|
HC CRYSTALS BODY FLUID
|
Facility
|
IP
|
$47.24
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
30000002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.79 |
| Max. Negotiated Rate |
$42.52 |
| Rate for Payer: Aetna American Axle |
$30.71
|
| Rate for Payer: Aetna Commercial |
$40.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.71
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cofinity Commercial |
$33.07
|
| Rate for Payer: Cofinity Commercial |
$40.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.79
|
| Rate for Payer: Healthscope Commercial |
$42.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.15
|
| Rate for Payer: PHP Commercial |
$40.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.71
|
| Rate for Payer: Priority Health SBD |
$29.76
|
| Rate for Payer: UMR Bronson Commercial |
$20.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.43
|
|
|
HC CRYSTALS BODY FLUID
|
Facility
|
OP
|
$47.24
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
30000002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$42.52 |
| Rate for Payer: Aetna American Axle |
$30.71
|
| Rate for Payer: Aetna Commercial |
$40.15
|
| Rate for Payer: Aetna Medicare |
$7.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.16
|
| Rate for Payer: BCBS Complete |
$4.13
|
| Rate for Payer: BCBS MAPPO |
$7.33
|
| Rate for Payer: BCN Medicare Advantage |
$7.33
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cofinity Commercial |
$40.63
|
| Rate for Payer: Cofinity Commercial |
$33.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.33
|
| Rate for Payer: Healthscope Commercial |
$42.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.43
|
| Rate for Payer: Mclaren Medicaid |
$3.93
|
| Rate for Payer: Mclaren Medicare |
$7.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.70
|
| Rate for Payer: Meridian Medicaid |
$4.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.15
|
| Rate for Payer: PACE Medicare |
$6.96
|
| Rate for Payer: PACE SWMI |
$7.33
|
| Rate for Payer: PHP Commercial |
$40.15
|
| Rate for Payer: PHP Medicare Advantage |
$7.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.71
|
| Rate for Payer: Priority Health Medicare |
$7.33
|
| Rate for Payer: Priority Health SBD |
$29.76
|
| Rate for Payer: Railroad Medicare Medicare |
$7.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.33
|
| Rate for Payer: UHC Exchange |
$14.01
|
| Rate for Payer: UHC Medicare Advantage |
$7.33
|
| Rate for Payer: UHCCP Medicaid |
$3.93
|
| Rate for Payer: UMR Bronson Commercial |
$17.48
|
| Rate for Payer: VA VA |
$7.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.43
|
|
|
HC C-SECTION (OB SURGERY)
|
Facility
|
IP
|
$2,996.16
|
|
| Hospital Charge Code |
36000024
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,318.31 |
| Max. Negotiated Rate |
$2,696.54 |
| Rate for Payer: Aetna American Axle |
$1,947.50
|
| Rate for Payer: Aetna Commercial |
$2,546.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,947.50
|
| Rate for Payer: Cash Price |
$2,396.93
|
| Rate for Payer: Cofinity Commercial |
$2,097.31
|
| Rate for Payer: Cofinity Commercial |
$2,576.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,097.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,396.93
|
| Rate for Payer: Healthscope Commercial |
$2,696.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,097.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,247.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,546.74
|
| Rate for Payer: PHP Commercial |
$2,546.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,947.50
|
| Rate for Payer: Priority Health SBD |
$1,887.58
|
| Rate for Payer: UMR Bronson Commercial |
$1,318.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,247.12
|
|
|
HC C-SECTION (OB SURGERY)
|
Facility
|
OP
|
$2,996.16
|
|
| Hospital Charge Code |
36000024
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,108.58 |
| Max. Negotiated Rate |
$2,696.54 |
| Rate for Payer: Aetna American Axle |
$1,947.50
|
| Rate for Payer: Aetna Commercial |
$2,546.74
|
| Rate for Payer: Aetna Medicare |
$1,498.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,947.50
|
| Rate for Payer: BCBS Complete |
$1,198.46
|
| Rate for Payer: Cash Price |
$2,396.93
|
| Rate for Payer: Cofinity Commercial |
$2,097.31
|
| Rate for Payer: Cofinity Commercial |
$2,576.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,097.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,396.93
|
| Rate for Payer: Healthscope Commercial |
$2,696.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,097.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,247.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,546.74
|
| Rate for Payer: PHP Commercial |
$2,546.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,947.50
|
| Rate for Payer: Priority Health SBD |
$1,887.58
|
| Rate for Payer: UMR Bronson Commercial |
$1,108.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,247.12
|
|
|
HC C-SECTION W/STERIL (OB SURGERY
|
Facility
|
IP
|
$3,679.58
|
|
| Hospital Charge Code |
36000025
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,619.02 |
| Max. Negotiated Rate |
$3,311.62 |
| Rate for Payer: Aetna American Axle |
$2,391.73
|
| Rate for Payer: Aetna Commercial |
$3,127.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,391.73
|
| Rate for Payer: Cash Price |
$2,943.66
|
| Rate for Payer: Cofinity Commercial |
$2,575.71
|
| Rate for Payer: Cofinity Commercial |
$3,164.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,575.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,943.66
|
| Rate for Payer: Healthscope Commercial |
$3,311.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,575.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,759.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,127.64
|
| Rate for Payer: PHP Commercial |
$3,127.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,391.73
|
| Rate for Payer: Priority Health SBD |
$2,318.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,619.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,759.68
|
|
|
HC C-SECTION W/STERIL (OB SURGERY
|
Facility
|
OP
|
$3,679.58
|
|
| Hospital Charge Code |
36000025
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,361.44 |
| Max. Negotiated Rate |
$3,311.62 |
| Rate for Payer: Aetna American Axle |
$2,391.73
|
| Rate for Payer: Aetna Commercial |
$3,127.64
|
| Rate for Payer: Aetna Medicare |
$1,839.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,391.73
|
| Rate for Payer: BCBS Complete |
$1,471.83
|
| Rate for Payer: Cash Price |
$2,943.66
|
| Rate for Payer: Cofinity Commercial |
$2,575.71
|
| Rate for Payer: Cofinity Commercial |
$3,164.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,575.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,943.66
|
| Rate for Payer: Healthscope Commercial |
$3,311.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,575.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,759.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,127.64
|
| Rate for Payer: PHP Commercial |
$3,127.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,391.73
|
| Rate for Payer: Priority Health SBD |
$2,318.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,361.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,759.68
|
|
|
HC CSF LACTATE
|
Facility
|
OP
|
$21.85
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100482
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.20 |
| Max. Negotiated Rate |
$32.57 |
| Rate for Payer: Aetna American Axle |
$14.20
|
| Rate for Payer: Aetna Commercial |
$18.57
|
| Rate for Payer: Aetna Medicare |
$12.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.46
|
| Rate for Payer: BCBS Complete |
$6.51
|
| Rate for Payer: BCBS MAPPO |
$11.57
|
| Rate for Payer: BCN Medicare Advantage |
$11.57
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$18.79
|
| Rate for Payer: Cofinity Commercial |
$15.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.57
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.39
|
| Rate for Payer: Mclaren Medicaid |
$6.20
|
| Rate for Payer: Mclaren Medicare |
$11.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.15
|
| Rate for Payer: Meridian Medicaid |
$6.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: PACE Medicare |
$10.99
|
| Rate for Payer: PACE SWMI |
$11.57
|
| Rate for Payer: PHP Commercial |
$18.57
|
| Rate for Payer: PHP Medicare Advantage |
$11.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.20
|
| Rate for Payer: Priority Health Medicare |
$11.57
|
| Rate for Payer: Priority Health SBD |
$13.77
|
| Rate for Payer: Railroad Medicare Medicare |
$11.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.57
|
| Rate for Payer: UHC Exchange |
$22.11
|
| Rate for Payer: UHC Medicare Advantage |
$11.57
|
| Rate for Payer: UHCCP Medicaid |
$6.20
|
| Rate for Payer: UMR Bronson Commercial |
$8.08
|
| Rate for Payer: VA VA |
$11.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.39
|
|
|
HC CSF LACTATE
|
Facility
|
IP
|
$21.85
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100482
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$19.66 |
| Rate for Payer: Aetna American Axle |
$14.20
|
| Rate for Payer: Aetna Commercial |
$18.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.20
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$15.29
|
| Rate for Payer: Cofinity Commercial |
$18.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: PHP Commercial |
$18.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.20
|
| Rate for Payer: Priority Health SBD |
$13.77
|
| Rate for Payer: UMR Bronson Commercial |
$9.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.39
|
|
|
HC CSU OBSERVATION PER HOUR
|
Facility
|
IP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200016
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$63.84 |
| Max. Negotiated Rate |
$130.57 |
| Rate for Payer: Aetna American Axle |
$94.30
|
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.30
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$101.56
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$101.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$101.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health SBD |
$91.40
|
| Rate for Payer: UMR Bronson Commercial |
$63.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.81
|
|
|
HC CSU OBSERVATION PER HOUR
|
Facility
|
OP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200016
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$53.68 |
| Max. Negotiated Rate |
$4,092.00 |
| Rate for Payer: Aetna American Axle |
$94.30
|
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: Aetna Medicare |
$72.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.30
|
| Rate for Payer: BCBS Complete |
$58.03
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Cofinity Commercial |
$101.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$101.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$101.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.81
|
| Rate for Payer: Meridian Medicaid |
$1,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health SBD |
$91.40
|
| Rate for Payer: UHC Core |
$4,092.00
|
| Rate for Payer: UMR Bronson Commercial |
$53.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.81
|
|
|
HC CSU R&B
|
Facility
|
IP
|
$7,308.69
|
|
| Hospital Charge Code |
21000002
|
|
Hospital Revenue Code
|
210
|
| Min. Negotiated Rate |
$3,215.82 |
| Max. Negotiated Rate |
$6,577.82 |
| Rate for Payer: Aetna American Axle |
$4,750.65
|
| Rate for Payer: Aetna Commercial |
$6,212.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,750.65
|
| Rate for Payer: Cash Price |
$5,846.95
|
| Rate for Payer: Cofinity Commercial |
$5,116.08
|
| Rate for Payer: Cofinity Commercial |
$6,285.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,116.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,846.95
|
| Rate for Payer: Healthscope Commercial |
$6,577.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,116.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,481.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,212.39
|
| Rate for Payer: PHP Commercial |
$6,212.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,750.65
|
| Rate for Payer: Priority Health SBD |
$4,604.47
|
| Rate for Payer: UMR Bronson Commercial |
$3,215.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,481.52
|
|
|
HC CT ABDOMEN AND PELVIS W CON
|
Facility
|
OP
|
$3,709.64
|
|
|
Service Code
|
CPT 74177
|
| Hospital Charge Code |
35200027
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$3,338.68 |
| Rate for Payer: Aetna American Axle |
$2,411.27
|
| Rate for Payer: Aetna Commercial |
$3,153.19
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,411.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$2,967.71
|
| Rate for Payer: Cash Price |
$2,967.71
|
| Rate for Payer: Cofinity Commercial |
$3,190.29
|
| Rate for Payer: Cofinity Commercial |
$2,596.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,596.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,967.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$3,338.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,596.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,782.23
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,153.19
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$3,153.19
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,411.27
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$2,337.07
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$665.64
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: UMR Bronson Commercial |
$1,372.57
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,782.23
|
|
|
HC CT ABDOMEN AND PELVIS W CON
|
Facility
|
IP
|
$3,709.64
|
|
|
Service Code
|
CPT 74177
|
| Hospital Charge Code |
35200027
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,632.24 |
| Max. Negotiated Rate |
$3,338.68 |
| Rate for Payer: Aetna American Axle |
$2,411.27
|
| Rate for Payer: Aetna Commercial |
$3,153.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,411.27
|
| Rate for Payer: Cash Price |
$2,967.71
|
| Rate for Payer: Cofinity Commercial |
$2,596.75
|
| Rate for Payer: Cofinity Commercial |
$3,190.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,596.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,967.71
|
| Rate for Payer: Healthscope Commercial |
$3,338.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,596.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,782.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,153.19
|
| Rate for Payer: PHP Commercial |
$3,153.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,411.27
|
| Rate for Payer: Priority Health SBD |
$2,337.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,632.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,782.23
|
|
|
HC CT ABDOMEN AND PELVIS WO CON
|
Facility
|
IP
|
$2,502.26
|
|
|
Service Code
|
CPT 74176
|
| Hospital Charge Code |
35200026
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,100.99 |
| Max. Negotiated Rate |
$2,252.03 |
| Rate for Payer: Aetna American Axle |
$1,626.47
|
| Rate for Payer: Aetna Commercial |
$2,126.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,626.47
|
| Rate for Payer: Cash Price |
$2,001.81
|
| Rate for Payer: Cofinity Commercial |
$1,751.58
|
| Rate for Payer: Cofinity Commercial |
$2,151.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,751.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,001.81
|
| Rate for Payer: Healthscope Commercial |
$2,252.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,751.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,876.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,126.92
|
| Rate for Payer: PHP Commercial |
$2,126.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,626.47
|
| Rate for Payer: Priority Health SBD |
$1,576.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,100.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,876.69
|
|
|
HC CT ABDOMEN AND PELVIS WO CON
|
Facility
|
OP
|
$2,502.26
|
|
|
Service Code
|
CPT 74176
|
| Hospital Charge Code |
35200026
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$2,252.03 |
| Rate for Payer: Aetna American Axle |
$1,626.47
|
| Rate for Payer: Aetna Commercial |
$2,126.92
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,626.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$2,001.81
|
| Rate for Payer: Cash Price |
$2,001.81
|
| Rate for Payer: Cofinity Commercial |
$2,151.94
|
| Rate for Payer: Cofinity Commercial |
$1,751.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,751.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,001.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$2,252.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,751.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,876.69
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,126.92
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$2,126.92
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,626.47
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,576.42
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$450.52
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: UMR Bronson Commercial |
$925.84
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,876.69
|
|
|
HC CT ABDOMEN AND PELVIS WO W CON
|
Facility
|
IP
|
$4,433.63
|
|
|
Service Code
|
CPT 74178
|
| Hospital Charge Code |
35200028
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,950.80 |
| Max. Negotiated Rate |
$3,990.27 |
| Rate for Payer: Aetna American Axle |
$2,881.86
|
| Rate for Payer: Aetna Commercial |
$3,768.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,881.86
|
| Rate for Payer: Cash Price |
$3,546.90
|
| Rate for Payer: Cofinity Commercial |
$3,103.54
|
| Rate for Payer: Cofinity Commercial |
$3,812.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,103.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,546.90
|
| Rate for Payer: Healthscope Commercial |
$3,990.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,103.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,325.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,768.59
|
| Rate for Payer: PHP Commercial |
$3,768.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,881.86
|
| Rate for Payer: Priority Health SBD |
$2,793.19
|
| Rate for Payer: UMR Bronson Commercial |
$1,950.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,325.22
|
|
|
HC CT ABDOMEN AND PELVIS WO W CON
|
Facility
|
OP
|
$4,433.63
|
|
|
Service Code
|
CPT 74178
|
| Hospital Charge Code |
35200028
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$3,990.27 |
| Rate for Payer: Aetna American Axle |
$2,881.86
|
| Rate for Payer: Aetna Commercial |
$3,768.59
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,881.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$3,546.90
|
| Rate for Payer: Cash Price |
$3,546.90
|
| Rate for Payer: Cofinity Commercial |
$3,812.92
|
| Rate for Payer: Cofinity Commercial |
$3,103.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,103.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,546.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$3,990.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,103.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,325.22
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,768.59
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$3,768.59
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,881.86
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$2,793.19
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$665.64
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: UMR Bronson Commercial |
$1,640.44
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,325.22
|
|
|
HC CT ABDOMEN ANGIO
|
Facility
|
IP
|
$1,097.42
|
|
|
Service Code
|
CPT 74175
|
| Hospital Charge Code |
35200025
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$482.86 |
| Max. Negotiated Rate |
$987.68 |
| Rate for Payer: Aetna American Axle |
$713.32
|
| Rate for Payer: Aetna Commercial |
$932.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$713.32
|
| Rate for Payer: Cash Price |
$877.94
|
| Rate for Payer: Cofinity Commercial |
$768.19
|
| Rate for Payer: Cofinity Commercial |
$943.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$768.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.94
|
| Rate for Payer: Healthscope Commercial |
$987.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$768.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$823.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.81
|
| Rate for Payer: PHP Commercial |
$932.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.32
|
| Rate for Payer: Priority Health SBD |
$691.37
|
| Rate for Payer: UMR Bronson Commercial |
$482.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$823.07
|
|
|
HC CT ABDOMEN ANGIO
|
Facility
|
OP
|
$1,097.42
|
|
|
Service Code
|
CPT 74175
|
| Hospital Charge Code |
35200025
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,048.00 |
| Rate for Payer: Aetna American Axle |
$713.32
|
| Rate for Payer: Aetna Commercial |
$932.81
|
| Rate for Payer: Aetna Medicare |
$180.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$713.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$877.94
|
| Rate for Payer: Cash Price |
$877.94
|
| Rate for Payer: Cofinity Commercial |
$943.78
|
| Rate for Payer: Cofinity Commercial |
$768.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$768.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$987.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$768.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$823.07
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.81
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$932.81
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.32
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health SBD |
$691.37
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.72
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$331.81
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$93.06
|
| Rate for Payer: UMR Bronson Commercial |
$406.05
|
| Rate for Payer: VA VA |
$173.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$823.07
|
|
|
HC CT ABDOMEN W CON
|
Facility
|
IP
|
$1,959.75
|
|
|
Service Code
|
CPT 74160
|
| Hospital Charge Code |
35200023
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$862.29 |
| Max. Negotiated Rate |
$1,763.78 |
| Rate for Payer: Aetna American Axle |
$1,273.84
|
| Rate for Payer: Aetna Commercial |
$1,665.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,273.84
|
| Rate for Payer: Cash Price |
$1,567.80
|
| Rate for Payer: Cofinity Commercial |
$1,371.83
|
| Rate for Payer: Cofinity Commercial |
$1,685.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,371.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,567.80
|
| Rate for Payer: Healthscope Commercial |
$1,763.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,371.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,469.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,665.79
|
| Rate for Payer: PHP Commercial |
$1,665.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.84
|
| Rate for Payer: Priority Health SBD |
$1,234.64
|
| Rate for Payer: UMR Bronson Commercial |
$862.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,469.81
|
|
|
HC CT ABDOMEN W CON
|
Facility
|
OP
|
$1,959.75
|
|
|
Service Code
|
CPT 74160
|
| Hospital Charge Code |
35200023
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,763.78 |
| Rate for Payer: Aetna American Axle |
$1,273.84
|
| Rate for Payer: Aetna Commercial |
$1,665.79
|
| Rate for Payer: Aetna Medicare |
$180.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,273.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,567.80
|
| Rate for Payer: Cash Price |
$1,567.80
|
| Rate for Payer: Cofinity Commercial |
$1,685.38
|
| Rate for Payer: Cofinity Commercial |
$1,371.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,371.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,567.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,763.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,371.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,469.81
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,665.79
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$1,665.79
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.84
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health SBD |
$1,234.64
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.72
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$331.81
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$93.06
|
| Rate for Payer: UMR Bronson Commercial |
$725.11
|
| Rate for Payer: VA VA |
$173.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,469.81
|
|
|
HC CT ABDOMEN WO CON
|
Facility
|
IP
|
$1,606.90
|
|
|
Service Code
|
CPT 74150
|
| Hospital Charge Code |
35200022
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$707.04 |
| Max. Negotiated Rate |
$1,446.21 |
| Rate for Payer: Aetna American Axle |
$1,044.48
|
| Rate for Payer: Aetna Commercial |
$1,365.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,044.48
|
| Rate for Payer: Cash Price |
$1,285.52
|
| Rate for Payer: Cofinity Commercial |
$1,124.83
|
| Rate for Payer: Cofinity Commercial |
$1,381.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,124.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,285.52
|
| Rate for Payer: Healthscope Commercial |
$1,446.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,124.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,205.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,365.87
|
| Rate for Payer: PHP Commercial |
$1,365.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,044.48
|
| Rate for Payer: Priority Health SBD |
$1,012.35
|
| Rate for Payer: UMR Bronson Commercial |
$707.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,205.17
|
|
|
HC CT ABDOMEN WO CON
|
Facility
|
OP
|
$1,606.90
|
|
|
Service Code
|
CPT 74150
|
| Hospital Charge Code |
35200022
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$1,446.21 |
| Rate for Payer: Aetna American Axle |
$1,044.48
|
| Rate for Payer: Aetna Commercial |
$1,365.87
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,044.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$1,285.52
|
| Rate for Payer: Cash Price |
$1,285.52
|
| Rate for Payer: Cofinity Commercial |
$1,381.93
|
| Rate for Payer: Cofinity Commercial |
$1,124.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,124.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,285.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$1,446.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,124.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,205.17
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,365.87
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$1,365.87
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,044.48
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$1,012.35
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$594.55
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,205.17
|
|
|
HC CT ABDOMEN WO W CON
|
Facility
|
OP
|
$2,453.63
|
|
|
Service Code
|
CPT 74170
|
| Hospital Charge Code |
35200024
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$2,208.27 |
| Rate for Payer: Aetna American Axle |
$1,594.86
|
| Rate for Payer: Aetna Commercial |
$2,085.59
|
| Rate for Payer: Aetna Medicare |
$180.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,594.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,962.90
|
| Rate for Payer: Cash Price |
$1,962.90
|
| Rate for Payer: Cofinity Commercial |
$2,110.12
|
| Rate for Payer: Cofinity Commercial |
$1,717.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,717.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,962.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$2,208.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,717.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,840.22
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,085.59
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$2,085.59
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,594.86
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health SBD |
$1,545.79
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.72
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$331.81
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$93.06
|
| Rate for Payer: UMR Bronson Commercial |
$907.84
|
| Rate for Payer: VA VA |
$173.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,840.22
|
|
|
HC CT ABDOMEN WO W CON
|
Facility
|
IP
|
$2,453.63
|
|
|
Service Code
|
CPT 74170
|
| Hospital Charge Code |
35200024
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,079.60 |
| Max. Negotiated Rate |
$2,208.27 |
| Rate for Payer: Aetna American Axle |
$1,594.86
|
| Rate for Payer: Aetna Commercial |
$2,085.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,594.86
|
| Rate for Payer: Cash Price |
$1,962.90
|
| Rate for Payer: Cofinity Commercial |
$1,717.54
|
| Rate for Payer: Cofinity Commercial |
$2,110.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,717.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,962.90
|
| Rate for Payer: Healthscope Commercial |
$2,208.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,717.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,840.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,085.59
|
| Rate for Payer: PHP Commercial |
$2,085.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,594.86
|
| Rate for Payer: Priority Health SBD |
$1,545.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,079.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,840.22
|
|
