|
HC CT CHEST SCREENING LUNG CANCER
|
Facility
|
OP
|
$505.03
|
|
|
Service Code
|
CPT 71271
|
| Hospital Charge Code |
35000040
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$1,048.00 |
| Rate for Payer: Aetna American Axle |
$328.27
|
| Rate for Payer: Aetna Commercial |
$429.28
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$328.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$185.41
|
| Rate for Payer: BCN Commercial |
$185.41
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$404.02
|
| Rate for Payer: Cash Price |
$404.02
|
| Rate for Payer: Cofinity Commercial |
$434.33
|
| Rate for Payer: Cofinity Commercial |
$353.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$353.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$404.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$454.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$353.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$378.77
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$429.28
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$429.28
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$328.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$318.17
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.01
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$130.01
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$186.86
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$378.77
|
|
|
HC CT CHEST WITH CON
|
Facility
|
IP
|
$1,737.15
|
|
|
Service Code
|
CPT 71260
|
| Hospital Charge Code |
35200001
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$764.35 |
| Max. Negotiated Rate |
$1,563.44 |
| Rate for Payer: Aetna American Axle |
$1,129.15
|
| Rate for Payer: Aetna Commercial |
$1,476.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,129.15
|
| Rate for Payer: Cash Price |
$1,389.72
|
| Rate for Payer: Cofinity Commercial |
$1,216.00
|
| Rate for Payer: Cofinity Commercial |
$1,493.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,216.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,389.72
|
| Rate for Payer: Healthscope Commercial |
$1,563.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,216.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,302.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,476.58
|
| Rate for Payer: PHP Commercial |
$1,476.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.15
|
| Rate for Payer: Priority Health SBD |
$1,094.40
|
| Rate for Payer: UMR Bronson Commercial |
$764.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,302.86
|
|
|
HC CT CHEST WITH CON
|
Facility
|
OP
|
$1,737.15
|
|
|
Service Code
|
CPT 71260
|
| Hospital Charge Code |
35200001
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$93.49 |
| Max. Negotiated Rate |
$1,563.44 |
| Rate for Payer: Aetna American Axle |
$1,129.15
|
| Rate for Payer: Aetna Commercial |
$1,476.58
|
| Rate for Payer: Aetna Medicare |
$181.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,129.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.02
|
| Rate for Payer: BCBS Complete |
$98.16
|
| Rate for Payer: BCBS MAPPO |
$174.42
|
| Rate for Payer: BCBS Trust/PPO |
$239.46
|
| Rate for Payer: BCN Commercial |
$239.46
|
| Rate for Payer: BCN Medicare Advantage |
$174.42
|
| Rate for Payer: Cash Price |
$1,389.72
|
| Rate for Payer: Cash Price |
$1,389.72
|
| Rate for Payer: Cofinity Commercial |
$1,493.95
|
| Rate for Payer: Cofinity Commercial |
$1,216.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,216.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,389.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.42
|
| Rate for Payer: Healthscope Commercial |
$1,563.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,216.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,302.86
|
| Rate for Payer: Mclaren Medicaid |
$93.49
|
| Rate for Payer: Mclaren Medicare |
$174.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.14
|
| Rate for Payer: Meridian Medicaid |
$98.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,476.58
|
| Rate for Payer: Nomi Health Commercial |
$523.26
|
| Rate for Payer: PACE Medicare |
$165.70
|
| Rate for Payer: PACE SWMI |
$174.42
|
| Rate for Payer: PHP Commercial |
$1,476.58
|
| Rate for Payer: PHP Medicare Advantage |
$174.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$548.19
|
| Rate for Payer: Priority Health Medicare |
$174.42
|
| Rate for Payer: Priority Health Narrow Network |
$438.55
|
| Rate for Payer: Priority Health SBD |
$1,094.40
|
| Rate for Payer: Railroad Medicare Medicare |
$174.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.13
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.42
|
| Rate for Payer: UHC Exchange |
$157.39
|
| Rate for Payer: UHC Medicare Advantage |
$174.42
|
| Rate for Payer: UHCCP Medicaid |
$93.49
|
| Rate for Payer: UMR Bronson Commercial |
$642.75
|
| Rate for Payer: VA VA |
$174.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,302.86
|
|
|
HC CT CHEST WO CON
|
Facility
|
OP
|
$1,514.09
|
|
|
Service Code
|
CPT 71250
|
| Hospital Charge Code |
35000005
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$1,362.68 |
| Rate for Payer: Aetna American Axle |
$984.16
|
| Rate for Payer: Aetna Commercial |
$1,286.98
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$984.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$175.84
|
| Rate for Payer: BCN Commercial |
$175.84
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$1,211.27
|
| Rate for Payer: Cash Price |
$1,211.27
|
| Rate for Payer: Cofinity Commercial |
$1,302.12
|
| Rate for Payer: Cofinity Commercial |
$1,059.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,059.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,211.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$1,362.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,059.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,135.57
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,286.98
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$1,286.98
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$953.88
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.32
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$125.75
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$560.21
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,135.57
|
|
|
HC CT CHEST WO CON
|
Facility
|
IP
|
$1,514.09
|
|
|
Service Code
|
CPT 71250
|
| Hospital Charge Code |
35000005
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$666.20 |
| Max. Negotiated Rate |
$1,362.68 |
| Rate for Payer: Aetna American Axle |
$984.16
|
| Rate for Payer: Aetna Commercial |
$1,286.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$984.16
|
| Rate for Payer: Cash Price |
$1,211.27
|
| Rate for Payer: Cofinity Commercial |
$1,059.86
|
| Rate for Payer: Cofinity Commercial |
$1,302.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,059.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,211.27
|
| Rate for Payer: Healthscope Commercial |
$1,362.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,059.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,135.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,286.98
|
| Rate for Payer: PHP Commercial |
$1,286.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.16
|
| Rate for Payer: Priority Health SBD |
$953.88
|
| Rate for Payer: UMR Bronson Commercial |
$666.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,135.57
|
|
|
HC CT CHEST WO W CON
|
Facility
|
OP
|
$2,055.93
|
|
|
Service Code
|
CPT 71270
|
| Hospital Charge Code |
35200002
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$93.49 |
| Max. Negotiated Rate |
$1,850.34 |
| Rate for Payer: Aetna American Axle |
$1,336.35
|
| Rate for Payer: Aetna Commercial |
$1,747.54
|
| Rate for Payer: Aetna Medicare |
$181.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,336.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.02
|
| Rate for Payer: BCBS Complete |
$98.16
|
| Rate for Payer: BCBS MAPPO |
$174.42
|
| Rate for Payer: BCBS Trust/PPO |
$293.52
|
| Rate for Payer: BCN Commercial |
$293.52
|
| Rate for Payer: BCN Medicare Advantage |
$174.42
|
| Rate for Payer: Cash Price |
$1,644.74
|
| Rate for Payer: Cash Price |
$1,644.74
|
| Rate for Payer: Cofinity Commercial |
$1,768.10
|
| Rate for Payer: Cofinity Commercial |
$1,439.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,439.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,644.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.42
|
| Rate for Payer: Healthscope Commercial |
$1,850.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,439.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,541.95
|
| Rate for Payer: Mclaren Medicaid |
$93.49
|
| Rate for Payer: Mclaren Medicare |
$174.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.14
|
| Rate for Payer: Meridian Medicaid |
$98.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,747.54
|
| Rate for Payer: Nomi Health Commercial |
$523.26
|
| Rate for Payer: PACE Medicare |
$165.70
|
| Rate for Payer: PACE SWMI |
$174.42
|
| Rate for Payer: PHP Commercial |
$1,747.54
|
| Rate for Payer: PHP Medicare Advantage |
$174.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,336.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$548.19
|
| Rate for Payer: Priority Health Medicare |
$174.42
|
| Rate for Payer: Priority Health Narrow Network |
$438.55
|
| Rate for Payer: Priority Health SBD |
$1,295.24
|
| Rate for Payer: Railroad Medicare Medicare |
$174.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.95
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.42
|
| Rate for Payer: UHC Exchange |
$184.50
|
| Rate for Payer: UHC Medicare Advantage |
$174.42
|
| Rate for Payer: UHCCP Medicaid |
$93.49
|
| Rate for Payer: UMR Bronson Commercial |
$760.69
|
| Rate for Payer: VA VA |
$174.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,541.95
|
|
|
HC CT CHEST WO W CON
|
Facility
|
IP
|
$2,055.93
|
|
|
Service Code
|
CPT 71270
|
| Hospital Charge Code |
35200002
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$904.61 |
| Max. Negotiated Rate |
$1,850.34 |
| Rate for Payer: Aetna American Axle |
$1,336.35
|
| Rate for Payer: Aetna Commercial |
$1,747.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,336.35
|
| Rate for Payer: Cash Price |
$1,644.74
|
| Rate for Payer: Cofinity Commercial |
$1,439.15
|
| Rate for Payer: Cofinity Commercial |
$1,768.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,439.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,644.74
|
| Rate for Payer: Healthscope Commercial |
$1,850.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,439.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,541.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,747.54
|
| Rate for Payer: PHP Commercial |
$1,747.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,336.35
|
| Rate for Payer: Priority Health SBD |
$1,295.24
|
| Rate for Payer: UMR Bronson Commercial |
$904.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,541.95
|
|
|
HC CT CORONARY ANGIO
|
Facility
|
OP
|
$1,380.41
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000019
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$1,242.37 |
| Rate for Payer: Aetna American Axle |
$897.27
|
| Rate for Payer: Aetna Commercial |
$1,173.35
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$897.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$448.83
|
| Rate for Payer: BCN Commercial |
$448.83
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$1,104.33
|
| Rate for Payer: Cash Price |
$1,104.33
|
| Rate for Payer: Cofinity Commercial |
$966.29
|
| Rate for Payer: Cofinity Commercial |
$1,187.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$966.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,104.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$1,242.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$966.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,035.31
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,173.35
|
| Rate for Payer: Nomi Health Commercial |
$1,049.73
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$1,173.35
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$897.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,099.76
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$879.81
|
| Rate for Payer: Priority Health SBD |
$869.66
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$333.96
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$303.60
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: UMR Bronson Commercial |
$510.75
|
| Rate for Payer: VA VA |
$349.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,035.31
|
|
|
HC CT CORONARY ANGIO
|
Facility
|
IP
|
$1,380.41
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000019
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$607.38 |
| Max. Negotiated Rate |
$1,242.37 |
| Rate for Payer: Aetna American Axle |
$897.27
|
| Rate for Payer: Aetna Commercial |
$1,173.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$897.27
|
| Rate for Payer: Cash Price |
$1,104.33
|
| Rate for Payer: Cofinity Commercial |
$1,187.15
|
| Rate for Payer: Cofinity Commercial |
$966.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$966.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,104.33
|
| Rate for Payer: Healthscope Commercial |
$1,242.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$966.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,035.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,173.35
|
| Rate for Payer: PHP Commercial |
$1,173.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$897.27
|
| Rate for Payer: Priority Health SBD |
$869.66
|
| Rate for Payer: UMR Bronson Commercial |
$607.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,035.31
|
|
|
HC CT CRYOABLATION GUIDANCE
|
Facility
|
OP
|
$1,096.58
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000041
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$405.73 |
| Max. Negotiated Rate |
$1,048.00 |
| Rate for Payer: Aetna American Axle |
$712.78
|
| Rate for Payer: Aetna Commercial |
$932.09
|
| Rate for Payer: Aetna Medicare |
$548.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$712.78
|
| Rate for Payer: BCBS Complete |
$438.63
|
| Rate for Payer: BCBS Trust/PPO |
$622.61
|
| Rate for Payer: BCN Commercial |
$622.61
|
| Rate for Payer: Cash Price |
$877.26
|
| Rate for Payer: Cash Price |
$877.26
|
| Rate for Payer: Cofinity Commercial |
$943.06
|
| Rate for Payer: Cofinity Commercial |
$767.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$767.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.26
|
| Rate for Payer: Healthscope Commercial |
$986.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$767.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$822.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.09
|
| Rate for Payer: PHP Commercial |
$932.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.78
|
| Rate for Payer: Priority Health SBD |
$690.85
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UMR Bronson Commercial |
$405.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$822.44
|
|
|
HC CT CRYOABLATION GUIDANCE
|
Facility
|
IP
|
$1,096.58
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000041
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$482.50 |
| Max. Negotiated Rate |
$986.92 |
| Rate for Payer: Aetna American Axle |
$712.78
|
| Rate for Payer: Aetna Commercial |
$932.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$712.78
|
| Rate for Payer: Cash Price |
$877.26
|
| Rate for Payer: Cofinity Commercial |
$767.61
|
| Rate for Payer: Cofinity Commercial |
$943.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$767.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.26
|
| Rate for Payer: Healthscope Commercial |
$986.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$767.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$822.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.09
|
| Rate for Payer: PHP Commercial |
$932.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.78
|
| Rate for Payer: Priority Health SBD |
$690.85
|
| Rate for Payer: UMR Bronson Commercial |
$482.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$822.44
|
|
|
HC CT FACIAL W CON
|
Facility
|
OP
|
$1,591.71
|
|
|
Service Code
|
CPT 70487
|
| Hospital Charge Code |
35100008
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$93.49 |
| Max. Negotiated Rate |
$1,432.54 |
| Rate for Payer: Aetna American Axle |
$1,034.61
|
| Rate for Payer: Aetna Commercial |
$1,352.95
|
| Rate for Payer: Aetna Medicare |
$181.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,034.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.02
|
| Rate for Payer: BCBS Complete |
$98.16
|
| Rate for Payer: BCBS MAPPO |
$174.42
|
| Rate for Payer: BCBS Trust/PPO |
$212.10
|
| Rate for Payer: BCN Commercial |
$212.10
|
| Rate for Payer: BCN Medicare Advantage |
$174.42
|
| Rate for Payer: Cash Price |
$1,273.37
|
| Rate for Payer: Cash Price |
$1,273.37
|
| Rate for Payer: Cofinity Commercial |
$1,368.87
|
| Rate for Payer: Cofinity Commercial |
$1,114.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,114.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,273.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.42
|
| Rate for Payer: Healthscope Commercial |
$1,432.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,114.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,193.78
|
| Rate for Payer: Mclaren Medicaid |
$93.49
|
| Rate for Payer: Mclaren Medicare |
$174.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.14
|
| Rate for Payer: Meridian Medicaid |
$98.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,352.95
|
| Rate for Payer: Nomi Health Commercial |
$523.26
|
| Rate for Payer: PACE Medicare |
$165.70
|
| Rate for Payer: PACE SWMI |
$174.42
|
| Rate for Payer: PHP Commercial |
$1,352.95
|
| Rate for Payer: PHP Medicare Advantage |
$174.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,034.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$548.19
|
| Rate for Payer: Priority Health Medicare |
$174.42
|
| Rate for Payer: Priority Health Narrow Network |
$438.55
|
| Rate for Payer: Priority Health SBD |
$1,002.78
|
| Rate for Payer: Railroad Medicare Medicare |
$174.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.94
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.42
|
| Rate for Payer: UHC Exchange |
$143.58
|
| Rate for Payer: UHC Medicare Advantage |
$174.42
|
| Rate for Payer: UHCCP Medicaid |
$93.49
|
| Rate for Payer: UMR Bronson Commercial |
$588.93
|
| Rate for Payer: VA VA |
$174.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,193.78
|
|
|
HC CT FACIAL W CON
|
Facility
|
IP
|
$1,591.71
|
|
|
Service Code
|
CPT 70487
|
| Hospital Charge Code |
35100008
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$700.35 |
| Max. Negotiated Rate |
$1,432.54 |
| Rate for Payer: Aetna American Axle |
$1,034.61
|
| Rate for Payer: Aetna Commercial |
$1,352.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,034.61
|
| Rate for Payer: Cash Price |
$1,273.37
|
| Rate for Payer: Cofinity Commercial |
$1,114.20
|
| Rate for Payer: Cofinity Commercial |
$1,368.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,114.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,273.37
|
| Rate for Payer: Healthscope Commercial |
$1,432.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,114.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,193.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,352.95
|
| Rate for Payer: PHP Commercial |
$1,352.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,034.61
|
| Rate for Payer: Priority Health SBD |
$1,002.78
|
| Rate for Payer: UMR Bronson Commercial |
$700.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,193.78
|
|
|
HC CT FACIAL WO CON
|
Facility
|
OP
|
$1,410.88
|
|
|
Service Code
|
CPT 70486
|
| Hospital Charge Code |
35100007
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$1,269.79 |
| Rate for Payer: Aetna American Axle |
$917.07
|
| Rate for Payer: Aetna Commercial |
$1,199.25
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$917.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$187.46
|
| Rate for Payer: BCN Commercial |
$187.46
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$1,128.70
|
| Rate for Payer: Cash Price |
$1,128.70
|
| Rate for Payer: Cofinity Commercial |
$987.62
|
| Rate for Payer: Cofinity Commercial |
$1,213.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$987.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,128.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$1,269.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$987.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,058.16
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,199.25
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$1,199.25
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$917.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$888.85
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.48
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$120.44
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$522.03
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,058.16
|
|
|
HC CT FACIAL WO CON
|
Facility
|
IP
|
$1,410.88
|
|
|
Service Code
|
CPT 70486
|
| Hospital Charge Code |
35100007
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$620.79 |
| Max. Negotiated Rate |
$1,269.79 |
| Rate for Payer: Aetna American Axle |
$917.07
|
| Rate for Payer: Aetna Commercial |
$1,199.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$917.07
|
| Rate for Payer: Cash Price |
$1,128.70
|
| Rate for Payer: Cofinity Commercial |
$1,213.36
|
| Rate for Payer: Cofinity Commercial |
$987.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$987.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,128.70
|
| Rate for Payer: Healthscope Commercial |
$1,269.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$987.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,058.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,199.25
|
| Rate for Payer: PHP Commercial |
$1,199.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$917.07
|
| Rate for Payer: Priority Health SBD |
$888.85
|
| Rate for Payer: UMR Bronson Commercial |
$620.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,058.16
|
|
|
HC CT FACIAL WO W CON
|
Facility
|
IP
|
$1,498.69
|
|
|
Service Code
|
CPT 70488
|
| Hospital Charge Code |
35101009
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$659.42 |
| Max. Negotiated Rate |
$1,348.82 |
| Rate for Payer: Aetna American Axle |
$974.15
|
| Rate for Payer: Aetna Commercial |
$1,273.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$974.15
|
| Rate for Payer: Cash Price |
$1,198.95
|
| Rate for Payer: Cofinity Commercial |
$1,049.08
|
| Rate for Payer: Cofinity Commercial |
$1,288.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,049.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,198.95
|
| Rate for Payer: Healthscope Commercial |
$1,348.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,049.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,124.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,273.89
|
| Rate for Payer: PHP Commercial |
$1,273.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$974.15
|
| Rate for Payer: Priority Health SBD |
$944.17
|
| Rate for Payer: UMR Bronson Commercial |
$659.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,124.02
|
|
|
HC CT FACIAL WO W CON
|
Facility
|
OP
|
$1,498.69
|
|
|
Service Code
|
CPT 70488
|
| Hospital Charge Code |
35101009
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$93.49 |
| Max. Negotiated Rate |
$1,348.82 |
| Rate for Payer: Aetna American Axle |
$974.15
|
| Rate for Payer: Aetna Commercial |
$1,273.89
|
| Rate for Payer: Aetna Medicare |
$181.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$974.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.02
|
| Rate for Payer: BCBS Complete |
$98.16
|
| Rate for Payer: BCBS MAPPO |
$174.42
|
| Rate for Payer: BCBS Trust/PPO |
$266.14
|
| Rate for Payer: BCN Commercial |
$266.14
|
| Rate for Payer: BCN Medicare Advantage |
$174.42
|
| Rate for Payer: Cash Price |
$1,198.95
|
| Rate for Payer: Cash Price |
$1,198.95
|
| Rate for Payer: Cofinity Commercial |
$1,288.87
|
| Rate for Payer: Cofinity Commercial |
$1,049.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,049.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,198.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.42
|
| Rate for Payer: Healthscope Commercial |
$1,348.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,049.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,124.02
|
| Rate for Payer: Mclaren Medicaid |
$93.49
|
| Rate for Payer: Mclaren Medicare |
$174.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.14
|
| Rate for Payer: Meridian Medicaid |
$98.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,273.89
|
| Rate for Payer: Nomi Health Commercial |
$523.26
|
| Rate for Payer: PACE Medicare |
$165.70
|
| Rate for Payer: PACE SWMI |
$174.42
|
| Rate for Payer: PHP Commercial |
$1,273.89
|
| Rate for Payer: PHP Medicare Advantage |
$174.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$974.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$548.19
|
| Rate for Payer: Priority Health Medicare |
$174.42
|
| Rate for Payer: Priority Health Narrow Network |
$438.55
|
| Rate for Payer: Priority Health SBD |
$944.17
|
| Rate for Payer: Railroad Medicare Medicare |
$174.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.97
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.42
|
| Rate for Payer: UHC Exchange |
$173.61
|
| Rate for Payer: UHC Medicare Advantage |
$174.42
|
| Rate for Payer: UHCCP Medicaid |
$93.49
|
| Rate for Payer: UMR Bronson Commercial |
$554.52
|
| Rate for Payer: VA VA |
$174.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,124.02
|
|
|
HC CT GUIDE JOINT ASP OR INJECTIO
|
Facility
|
IP
|
$1,448.55
|
|
|
Service Code
|
CPT 77012
|
| Hospital Charge Code |
35000029
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$637.36 |
| Max. Negotiated Rate |
$1,303.70 |
| Rate for Payer: Aetna American Axle |
$941.56
|
| Rate for Payer: Aetna Commercial |
$1,231.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$941.56
|
| Rate for Payer: Cash Price |
$1,158.84
|
| Rate for Payer: Cofinity Commercial |
$1,013.98
|
| Rate for Payer: Cofinity Commercial |
$1,245.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,013.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,158.84
|
| Rate for Payer: Healthscope Commercial |
$1,303.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,013.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,086.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,231.27
|
| Rate for Payer: PHP Commercial |
$1,231.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.56
|
| Rate for Payer: Priority Health SBD |
$912.59
|
| Rate for Payer: UMR Bronson Commercial |
$637.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,086.41
|
|
|
HC CT GUIDE JOINT ASP OR INJECTIO
|
Facility
|
OP
|
$1,448.55
|
|
|
Service Code
|
CPT 77012
|
| Hospital Charge Code |
35000029
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$129.62 |
| Max. Negotiated Rate |
$1,303.70 |
| Rate for Payer: Aetna American Axle |
$941.56
|
| Rate for Payer: Aetna Commercial |
$1,231.27
|
| Rate for Payer: Aetna Medicare |
$724.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$941.56
|
| Rate for Payer: BCBS Complete |
$579.42
|
| Rate for Payer: BCBS Trust/PPO |
$145.04
|
| Rate for Payer: BCN Commercial |
$145.04
|
| Rate for Payer: Cash Price |
$1,158.84
|
| Rate for Payer: Cash Price |
$1,158.84
|
| Rate for Payer: Cofinity Commercial |
$1,013.98
|
| Rate for Payer: Cofinity Commercial |
$1,245.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,013.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,158.84
|
| Rate for Payer: Healthscope Commercial |
$1,303.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,013.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,086.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,231.27
|
| Rate for Payer: PHP Commercial |
$1,231.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.56
|
| Rate for Payer: Priority Health SBD |
$912.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.58
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Exchange |
$129.62
|
| Rate for Payer: UMR Bronson Commercial |
$535.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,086.41
|
|
|
HC CT GUIDE NEEDLE PLACEMENT
|
Facility
|
IP
|
$1,310.90
|
|
|
Service Code
|
CPT 77012
|
| Hospital Charge Code |
35000028
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$576.80 |
| Max. Negotiated Rate |
$1,179.81 |
| Rate for Payer: Aetna American Axle |
$852.08
|
| Rate for Payer: Aetna Commercial |
$1,114.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$852.08
|
| Rate for Payer: Cash Price |
$1,048.72
|
| Rate for Payer: Cofinity Commercial |
$1,127.37
|
| Rate for Payer: Cofinity Commercial |
$917.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$917.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,048.72
|
| Rate for Payer: Healthscope Commercial |
$1,179.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$917.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$983.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,114.26
|
| Rate for Payer: PHP Commercial |
$1,114.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$852.08
|
| Rate for Payer: Priority Health SBD |
$825.87
|
| Rate for Payer: UMR Bronson Commercial |
$576.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$983.18
|
|
|
HC CT GUIDE NEEDLE PLACEMENT
|
Facility
|
OP
|
$1,310.90
|
|
|
Service Code
|
CPT 77012
|
| Hospital Charge Code |
35000028
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$129.62 |
| Max. Negotiated Rate |
$1,179.81 |
| Rate for Payer: Aetna American Axle |
$852.08
|
| Rate for Payer: Aetna Commercial |
$1,114.26
|
| Rate for Payer: Aetna Medicare |
$655.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$852.08
|
| Rate for Payer: BCBS Complete |
$524.36
|
| Rate for Payer: BCBS Trust/PPO |
$145.04
|
| Rate for Payer: BCN Commercial |
$145.04
|
| Rate for Payer: Cash Price |
$1,048.72
|
| Rate for Payer: Cash Price |
$1,048.72
|
| Rate for Payer: Cofinity Commercial |
$1,127.37
|
| Rate for Payer: Cofinity Commercial |
$917.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$917.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,048.72
|
| Rate for Payer: Healthscope Commercial |
$1,179.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$917.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$983.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,114.26
|
| Rate for Payer: PHP Commercial |
$1,114.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$852.08
|
| Rate for Payer: Priority Health SBD |
$825.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.58
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Exchange |
$129.62
|
| Rate for Payer: UMR Bronson Commercial |
$485.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$983.18
|
|
|
HC CT GUIDE PLACEMENT OF THERAPY FIELDS
|
Facility
|
IP
|
$710.59
|
|
|
Service Code
|
CPT 77014
|
| Hospital Charge Code |
33300001
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$312.66 |
| Max. Negotiated Rate |
$639.53 |
| Rate for Payer: Aetna American Axle |
$461.88
|
| Rate for Payer: Aetna Commercial |
$604.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.88
|
| Rate for Payer: Cash Price |
$568.47
|
| Rate for Payer: Cofinity Commercial |
$497.41
|
| Rate for Payer: Cofinity Commercial |
$611.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$497.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$568.47
|
| Rate for Payer: Healthscope Commercial |
$639.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$497.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$532.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$604.00
|
| Rate for Payer: PHP Commercial |
$604.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$461.88
|
| Rate for Payer: Priority Health SBD |
$447.67
|
| Rate for Payer: UMR Bronson Commercial |
$312.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$532.94
|
|
|
HC CT GUIDE PLACEMENT OF THERAPY FIELDS
|
Facility
|
OP
|
$710.59
|
|
|
Service Code
|
CPT 77014
|
| Hospital Charge Code |
33300001
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$110.00 |
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$461.88
|
| Rate for Payer: Aetna Commercial |
$604.00
|
| Rate for Payer: Aetna Medicare |
$355.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.88
|
| Rate for Payer: BCBS Complete |
$284.24
|
| Rate for Payer: BCBS Trust/PPO |
$154.63
|
| Rate for Payer: BCN Commercial |
$154.63
|
| Rate for Payer: Cash Price |
$568.47
|
| Rate for Payer: Cash Price |
$568.47
|
| Rate for Payer: Cash Price |
$568.47
|
| Rate for Payer: Cofinity Commercial |
$611.11
|
| Rate for Payer: Cofinity Commercial |
$497.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$497.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$568.47
|
| Rate for Payer: Healthscope Commercial |
$639.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$497.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$532.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$604.00
|
| Rate for Payer: PHP Commercial |
$604.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$461.88
|
| Rate for Payer: Priority Health SBD |
$447.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.00
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Exchange |
$110.00
|
| Rate for Payer: UMR Bronson Commercial |
$262.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$532.94
|
|
|
HC CT GUIDE STEREOTACTIC LOCAL
|
Facility
|
OP
|
$1,197.50
|
|
|
Service Code
|
CPT 77011
|
| Hospital Charge Code |
35000033
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$202.37 |
| Max. Negotiated Rate |
$1,077.75 |
| Rate for Payer: Aetna American Axle |
$778.38
|
| Rate for Payer: Aetna Commercial |
$1,017.88
|
| Rate for Payer: Aetna Medicare |
$598.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$778.38
|
| Rate for Payer: BCBS Complete |
$479.00
|
| Rate for Payer: BCBS Trust/PPO |
$329.77
|
| Rate for Payer: BCN Commercial |
$329.77
|
| Rate for Payer: Cash Price |
$958.00
|
| Rate for Payer: Cash Price |
$958.00
|
| Rate for Payer: Cofinity Commercial |
$1,029.85
|
| Rate for Payer: Cofinity Commercial |
$838.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$838.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$958.00
|
| Rate for Payer: Healthscope Commercial |
$1,077.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$838.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$898.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,017.88
|
| Rate for Payer: PHP Commercial |
$1,017.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$778.38
|
| Rate for Payer: Priority Health SBD |
$754.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.61
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Exchange |
$202.37
|
| Rate for Payer: UMR Bronson Commercial |
$443.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$898.12
|
|
|
HC CT GUIDE STEREOTACTIC LOCAL
|
Facility
|
IP
|
$1,197.50
|
|
|
Service Code
|
CPT 77011
|
| Hospital Charge Code |
35000033
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$526.90 |
| Max. Negotiated Rate |
$1,077.75 |
| Rate for Payer: Aetna American Axle |
$778.38
|
| Rate for Payer: Aetna Commercial |
$1,017.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$778.38
|
| Rate for Payer: Cash Price |
$958.00
|
| Rate for Payer: Cofinity Commercial |
$1,029.85
|
| Rate for Payer: Cofinity Commercial |
$838.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$838.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$958.00
|
| Rate for Payer: Healthscope Commercial |
$1,077.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$838.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$898.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,017.88
|
| Rate for Payer: PHP Commercial |
$1,017.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$778.38
|
| Rate for Payer: Priority Health SBD |
$754.42
|
| Rate for Payer: UMR Bronson Commercial |
$526.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$898.12
|
|
