|
HC CT PLEURAL FIBRINOLYSIS INITIAL
|
Facility
|
OP
|
$983.98
|
|
|
Service Code
|
CPT 32561
|
| Hospital Charge Code |
36100323
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$64.49 |
| Max. Negotiated Rate |
$1,903.90 |
| Rate for Payer: Aetna American Axle |
$639.59
|
| Rate for Payer: Aetna Commercial |
$836.38
|
| Rate for Payer: Aetna Medicare |
$629.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$639.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$757.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$757.20
|
| Rate for Payer: BCBS Complete |
$340.92
|
| Rate for Payer: BCBS MAPPO |
$605.76
|
| Rate for Payer: BCBS Trust/PPO |
$638.95
|
| Rate for Payer: BCN Commercial |
$638.95
|
| Rate for Payer: BCN Medicare Advantage |
$605.76
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cofinity Commercial |
$846.22
|
| Rate for Payer: Cofinity Commercial |
$688.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$688.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$605.76
|
| Rate for Payer: Healthscope Commercial |
$885.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$688.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$737.98
|
| Rate for Payer: Mclaren Medicaid |
$324.69
|
| Rate for Payer: Mclaren Medicare |
$605.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$636.05
|
| Rate for Payer: Meridian Medicaid |
$340.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$696.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.38
|
| Rate for Payer: Nomi Health Commercial |
$1,272.10
|
| Rate for Payer: PACE Medicare |
$575.47
|
| Rate for Payer: PACE SWMI |
$605.76
|
| Rate for Payer: PHP Commercial |
$836.38
|
| Rate for Payer: PHP Medicare Advantage |
$605.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,903.90
|
| Rate for Payer: Priority Health Medicare |
$605.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,523.12
|
| Rate for Payer: Priority Health SBD |
$619.91
|
| Rate for Payer: Railroad Medicare Medicare |
$605.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.94
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$605.76
|
| Rate for Payer: UHC Exchange |
$64.49
|
| Rate for Payer: UHC Medicare Advantage |
$605.76
|
| Rate for Payer: UHCCP Medicaid |
$324.69
|
| Rate for Payer: UMR Bronson Commercial |
$364.07
|
| Rate for Payer: VA VA |
$605.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$737.98
|
|
|
HC CT PLEURAL FIBRINOLYSIS INITIAL
|
Facility
|
IP
|
$983.98
|
|
|
Service Code
|
CPT 32561
|
| Hospital Charge Code |
36100323
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$432.95 |
| Max. Negotiated Rate |
$885.58 |
| Rate for Payer: Aetna American Axle |
$639.59
|
| Rate for Payer: Aetna Commercial |
$836.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$639.59
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cofinity Commercial |
$688.79
|
| Rate for Payer: Cofinity Commercial |
$846.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$688.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.18
|
| Rate for Payer: Healthscope Commercial |
$885.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$688.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$737.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.38
|
| Rate for Payer: PHP Commercial |
$836.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.59
|
| Rate for Payer: Priority Health SBD |
$619.91
|
| Rate for Payer: UMR Bronson Commercial |
$432.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$737.98
|
|
|
HC CT PLEURAL FIBRINOLYSIS SUB DAY
|
Facility
|
IP
|
$983.98
|
|
|
Service Code
|
CPT 32562
|
| Hospital Charge Code |
36100322
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$432.95 |
| Max. Negotiated Rate |
$885.58 |
| Rate for Payer: Aetna American Axle |
$639.59
|
| Rate for Payer: Aetna Commercial |
$836.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$639.59
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cofinity Commercial |
$688.79
|
| Rate for Payer: Cofinity Commercial |
$846.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$688.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.18
|
| Rate for Payer: Healthscope Commercial |
$885.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$688.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$737.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.38
|
| Rate for Payer: PHP Commercial |
$836.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.59
|
| Rate for Payer: Priority Health SBD |
$619.91
|
| Rate for Payer: UMR Bronson Commercial |
$432.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$737.98
|
|
|
HC CT PLEURAL FIBRINOLYSIS SUB DAY
|
Facility
|
OP
|
$983.98
|
|
|
Service Code
|
CPT 32562
|
| Hospital Charge Code |
36100322
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$57.61 |
| Max. Negotiated Rate |
$1,903.90 |
| Rate for Payer: Aetna American Axle |
$639.59
|
| Rate for Payer: Aetna Commercial |
$836.38
|
| Rate for Payer: Aetna Medicare |
$629.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$639.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$757.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$757.20
|
| Rate for Payer: BCBS Complete |
$340.92
|
| Rate for Payer: BCBS MAPPO |
$605.76
|
| Rate for Payer: BCBS Trust/PPO |
$638.95
|
| Rate for Payer: BCN Commercial |
$638.95
|
| Rate for Payer: BCN Medicare Advantage |
$605.76
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cofinity Commercial |
$846.22
|
| Rate for Payer: Cofinity Commercial |
$688.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$688.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$605.76
|
| Rate for Payer: Healthscope Commercial |
$885.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$688.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$737.98
|
| Rate for Payer: Mclaren Medicaid |
$324.69
|
| Rate for Payer: Mclaren Medicare |
$605.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$636.05
|
| Rate for Payer: Meridian Medicaid |
$340.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$696.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.38
|
| Rate for Payer: Nomi Health Commercial |
$1,272.10
|
| Rate for Payer: PACE Medicare |
$575.47
|
| Rate for Payer: PACE SWMI |
$605.76
|
| Rate for Payer: PHP Commercial |
$836.38
|
| Rate for Payer: PHP Medicare Advantage |
$605.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,903.90
|
| Rate for Payer: Priority Health Medicare |
$605.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,523.12
|
| Rate for Payer: Priority Health SBD |
$619.91
|
| Rate for Payer: Railroad Medicare Medicare |
$605.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.37
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$605.76
|
| Rate for Payer: UHC Exchange |
$57.61
|
| Rate for Payer: UHC Medicare Advantage |
$605.76
|
| Rate for Payer: UHCCP Medicaid |
$324.69
|
| Rate for Payer: UMR Bronson Commercial |
$364.07
|
| Rate for Payer: VA VA |
$605.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$737.98
|
|
|
HC CT RF/MICROWAVE ABLATION
|
Facility
|
OP
|
$1,096.58
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000042
|
|
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 RF/MICROWAVE ABLATION
|
Facility
|
IP
|
$1,096.58
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000042
|
|
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 CTRL NASAL HEMRRG ANT COMPLEX
|
Facility
|
OP
|
$440.64
|
|
|
Service Code
|
CPT 30903
|
| Hospital Charge Code |
76100414
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$286.42
|
| Rate for Payer: Aetna Commercial |
$374.54
|
| Rate for Payer: Aetna Medicare |
$131.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$233.71
|
| Rate for Payer: BCN Commercial |
$233.71
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cofinity Commercial |
$378.95
|
| Rate for Payer: Cofinity Commercial |
$308.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$308.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$396.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$308.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.48
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.54
|
| Rate for Payer: Nomi Health Commercial |
$265.21
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$374.54
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.95
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$317.56
|
| Rate for Payer: Priority Health SBD |
$277.60
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.86
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$75.33
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: UMR Bronson Commercial |
$163.04
|
| Rate for Payer: VA VA |
$126.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.48
|
|
|
HC CTRL NASAL HEMRRG ANT COMPLEX
|
Facility
|
IP
|
$440.64
|
|
|
Service Code
|
CPT 30903
|
| Hospital Charge Code |
76100414
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$193.88 |
| Max. Negotiated Rate |
$396.58 |
| Rate for Payer: Aetna American Axle |
$286.42
|
| Rate for Payer: Aetna Commercial |
$374.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.42
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cofinity Commercial |
$308.45
|
| Rate for Payer: Cofinity Commercial |
$378.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$308.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.51
|
| Rate for Payer: Healthscope Commercial |
$396.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$308.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.54
|
| Rate for Payer: PHP Commercial |
$374.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.42
|
| Rate for Payer: Priority Health SBD |
$277.60
|
| Rate for Payer: UMR Bronson Commercial |
$193.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.48
|
|
|
HC CTRL NASAL HEMRRG POSTERIOR PACKS/CAUTERY SUBSQ
|
Facility
|
OP
|
$596.70
|
|
|
Service Code
|
CPT 30906
|
| Hospital Charge Code |
76100394
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.95 |
| Max. Negotiated Rate |
$715.11 |
| Rate for Payer: Aetna American Axle |
$387.86
|
| Rate for Payer: Aetna Commercial |
$507.20
|
| Rate for Payer: Aetna Medicare |
$236.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$284.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$284.40
|
| Rate for Payer: BCBS Complete |
$128.05
|
| Rate for Payer: BCBS MAPPO |
$227.52
|
| Rate for Payer: BCBS Trust/PPO |
$149.05
|
| Rate for Payer: BCN Commercial |
$149.05
|
| Rate for Payer: BCN Medicare Advantage |
$227.52
|
| Rate for Payer: Cash Price |
$477.36
|
| Rate for Payer: Cash Price |
$477.36
|
| Rate for Payer: Cash Price |
$477.36
|
| Rate for Payer: Cofinity Commercial |
$513.16
|
| Rate for Payer: Cofinity Commercial |
$417.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$417.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.52
|
| Rate for Payer: Healthscope Commercial |
$537.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$417.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.52
|
| Rate for Payer: Mclaren Medicaid |
$121.95
|
| Rate for Payer: Mclaren Medicare |
$227.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.90
|
| Rate for Payer: Meridian Medicaid |
$128.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$261.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.20
|
| Rate for Payer: Nomi Health Commercial |
$477.79
|
| Rate for Payer: PACE Medicare |
$216.14
|
| Rate for Payer: PACE SWMI |
$227.52
|
| Rate for Payer: PHP Commercial |
$507.20
|
| Rate for Payer: PHP Medicare Advantage |
$227.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$715.11
|
| Rate for Payer: Priority Health Medicare |
$227.52
|
| Rate for Payer: Priority Health Narrow Network |
$572.09
|
| Rate for Payer: Priority Health SBD |
$375.92
|
| Rate for Payer: Railroad Medicare Medicare |
$227.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.57
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$227.52
|
| Rate for Payer: UHC Exchange |
$128.70
|
| Rate for Payer: UHC Medicare Advantage |
$227.52
|
| Rate for Payer: UHCCP Medicaid |
$121.95
|
| Rate for Payer: UMR Bronson Commercial |
$220.78
|
| Rate for Payer: VA VA |
$227.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.52
|
|
|
HC CTRL NASAL HEMRRG POSTERIOR PACKS/CAUTERY SUBSQ
|
Facility
|
IP
|
$596.70
|
|
|
Service Code
|
CPT 30906
|
| Hospital Charge Code |
76100394
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$262.55 |
| Max. Negotiated Rate |
$537.03 |
| Rate for Payer: Aetna American Axle |
$387.86
|
| Rate for Payer: Aetna Commercial |
$507.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.86
|
| Rate for Payer: Cash Price |
$477.36
|
| Rate for Payer: Cofinity Commercial |
$417.69
|
| Rate for Payer: Cofinity Commercial |
$513.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$417.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.36
|
| Rate for Payer: Healthscope Commercial |
$537.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$417.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.20
|
| Rate for Payer: PHP Commercial |
$507.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.86
|
| Rate for Payer: Priority Health SBD |
$375.92
|
| Rate for Payer: UMR Bronson Commercial |
$262.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.52
|
|
|
HC CT SI JTS W CON
|
Facility
|
IP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000025
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$310.42 |
| Max. Negotiated Rate |
$634.94 |
| Rate for Payer: Aetna American Axle |
$458.57
|
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.57
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$493.84
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$493.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health SBD |
$444.46
|
| Rate for Payer: UMR Bronson Commercial |
$310.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.12
|
|
|
HC CT SI JTS W CON
|
Facility
|
OP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000025
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$1,048.00 |
| Rate for Payer: Aetna American Axle |
$458.57
|
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$183.36
|
| Rate for Payer: BCN Commercial |
$183.36
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Cofinity Commercial |
$493.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$493.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.12
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$444.46
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.71
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$123.37
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$261.03
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.12
|
|
|
HC CT SI JTS WO CON
|
Facility
|
IP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000023
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$310.42 |
| Max. Negotiated Rate |
$634.94 |
| Rate for Payer: Aetna American Axle |
$458.57
|
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.57
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$493.84
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$493.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health SBD |
$444.46
|
| Rate for Payer: UMR Bronson Commercial |
$310.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.12
|
|
|
HC CT SI JTS WO CON
|
Facility
|
OP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000023
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$1,048.00 |
| Rate for Payer: Aetna American Axle |
$458.57
|
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$183.36
|
| Rate for Payer: BCN Commercial |
$183.36
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Cofinity Commercial |
$493.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$493.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.12
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$444.46
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.71
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$123.37
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$261.03
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.12
|
|
|
HC CT SI JTS WO W CON
|
Facility
|
IP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000026
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$310.42 |
| Max. Negotiated Rate |
$634.94 |
| Rate for Payer: Aetna American Axle |
$458.57
|
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.57
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$493.84
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$493.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health SBD |
$444.46
|
| Rate for Payer: UMR Bronson Commercial |
$310.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.12
|
|
|
HC CT SI JTS WO W CON
|
Facility
|
OP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000026
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$1,048.00 |
| Rate for Payer: Aetna American Axle |
$458.57
|
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$183.36
|
| Rate for Payer: BCN Commercial |
$183.36
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Cofinity Commercial |
$493.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$493.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.12
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$444.46
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.71
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$123.37
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$261.03
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.12
|
|
|
HC CT SOFT TISS NECK W CON
|
Facility
|
OP
|
$1,634.26
|
|
|
Service Code
|
CPT 70491
|
| Hospital Charge Code |
35000002
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$93.49 |
| Max. Negotiated Rate |
$1,470.83 |
| Rate for Payer: Aetna American Axle |
$1,062.27
|
| Rate for Payer: Aetna Commercial |
$1,389.12
|
| Rate for Payer: Aetna Medicare |
$181.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,062.27
|
| 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 |
$255.20
|
| Rate for Payer: BCN Commercial |
$255.20
|
| Rate for Payer: BCN Medicare Advantage |
$174.42
|
| Rate for Payer: Cash Price |
$1,307.41
|
| Rate for Payer: Cash Price |
$1,307.41
|
| Rate for Payer: Cofinity Commercial |
$1,405.46
|
| Rate for Payer: Cofinity Commercial |
$1,143.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,143.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,307.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.42
|
| Rate for Payer: Healthscope Commercial |
$1,470.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,143.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,225.70
|
| 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 |
$1,389.12
|
| 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 |
$1,389.12
|
| 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 |
$1,062.27
|
| 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 |
$1,029.58
|
| Rate for Payer: Railroad Medicare Medicare |
$174.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.32
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.42
|
| Rate for Payer: UHC Exchange |
$173.93
|
| Rate for Payer: UHC Medicare Advantage |
$174.42
|
| Rate for Payer: UHCCP Medicaid |
$93.49
|
| Rate for Payer: UMR Bronson Commercial |
$604.68
|
| Rate for Payer: VA VA |
$174.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,225.70
|
|
|
HC CT SOFT TISS NECK W CON
|
Facility
|
IP
|
$1,634.26
|
|
|
Service Code
|
CPT 70491
|
| Hospital Charge Code |
35000002
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$719.07 |
| Max. Negotiated Rate |
$1,470.83 |
| Rate for Payer: Aetna American Axle |
$1,062.27
|
| Rate for Payer: Aetna Commercial |
$1,389.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,062.27
|
| Rate for Payer: Cash Price |
$1,307.41
|
| Rate for Payer: Cofinity Commercial |
$1,143.98
|
| Rate for Payer: Cofinity Commercial |
$1,405.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,143.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,307.41
|
| Rate for Payer: Healthscope Commercial |
$1,470.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,143.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,225.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,389.12
|
| Rate for Payer: PHP Commercial |
$1,389.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,062.27
|
| Rate for Payer: Priority Health SBD |
$1,029.58
|
| Rate for Payer: UMR Bronson Commercial |
$719.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,225.70
|
|
|
HC CT SOFT TISS NECK WO CON
|
Facility
|
OP
|
$1,383.22
|
|
|
Service Code
|
CPT 70490
|
| Hospital Charge Code |
35000001
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$1,244.90 |
| Rate for Payer: Aetna American Axle |
$899.09
|
| Rate for Payer: Aetna Commercial |
$1,175.74
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$899.09
|
| 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 |
$192.25
|
| Rate for Payer: BCN Commercial |
$192.25
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$1,106.58
|
| Rate for Payer: Cash Price |
$1,106.58
|
| Rate for Payer: Cofinity Commercial |
$968.25
|
| Rate for Payer: Cofinity Commercial |
$1,189.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$968.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,106.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$1,244.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$968.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,037.42
|
| 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 |
$1,175.74
|
| 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 |
$1,175.74
|
| 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 |
$899.09
|
| 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 |
$871.43
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$156.12
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$141.93
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$511.79
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,037.42
|
|
|
HC CT SOFT TISS NECK WO CON
|
Facility
|
IP
|
$1,383.22
|
|
|
Service Code
|
CPT 70490
|
| Hospital Charge Code |
35000001
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$608.62 |
| Max. Negotiated Rate |
$1,244.90 |
| Rate for Payer: Aetna American Axle |
$899.09
|
| Rate for Payer: Aetna Commercial |
$1,175.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$899.09
|
| Rate for Payer: Cash Price |
$1,106.58
|
| Rate for Payer: Cofinity Commercial |
$1,189.57
|
| Rate for Payer: Cofinity Commercial |
$968.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$968.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,106.58
|
| Rate for Payer: Healthscope Commercial |
$1,244.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$968.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,037.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,175.74
|
| Rate for Payer: PHP Commercial |
$1,175.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$899.09
|
| Rate for Payer: Priority Health SBD |
$871.43
|
| Rate for Payer: UMR Bronson Commercial |
$608.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,037.42
|
|
|
HC CT SOFT TISS NECK WO W CON
|
Facility
|
IP
|
$1,881.46
|
|
|
Service Code
|
CPT 70492
|
| Hospital Charge Code |
35000003
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$827.84 |
| Max. Negotiated Rate |
$1,693.31 |
| Rate for Payer: Aetna American Axle |
$1,222.95
|
| Rate for Payer: Aetna Commercial |
$1,599.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,222.95
|
| Rate for Payer: Cash Price |
$1,505.17
|
| Rate for Payer: Cofinity Commercial |
$1,317.02
|
| Rate for Payer: Cofinity Commercial |
$1,618.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,317.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,505.17
|
| Rate for Payer: Healthscope Commercial |
$1,693.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,317.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,411.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,599.24
|
| Rate for Payer: PHP Commercial |
$1,599.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,222.95
|
| Rate for Payer: Priority Health SBD |
$1,185.32
|
| Rate for Payer: UMR Bronson Commercial |
$827.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,411.10
|
|
|
HC CT SOFT TISS NECK WO W CON
|
Facility
|
OP
|
$1,881.46
|
|
|
Service Code
|
CPT 70492
|
| Hospital Charge Code |
35000003
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$93.49 |
| Max. Negotiated Rate |
$1,693.31 |
| Rate for Payer: Aetna American Axle |
$1,222.95
|
| Rate for Payer: Aetna Commercial |
$1,599.24
|
| Rate for Payer: Aetna Medicare |
$181.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,222.95
|
| 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 |
$310.62
|
| Rate for Payer: BCN Commercial |
$310.62
|
| Rate for Payer: BCN Medicare Advantage |
$174.42
|
| Rate for Payer: Cash Price |
$1,505.17
|
| Rate for Payer: Cash Price |
$1,505.17
|
| Rate for Payer: Cofinity Commercial |
$1,618.06
|
| Rate for Payer: Cofinity Commercial |
$1,317.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,317.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,505.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.42
|
| Rate for Payer: Healthscope Commercial |
$1,693.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,317.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,411.10
|
| 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 |
$1,599.24
|
| 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 |
$1,599.24
|
| 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 |
$1,222.95
|
| 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 |
$1,185.32
|
| Rate for Payer: Railroad Medicare Medicare |
$174.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.26
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.42
|
| Rate for Payer: UHC Exchange |
$208.42
|
| Rate for Payer: UHC Medicare Advantage |
$174.42
|
| Rate for Payer: UHCCP Medicaid |
$93.49
|
| Rate for Payer: UMR Bronson Commercial |
$696.14
|
| Rate for Payer: VA VA |
$174.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,411.10
|
|
|
HC CT SPINE CERVICAL W CON
|
Facility
|
OP
|
$1,938.61
|
|
|
Service Code
|
CPT 72126
|
| Hospital Charge Code |
35200004
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$159.06 |
| Max. Negotiated Rate |
$1,744.75 |
| Rate for Payer: Aetna American Axle |
$1,260.10
|
| Rate for Payer: Aetna Commercial |
$1,647.82
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,260.10
|
| 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 |
$238.09
|
| Rate for Payer: BCN Commercial |
$238.09
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$1,550.89
|
| Rate for Payer: Cash Price |
$1,550.89
|
| Rate for Payer: Cofinity Commercial |
$1,667.20
|
| Rate for Payer: Cofinity Commercial |
$1,357.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,357.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,550.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$1,744.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,357.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,453.96
|
| 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 |
$1,647.82
|
| 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 |
$1,647.82
|
| 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 |
$1,260.10
|
| 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 |
$1,221.32
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.97
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$159.06
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: UMR Bronson Commercial |
$717.29
|
| Rate for Payer: VA VA |
$349.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,453.96
|
|
|
HC CT SPINE CERVICAL W CON
|
Facility
|
IP
|
$1,938.61
|
|
|
Service Code
|
CPT 72126
|
| Hospital Charge Code |
35200004
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$852.99 |
| Max. Negotiated Rate |
$1,744.75 |
| Rate for Payer: Aetna American Axle |
$1,260.10
|
| Rate for Payer: Aetna Commercial |
$1,647.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,260.10
|
| Rate for Payer: Cash Price |
$1,550.89
|
| Rate for Payer: Cofinity Commercial |
$1,357.03
|
| Rate for Payer: Cofinity Commercial |
$1,667.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,357.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,550.89
|
| Rate for Payer: Healthscope Commercial |
$1,744.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,357.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,453.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,647.82
|
| Rate for Payer: PHP Commercial |
$1,647.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,260.10
|
| Rate for Payer: Priority Health SBD |
$1,221.32
|
| Rate for Payer: UMR Bronson Commercial |
$852.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,453.96
|
|
|
HC CT SPINE CERVICAL WO CON
|
Facility
|
IP
|
$1,617.92
|
|
|
Service Code
|
CPT 72125
|
| Hospital Charge Code |
35200003
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$711.88 |
| Max. Negotiated Rate |
$1,456.13 |
| Rate for Payer: Aetna American Axle |
$1,051.65
|
| Rate for Payer: Aetna Commercial |
$1,375.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,051.65
|
| Rate for Payer: Cash Price |
$1,294.34
|
| Rate for Payer: Cofinity Commercial |
$1,132.54
|
| Rate for Payer: Cofinity Commercial |
$1,391.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,132.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,294.34
|
| Rate for Payer: Healthscope Commercial |
$1,456.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,132.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,213.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,375.23
|
| Rate for Payer: PHP Commercial |
$1,375.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.65
|
| Rate for Payer: Priority Health SBD |
$1,019.29
|
| Rate for Payer: UMR Bronson Commercial |
$711.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,213.44
|
|
