HC NCS 1-2 STUDIES INCL F&H WAVES
|
Facility
|
OP
|
$484.65
|
|
Service Code
|
CPT 95907
|
Hospital Charge Code |
92200027
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$75.95 |
Max. Negotiated Rate |
$522.00 |
Rate for Payer: Aetna American Axle |
$315.02
|
Rate for Payer: Aetna Commercial |
$411.95
|
Rate for Payer: Aetna Medicare |
$144.40
|
Rate for Payer: Aetna New Business (MI Preferred) |
$315.02
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.56
|
Rate for Payer: Amish Plain Church Group Commercial |
$173.56
|
Rate for Payer: BCBS Complete |
$79.76
|
Rate for Payer: BCBS MAPPO |
$138.85
|
Rate for Payer: BCBS Trust/PPO |
$189.35
|
Rate for Payer: BCN Medicare Advantage |
$138.85
|
Rate for Payer: Cash Price |
$387.72
|
Rate for Payer: Cash Price |
$387.72
|
Rate for Payer: Cash Price |
$387.72
|
Rate for Payer: Cofinity Commercial |
$339.26
|
Rate for Payer: Cofinity Commercial |
$416.80
|
Rate for Payer: Encore Health Key Benefits Commercial |
$387.72
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
Rate for Payer: Healthscope Commercial |
$436.18
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$339.26
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$363.49
|
Rate for Payer: Mclaren Medicaid |
$75.95
|
Rate for Payer: Mclaren Medicare |
$138.85
|
Rate for Payer: Meridian Medicaid |
$79.76
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.79
|
Rate for Payer: MI Amish Medical Board Commercial |
$159.68
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$411.95
|
Rate for Payer: PACE Medicare |
$131.91
|
Rate for Payer: PACE SWMI |
$138.85
|
Rate for Payer: PHP Commercial |
$411.95
|
Rate for Payer: PHP Medicare Advantage |
$138.85
|
Rate for Payer: Priority Health Choice Medicaid |
$75.95
|
Rate for Payer: Priority Health Cigna Priority Health |
$339.26
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$437.09
|
Rate for Payer: Priority Health Medicare |
$138.85
|
Rate for Payer: Priority Health Narrow Network |
$349.67
|
Rate for Payer: Priority Health SBD |
$305.33
|
Rate for Payer: Railroad Medicare Medicare |
$138.85
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$97.25
|
Rate for Payer: UHC Core |
$522.00
|
Rate for Payer: UHC Dual Complete DSNP |
$138.85
|
Rate for Payer: UHC Exchange |
$88.41
|
Rate for Payer: UHC Medicare Advantage |
$143.02
|
Rate for Payer: UMR Bronson Commercial |
$179.32
|
Rate for Payer: VA VA |
$138.85
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$363.49
|
|
HC NCS 1-2 STUDIES INCL F&H WAVES
|
Facility
|
IP
|
$484.65
|
|
Service Code
|
CPT 95907
|
Hospital Charge Code |
92200027
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$213.25 |
Max. Negotiated Rate |
$436.18 |
Rate for Payer: Aetna American Axle |
$315.02
|
Rate for Payer: Aetna Commercial |
$411.95
|
Rate for Payer: Aetna New Business (MI Preferred) |
$315.02
|
Rate for Payer: Cash Price |
$387.72
|
Rate for Payer: Cofinity Commercial |
$339.26
|
Rate for Payer: Cofinity Commercial |
$416.80
|
Rate for Payer: Encore Health Key Benefits Commercial |
$387.72
|
Rate for Payer: Healthscope Commercial |
$436.18
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$339.26
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$363.49
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$411.95
|
Rate for Payer: PHP Commercial |
$411.95
|
Rate for Payer: Priority Health Cigna Priority Health |
$339.26
|
Rate for Payer: Priority Health SBD |
$305.33
|
Rate for Payer: UMR Bronson Commercial |
$213.25
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$363.49
|
|
HC NCS 13 OR MORE STUDIES INCL F&H WAVES
|
Facility
|
OP
|
$2,896.50
|
|
Service Code
|
CPT 95913
|
Hospital Charge Code |
92200033
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$260.60 |
Max. Negotiated Rate |
$2,606.85 |
Rate for Payer: Aetna American Axle |
$1,882.72
|
Rate for Payer: Aetna Commercial |
$2,462.02
|
Rate for Payer: Aetna Medicare |
$495.48
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,882.72
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$595.52
|
Rate for Payer: Amish Plain Church Group Commercial |
$595.52
|
Rate for Payer: BCBS Complete |
$273.66
|
Rate for Payer: BCBS MAPPO |
$476.42
|
Rate for Payer: BCBS Trust/PPO |
$514.42
|
Rate for Payer: BCN Medicare Advantage |
$476.42
|
Rate for Payer: Cash Price |
$2,317.20
|
Rate for Payer: Cash Price |
$2,317.20
|
Rate for Payer: Cash Price |
$2,317.20
|
Rate for Payer: Cofinity Commercial |
$2,027.55
|
Rate for Payer: Cofinity Commercial |
$2,490.99
|
Rate for Payer: Encore Health Key Benefits Commercial |
$2,317.20
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.42
|
Rate for Payer: Healthscope Commercial |
$2,606.85
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,027.55
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,172.38
|
Rate for Payer: Mclaren Medicaid |
$260.60
|
Rate for Payer: Mclaren Medicare |
$476.42
|
Rate for Payer: Meridian Medicaid |
$273.66
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$500.24
|
Rate for Payer: MI Amish Medical Board Commercial |
$547.88
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,462.02
|
Rate for Payer: PACE Medicare |
$452.60
|
Rate for Payer: PACE SWMI |
$476.42
|
Rate for Payer: PHP Commercial |
$2,462.02
|
Rate for Payer: PHP Medicare Advantage |
$476.42
|
Rate for Payer: Priority Health Choice Medicaid |
$260.60
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,027.55
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,499.80
|
Rate for Payer: Priority Health Medicare |
$476.42
|
Rate for Payer: Priority Health Narrow Network |
$1,199.84
|
Rate for Payer: Priority Health SBD |
$1,824.80
|
Rate for Payer: Railroad Medicare Medicare |
$476.42
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$307.60
|
Rate for Payer: UHC Core |
$522.00
|
Rate for Payer: UHC Dual Complete DSNP |
$476.42
|
Rate for Payer: UHC Exchange |
$279.64
|
Rate for Payer: UHC Medicare Advantage |
$490.71
|
Rate for Payer: UMR Bronson Commercial |
$1,071.70
|
Rate for Payer: VA VA |
$476.42
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,172.38
|
|
HC NCS 13 OR MORE STUDIES INCL F&H WAVES
|
Facility
|
IP
|
$2,896.50
|
|
Service Code
|
CPT 95913
|
Hospital Charge Code |
92200033
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$1,274.46 |
Max. Negotiated Rate |
$2,606.85 |
Rate for Payer: Aetna American Axle |
$1,882.72
|
Rate for Payer: Aetna Commercial |
$2,462.02
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,882.72
|
Rate for Payer: Cash Price |
$2,317.20
|
Rate for Payer: Cofinity Commercial |
$2,027.55
|
Rate for Payer: Cofinity Commercial |
$2,490.99
|
Rate for Payer: Encore Health Key Benefits Commercial |
$2,317.20
|
Rate for Payer: Healthscope Commercial |
$2,606.85
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,027.55
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,172.38
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,462.02
|
Rate for Payer: PHP Commercial |
$2,462.02
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,027.55
|
Rate for Payer: Priority Health SBD |
$1,824.80
|
Rate for Payer: UMR Bronson Commercial |
$1,274.46
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,172.38
|
|
HC NCS 3-4 STUDIES INCL F&H WAVES
|
Facility
|
IP
|
$895.52
|
|
Service Code
|
CPT 95908
|
Hospital Charge Code |
92200028
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$394.03 |
Max. Negotiated Rate |
$805.97 |
Rate for Payer: Aetna American Axle |
$582.09
|
Rate for Payer: Aetna Commercial |
$761.19
|
Rate for Payer: Aetna New Business (MI Preferred) |
$582.09
|
Rate for Payer: Cash Price |
$716.42
|
Rate for Payer: Cofinity Commercial |
$626.86
|
Rate for Payer: Cofinity Commercial |
$770.15
|
Rate for Payer: Encore Health Key Benefits Commercial |
$716.42
|
Rate for Payer: Healthscope Commercial |
$805.97
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$626.86
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$671.64
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$761.19
|
Rate for Payer: PHP Commercial |
$761.19
|
Rate for Payer: Priority Health Cigna Priority Health |
$626.86
|
Rate for Payer: Priority Health SBD |
$564.18
|
Rate for Payer: UMR Bronson Commercial |
$394.03
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$671.64
|
|
HC NCS 3-4 STUDIES INCL F&H WAVES
|
Facility
|
OP
|
$895.52
|
|
Service Code
|
CPT 95908
|
Hospital Charge Code |
92200028
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$109.69 |
Max. Negotiated Rate |
$878.32 |
Rate for Payer: Aetna American Axle |
$582.09
|
Rate for Payer: Aetna Commercial |
$761.19
|
Rate for Payer: Aetna Medicare |
$290.16
|
Rate for Payer: Aetna New Business (MI Preferred) |
$582.09
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
Rate for Payer: BCBS Complete |
$160.26
|
Rate for Payer: BCBS MAPPO |
$279.00
|
Rate for Payer: BCBS Trust/PPO |
$234.58
|
Rate for Payer: BCN Medicare Advantage |
$279.00
|
Rate for Payer: Cash Price |
$716.42
|
Rate for Payer: Cash Price |
$716.42
|
Rate for Payer: Cash Price |
$716.42
|
Rate for Payer: Cofinity Commercial |
$770.15
|
Rate for Payer: Cofinity Commercial |
$626.86
|
Rate for Payer: Encore Health Key Benefits Commercial |
$716.42
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
Rate for Payer: Healthscope Commercial |
$805.97
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$626.86
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$671.64
|
Rate for Payer: Mclaren Medicaid |
$152.61
|
Rate for Payer: Mclaren Medicare |
$279.00
|
Rate for Payer: Meridian Medicaid |
$160.26
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$761.19
|
Rate for Payer: PACE Medicare |
$265.05
|
Rate for Payer: PACE SWMI |
$279.00
|
Rate for Payer: PHP Commercial |
$761.19
|
Rate for Payer: PHP Medicare Advantage |
$279.00
|
Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
Rate for Payer: Priority Health Cigna Priority Health |
$626.86
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$878.32
|
Rate for Payer: Priority Health Medicare |
$279.00
|
Rate for Payer: Priority Health Narrow Network |
$702.66
|
Rate for Payer: Priority Health SBD |
$564.18
|
Rate for Payer: Railroad Medicare Medicare |
$279.00
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$120.66
|
Rate for Payer: UHC Core |
$522.00
|
Rate for Payer: UHC Dual Complete DSNP |
$279.00
|
Rate for Payer: UHC Exchange |
$109.69
|
Rate for Payer: UHC Medicare Advantage |
$287.37
|
Rate for Payer: UMR Bronson Commercial |
$331.34
|
Rate for Payer: VA VA |
$279.00
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$671.64
|
|
HC NCS 5-6 STUDIES INCL F&H WAVES
|
Facility
|
IP
|
$1,106.75
|
|
Service Code
|
CPT 95909
|
Hospital Charge Code |
92200029
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$486.97 |
Max. Negotiated Rate |
$996.08 |
Rate for Payer: Aetna American Axle |
$719.39
|
Rate for Payer: Aetna Commercial |
$940.74
|
Rate for Payer: Aetna New Business (MI Preferred) |
$719.39
|
Rate for Payer: Cash Price |
$885.40
|
Rate for Payer: Cofinity Commercial |
$774.72
|
Rate for Payer: Cofinity Commercial |
$951.80
|
Rate for Payer: Encore Health Key Benefits Commercial |
$885.40
|
Rate for Payer: Healthscope Commercial |
$996.08
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$774.72
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$830.06
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$940.74
|
Rate for Payer: PHP Commercial |
$940.74
|
Rate for Payer: Priority Health Cigna Priority Health |
$774.72
|
Rate for Payer: Priority Health SBD |
$697.25
|
Rate for Payer: UMR Bronson Commercial |
$486.97
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$830.06
|
|
HC NCS 5-6 STUDIES INCL F&H WAVES
|
Facility
|
OP
|
$1,106.75
|
|
Service Code
|
CPT 95909
|
Hospital Charge Code |
92200029
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$131.63 |
Max. Negotiated Rate |
$996.08 |
Rate for Payer: Aetna American Axle |
$719.39
|
Rate for Payer: Aetna Commercial |
$940.74
|
Rate for Payer: Aetna Medicare |
$290.16
|
Rate for Payer: Aetna New Business (MI Preferred) |
$719.39
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
Rate for Payer: BCBS Complete |
$160.26
|
Rate for Payer: BCBS MAPPO |
$279.00
|
Rate for Payer: BCBS Trust/PPO |
$281.49
|
Rate for Payer: BCN Medicare Advantage |
$279.00
|
Rate for Payer: Cash Price |
$885.40
|
Rate for Payer: Cash Price |
$885.40
|
Rate for Payer: Cash Price |
$885.40
|
Rate for Payer: Cofinity Commercial |
$951.80
|
Rate for Payer: Cofinity Commercial |
$774.72
|
Rate for Payer: Encore Health Key Benefits Commercial |
$885.40
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
Rate for Payer: Healthscope Commercial |
$996.08
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$774.72
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$830.06
|
Rate for Payer: Mclaren Medicaid |
$152.61
|
Rate for Payer: Mclaren Medicare |
$279.00
|
Rate for Payer: Meridian Medicaid |
$160.26
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$940.74
|
Rate for Payer: PACE Medicare |
$265.05
|
Rate for Payer: PACE SWMI |
$279.00
|
Rate for Payer: PHP Commercial |
$940.74
|
Rate for Payer: PHP Medicare Advantage |
$279.00
|
Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
Rate for Payer: Priority Health Cigna Priority Health |
$774.72
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$878.32
|
Rate for Payer: Priority Health Medicare |
$279.00
|
Rate for Payer: Priority Health Narrow Network |
$702.66
|
Rate for Payer: Priority Health SBD |
$697.25
|
Rate for Payer: Railroad Medicare Medicare |
$279.00
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$144.79
|
Rate for Payer: UHC Core |
$522.00
|
Rate for Payer: UHC Dual Complete DSNP |
$279.00
|
Rate for Payer: UHC Exchange |
$131.63
|
Rate for Payer: UHC Medicare Advantage |
$287.37
|
Rate for Payer: UMR Bronson Commercial |
$409.50
|
Rate for Payer: VA VA |
$279.00
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$830.06
|
|
HC NCS 7-8 STUDIES INCL F&H WAVES
|
Facility
|
OP
|
$1,429.29
|
|
Service Code
|
CPT 95910
|
Hospital Charge Code |
92200030
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$152.61 |
Max. Negotiated Rate |
$1,286.36 |
Rate for Payer: Aetna American Axle |
$929.04
|
Rate for Payer: Aetna Commercial |
$1,214.90
|
Rate for Payer: Aetna Medicare |
$290.16
|
Rate for Payer: Aetna New Business (MI Preferred) |
$929.04
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
Rate for Payer: BCBS Complete |
$160.26
|
Rate for Payer: BCBS MAPPO |
$279.00
|
Rate for Payer: BCBS Trust/PPO |
$360.24
|
Rate for Payer: BCN Medicare Advantage |
$279.00
|
Rate for Payer: Cash Price |
$1,143.43
|
Rate for Payer: Cash Price |
$1,143.43
|
Rate for Payer: Cash Price |
$1,143.43
|
Rate for Payer: Cofinity Commercial |
$1,000.50
|
Rate for Payer: Cofinity Commercial |
$1,229.19
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,143.43
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
Rate for Payer: Healthscope Commercial |
$1,286.36
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,000.50
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,071.97
|
Rate for Payer: Mclaren Medicaid |
$152.61
|
Rate for Payer: Mclaren Medicare |
$279.00
|
Rate for Payer: Meridian Medicaid |
$160.26
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,214.90
|
Rate for Payer: PACE Medicare |
$265.05
|
Rate for Payer: PACE SWMI |
$279.00
|
Rate for Payer: PHP Commercial |
$1,214.90
|
Rate for Payer: PHP Medicare Advantage |
$279.00
|
Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,000.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$878.32
|
Rate for Payer: Priority Health Medicare |
$279.00
|
Rate for Payer: Priority Health Narrow Network |
$702.66
|
Rate for Payer: Priority Health SBD |
$900.45
|
Rate for Payer: Railroad Medicare Medicare |
$279.00
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$189.10
|
Rate for Payer: UHC Core |
$522.00
|
Rate for Payer: UHC Dual Complete DSNP |
$279.00
|
Rate for Payer: UHC Exchange |
$171.91
|
Rate for Payer: UHC Medicare Advantage |
$287.37
|
Rate for Payer: UMR Bronson Commercial |
$528.84
|
Rate for Payer: VA VA |
$279.00
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,071.97
|
|
HC NCS 7-8 STUDIES INCL F&H WAVES
|
Facility
|
IP
|
$1,429.29
|
|
Service Code
|
CPT 95910
|
Hospital Charge Code |
92200030
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$628.89 |
Max. Negotiated Rate |
$1,286.36 |
Rate for Payer: Aetna American Axle |
$929.04
|
Rate for Payer: Aetna Commercial |
$1,214.90
|
Rate for Payer: Aetna New Business (MI Preferred) |
$929.04
|
Rate for Payer: Cash Price |
$1,143.43
|
Rate for Payer: Cofinity Commercial |
$1,000.50
|
Rate for Payer: Cofinity Commercial |
$1,229.19
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,143.43
|
Rate for Payer: Healthscope Commercial |
$1,286.36
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,000.50
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,071.97
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,214.90
|
Rate for Payer: PHP Commercial |
$1,214.90
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,000.50
|
Rate for Payer: Priority Health SBD |
$900.45
|
Rate for Payer: UMR Bronson Commercial |
$628.89
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,071.97
|
|
HC NCS 9-10 STUDIES INCL F&H WAVES
|
Facility
|
IP
|
$1,770.78
|
|
Service Code
|
CPT 95911
|
Hospital Charge Code |
92200031
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$779.14 |
Max. Negotiated Rate |
$1,593.70 |
Rate for Payer: Aetna American Axle |
$1,151.01
|
Rate for Payer: Aetna Commercial |
$1,505.16
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,151.01
|
Rate for Payer: Cash Price |
$1,416.62
|
Rate for Payer: Cofinity Commercial |
$1,239.55
|
Rate for Payer: Cofinity Commercial |
$1,522.87
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,416.62
|
Rate for Payer: Healthscope Commercial |
$1,593.70
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,239.55
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,328.08
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,505.16
|
Rate for Payer: PHP Commercial |
$1,505.16
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,239.55
|
Rate for Payer: Priority Health SBD |
$1,115.59
|
Rate for Payer: UMR Bronson Commercial |
$779.14
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,328.08
|
|
HC NCS 9-10 STUDIES INCL F&H WAVES
|
Facility
|
OP
|
$1,770.78
|
|
Service Code
|
CPT 95911
|
Hospital Charge Code |
92200031
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$207.27 |
Max. Negotiated Rate |
$1,593.70 |
Rate for Payer: Aetna American Axle |
$1,151.01
|
Rate for Payer: Aetna Commercial |
$1,505.16
|
Rate for Payer: Aetna Medicare |
$495.48
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,151.01
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$595.52
|
Rate for Payer: Amish Plain Church Group Commercial |
$595.52
|
Rate for Payer: BCBS Complete |
$273.66
|
Rate for Payer: BCBS MAPPO |
$476.42
|
Rate for Payer: BCBS Trust/PPO |
$413.88
|
Rate for Payer: BCN Medicare Advantage |
$476.42
|
Rate for Payer: Cash Price |
$1,416.62
|
Rate for Payer: Cash Price |
$1,416.62
|
Rate for Payer: Cash Price |
$1,416.62
|
Rate for Payer: Cofinity Commercial |
$1,522.87
|
Rate for Payer: Cofinity Commercial |
$1,239.55
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,416.62
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.42
|
Rate for Payer: Healthscope Commercial |
$1,593.70
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,239.55
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,328.08
|
Rate for Payer: Mclaren Medicaid |
$260.60
|
Rate for Payer: Mclaren Medicare |
$476.42
|
Rate for Payer: Meridian Medicaid |
$273.66
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$500.24
|
Rate for Payer: MI Amish Medical Board Commercial |
$547.88
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,505.16
|
Rate for Payer: PACE Medicare |
$452.60
|
Rate for Payer: PACE SWMI |
$476.42
|
Rate for Payer: PHP Commercial |
$1,505.16
|
Rate for Payer: PHP Medicare Advantage |
$476.42
|
Rate for Payer: Priority Health Choice Medicaid |
$260.60
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,239.55
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,499.80
|
Rate for Payer: Priority Health Medicare |
$476.42
|
Rate for Payer: Priority Health Narrow Network |
$1,199.84
|
Rate for Payer: Priority Health SBD |
$1,115.59
|
Rate for Payer: Railroad Medicare Medicare |
$476.42
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$228.00
|
Rate for Payer: UHC Core |
$522.00
|
Rate for Payer: UHC Dual Complete DSNP |
$476.42
|
Rate for Payer: UHC Exchange |
$207.27
|
Rate for Payer: UHC Medicare Advantage |
$490.71
|
Rate for Payer: UMR Bronson Commercial |
$655.19
|
Rate for Payer: VA VA |
$476.42
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,328.08
|
|
HC NEEDLE 14 GAUGE LONG
|
Facility
|
OP
|
$108.00
|
|
Hospital Charge Code |
27000674
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$39.96 |
Max. Negotiated Rate |
$97.20 |
Rate for Payer: Aetna American Axle |
$70.20
|
Rate for Payer: Aetna Commercial |
$91.80
|
Rate for Payer: Aetna New Business (MI Preferred) |
$70.20
|
Rate for Payer: BCBS Complete |
$43.20
|
Rate for Payer: Cash Price |
$86.40
|
Rate for Payer: Cofinity Commercial |
$75.60
|
Rate for Payer: Cofinity Commercial |
$92.88
|
Rate for Payer: Encore Health Key Benefits Commercial |
$86.40
|
Rate for Payer: Healthscope Commercial |
$97.20
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.60
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.00
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.80
|
Rate for Payer: PHP Commercial |
$91.80
|
Rate for Payer: Priority Health Cigna Priority Health |
$75.60
|
Rate for Payer: Priority Health SBD |
$68.04
|
Rate for Payer: UMR Bronson Commercial |
$39.96
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.00
|
|
HC NEEDLE 14 GAUGE LONG
|
Facility
|
IP
|
$108.00
|
|
Hospital Charge Code |
27000674
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$47.52 |
Max. Negotiated Rate |
$97.20 |
Rate for Payer: Aetna American Axle |
$70.20
|
Rate for Payer: Aetna Commercial |
$91.80
|
Rate for Payer: Aetna New Business (MI Preferred) |
$70.20
|
Rate for Payer: Cash Price |
$86.40
|
Rate for Payer: Cofinity Commercial |
$75.60
|
Rate for Payer: Cofinity Commercial |
$92.88
|
Rate for Payer: Encore Health Key Benefits Commercial |
$86.40
|
Rate for Payer: Healthscope Commercial |
$97.20
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.60
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.00
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.80
|
Rate for Payer: PHP Commercial |
$91.80
|
Rate for Payer: Priority Health Cigna Priority Health |
$75.60
|
Rate for Payer: Priority Health SBD |
$68.04
|
Rate for Payer: UMR Bronson Commercial |
$47.52
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.00
|
|
HC NEEDLE 1 EXTREMITY NON PARASPINAL
|
Facility
|
IP
|
$247.66
|
|
Service Code
|
CPT 95870
|
Hospital Charge Code |
92200009
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$108.97 |
Max. Negotiated Rate |
$222.89 |
Rate for Payer: Aetna American Axle |
$160.98
|
Rate for Payer: Aetna Commercial |
$210.51
|
Rate for Payer: Aetna New Business (MI Preferred) |
$160.98
|
Rate for Payer: Cash Price |
$198.13
|
Rate for Payer: Cofinity Commercial |
$173.36
|
Rate for Payer: Cofinity Commercial |
$212.99
|
Rate for Payer: Encore Health Key Benefits Commercial |
$198.13
|
Rate for Payer: Healthscope Commercial |
$222.89
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$173.36
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.74
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$210.51
|
Rate for Payer: PHP Commercial |
$210.51
|
Rate for Payer: Priority Health Cigna Priority Health |
$173.36
|
Rate for Payer: Priority Health SBD |
$156.03
|
Rate for Payer: UMR Bronson Commercial |
$108.97
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.74
|
|
HC NEEDLE 1 EXTREMITY NON PARASPINAL
|
Facility
|
OP
|
$247.66
|
|
Service Code
|
CPT 95870
|
Hospital Charge Code |
92200009
|
Hospital Revenue Code
|
922
|
Min. Negotiated Rate |
$62.11 |
Max. Negotiated Rate |
$522.00 |
Rate for Payer: Aetna American Axle |
$160.98
|
Rate for Payer: Aetna Commercial |
$210.51
|
Rate for Payer: Aetna Medicare |
$118.09
|
Rate for Payer: Aetna New Business (MI Preferred) |
$160.98
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
Rate for Payer: BCBS Complete |
$65.22
|
Rate for Payer: BCBS MAPPO |
$113.55
|
Rate for Payer: BCBS Trust/PPO |
$321.71
|
Rate for Payer: BCN Medicare Advantage |
$113.55
|
Rate for Payer: Cash Price |
$198.13
|
Rate for Payer: Cash Price |
$198.13
|
Rate for Payer: Cash Price |
$198.13
|
Rate for Payer: Cofinity Commercial |
$212.99
|
Rate for Payer: Cofinity Commercial |
$173.36
|
Rate for Payer: Encore Health Key Benefits Commercial |
$198.13
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
Rate for Payer: Healthscope Commercial |
$222.89
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$173.36
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.74
|
Rate for Payer: Mclaren Medicaid |
$62.11
|
Rate for Payer: Mclaren Medicare |
$113.55
|
Rate for Payer: Meridian Medicaid |
$65.22
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$210.51
|
Rate for Payer: PACE Medicare |
$107.87
|
Rate for Payer: PACE SWMI |
$113.55
|
Rate for Payer: PHP Commercial |
$210.51
|
Rate for Payer: PHP Medicare Advantage |
$113.55
|
Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
Rate for Payer: Priority Health Cigna Priority Health |
$173.36
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.43
|
Rate for Payer: Priority Health Medicare |
$113.55
|
Rate for Payer: Priority Health Narrow Network |
$285.94
|
Rate for Payer: Priority Health SBD |
$156.03
|
Rate for Payer: Railroad Medicare Medicare |
$113.55
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$89.68
|
Rate for Payer: UHC Core |
$522.00
|
Rate for Payer: UHC Dual Complete DSNP |
$113.55
|
Rate for Payer: UHC Exchange |
$81.53
|
Rate for Payer: UHC Medicare Advantage |
$116.96
|
Rate for Payer: UMR Bronson Commercial |
$91.63
|
Rate for Payer: VA VA |
$113.55
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.74
|
|
HC NEEDLE BRACHYTHERAPY EACH
|
Facility
|
OP
|
$72.45
|
|
Service Code
|
HCPCS C1715
|
Hospital Charge Code |
27200247
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$0.03 |
Max. Negotiated Rate |
$65.20 |
Rate for Payer: Aetna American Axle |
$47.09
|
Rate for Payer: Aetna Commercial |
$61.58
|
Rate for Payer: Aetna New Business (MI Preferred) |
$47.09
|
Rate for Payer: BCBS Complete |
$28.98
|
Rate for Payer: BCBS Trust/PPO |
$0.03
|
Rate for Payer: Cash Price |
$57.96
|
Rate for Payer: Cash Price |
$57.96
|
Rate for Payer: Cofinity Commercial |
$50.72
|
Rate for Payer: Cofinity Commercial |
$62.31
|
Rate for Payer: Encore Health Key Benefits Commercial |
$57.96
|
Rate for Payer: Healthscope Commercial |
$65.20
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.72
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.34
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.58
|
Rate for Payer: PHP Commercial |
$61.58
|
Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
Rate for Payer: Priority Health SBD |
$45.64
|
Rate for Payer: UMR Bronson Commercial |
$26.81
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.34
|
|
HC NEEDLE BRACHYTHERAPY EACH
|
Facility
|
IP
|
$72.45
|
|
Service Code
|
HCPCS C1715
|
Hospital Charge Code |
27200247
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$31.88 |
Max. Negotiated Rate |
$65.20 |
Rate for Payer: Aetna American Axle |
$47.09
|
Rate for Payer: Aetna Commercial |
$61.58
|
Rate for Payer: Aetna New Business (MI Preferred) |
$47.09
|
Rate for Payer: Cash Price |
$57.96
|
Rate for Payer: Cofinity Commercial |
$50.72
|
Rate for Payer: Cofinity Commercial |
$62.31
|
Rate for Payer: Encore Health Key Benefits Commercial |
$57.96
|
Rate for Payer: Healthscope Commercial |
$65.20
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.72
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.34
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.58
|
Rate for Payer: PHP Commercial |
$61.58
|
Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
Rate for Payer: Priority Health SBD |
$45.64
|
Rate for Payer: UMR Bronson Commercial |
$31.88
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.34
|
|
HC NEEDLE INSERT W/O INJECT 1 OR 2 MUSCLES
|
Facility
|
OP
|
$51.00
|
|
Service Code
|
CPT 20560
|
Hospital Charge Code |
76100364
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$14.41 |
Max. Negotiated Rate |
$83.33 |
Rate for Payer: Aetna American Axle |
$33.15
|
Rate for Payer: Aetna Commercial |
$43.35
|
Rate for Payer: Aetna Medicare |
$27.53
|
Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.09
|
Rate for Payer: Amish Plain Church Group Commercial |
$33.09
|
Rate for Payer: BCBS Complete |
$15.20
|
Rate for Payer: BCBS MAPPO |
$26.47
|
Rate for Payer: BCN Medicare Advantage |
$26.47
|
Rate for Payer: Cash Price |
$40.80
|
Rate for Payer: Cash Price |
$40.80
|
Rate for Payer: Cofinity Commercial |
$35.70
|
Rate for Payer: Cofinity Commercial |
$43.86
|
Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.47
|
Rate for Payer: Healthscope Commercial |
$45.90
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
Rate for Payer: Mclaren Medicaid |
$14.48
|
Rate for Payer: Mclaren Medicare |
$26.47
|
Rate for Payer: Meridian Medicaid |
$15.20
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.79
|
Rate for Payer: MI Amish Medical Board Commercial |
$30.44
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
Rate for Payer: PACE Medicare |
$25.15
|
Rate for Payer: PACE SWMI |
$26.47
|
Rate for Payer: PHP Commercial |
$43.35
|
Rate for Payer: PHP Medicare Advantage |
$26.47
|
Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.33
|
Rate for Payer: Priority Health Medicare |
$26.47
|
Rate for Payer: Priority Health Narrow Network |
$66.66
|
Rate for Payer: Priority Health SBD |
$32.13
|
Rate for Payer: Railroad Medicare Medicare |
$26.47
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$15.85
|
Rate for Payer: UHC Dual Complete DSNP |
$26.47
|
Rate for Payer: UHC Exchange |
$14.41
|
Rate for Payer: UHC Medicare Advantage |
$27.26
|
Rate for Payer: UMR Bronson Commercial |
$18.87
|
Rate for Payer: VA VA |
$26.47
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
HC NEEDLE INSERT W/O INJECT 1 OR 2 MUSCLES
|
Facility
|
IP
|
$51.00
|
|
Service Code
|
CPT 20560
|
Hospital Charge Code |
76100364
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$22.44 |
Max. Negotiated Rate |
$45.90 |
Rate for Payer: Aetna American Axle |
$33.15
|
Rate for Payer: Aetna Commercial |
$43.35
|
Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
Rate for Payer: Cash Price |
$40.80
|
Rate for Payer: Cofinity Commercial |
$35.70
|
Rate for Payer: Cofinity Commercial |
$43.86
|
Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
Rate for Payer: Healthscope Commercial |
$45.90
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
Rate for Payer: PHP Commercial |
$43.35
|
Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
Rate for Payer: Priority Health SBD |
$32.13
|
Rate for Payer: UMR Bronson Commercial |
$22.44
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
HC NEEDLE INSERT W/O INJECTION, 1 OR 2 MUSCLES
|
Facility
|
IP
|
$30.00
|
|
Service Code
|
CPT 20560
|
Hospital Charge Code |
42000060
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$13.20 |
Max. Negotiated Rate |
$27.00 |
Rate for Payer: Aetna American Axle |
$19.50
|
Rate for Payer: Aetna Commercial |
$25.50
|
Rate for Payer: Aetna New Business (MI Preferred) |
$19.50
|
Rate for Payer: Cash Price |
$24.00
|
Rate for Payer: Cofinity Commercial |
$21.00
|
Rate for Payer: Cofinity Commercial |
$25.80
|
Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
Rate for Payer: Healthscope Commercial |
$27.00
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.00
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.50
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
Rate for Payer: PHP Commercial |
$25.50
|
Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
Rate for Payer: Priority Health SBD |
$18.90
|
Rate for Payer: UMR Bronson Commercial |
$13.20
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.50
|
|
HC NEEDLE INSERT W/O INJECTION, 1 OR 2 MUSCLES
|
Facility
|
OP
|
$30.00
|
|
Service Code
|
CPT 20560
|
Hospital Charge Code |
42000060
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$11.10 |
Max. Negotiated Rate |
$83.33 |
Rate for Payer: Aetna American Axle |
$19.50
|
Rate for Payer: Aetna Commercial |
$25.50
|
Rate for Payer: Aetna Medicare |
$27.53
|
Rate for Payer: Aetna New Business (MI Preferred) |
$19.50
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.09
|
Rate for Payer: Amish Plain Church Group Commercial |
$33.09
|
Rate for Payer: BCBS Complete |
$15.20
|
Rate for Payer: BCBS MAPPO |
$26.47
|
Rate for Payer: BCN Medicare Advantage |
$26.47
|
Rate for Payer: Cash Price |
$24.00
|
Rate for Payer: Cash Price |
$24.00
|
Rate for Payer: Cofinity Commercial |
$25.80
|
Rate for Payer: Cofinity Commercial |
$21.00
|
Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.47
|
Rate for Payer: Healthscope Commercial |
$27.00
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.00
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.50
|
Rate for Payer: Mclaren Medicaid |
$14.48
|
Rate for Payer: Mclaren Medicare |
$26.47
|
Rate for Payer: Meridian Medicaid |
$15.20
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.79
|
Rate for Payer: MI Amish Medical Board Commercial |
$30.44
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
Rate for Payer: PACE Medicare |
$25.15
|
Rate for Payer: PACE SWMI |
$26.47
|
Rate for Payer: PHP Commercial |
$25.50
|
Rate for Payer: PHP Medicare Advantage |
$26.47
|
Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.33
|
Rate for Payer: Priority Health Medicare |
$26.47
|
Rate for Payer: Priority Health Narrow Network |
$66.66
|
Rate for Payer: Priority Health SBD |
$18.90
|
Rate for Payer: Railroad Medicare Medicare |
$26.47
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$15.85
|
Rate for Payer: UHC Dual Complete DSNP |
$26.47
|
Rate for Payer: UHC Exchange |
$14.41
|
Rate for Payer: UHC Medicare Advantage |
$27.26
|
Rate for Payer: UMR Bronson Commercial |
$11.10
|
Rate for Payer: VA VA |
$26.47
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.50
|
|
HC NEEDLE INSERT W/O INJECTION, 3 OR MORE MUSCLES
|
Facility
|
IP
|
$50.00
|
|
Service Code
|
CPT 20561
|
Hospital Charge Code |
42000061
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$22.00 |
Max. Negotiated Rate |
$45.00 |
Rate for Payer: Aetna American Axle |
$32.50
|
Rate for Payer: Aetna Commercial |
$42.50
|
Rate for Payer: Aetna New Business (MI Preferred) |
$32.50
|
Rate for Payer: Cash Price |
$40.00
|
Rate for Payer: Cofinity Commercial |
$35.00
|
Rate for Payer: Cofinity Commercial |
$43.00
|
Rate for Payer: Encore Health Key Benefits Commercial |
$40.00
|
Rate for Payer: Healthscope Commercial |
$45.00
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.00
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.50
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.50
|
Rate for Payer: PHP Commercial |
$42.50
|
Rate for Payer: Priority Health Cigna Priority Health |
$35.00
|
Rate for Payer: Priority Health SBD |
$31.50
|
Rate for Payer: UMR Bronson Commercial |
$22.00
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.50
|
|
HC NEEDLE INSERT W/O INJECTION, 3 OR MORE MUSCLES
|
Facility
|
OP
|
$50.00
|
|
Service Code
|
CPT 20561
|
Hospital Charge Code |
42000061
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$14.48 |
Max. Negotiated Rate |
$83.33 |
Rate for Payer: Aetna American Axle |
$32.50
|
Rate for Payer: Aetna Commercial |
$42.50
|
Rate for Payer: Aetna Medicare |
$27.53
|
Rate for Payer: Aetna New Business (MI Preferred) |
$32.50
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.09
|
Rate for Payer: Amish Plain Church Group Commercial |
$33.09
|
Rate for Payer: BCBS Complete |
$15.20
|
Rate for Payer: BCBS MAPPO |
$26.47
|
Rate for Payer: BCN Medicare Advantage |
$26.47
|
Rate for Payer: Cash Price |
$40.00
|
Rate for Payer: Cash Price |
$40.00
|
Rate for Payer: Cofinity Commercial |
$43.00
|
Rate for Payer: Cofinity Commercial |
$35.00
|
Rate for Payer: Encore Health Key Benefits Commercial |
$40.00
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.47
|
Rate for Payer: Healthscope Commercial |
$45.00
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.00
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.50
|
Rate for Payer: Mclaren Medicaid |
$14.48
|
Rate for Payer: Mclaren Medicare |
$26.47
|
Rate for Payer: Meridian Medicaid |
$15.20
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.79
|
Rate for Payer: MI Amish Medical Board Commercial |
$30.44
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.50
|
Rate for Payer: PACE Medicare |
$25.15
|
Rate for Payer: PACE SWMI |
$26.47
|
Rate for Payer: PHP Commercial |
$42.50
|
Rate for Payer: PHP Medicare Advantage |
$26.47
|
Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
Rate for Payer: Priority Health Cigna Priority Health |
$35.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.33
|
Rate for Payer: Priority Health Medicare |
$26.47
|
Rate for Payer: Priority Health Narrow Network |
$66.66
|
Rate for Payer: Priority Health SBD |
$31.50
|
Rate for Payer: Railroad Medicare Medicare |
$26.47
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$23.77
|
Rate for Payer: UHC Dual Complete DSNP |
$26.47
|
Rate for Payer: UHC Exchange |
$21.61
|
Rate for Payer: UHC Medicare Advantage |
$27.26
|
Rate for Payer: UMR Bronson Commercial |
$18.50
|
Rate for Payer: VA VA |
$26.47
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.50
|
|
HC NEEDLE LOC WIRE
|
Facility
|
IP
|
$52.02
|
|
Service Code
|
HCPCS C1819
|
Hospital Charge Code |
27200323
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$22.89 |
Max. Negotiated Rate |
$46.82 |
Rate for Payer: Aetna American Axle |
$33.81
|
Rate for Payer: Aetna Commercial |
$44.22
|
Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
Rate for Payer: Cash Price |
$41.62
|
Rate for Payer: Cofinity Commercial |
$36.41
|
Rate for Payer: Cofinity Commercial |
$44.74
|
Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
Rate for Payer: Healthscope Commercial |
$46.82
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.22
|
Rate for Payer: PHP Commercial |
$44.22
|
Rate for Payer: Priority Health Cigna Priority Health |
$36.41
|
Rate for Payer: Priority Health SBD |
$32.77
|
Rate for Payer: UMR Bronson Commercial |
$22.89
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|