|
HC MR BREAST WO CON UNI
|
Facility
|
IP
|
$1,538.00
|
|
|
Service Code
|
CPT 77046
|
| Hospital Charge Code |
61000090
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$676.72 |
| Max. Negotiated Rate |
$1,384.20 |
| Rate for Payer: Aetna American Axle |
$999.70
|
| Rate for Payer: Aetna Commercial |
$1,307.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$999.70
|
| Rate for Payer: Cash Price |
$1,230.40
|
| Rate for Payer: Cofinity Commercial |
$1,076.60
|
| Rate for Payer: Cofinity Commercial |
$1,322.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,230.40
|
| Rate for Payer: Healthscope Commercial |
$1,384.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,076.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,153.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,307.30
|
| Rate for Payer: PHP Commercial |
$1,307.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,076.60
|
| Rate for Payer: Priority Health SBD |
$968.94
|
| Rate for Payer: UMR Bronson Commercial |
$676.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,153.50
|
|
|
HC MR CARDIAC FOR MORPHOLOGY WO CON
|
Facility
|
IP
|
$2,111.40
|
|
|
Service Code
|
CPT 75557
|
| Hospital Charge Code |
61000046
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$929.02 |
| Max. Negotiated Rate |
$1,900.26 |
| Rate for Payer: Aetna American Axle |
$1,372.41
|
| Rate for Payer: Aetna Commercial |
$1,794.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,372.41
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cofinity Commercial |
$1,477.98
|
| Rate for Payer: Cofinity Commercial |
$1,815.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Healthscope Commercial |
$1,900.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,477.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,583.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,794.69
|
| Rate for Payer: PHP Commercial |
$1,794.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,477.98
|
| Rate for Payer: Priority Health SBD |
$1,330.18
|
| Rate for Payer: UMR Bronson Commercial |
$929.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,583.55
|
|
|
HC MR CARDIAC FOR MORPHOLOGY WO CON
|
Facility
|
OP
|
$2,111.40
|
|
|
Service Code
|
CPT 75557
|
| Hospital Charge Code |
61000046
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$1,372.41
|
| Rate for Payer: Aetna Commercial |
$1,794.69
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,372.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$342.71
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cofinity Commercial |
$1,477.98
|
| Rate for Payer: Cofinity Commercial |
$1,815.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$1,900.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,477.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,583.55
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,794.69
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$1,794.69
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,477.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.66
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$548.53
|
| Rate for Payer: Priority Health SBD |
$1,330.18
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.04
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$280.95
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$781.22
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,583.55
|
|
|
HC MR CARDIAC MORP AND FUNC WO W CON
|
Facility
|
OP
|
$971.55
|
|
|
Service Code
|
CPT 75561
|
| Hospital Charge Code |
61000047
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$631.51
|
| Rate for Payer: Aetna Commercial |
$825.82
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$631.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$490.95
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$777.24
|
| Rate for Payer: Cash Price |
$777.24
|
| Rate for Payer: Cofinity Commercial |
$680.08
|
| Rate for Payer: Cofinity Commercial |
$835.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$874.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$680.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$728.66
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$825.82
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$825.82
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$680.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,076.13
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$860.90
|
| Rate for Payer: Priority Health SBD |
$612.08
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$403.77
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$367.06
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$359.47
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$728.66
|
|
|
HC MR CARDIAC MORP AND FUNC WO W CON
|
Facility
|
IP
|
$971.55
|
|
|
Service Code
|
CPT 75561
|
| Hospital Charge Code |
61000047
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$427.48 |
| Max. Negotiated Rate |
$874.40 |
| Rate for Payer: Aetna American Axle |
$631.51
|
| Rate for Payer: Aetna Commercial |
$825.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$631.51
|
| Rate for Payer: Cash Price |
$777.24
|
| Rate for Payer: Cofinity Commercial |
$680.08
|
| Rate for Payer: Cofinity Commercial |
$835.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.24
|
| Rate for Payer: Healthscope Commercial |
$874.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$680.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$728.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$825.82
|
| Rate for Payer: PHP Commercial |
$825.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$680.08
|
| Rate for Payer: Priority Health SBD |
$612.08
|
| Rate for Payer: UMR Bronson Commercial |
$427.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$728.66
|
|
|
HC MR CARDIAC VELOCITY MAPPING
|
Facility
|
IP
|
$1,215.00
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
61000048
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$534.60 |
| Max. Negotiated Rate |
$1,093.50 |
| Rate for Payer: Aetna American Axle |
$789.75
|
| Rate for Payer: Aetna Commercial |
$1,032.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$789.75
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cofinity Commercial |
$1,044.90
|
| Rate for Payer: Cofinity Commercial |
$850.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$972.00
|
| Rate for Payer: Healthscope Commercial |
$1,093.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$850.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$911.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,032.75
|
| Rate for Payer: PHP Commercial |
$1,032.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$850.50
|
| Rate for Payer: Priority Health SBD |
$765.45
|
| Rate for Payer: UMR Bronson Commercial |
$534.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$911.25
|
|
|
HC MR CARDIAC VELOCITY MAPPING
|
Facility
|
OP
|
$1,215.00
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
61000048
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$45.84 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$789.75
|
| Rate for Payer: Aetna Commercial |
$1,032.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$789.75
|
| Rate for Payer: BCBS Complete |
$486.00
|
| Rate for Payer: BCBS Trust/PPO |
$67.79
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cofinity Commercial |
$850.50
|
| Rate for Payer: Cofinity Commercial |
$1,044.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$972.00
|
| Rate for Payer: Healthscope Commercial |
$1,093.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$850.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$911.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,032.75
|
| Rate for Payer: PHP Commercial |
$1,032.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$850.50
|
| Rate for Payer: Priority Health SBD |
$765.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.42
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Exchange |
$45.84
|
| Rate for Payer: UMR Bronson Commercial |
$449.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$911.25
|
|
|
HC MR CHEST W CON
|
Facility
|
OP
|
$2,287.25
|
|
|
Service Code
|
CPT 71551
|
| Hospital Charge Code |
61000011
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$377.54 |
| Max. Negotiated Rate |
$2,240.48 |
| Rate for Payer: Aetna American Axle |
$1,486.71
|
| Rate for Payer: Aetna Commercial |
$1,944.16
|
| Rate for Payer: Aetna Medicare |
$740.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,486.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$889.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$889.64
|
| Rate for Payer: BCBS Complete |
$408.81
|
| Rate for Payer: BCBS MAPPO |
$711.71
|
| Rate for Payer: BCBS Trust/PPO |
$589.14
|
| Rate for Payer: BCN Medicare Advantage |
$711.71
|
| Rate for Payer: Cash Price |
$1,829.80
|
| Rate for Payer: Cash Price |
$1,829.80
|
| Rate for Payer: Cofinity Commercial |
$1,601.08
|
| Rate for Payer: Cofinity Commercial |
$1,967.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,829.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$711.71
|
| Rate for Payer: Healthscope Commercial |
$2,058.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,601.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,715.44
|
| Rate for Payer: Mclaren Medicaid |
$389.31
|
| Rate for Payer: Mclaren Medicare |
$711.71
|
| Rate for Payer: Meridian Medicaid |
$408.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$747.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$818.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,944.16
|
| Rate for Payer: PACE Medicare |
$676.12
|
| Rate for Payer: PACE SWMI |
$711.71
|
| Rate for Payer: PHP Commercial |
$1,944.16
|
| Rate for Payer: PHP Medicare Advantage |
$711.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,601.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,240.48
|
| Rate for Payer: Priority Health Medicare |
$711.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,792.38
|
| Rate for Payer: Priority Health SBD |
$1,440.97
|
| Rate for Payer: Railroad Medicare Medicare |
$711.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$415.29
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$711.71
|
| Rate for Payer: UHC Exchange |
$377.54
|
| Rate for Payer: UHC Medicare Advantage |
$733.06
|
| Rate for Payer: UMR Bronson Commercial |
$846.28
|
| Rate for Payer: VA VA |
$711.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,715.44
|
|
|
HC MR CHEST W CON
|
Facility
|
IP
|
$2,287.25
|
|
|
Service Code
|
CPT 71551
|
| Hospital Charge Code |
61000011
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,006.39 |
| Max. Negotiated Rate |
$2,058.52 |
| Rate for Payer: Aetna American Axle |
$1,486.71
|
| Rate for Payer: Aetna Commercial |
$1,944.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,486.71
|
| Rate for Payer: Cash Price |
$1,829.80
|
| Rate for Payer: Cofinity Commercial |
$1,601.08
|
| Rate for Payer: Cofinity Commercial |
$1,967.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,829.80
|
| Rate for Payer: Healthscope Commercial |
$2,058.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,601.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,715.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,944.16
|
| Rate for Payer: PHP Commercial |
$1,944.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,601.08
|
| Rate for Payer: Priority Health SBD |
$1,440.97
|
| Rate for Payer: UMR Bronson Commercial |
$1,006.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,715.44
|
|
|
HC MR CHEST WO CON
|
Facility
|
IP
|
$1,992.40
|
|
|
Service Code
|
CPT 71550
|
| Hospital Charge Code |
61000010
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$876.66 |
| Max. Negotiated Rate |
$1,793.16 |
| Rate for Payer: Aetna American Axle |
$1,295.06
|
| Rate for Payer: Aetna Commercial |
$1,693.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,295.06
|
| Rate for Payer: Cash Price |
$1,593.92
|
| Rate for Payer: Cofinity Commercial |
$1,394.68
|
| Rate for Payer: Cofinity Commercial |
$1,713.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,593.92
|
| Rate for Payer: Healthscope Commercial |
$1,793.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,394.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,494.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,693.54
|
| Rate for Payer: PHP Commercial |
$1,693.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,394.68
|
| Rate for Payer: Priority Health SBD |
$1,255.21
|
| Rate for Payer: UMR Bronson Commercial |
$876.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,494.30
|
|
|
HC MR CHEST WO CON
|
Facility
|
OP
|
$1,992.40
|
|
|
Service Code
|
CPT 71550
|
| Hospital Charge Code |
61000010
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$1,295.06
|
| Rate for Payer: Aetna Commercial |
$1,693.54
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,295.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$542.26
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,593.92
|
| Rate for Payer: Cash Price |
$1,593.92
|
| Rate for Payer: Cofinity Commercial |
$1,713.46
|
| Rate for Payer: Cofinity Commercial |
$1,394.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,593.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$1,793.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,394.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,494.30
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,693.54
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$1,693.54
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,394.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.66
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$548.53
|
| Rate for Payer: Priority Health SBD |
$1,255.21
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$375.67
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$341.52
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$737.19
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,494.30
|
|
|
HC MR CHEST WO W CON
|
Facility
|
IP
|
$2,992.94
|
|
|
Service Code
|
CPT 71552
|
| Hospital Charge Code |
61000012
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,316.89 |
| Max. Negotiated Rate |
$2,693.65 |
| Rate for Payer: Aetna American Axle |
$1,945.41
|
| Rate for Payer: Aetna Commercial |
$2,544.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,945.41
|
| Rate for Payer: Cash Price |
$2,394.35
|
| Rate for Payer: Cofinity Commercial |
$2,095.06
|
| Rate for Payer: Cofinity Commercial |
$2,573.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,394.35
|
| Rate for Payer: Healthscope Commercial |
$2,693.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,095.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,244.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,544.00
|
| Rate for Payer: PHP Commercial |
$2,544.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,095.06
|
| Rate for Payer: Priority Health SBD |
$1,885.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,316.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,244.70
|
|
|
HC MR CHEST WO W CON
|
Facility
|
OP
|
$2,992.94
|
|
|
Service Code
|
CPT 71552
|
| Hospital Charge Code |
61000012
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,693.65 |
| Rate for Payer: Aetna American Axle |
$1,945.41
|
| Rate for Payer: Aetna Commercial |
$2,544.00
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,945.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$737.37
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$2,394.35
|
| Rate for Payer: Cash Price |
$2,394.35
|
| Rate for Payer: Cofinity Commercial |
$2,573.93
|
| Rate for Payer: Cofinity Commercial |
$2,095.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,394.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,693.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,095.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,244.70
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,544.00
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$2,544.00
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,095.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,076.13
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$860.90
|
| Rate for Payer: Priority Health SBD |
$1,885.55
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$524.07
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$476.43
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,107.39
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,244.70
|
|
|
HC MR ELASTOGRAPHY
|
Facility
|
OP
|
$352.92
|
|
|
Service Code
|
CPT 76391
|
| Hospital Charge Code |
61000089
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$229.40
|
| Rate for Payer: Aetna Commercial |
$299.98
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$302.17
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$282.34
|
| Rate for Payer: Cash Price |
$282.34
|
| Rate for Payer: Cofinity Commercial |
$303.51
|
| Rate for Payer: Cofinity Commercial |
$247.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$317.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$247.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.69
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$299.98
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$299.98
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.66
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$548.53
|
| Rate for Payer: Priority Health SBD |
$222.34
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.31
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$203.01
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$130.58
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.69
|
|
|
HC MR ELASTOGRAPHY
|
Facility
|
IP
|
$352.92
|
|
|
Service Code
|
CPT 76391
|
| Hospital Charge Code |
61000089
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$155.28 |
| Max. Negotiated Rate |
$317.63 |
| Rate for Payer: Aetna American Axle |
$229.40
|
| Rate for Payer: Aetna Commercial |
$299.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.40
|
| Rate for Payer: Cash Price |
$282.34
|
| Rate for Payer: Cofinity Commercial |
$247.04
|
| Rate for Payer: Cofinity Commercial |
$303.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.34
|
| Rate for Payer: Healthscope Commercial |
$317.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$247.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$299.98
|
| Rate for Payer: PHP Commercial |
$299.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.04
|
| Rate for Payer: Priority Health SBD |
$222.34
|
| Rate for Payer: UMR Bronson Commercial |
$155.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.69
|
|
|
HC MR GUIDANCE FOR NEEDLE PLACEMENT
|
Facility
|
OP
|
$1,025.10
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100004
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$379.29 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$666.32
|
| Rate for Payer: Aetna Commercial |
$871.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$666.32
|
| Rate for Payer: BCBS Complete |
$410.04
|
| Rate for Payer: BCBS Trust/PPO |
$682.26
|
| Rate for Payer: Cash Price |
$820.08
|
| Rate for Payer: Cash Price |
$820.08
|
| Rate for Payer: Cofinity Commercial |
$717.57
|
| Rate for Payer: Cofinity Commercial |
$881.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$820.08
|
| Rate for Payer: Healthscope Commercial |
$922.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$717.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$768.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$871.34
|
| Rate for Payer: PHP Commercial |
$871.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$717.57
|
| Rate for Payer: Priority Health SBD |
$645.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$459.60
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Exchange |
$417.82
|
| Rate for Payer: UMR Bronson Commercial |
$379.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$768.82
|
|
|
HC MR GUIDANCE FOR NEEDLE PLACEMENT
|
Facility
|
IP
|
$1,025.10
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100004
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$451.04 |
| Max. Negotiated Rate |
$922.59 |
| Rate for Payer: Aetna American Axle |
$666.32
|
| Rate for Payer: Aetna Commercial |
$871.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$666.32
|
| Rate for Payer: Cash Price |
$820.08
|
| Rate for Payer: Cofinity Commercial |
$717.57
|
| Rate for Payer: Cofinity Commercial |
$881.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$820.08
|
| Rate for Payer: Healthscope Commercial |
$922.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$717.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$768.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$871.34
|
| Rate for Payer: PHP Commercial |
$871.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$717.57
|
| Rate for Payer: Priority Health SBD |
$645.81
|
| Rate for Payer: UMR Bronson Commercial |
$451.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$768.82
|
|
|
HC MR LOWER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
IP
|
$2,955.86
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000040
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,300.58 |
| Max. Negotiated Rate |
$2,660.27 |
| Rate for Payer: Aetna American Axle |
$1,921.31
|
| Rate for Payer: Aetna Commercial |
$2,512.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,921.31
|
| Rate for Payer: Cash Price |
$2,364.69
|
| Rate for Payer: Cofinity Commercial |
$2,069.10
|
| Rate for Payer: Cofinity Commercial |
$2,542.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,364.69
|
| Rate for Payer: Healthscope Commercial |
$2,660.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,069.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,216.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,512.48
|
| Rate for Payer: PHP Commercial |
$2,512.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,069.10
|
| Rate for Payer: Priority Health SBD |
$1,862.19
|
| Rate for Payer: UMR Bronson Commercial |
$1,300.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,216.90
|
|
|
HC MR LOWER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
OP
|
$2,955.86
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000040
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,660.27 |
| Rate for Payer: Aetna American Axle |
$1,921.31
|
| Rate for Payer: Aetna Commercial |
$2,512.48
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,921.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$575.83
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$2,364.69
|
| Rate for Payer: Cash Price |
$2,364.69
|
| Rate for Payer: Cofinity Commercial |
$2,069.10
|
| Rate for Payer: Cofinity Commercial |
$2,542.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,364.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,660.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,069.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,216.90
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,512.48
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$2,512.48
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,069.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,076.13
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$860.90
|
| Rate for Payer: Priority Health SBD |
$1,862.19
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$428.63
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$389.66
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,093.67
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,216.90
|
|
|
HC MR LOWER EXTREM ANY JOINT W CON
|
Facility
|
OP
|
$2,252.06
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000037
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$316.96 |
| Max. Negotiated Rate |
$2,240.48 |
| Rate for Payer: Aetna American Axle |
$1,463.84
|
| Rate for Payer: Aetna American Axle |
$2,195.76
|
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: Aetna Commercial |
$2,871.38
|
| Rate for Payer: Aetna Medicare |
$740.18
|
| Rate for Payer: Aetna Medicare |
$740.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,195.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,463.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$889.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$889.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$889.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$889.64
|
| Rate for Payer: BCBS Complete |
$408.81
|
| Rate for Payer: BCBS Complete |
$408.81
|
| Rate for Payer: BCBS MAPPO |
$711.71
|
| Rate for Payer: BCBS MAPPO |
$711.71
|
| Rate for Payer: BCBS Trust/PPO |
$477.65
|
| Rate for Payer: BCBS Trust/PPO |
$477.65
|
| Rate for Payer: BCN Medicare Advantage |
$711.71
|
| Rate for Payer: BCN Medicare Advantage |
$711.71
|
| Rate for Payer: Cash Price |
$2,702.47
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cash Price |
$2,702.47
|
| Rate for Payer: Cofinity Commercial |
$2,364.66
|
| Rate for Payer: Cofinity Commercial |
$2,905.16
|
| Rate for Payer: Cofinity Commercial |
$1,936.77
|
| Rate for Payer: Cofinity Commercial |
$1,576.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,702.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$711.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$711.71
|
| Rate for Payer: Healthscope Commercial |
$3,040.28
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,364.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,576.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,533.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,689.04
|
| Rate for Payer: Mclaren Medicaid |
$389.31
|
| Rate for Payer: Mclaren Medicaid |
$389.31
|
| Rate for Payer: Mclaren Medicare |
$711.71
|
| Rate for Payer: Mclaren Medicare |
$711.71
|
| Rate for Payer: Meridian Medicaid |
$408.81
|
| Rate for Payer: Meridian Medicaid |
$408.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$747.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$747.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$818.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$818.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,871.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,914.25
|
| Rate for Payer: PACE Medicare |
$676.12
|
| Rate for Payer: PACE Medicare |
$676.12
|
| Rate for Payer: PACE SWMI |
$711.71
|
| Rate for Payer: PACE SWMI |
$711.71
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: PHP Commercial |
$2,871.38
|
| Rate for Payer: PHP Medicare Advantage |
$711.71
|
| Rate for Payer: PHP Medicare Advantage |
$711.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,364.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,576.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,240.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,240.48
|
| Rate for Payer: Priority Health Medicare |
$711.71
|
| Rate for Payer: Priority Health Medicare |
$711.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,792.38
|
| Rate for Payer: Priority Health Narrow Network |
$1,792.38
|
| Rate for Payer: Priority Health SBD |
$1,418.80
|
| Rate for Payer: Priority Health SBD |
$2,128.20
|
| Rate for Payer: Railroad Medicare Medicare |
$711.71
|
| Rate for Payer: Railroad Medicare Medicare |
$711.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.66
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$711.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$711.71
|
| Rate for Payer: UHC Exchange |
$316.96
|
| Rate for Payer: UHC Exchange |
$316.96
|
| Rate for Payer: UHC Medicare Advantage |
$733.06
|
| Rate for Payer: UHC Medicare Advantage |
$733.06
|
| Rate for Payer: UMR Bronson Commercial |
$1,249.89
|
| Rate for Payer: UMR Bronson Commercial |
$833.26
|
| Rate for Payer: VA VA |
$711.71
|
| Rate for Payer: VA VA |
$711.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,533.57
|
|
|
HC MR LOWER EXTREM ANY JOINT W CON
|
Facility
|
IP
|
$2,252.06
|
|
|
Service Code
|
CPT 73722
|
| Hospital Charge Code |
61000037
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$990.91 |
| Max. Negotiated Rate |
$2,026.85 |
| Rate for Payer: Aetna American Axle |
$1,463.84
|
| Rate for Payer: Aetna American Axle |
$2,195.76
|
| Rate for Payer: Aetna Commercial |
$2,871.38
|
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,195.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,463.84
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cash Price |
$2,702.47
|
| Rate for Payer: Cofinity Commercial |
$2,905.16
|
| Rate for Payer: Cofinity Commercial |
$1,576.44
|
| Rate for Payer: Cofinity Commercial |
$1,936.77
|
| Rate for Payer: Cofinity Commercial |
$2,364.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,702.47
|
| Rate for Payer: Healthscope Commercial |
$3,040.28
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,576.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,364.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,689.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,533.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,914.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,871.38
|
| Rate for Payer: PHP Commercial |
$2,871.38
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,576.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,364.66
|
| Rate for Payer: Priority Health SBD |
$1,418.80
|
| Rate for Payer: Priority Health SBD |
$2,128.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,486.36
|
| Rate for Payer: UMR Bronson Commercial |
$990.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,533.57
|
|
|
HC MR LOWER EXTREM ANY JOINT WO CON
|
Facility
|
OP
|
$1,932.90
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000035
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$1,256.38
|
| Rate for Payer: Aetna American Axle |
$1,884.58
|
| Rate for Payer: Aetna Commercial |
$2,464.45
|
| Rate for Payer: Aetna Commercial |
$1,642.96
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,256.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,884.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$278.10
|
| Rate for Payer: BCBS Trust/PPO |
$278.10
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$2,319.48
|
| Rate for Payer: Cash Price |
$2,319.48
|
| Rate for Payer: Cash Price |
$1,546.32
|
| Rate for Payer: Cash Price |
$1,546.32
|
| Rate for Payer: Cofinity Commercial |
$1,353.03
|
| Rate for Payer: Cofinity Commercial |
$2,493.44
|
| Rate for Payer: Cofinity Commercial |
$2,029.54
|
| Rate for Payer: Cofinity Commercial |
$1,662.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,546.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,319.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$2,609.42
|
| Rate for Payer: Healthscope Commercial |
$1,739.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,029.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,353.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,174.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,449.68
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,642.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,464.45
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$1,642.96
|
| Rate for Payer: PHP Commercial |
$2,464.45
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,029.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,353.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.66
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$548.53
|
| Rate for Payer: Priority Health Narrow Network |
$548.53
|
| Rate for Payer: Priority Health SBD |
$1,826.59
|
| Rate for Payer: Priority Health SBD |
$1,217.73
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.12
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$204.65
|
| Rate for Payer: UHC Exchange |
$204.65
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,072.76
|
| Rate for Payer: UMR Bronson Commercial |
$715.17
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,449.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,174.51
|
|
|
HC MR LOWER EXTREM ANY JOINT WO CON
|
Facility
|
IP
|
$2,899.35
|
|
|
Service Code
|
CPT 73721
|
| Hospital Charge Code |
61000035
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,275.71 |
| Max. Negotiated Rate |
$2,609.42 |
| Rate for Payer: Aetna American Axle |
$1,884.58
|
| Rate for Payer: Aetna American Axle |
$1,256.38
|
| Rate for Payer: Aetna Commercial |
$1,642.96
|
| Rate for Payer: Aetna Commercial |
$2,464.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,256.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,884.58
|
| Rate for Payer: Cash Price |
$2,319.48
|
| Rate for Payer: Cash Price |
$1,546.32
|
| Rate for Payer: Cofinity Commercial |
$1,353.03
|
| Rate for Payer: Cofinity Commercial |
$2,493.44
|
| Rate for Payer: Cofinity Commercial |
$2,029.54
|
| Rate for Payer: Cofinity Commercial |
$1,662.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,546.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,319.48
|
| Rate for Payer: Healthscope Commercial |
$2,609.42
|
| Rate for Payer: Healthscope Commercial |
$1,739.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,353.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,029.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,174.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,449.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,642.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,464.45
|
| Rate for Payer: PHP Commercial |
$1,642.96
|
| Rate for Payer: PHP Commercial |
$2,464.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,353.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,029.54
|
| Rate for Payer: Priority Health SBD |
$1,217.73
|
| Rate for Payer: Priority Health SBD |
$1,826.59
|
| Rate for Payer: UMR Bronson Commercial |
$850.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,275.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,449.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,174.51
|
|
|
HC MR LOWER EXTREM ANY JOINT WO W CON
|
Facility
|
IP
|
$2,533.57
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000039
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,114.77 |
| Max. Negotiated Rate |
$2,280.21 |
| Rate for Payer: Aetna American Axle |
$1,646.82
|
| Rate for Payer: Aetna American Axle |
$2,470.23
|
| Rate for Payer: Aetna Commercial |
$2,153.53
|
| Rate for Payer: Aetna Commercial |
$3,230.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,470.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,646.82
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cofinity Commercial |
$2,178.87
|
| Rate for Payer: Cofinity Commercial |
$1,773.50
|
| Rate for Payer: Cofinity Commercial |
$2,660.25
|
| Rate for Payer: Cofinity Commercial |
$3,268.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,026.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,040.29
|
| Rate for Payer: Healthscope Commercial |
$3,420.32
|
| Rate for Payer: Healthscope Commercial |
$2,280.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,660.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,773.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,900.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,850.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,153.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,230.31
|
| Rate for Payer: PHP Commercial |
$2,153.53
|
| Rate for Payer: PHP Commercial |
$3,230.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,660.25
|
| Rate for Payer: Priority Health SBD |
$1,596.15
|
| Rate for Payer: Priority Health SBD |
$2,394.23
|
| Rate for Payer: UMR Bronson Commercial |
$1,114.77
|
| Rate for Payer: UMR Bronson Commercial |
$1,672.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,850.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,900.18
|
|
|
HC MR LOWER EXTREM ANY JOINT WO W CON
|
Facility
|
OP
|
$2,533.57
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000039
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,280.21 |
| Rate for Payer: Aetna American Axle |
$1,646.82
|
| Rate for Payer: Aetna American Axle |
$2,470.23
|
| Rate for Payer: Aetna Commercial |
$2,153.53
|
| Rate for Payer: Aetna Commercial |
$3,230.31
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,470.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,646.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$575.83
|
| Rate for Payer: BCBS Trust/PPO |
$575.83
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cofinity Commercial |
$3,268.31
|
| Rate for Payer: Cofinity Commercial |
$1,773.50
|
| Rate for Payer: Cofinity Commercial |
$2,178.87
|
| Rate for Payer: Cofinity Commercial |
$2,660.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,040.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,026.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,280.21
|
| Rate for Payer: Healthscope Commercial |
$3,420.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,660.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,773.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,900.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,850.27
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,153.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,230.31
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$3,230.31
|
| Rate for Payer: PHP Commercial |
$2,153.53
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,660.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,076.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,076.13
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$860.90
|
| Rate for Payer: Priority Health Narrow Network |
$860.90
|
| Rate for Payer: Priority Health SBD |
$2,394.23
|
| Rate for Payer: Priority Health SBD |
$1,596.15
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$428.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$428.63
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$389.66
|
| Rate for Payer: UHC Exchange |
$389.66
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,406.13
|
| Rate for Payer: UMR Bronson Commercial |
$937.42
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,900.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,850.27
|
|
