|
HC NIFOMETER
|
Facility
|
OP
|
$82.48
|
|
| Hospital Charge Code |
27000125
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.52 |
| Max. Negotiated Rate |
$74.23 |
| Rate for Payer: Aetna American Axle |
$53.61
|
| Rate for Payer: Aetna Commercial |
$70.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.61
|
| Rate for Payer: BCBS Complete |
$32.99
|
| Rate for Payer: Cash Price |
$65.98
|
| Rate for Payer: Cofinity Commercial |
$57.74
|
| Rate for Payer: Cofinity Commercial |
$70.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.98
|
| Rate for Payer: Healthscope Commercial |
$74.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.11
|
| Rate for Payer: PHP Commercial |
$70.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.74
|
| Rate for Payer: Priority Health SBD |
$51.96
|
| Rate for Payer: UMR Bronson Commercial |
$30.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.86
|
|
|
HC NITRIC OXIDE EXPIRED GAS DETERMINATION
|
Facility
|
OP
|
$49.14
|
|
|
Service Code
|
CPT 95012
|
| Hospital Charge Code |
46000031
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$18.18 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$31.94
|
| Rate for Payer: Aetna Commercial |
$41.77
|
| Rate for Payer: Aetna Medicare |
$37.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.56
|
| Rate for Payer: BCBS Complete |
$20.48
|
| Rate for Payer: BCBS MAPPO |
$35.65
|
| Rate for Payer: BCBS Trust/PPO |
$26.61
|
| Rate for Payer: BCN Medicare Advantage |
$35.65
|
| Rate for Payer: Cash Price |
$39.31
|
| Rate for Payer: Cash Price |
$39.31
|
| Rate for Payer: Cash Price |
$39.31
|
| Rate for Payer: Cofinity Commercial |
$42.26
|
| Rate for Payer: Cofinity Commercial |
$34.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.65
|
| Rate for Payer: Healthscope Commercial |
$44.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.86
|
| Rate for Payer: Mclaren Medicaid |
$19.50
|
| Rate for Payer: Mclaren Medicare |
$35.65
|
| Rate for Payer: Meridian Medicaid |
$20.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$37.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.77
|
| Rate for Payer: PACE Medicare |
$33.87
|
| Rate for Payer: PACE SWMI |
$35.65
|
| Rate for Payer: PHP Commercial |
$41.77
|
| Rate for Payer: PHP Medicare Advantage |
$35.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.22
|
| Rate for Payer: Priority Health Medicare |
$35.65
|
| Rate for Payer: Priority Health Narrow Network |
$89.78
|
| Rate for Payer: Priority Health SBD |
$30.96
|
| Rate for Payer: Railroad Medicare Medicare |
$35.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.53
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.65
|
| Rate for Payer: UHC Exchange |
$18.66
|
| Rate for Payer: UHC Medicare Advantage |
$36.72
|
| Rate for Payer: UMR Bronson Commercial |
$18.18
|
| Rate for Payer: VA VA |
$35.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.86
|
|
|
HC NITRIC OXIDE EXPIRED GAS DETERMINATION
|
Facility
|
IP
|
$49.14
|
|
|
Service Code
|
CPT 95012
|
| Hospital Charge Code |
46000031
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$21.62 |
| Max. Negotiated Rate |
$44.23 |
| Rate for Payer: Aetna American Axle |
$31.94
|
| Rate for Payer: Aetna Commercial |
$41.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.94
|
| Rate for Payer: Cash Price |
$39.31
|
| Rate for Payer: Cofinity Commercial |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$42.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.31
|
| Rate for Payer: Healthscope Commercial |
$44.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.77
|
| Rate for Payer: PHP Commercial |
$41.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.40
|
| Rate for Payer: Priority Health SBD |
$30.96
|
| Rate for Payer: UMR Bronson Commercial |
$21.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.86
|
|
|
HC NJX NONCMPND SCLEROSANT MULTIPLE INCMPTNT VEINS
|
Facility
|
OP
|
$4,800.00
|
|
|
Service Code
|
CPT 36466
|
| Hospital Charge Code |
76100402
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$145.71 |
| Max. Negotiated Rate |
$5,102.91 |
| Rate for Payer: Aetna American Axle |
$3,120.00
|
| Rate for Payer: Aetna Commercial |
$4,080.00
|
| Rate for Payer: Aetna Medicare |
$1,685.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,120.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,026.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,026.22
|
| Rate for Payer: BCBS Complete |
$931.09
|
| Rate for Payer: BCBS MAPPO |
$1,620.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,586.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,620.98
|
| Rate for Payer: Cash Price |
$3,840.00
|
| Rate for Payer: Cash Price |
$3,840.00
|
| Rate for Payer: Cofinity Commercial |
$4,128.00
|
| Rate for Payer: Cofinity Commercial |
$3,360.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,840.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,620.98
|
| Rate for Payer: Healthscope Commercial |
$4,320.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,360.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,600.00
|
| Rate for Payer: Mclaren Medicaid |
$886.68
|
| Rate for Payer: Mclaren Medicare |
$1,620.98
|
| Rate for Payer: Meridian Medicaid |
$931.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,702.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,864.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,080.00
|
| Rate for Payer: PACE Medicare |
$1,539.93
|
| Rate for Payer: PACE SWMI |
$1,620.98
|
| Rate for Payer: PHP Commercial |
$4,080.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,620.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,360.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,102.91
|
| Rate for Payer: Priority Health Medicare |
$1,620.98
|
| Rate for Payer: Priority Health Narrow Network |
$4,082.33
|
| Rate for Payer: Priority Health SBD |
$3,024.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,620.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,620.98
|
| Rate for Payer: UHC Exchange |
$145.71
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,776.00
|
| Rate for Payer: VA VA |
$1,620.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,600.00
|
|
|
HC NJX NONCMPND SCLEROSANT MULTIPLE INCMPTNT VEINS
|
Facility
|
IP
|
$4,800.00
|
|
|
Service Code
|
CPT 36466
|
| Hospital Charge Code |
76100402
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,112.00 |
| Max. Negotiated Rate |
$4,320.00 |
| Rate for Payer: Aetna American Axle |
$3,120.00
|
| Rate for Payer: Aetna Commercial |
$4,080.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,120.00
|
| Rate for Payer: Cash Price |
$3,840.00
|
| Rate for Payer: Cofinity Commercial |
$3,360.00
|
| Rate for Payer: Cofinity Commercial |
$4,128.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,840.00
|
| Rate for Payer: Healthscope Commercial |
$4,320.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,360.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,600.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,080.00
|
| Rate for Payer: PHP Commercial |
$4,080.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,360.00
|
| Rate for Payer: Priority Health SBD |
$3,024.00
|
| Rate for Payer: UMR Bronson Commercial |
$2,112.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,600.00
|
|
|
HC NM BONE MARROW LIMITED AREA
|
Facility
|
OP
|
$883.99
|
|
|
Service Code
|
CPT 78102
|
| Hospital Charge Code |
34100009
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$157.50 |
| Max. Negotiated Rate |
$1,154.12 |
| Rate for Payer: Aetna American Axle |
$574.59
|
| Rate for Payer: Aetna Commercial |
$751.39
|
| Rate for Payer: Aetna Medicare |
$381.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$574.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$261.00
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$707.19
|
| Rate for Payer: Cash Price |
$707.19
|
| Rate for Payer: Cofinity Commercial |
$760.23
|
| Rate for Payer: Cofinity Commercial |
$618.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$795.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$618.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$662.99
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$751.39
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$751.39
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.12
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$923.30
|
| Rate for Payer: Priority Health SBD |
$556.91
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.25
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.61
|
| Rate for Payer: UHC Exchange |
$157.50
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: UMR Bronson Commercial |
$327.08
|
| Rate for Payer: VA VA |
$366.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$662.99
|
|
|
HC NM BONE MARROW LIMITED AREA
|
Facility
|
IP
|
$883.99
|
|
|
Service Code
|
CPT 78102
|
| Hospital Charge Code |
34100009
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$388.96 |
| Max. Negotiated Rate |
$795.59 |
| Rate for Payer: Aetna American Axle |
$574.59
|
| Rate for Payer: Aetna Commercial |
$751.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$574.59
|
| Rate for Payer: Cash Price |
$707.19
|
| Rate for Payer: Cofinity Commercial |
$618.79
|
| Rate for Payer: Cofinity Commercial |
$760.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.19
|
| Rate for Payer: Healthscope Commercial |
$795.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$618.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$662.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$751.39
|
| Rate for Payer: PHP Commercial |
$751.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.79
|
| Rate for Payer: Priority Health SBD |
$556.91
|
| Rate for Payer: UMR Bronson Commercial |
$388.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$662.99
|
|
|
HC NM BONE MARROW MULTIPLE AREA
|
Facility
|
IP
|
$1,126.87
|
|
|
Service Code
|
CPT 78103
|
| Hospital Charge Code |
34100010
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$495.82 |
| Max. Negotiated Rate |
$1,014.18 |
| Rate for Payer: Aetna American Axle |
$732.47
|
| Rate for Payer: Aetna Commercial |
$957.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$732.47
|
| Rate for Payer: Cash Price |
$901.50
|
| Rate for Payer: Cofinity Commercial |
$788.81
|
| Rate for Payer: Cofinity Commercial |
$969.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$901.50
|
| Rate for Payer: Healthscope Commercial |
$1,014.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$788.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$845.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$957.84
|
| Rate for Payer: PHP Commercial |
$957.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.81
|
| Rate for Payer: Priority Health SBD |
$709.93
|
| Rate for Payer: UMR Bronson Commercial |
$495.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$845.15
|
|
|
HC NM BONE MARROW MULTIPLE AREA
|
Facility
|
OP
|
$1,126.87
|
|
|
Service Code
|
CPT 78103
|
| Hospital Charge Code |
34100010
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$167.98 |
| Max. Negotiated Rate |
$1,154.12 |
| Rate for Payer: Aetna American Axle |
$732.47
|
| Rate for Payer: Aetna Commercial |
$957.84
|
| Rate for Payer: Aetna Medicare |
$381.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$732.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$274.93
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$901.50
|
| Rate for Payer: Cash Price |
$901.50
|
| Rate for Payer: Cofinity Commercial |
$788.81
|
| Rate for Payer: Cofinity Commercial |
$969.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$901.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$1,014.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$788.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$845.15
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$957.84
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$957.84
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.12
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$923.30
|
| Rate for Payer: Priority Health SBD |
$709.93
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.78
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.61
|
| Rate for Payer: UHC Exchange |
$167.98
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: UMR Bronson Commercial |
$416.94
|
| Rate for Payer: VA VA |
$366.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$845.15
|
|
|
HC NM BONE MARROW WHOLE BODY
|
Facility
|
IP
|
$1,045.41
|
|
|
Service Code
|
CPT 78104
|
| Hospital Charge Code |
34100011
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$459.98 |
| Max. Negotiated Rate |
$940.87 |
| Rate for Payer: Aetna American Axle |
$679.52
|
| Rate for Payer: Aetna Commercial |
$888.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$679.52
|
| Rate for Payer: Cash Price |
$836.33
|
| Rate for Payer: Cofinity Commercial |
$731.79
|
| Rate for Payer: Cofinity Commercial |
$899.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$836.33
|
| Rate for Payer: Healthscope Commercial |
$940.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$731.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$784.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$888.60
|
| Rate for Payer: PHP Commercial |
$888.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.79
|
| Rate for Payer: Priority Health SBD |
$658.61
|
| Rate for Payer: UMR Bronson Commercial |
$459.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$784.06
|
|
|
HC NM BONE MARROW WHOLE BODY
|
Facility
|
OP
|
$1,045.41
|
|
|
Service Code
|
CPT 78104
|
| Hospital Charge Code |
34100011
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$1,154.12 |
| Rate for Payer: Aetna American Axle |
$679.52
|
| Rate for Payer: Aetna Commercial |
$888.60
|
| Rate for Payer: Aetna Medicare |
$381.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$679.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$375.02
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$836.33
|
| Rate for Payer: Cash Price |
$836.33
|
| Rate for Payer: Cofinity Commercial |
$731.79
|
| Rate for Payer: Cofinity Commercial |
$899.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$836.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$940.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$731.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$784.06
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$888.60
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$888.60
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.12
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$923.30
|
| Rate for Payer: Priority Health SBD |
$658.61
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.17
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.61
|
| Rate for Payer: UHC Exchange |
$225.61
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: UMR Bronson Commercial |
$386.80
|
| Rate for Payer: VA VA |
$366.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$784.06
|
|
|
HC NM BONE MULTIPLE AREAS
|
Facility
|
OP
|
$1,270.68
|
|
|
Service Code
|
CPT 78305
|
| Hospital Charge Code |
34100024
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$1,154.12 |
| Rate for Payer: Aetna American Axle |
$825.94
|
| Rate for Payer: Aetna Commercial |
$1,080.08
|
| Rate for Payer: Aetna Medicare |
$381.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$825.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$415.56
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$1,016.54
|
| Rate for Payer: Cash Price |
$1,016.54
|
| Rate for Payer: Cofinity Commercial |
$889.48
|
| Rate for Payer: Cofinity Commercial |
$1,092.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,016.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$1,143.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$889.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$953.01
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,080.08
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$1,080.08
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$889.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.12
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$923.30
|
| Rate for Payer: Priority Health SBD |
$800.53
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.42
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.61
|
| Rate for Payer: UHC Exchange |
$244.93
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: UMR Bronson Commercial |
$470.15
|
| Rate for Payer: VA VA |
$366.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$953.01
|
|
|
HC NM BONE MULTIPLE AREAS
|
Facility
|
IP
|
$1,270.68
|
|
|
Service Code
|
CPT 78305
|
| Hospital Charge Code |
34100024
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$559.10 |
| Max. Negotiated Rate |
$1,143.61 |
| Rate for Payer: Aetna American Axle |
$825.94
|
| Rate for Payer: Aetna Commercial |
$1,080.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$825.94
|
| Rate for Payer: Cash Price |
$1,016.54
|
| Rate for Payer: Cofinity Commercial |
$1,092.78
|
| Rate for Payer: Cofinity Commercial |
$889.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,016.54
|
| Rate for Payer: Healthscope Commercial |
$1,143.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$889.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$953.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,080.08
|
| Rate for Payer: PHP Commercial |
$1,080.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$889.48
|
| Rate for Payer: Priority Health SBD |
$800.53
|
| Rate for Payer: UMR Bronson Commercial |
$559.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$953.01
|
|
|
HC NM BONE SINGLE AREA
|
Facility
|
OP
|
$1,180.85
|
|
|
Service Code
|
CPT 78300
|
| Hospital Charge Code |
34100023
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$1,154.12 |
| Rate for Payer: Aetna American Axle |
$767.55
|
| Rate for Payer: Aetna Commercial |
$1,003.72
|
| Rate for Payer: Aetna Medicare |
$381.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$346.52
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$944.68
|
| Rate for Payer: Cash Price |
$944.68
|
| Rate for Payer: Cofinity Commercial |
$826.60
|
| Rate for Payer: Cofinity Commercial |
$1,015.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$944.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$1,062.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$826.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$885.64
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,003.72
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$1,003.72
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$826.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.12
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$923.30
|
| Rate for Payer: Priority Health SBD |
$743.94
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.31
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.61
|
| Rate for Payer: UHC Exchange |
$203.01
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: UMR Bronson Commercial |
$436.91
|
| Rate for Payer: VA VA |
$366.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$885.64
|
|
|
HC NM BONE SINGLE AREA
|
Facility
|
IP
|
$1,180.85
|
|
|
Service Code
|
CPT 78300
|
| Hospital Charge Code |
34100023
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$519.57 |
| Max. Negotiated Rate |
$1,062.76 |
| Rate for Payer: Aetna American Axle |
$767.55
|
| Rate for Payer: Aetna Commercial |
$1,003.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.55
|
| Rate for Payer: Cash Price |
$944.68
|
| Rate for Payer: Cofinity Commercial |
$826.60
|
| Rate for Payer: Cofinity Commercial |
$1,015.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$944.68
|
| Rate for Payer: Healthscope Commercial |
$1,062.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$826.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$885.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,003.72
|
| Rate for Payer: PHP Commercial |
$1,003.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$826.60
|
| Rate for Payer: Priority Health SBD |
$743.94
|
| Rate for Payer: UMR Bronson Commercial |
$519.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$885.64
|
|
|
HC NM BONE TOTAL BODY
|
Facility
|
OP
|
$1,731.32
|
|
|
Service Code
|
CPT 78306
|
| Hospital Charge Code |
34100025
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$1,558.19 |
| Rate for Payer: Aetna American Axle |
$1,125.36
|
| Rate for Payer: Aetna Commercial |
$1,471.62
|
| Rate for Payer: Aetna Medicare |
$381.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,125.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$447.24
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$1,385.06
|
| Rate for Payer: Cash Price |
$1,385.06
|
| Rate for Payer: Cofinity Commercial |
$1,211.92
|
| Rate for Payer: Cofinity Commercial |
$1,488.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,385.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$1,558.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,211.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,298.49
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,471.62
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$1,471.62
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,211.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.12
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$923.30
|
| Rate for Payer: Priority Health SBD |
$1,090.73
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.03
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.61
|
| Rate for Payer: UHC Exchange |
$264.57
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: UMR Bronson Commercial |
$640.59
|
| Rate for Payer: VA VA |
$366.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,298.49
|
|
|
HC NM BONE TOTAL BODY
|
Facility
|
IP
|
$1,731.32
|
|
|
Service Code
|
CPT 78306
|
| Hospital Charge Code |
34100025
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$761.78 |
| Max. Negotiated Rate |
$1,558.19 |
| Rate for Payer: Aetna American Axle |
$1,125.36
|
| Rate for Payer: Aetna Commercial |
$1,471.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,125.36
|
| Rate for Payer: Cash Price |
$1,385.06
|
| Rate for Payer: Cofinity Commercial |
$1,211.92
|
| Rate for Payer: Cofinity Commercial |
$1,488.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,385.06
|
| Rate for Payer: Healthscope Commercial |
$1,558.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,211.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,298.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,471.62
|
| Rate for Payer: PHP Commercial |
$1,471.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,211.92
|
| Rate for Payer: Priority Health SBD |
$1,090.73
|
| Rate for Payer: UMR Bronson Commercial |
$761.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,298.49
|
|
|
HC NM BONE W BLOOD FLOW 3 PHASE
|
Facility
|
OP
|
$1,701.22
|
|
|
Service Code
|
CPT 78315
|
| Hospital Charge Code |
34100026
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$1,531.10 |
| Rate for Payer: Aetna American Axle |
$1,105.79
|
| Rate for Payer: Aetna Commercial |
$1,446.04
|
| Rate for Payer: Aetna Medicare |
$381.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,105.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$522.63
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$1,360.98
|
| Rate for Payer: Cash Price |
$1,360.98
|
| Rate for Payer: Cofinity Commercial |
$1,463.05
|
| Rate for Payer: Cofinity Commercial |
$1,190.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,360.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$1,531.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,190.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,275.92
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,446.04
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$1,446.04
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,190.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.12
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$923.30
|
| Rate for Payer: Priority Health SBD |
$1,071.77
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.18
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.61
|
| Rate for Payer: UHC Exchange |
$311.07
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: UMR Bronson Commercial |
$629.45
|
| Rate for Payer: VA VA |
$366.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,275.92
|
|
|
HC NM BONE W BLOOD FLOW 3 PHASE
|
Facility
|
IP
|
$1,701.22
|
|
|
Service Code
|
CPT 78315
|
| Hospital Charge Code |
34100026
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$748.54 |
| Max. Negotiated Rate |
$1,531.10 |
| Rate for Payer: Aetna American Axle |
$1,105.79
|
| Rate for Payer: Aetna Commercial |
$1,446.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,105.79
|
| Rate for Payer: Cash Price |
$1,360.98
|
| Rate for Payer: Cofinity Commercial |
$1,190.85
|
| Rate for Payer: Cofinity Commercial |
$1,463.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,360.98
|
| Rate for Payer: Healthscope Commercial |
$1,531.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,190.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,275.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,446.04
|
| Rate for Payer: PHP Commercial |
$1,446.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,190.85
|
| Rate for Payer: Priority Health SBD |
$1,071.77
|
| Rate for Payer: UMR Bronson Commercial |
$748.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,275.92
|
|
|
HC NM BRAIN <4 STATC VIEW W VAS F
|
Facility
|
OP
|
$1,270.68
|
|
|
Service Code
|
CPT 78601
|
| Hospital Charge Code |
34100038
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$196.79 |
| Max. Negotiated Rate |
$1,154.12 |
| Rate for Payer: Aetna American Axle |
$825.94
|
| Rate for Payer: Aetna Commercial |
$1,080.08
|
| Rate for Payer: Aetna Medicare |
$381.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$825.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$340.18
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$1,016.54
|
| Rate for Payer: Cash Price |
$1,016.54
|
| Rate for Payer: Cofinity Commercial |
$889.48
|
| Rate for Payer: Cofinity Commercial |
$1,092.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,016.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$1,143.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$889.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$953.01
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,080.08
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$1,080.08
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$889.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.12
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$923.30
|
| Rate for Payer: Priority Health SBD |
$800.53
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.47
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.61
|
| Rate for Payer: UHC Exchange |
$196.79
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: UMR Bronson Commercial |
$470.15
|
| Rate for Payer: VA VA |
$366.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$953.01
|
|
|
HC NM BRAIN <4 STATC VIEW W VAS F
|
Facility
|
IP
|
$1,270.68
|
|
|
Service Code
|
CPT 78601
|
| Hospital Charge Code |
34100038
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$559.10 |
| Max. Negotiated Rate |
$1,143.61 |
| Rate for Payer: Aetna American Axle |
$825.94
|
| Rate for Payer: Aetna Commercial |
$1,080.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$825.94
|
| Rate for Payer: Cash Price |
$1,016.54
|
| Rate for Payer: Cofinity Commercial |
$1,092.78
|
| Rate for Payer: Cofinity Commercial |
$889.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,016.54
|
| Rate for Payer: Healthscope Commercial |
$1,143.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$889.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$953.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,080.08
|
| Rate for Payer: PHP Commercial |
$1,080.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$889.48
|
| Rate for Payer: Priority Health SBD |
$800.53
|
| Rate for Payer: UMR Bronson Commercial |
$559.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$953.01
|
|
|
HC NM BREAST IMAGING BILAT
|
Facility
|
IP
|
$1,160.25
|
|
|
Service Code
|
CPT 78800
|
| Hospital Charge Code |
34100053
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$510.51 |
| Max. Negotiated Rate |
$1,044.22 |
| Rate for Payer: Aetna American Axle |
$754.16
|
| Rate for Payer: Aetna Commercial |
$986.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$754.16
|
| Rate for Payer: Cash Price |
$928.20
|
| Rate for Payer: Cofinity Commercial |
$812.18
|
| Rate for Payer: Cofinity Commercial |
$997.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.20
|
| Rate for Payer: Healthscope Commercial |
$1,044.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$812.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$870.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$986.21
|
| Rate for Payer: PHP Commercial |
$986.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$812.18
|
| Rate for Payer: Priority Health SBD |
$730.96
|
| Rate for Payer: UMR Bronson Commercial |
$510.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$870.19
|
|
|
HC NM BREAST IMAGING BILAT
|
Facility
|
OP
|
$1,160.25
|
|
|
Service Code
|
CPT 78800
|
| Hospital Charge Code |
34100053
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$1,154.12 |
| Rate for Payer: Aetna American Axle |
$754.16
|
| Rate for Payer: Aetna Commercial |
$986.21
|
| Rate for Payer: Aetna Medicare |
$381.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$754.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$389.59
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$928.20
|
| Rate for Payer: Cash Price |
$928.20
|
| Rate for Payer: Cofinity Commercial |
$812.18
|
| Rate for Payer: Cofinity Commercial |
$997.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$1,044.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$812.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$870.19
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$986.21
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$986.21
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$812.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.12
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$923.30
|
| Rate for Payer: Priority Health SBD |
$730.96
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.05
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.61
|
| Rate for Payer: UHC Exchange |
$228.23
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: UMR Bronson Commercial |
$429.29
|
| Rate for Payer: VA VA |
$366.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$870.19
|
|
|
HC NM CARDIAC GATED WALL MUGA
|
Facility
|
OP
|
$1,300.78
|
|
|
Service Code
|
CPT 78472
|
| Hospital Charge Code |
34100030
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$1,170.70 |
| Rate for Payer: Aetna American Axle |
$845.51
|
| Rate for Payer: Aetna Commercial |
$1,105.66
|
| Rate for Payer: Aetna Medicare |
$381.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$845.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$318.01
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$1,040.62
|
| Rate for Payer: Cash Price |
$1,040.62
|
| Rate for Payer: Cofinity Commercial |
$1,118.67
|
| Rate for Payer: Cofinity Commercial |
$910.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,040.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$1,170.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$910.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$975.58
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,105.66
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$1,105.66
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$910.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.12
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$923.30
|
| Rate for Payer: Priority Health SBD |
$819.49
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.28
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.61
|
| Rate for Payer: UHC Exchange |
$206.62
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: UMR Bronson Commercial |
$481.29
|
| Rate for Payer: VA VA |
$366.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$975.58
|
|
|
HC NM CARDIAC GATED WALL MUGA
|
Facility
|
IP
|
$1,300.78
|
|
|
Service Code
|
CPT 78472
|
| Hospital Charge Code |
34100030
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$572.34 |
| Max. Negotiated Rate |
$1,170.70 |
| Rate for Payer: Aetna American Axle |
$845.51
|
| Rate for Payer: Aetna Commercial |
$1,105.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$845.51
|
| Rate for Payer: Cash Price |
$1,040.62
|
| Rate for Payer: Cofinity Commercial |
$910.55
|
| Rate for Payer: Cofinity Commercial |
$1,118.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,040.62
|
| Rate for Payer: Healthscope Commercial |
$1,170.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$910.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$975.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,105.66
|
| Rate for Payer: PHP Commercial |
$1,105.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$910.55
|
| Rate for Payer: Priority Health SBD |
$819.49
|
| Rate for Payer: UMR Bronson Commercial |
$572.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$975.58
|
|
