medicare |
$371.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,299.12
|
| Rate for Payer: UHC Core |
$1,041.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$371.82
|
| Rate for Payer: UHC Exchange |
$785.47
|
| Rate for Payer: UHC Medicaid |
$194.46
|
| Rate for Payer: UHCCP Medicaid |
$194.46
|
| Rate for Payer: UMR Bronson Commercial |
$739.50
|
| Rate for Payer: VA VA |
$371.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,498.99
|
|
|
HC EEG W/O VID EA 12-26 HR UNMNTR
|
Facility
|
IP
|
$1,998.65
|
|
|
Service Code
|
CPT 95708
|
| Hospital Charge Code |
74000021
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$879.41 |
| Max. Negotiated Rate |
$1,798.79 |
| Rate for Payer: Aetna American Axle |
$1,299.12
|
| Rate for Payer: Aetna Commercial |
$1,698.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,299.12
|
| Rate for Payer: Cash Price |
$1,598.92
|
| Rate for Payer: Cofinity Advantage |
$1,399.06
|
| Rate for Payer: Cofinity Commercial |
$1,718.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,598.92
|
| Rate for Payer: Healthscope Commercial |
$1,798.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,399.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,498.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,698.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,498.99
|
| Rate for Payer: PHP Commercial |
$1,698.85
|
| Rate for Payer: Priority Health SBD |
$1,259.15
|
| Rate for Payer: UMR Bronson Commercial |
$879.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,498.99
|
|
|
HC EGD W EUS EXAM ESOPH ONLY
|
Facility
|
IP
|
$2,909.09
|
|
| Hospital Charge Code |
36000035
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,280.00 |
| Max. Negotiated Rate |
$2,618.18 |
| Rate for Payer: Aetna American Axle |
$1,890.91
|
| Rate for Payer: Aetna Commercial |
$2,472.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,890.91
|
| Rate for Payer: Cash Price |
$2,327.27
|
| Rate for Payer: Cofinity Advantage |
$2,036.36
|
| Rate for Payer: Cofinity Commercial |
$2,501.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,327.27
|
| Rate for Payer: Healthscope Commercial |
$2,618.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,036.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,181.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,472.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,181.82
|
| Rate for Payer: PHP Commercial |
$2,472.73
|
| Rate for Payer: Priority Health SBD |
$1,832.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,280.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,181.82
|
|
|
HC EGD W EUS EXAM ESOPH ONLY
|
Facility
|
OP
|
$2,909.09
|
|
| Hospital Charge Code |
36000035
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,076.36 |
| Max. Negotiated Rate |
$2,618.18 |
| Rate for Payer: Aetna American Axle |
$1,890.91
|
| Rate for Payer: Aetna Commercial |
$2,472.73
|
| Rate for Payer: Aetna Medicare |
$1,454.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,890.91
|
| Rate for Payer: BCBS Complete |
$1,163.64
|
| Rate for Payer: Cash Price |
$2,327.27
|
| Rate for Payer: Cofinity Advantage |
$2,036.36
|
| Rate for Payer: Cofinity Commercial |
$2,501.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,327.27
|
| Rate for Payer: Healthscope Commercial |
$2,618.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,036.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,181.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,327.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,472.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,181.82
|
| Rate for Payer: PHP Commercial |
$2,472.73
|
| Rate for Payer: Priority Health SBD |
$1,832.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,076.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,181.82
|
|
|
HC EGD W EUS EXAM ESOPH,STOM,DUO,
|
Facility
|
IP
|
$3,038.67
|
|
| Hospital Charge Code |
36000036
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,337.01 |
| Max. Negotiated Rate |
$2,734.80 |
| Rate for Payer: Aetna American Axle |
$1,975.14
|
| Rate for Payer: Aetna Commercial |
$2,582.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,975.14
|
| Rate for Payer: Cash Price |
$2,430.94
|
| Rate for Payer: Cofinity Advantage |
$2,127.07
|
| Rate for Payer: Cofinity Commercial |
$2,613.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,430.94
|
| Rate for Payer: Healthscope Commercial |
$2,734.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,127.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,279.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,582.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,279.00
|
| Rate for Payer: PHP Commercial |
$2,582.87
|
| Rate for Payer: Priority Health SBD |
$1,914.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,337.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,279.00
|
|
|
HC EGD W EUS EXAM ESOPH,STOM,DUO,
|
Facility
|
OP
|
$3,038.67
|
|
| Hospital Charge Code |
36000036
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,124.31 |
| Max. Negotiated Rate |
$2,734.80 |
| Rate for Payer: Aetna American Axle |
$1,975.14
|
| Rate for Payer: Aetna Commercial |
$2,582.87
|
| Rate for Payer: Aetna Medicare |
$1,519.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,975.14
|
| Rate for Payer: BCBS Complete |
$1,215.47
|
| Rate for Payer: Cash Price |
$2,430.94
|
| Rate for Payer: Cofinity Advantage |
$2,127.07
|
| Rate for Payer: Cofinity Commercial |
$2,613.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,430.94
|
| Rate for Payer: Healthscope Commercial |
$2,734.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,127.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,279.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,430.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,582.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,279.00
|
| Rate for Payer: PHP Commercial |
$2,582.87
|
| Rate for Payer: Priority Health SBD |
$1,914.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,124.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,279.00
|
|
|
HC EGG WHITE IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200041
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC EGG WHITE IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200041
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC EGG YOLK, IGE
|
Facility
|
OP
|
$31.83
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200482
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna American Axle |
$20.69
|
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Advantage |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$20.05
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$11.78
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC EGG YOLK, IGE
|
Facility
|
IP
|
$31.83
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200482
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.01 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna American Axle |
$20.69
|
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.69
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Advantage |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: Priority Health SBD |
$20.05
|
| Rate for Payer: UMR Bronson Commercial |
$14.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC EKG RHYTHM STRIP
|
Facility
|
OP
|
$75.34
|
|
|
Service Code
|
CPT 93041
|
| Hospital Charge Code |
73000002
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$26.77 |
| Max. Negotiated Rate |
$190.09 |
| Rate for Payer: Aetna American Axle |
$48.97
|
| Rate for Payer: Aetna Commercial |
$64.04
|
| Rate for Payer: Aetna Medicare |
$61.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS Trust/PPO |
$26.77
|
| Rate for Payer: BCN Commercial |
$26.77
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$60.27
|
| Rate for Payer: Cash Price |
$60.27
|
| Rate for Payer: Cofinity Advantage |
$52.74
|
| Rate for Payer: Cofinity Commercial |
$64.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$67.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.51
|
| Rate for Payer: Mclaren Medicaid |
$58.78
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$61.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.04
|
| Rate for Payer: Nomi Health Commercial |
$176.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.51
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$64.04
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$190.09
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health SBD |
$47.46
|
| Rate for Payer: Priority Health Tiered Network |
$152.07
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.97
|
| Rate for Payer: UHC Core |
$39.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$29.61
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: UMR Bronson Commercial |
$27.88
|
| Rate for Payer: VA VA |
$58.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.51
|
|
|
HC EKG RHYTHM STRIP
|
Facility
|
IP
|
$75.34
|
|
|
Service Code
|
CPT 93041
|
| Hospital Charge Code |
73000002
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$33.15 |
| Max. Negotiated Rate |
$67.81 |
| Rate for Payer: Aetna American Axle |
$48.97
|
| Rate for Payer: Aetna Commercial |
$64.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.97
|
| Rate for Payer: Cash Price |
$60.27
|
| Rate for Payer: Cofinity Advantage |
$52.74
|
| Rate for Payer: Cofinity Commercial |
$64.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.27
|
| Rate for Payer: Healthscope Commercial |
$67.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.51
|
| Rate for Payer: PHP Commercial |
$64.04
|
| Rate for Payer: Priority Health SBD |
$47.46
|
| Rate for Payer: UMR Bronson Commercial |
$33.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.51
|
|
|
HC EKG TRACING FOR INITIAL PREV
|
Facility
|
OP
|
$37.12
|
|
|
Service Code
|
HCPCS G0404
|
| Hospital Charge Code |
73000004
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$13.73 |
| Max. Negotiated Rate |
$93.19 |
| Rate for Payer: Aetna American Axle |
$24.13
|
| Rate for Payer: Aetna Commercial |
$31.55
|
| Rate for Payer: Aetna Medicare |
$29.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.02
|
| Rate for Payer: BCBS Complete |
$15.83
|
| Rate for Payer: BCBS MAPPO |
$28.82
|
| Rate for Payer: BCN Medicare Advantage |
$28.82
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cofinity Advantage |
$25.98
|
| Rate for Payer: Cofinity Commercial |
$31.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.82
|
| Rate for Payer: Healthscope Commercial |
$33.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.84
|
| Rate for Payer: Mclaren Medicaid |
$28.82
|
| Rate for Payer: Mclaren Medicare |
$28.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.26
|
| Rate for Payer: Meridian Medicaid |
$30.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.55
|
| Rate for Payer: Nomi Health Commercial |
$86.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.84
|
| Rate for Payer: PACE Medicare |
$27.38
|
| Rate for Payer: PACE SWMI |
$28.82
|
| Rate for Payer: PHP Commercial |
$31.55
|
| Rate for Payer: PHP Medicare Advantage |
$28.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$93.19
|
| Rate for Payer: Priority Health Medicare |
$28.82
|
| Rate for Payer: Priority Health SBD |
$23.39
|
| Rate for Payer: Priority Health Tiered Network |
$74.55
|
| Rate for Payer: Railroad Medicare Medicare |
$28.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.13
|
| Rate for Payer: UHC Core |
$19.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.82
|
| Rate for Payer: UHC Exchange |
$14.59
|
| Rate for Payer: UHC Medicaid |
$15.07
|
| Rate for Payer: UHCCP Medicaid |
$15.07
|
| Rate for Payer: UMR Bronson Commercial |
$13.73
|
| Rate for Payer: VA VA |
$28.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.84
|
|
|
HC EKG TRACING FOR INITIAL PREV
|
Facility
|
IP
|
$37.12
|
|
|
Service Code
|
HCPCS G0404
|
| Hospital Charge Code |
73000004
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$16.33 |
| Max. Negotiated Rate |
$33.41 |
| Rate for Payer: Aetna American Axle |
$24.13
|
| Rate for Payer: Aetna Commercial |
$31.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.13
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cofinity Advantage |
$25.98
|
| Rate for Payer: Cofinity Commercial |
$31.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.70
|
| Rate for Payer: Healthscope Commercial |
$33.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.84
|
| Rate for Payer: PHP Commercial |
$31.55
|
| Rate for Payer: Priority Health SBD |
$23.39
|
| Rate for Payer: UMR Bronson Commercial |
$16.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.84
|
|
|
HC EKO INFUSION SYSTEM
|
Facility
|
IP
|
$7,849.99
|
|
| Hospital Charge Code |
27200279
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,454.00 |
| Max. Negotiated Rate |
$7,064.99 |
| Rate for Payer: Aetna American Axle |
$5,102.49
|
| Rate for Payer: Aetna Commercial |
$6,672.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,102.49
|
| Rate for Payer: Cash Price |
$6,279.99
|
| Rate for Payer: Cofinity Advantage |
$5,494.99
|
| Rate for Payer: Cofinity Commercial |
$6,750.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,279.99
|
| Rate for Payer: Healthscope Commercial |
$7,064.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,494.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,887.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,672.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,887.49
|
| Rate for Payer: PHP Commercial |
$6,672.49
|
| Rate for Payer: Priority Health SBD |
$4,945.49
|
| Rate for Payer: UMR Bronson Commercial |
$3,454.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,887.49
|
|
|
HC EKO INFUSION SYSTEM
|
Facility
|
OP
|
$7,849.99
|
|
| Hospital Charge Code |
27200279
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,904.50 |
| Max. Negotiated Rate |
$7,064.99 |
| Rate for Payer: Aetna American Axle |
$5,102.49
|
| Rate for Payer: Aetna Commercial |
$6,672.49
|
| Rate for Payer: Aetna Medicare |
$3,924.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,102.49
|
| Rate for Payer: BCBS Complete |
$3,140.00
|
| Rate for Payer: Cash Price |
$6,279.99
|
| Rate for Payer: Cofinity Advantage |
$5,494.99
|
| Rate for Payer: Cofinity Commercial |
$6,750.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,279.99
|
| Rate for Payer: Healthscope Commercial |
$7,064.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,494.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,887.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,279.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,672.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,887.49
|
| Rate for Payer: PHP Commercial |
$6,672.49
|
| Rate for Payer: Priority Health SBD |
$4,945.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,102.49
|
| Rate for Payer: UHC Core |
$4,089.84
|
| Rate for Payer: UHC Exchange |
$3,085.05
|
| Rate for Payer: UMR Bronson Commercial |
$2,904.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,887.49
|
|
|
HC ELEC ALYS IMPLT BRN NPGT PRGRMG EA ADDL 15 MIN
|
Facility
|
OP
|
$71.00
|
|
|
Service Code
|
CPT 95984
|
| Hospital Charge Code |
76100548
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$26.27 |
| Max. Negotiated Rate |
$63.90 |
| Rate for Payer: Aetna American Axle |
$46.15
|
| Rate for Payer: Aetna Commercial |
$60.35
|
| Rate for Payer: Aetna Medicare |
$35.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.15
|
| Rate for Payer: BCBS Complete |
$28.40
|
| Rate for Payer: BCBS Trust/PPO |
$59.18
|
| Rate for Payer: BCN Commercial |
$59.18
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cofinity Advantage |
$49.70
|
| Rate for Payer: Cofinity Commercial |
$61.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.80
|
| Rate for Payer: Healthscope Commercial |
$63.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.25
|
| Rate for Payer: PHP Commercial |
$60.35
|
| Rate for Payer: Priority Health SBD |
$44.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.15
|
| Rate for Payer: UHC Core |
$36.99
|
| Rate for Payer: UHC Exchange |
$27.90
|
| Rate for Payer: UMR Bronson Commercial |
$26.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.25
|
|
|
HC ELEC ALYS IMPLT BRN NPGT PRGRMG EA ADDL 15 MIN
|
Facility
|
IP
|
$71.00
|
|
|
Service Code
|
CPT 95984
|
| Hospital Charge Code |
76100548
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$31.24 |
| Max. Negotiated Rate |
$63.90 |
| Rate for Payer: Aetna American Axle |
$46.15
|
| Rate for Payer: Aetna Commercial |
$60.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.15
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cofinity Advantage |
$49.70
|
| Rate for Payer: Cofinity Commercial |
$61.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.80
|
| Rate for Payer: Healthscope Commercial |
$63.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.25
|
| Rate for Payer: PHP Commercial |
$60.35
|
| Rate for Payer: Priority Health SBD |
$44.73
|
| Rate for Payer: UMR Bronson Commercial |
$31.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.25
|
|
|
HC ELEC ALYS IMPLT COMPLEX CN NPGT PRGRMG
|
Facility
|
OP
|
$271.00
|
|
|
Service Code
|
CPT 95977
|
| Hospital Charge Code |
76100550
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$49.54 |
| Max. Negotiated Rate |
$306.34 |
| Rate for Payer: Aetna American Axle |
$176.15
|
| Rate for Payer: Aetna Commercial |
$230.35
|
| Rate for Payer: Aetna Medicare |
$98.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$118.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$118.41
|
| Rate for Payer: BCBS Complete |
$52.03
|
| Rate for Payer: BCBS MAPPO |
$94.73
|
| Rate for Payer: BCBS Trust/PPO |
$64.81
|
| Rate for Payer: BCN Commercial |
$64.81
|
| Rate for Payer: BCN Medicare Advantage |
$94.73
|
| Rate for Payer: Cash Price |
$216.80
|
| Rate for Payer: Cash Price |
$216.80
|
| Rate for Payer: Cofinity Advantage |
$189.70
|
| Rate for Payer: Cofinity Commercial |
$233.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.73
|
| Rate for Payer: Healthscope Commercial |
$243.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$189.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.25
|
| Rate for Payer: Mclaren Medicaid |
$94.73
|
| Rate for Payer: Mclaren Medicare |
$94.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.47
|
| Rate for Payer: Meridian Medicaid |
$99.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$108.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$104.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.35
|
| Rate for Payer: Nomi Health Commercial |
$284.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$203.25
|
| Rate for Payer: PACE Medicare |
$89.99
|
| Rate for Payer: PACE SWMI |
$94.73
|
| Rate for Payer: PHP Commercial |
$230.35
|
| Rate for Payer: PHP Medicare Advantage |
$94.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$306.34
|
| Rate for Payer: Priority Health Medicare |
$94.73
|
| Rate for Payer: Priority Health SBD |
$170.73
|
| Rate for Payer: Priority Health Tiered Network |
$245.07
|
| Rate for Payer: Railroad Medicare Medicare |
$94.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.15
|
| Rate for Payer: UHC Core |
$141.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$94.73
|
| Rate for Payer: UHC Exchange |
$106.50
|
| Rate for Payer: UHC Medicaid |
$49.54
|
| Rate for Payer: UHCCP Medicaid |
$49.54
|
| Rate for Payer: UMR Bronson Commercial |
$100.27
|
| Rate for Payer: VA VA |
$94.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.25
|
|
|
HC ELEC ALYS IMPLT COMPLEX CN NPGT PRGRMG
|
Facility
|
IP
|
$271.00
|
|
|
Service Code
|
CPT 95977
|
| Hospital Charge Code |
76100550
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$119.24 |
| Max. Negotiated Rate |
$243.90 |
| Rate for Payer: Aetna American Axle |
$176.15
|
| Rate for Payer: Aetna Commercial |
$230.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.15
|
| Rate for Payer: Cash Price |
$216.80
|
| Rate for Payer: Cofinity Advantage |
$189.70
|
| Rate for Payer: Cofinity Commercial |
$233.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.80
|
| Rate for Payer: Healthscope Commercial |
$243.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$189.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$203.25
|
| Rate for Payer: PHP Commercial |
$230.35
|
| Rate for Payer: Priority Health SBD |
$170.73
|
| Rate for Payer: UMR Bronson Commercial |
$119.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.25
|
|
