|
HC DEVICE NOT RETURNED APNEALINK
|
Professional
|
Both
|
$845.00
|
|
|
Service Code
|
HCPCS 00602
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$338.00 |
| Max. Negotiated Rate |
$549.25 |
| Rate for Payer: Aetna Medicare |
$422.50
|
| Rate for Payer: BCBS Complete |
$338.00
|
| Rate for Payer: Cash Price |
$676.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$549.25
|
| Rate for Payer: UMR Bronson Commercial |
$388.70
|
|
|
HC DEVICE NOT RETURNED APNEALINK PLUS
|
Professional
|
Both
|
$1,579.00
|
|
|
Service Code
|
HCPCS 00603
|
| Hospital Charge Code |
27000603
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$631.60 |
| Max. Negotiated Rate |
$1,026.35 |
| Rate for Payer: Aetna Medicare |
$789.50
|
| Rate for Payer: BCBS Complete |
$631.60
|
| Rate for Payer: Cash Price |
$1,263.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,026.35
|
| Rate for Payer: UMR Bronson Commercial |
$726.34
|
|
|
HC DEVICE NOT RETURNED APNEALINK PLUS
|
Professional
|
Both
|
$1,579.00
|
|
|
Service Code
|
HCPCS 00603
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$631.60 |
| Max. Negotiated Rate |
$1,026.35 |
| Rate for Payer: Aetna Medicare |
$789.50
|
| Rate for Payer: BCBS Complete |
$631.60
|
| Rate for Payer: Cash Price |
$1,263.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,026.35
|
| Rate for Payer: UMR Bronson Commercial |
$726.34
|
|
|
HC DEVICE NOT RETURNED APNEALINK PLUS
|
Facility
|
OP
|
$1,548.00
|
|
| Hospital Charge Code |
27000603
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$572.76 |
| Max. Negotiated Rate |
$1,393.20 |
| Rate for Payer: Aetna American Axle |
$1,006.20
|
| Rate for Payer: Aetna Commercial |
$1,315.80
|
| Rate for Payer: Aetna Medicare |
$774.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,006.20
|
| Rate for Payer: BCBS Complete |
$619.20
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Cofinity Commercial |
$1,083.60
|
| Rate for Payer: Cofinity Commercial |
$1,331.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,083.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,238.40
|
| Rate for Payer: Healthscope Commercial |
$1,393.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,083.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,161.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,315.80
|
| Rate for Payer: PHP Commercial |
$1,315.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.20
|
| Rate for Payer: Priority Health SBD |
$975.24
|
| Rate for Payer: UMR Bronson Commercial |
$572.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,161.00
|
|
|
HC DEVICE NOT RETURNED APNEALINK PLUS
|
Facility
|
IP
|
$1,548.00
|
|
| Hospital Charge Code |
27000603
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$681.12 |
| Max. Negotiated Rate |
$1,393.20 |
| Rate for Payer: Aetna American Axle |
$1,006.20
|
| Rate for Payer: Aetna Commercial |
$1,315.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,006.20
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Cofinity Commercial |
$1,083.60
|
| Rate for Payer: Cofinity Commercial |
$1,331.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,083.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,238.40
|
| Rate for Payer: Healthscope Commercial |
$1,393.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,083.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,161.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,315.80
|
| Rate for Payer: PHP Commercial |
$1,315.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.20
|
| Rate for Payer: Priority Health SBD |
$975.24
|
| Rate for Payer: UMR Bronson Commercial |
$681.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,161.00
|
|
|
HC DEVICE NOT RETURNED CADD PUMP
|
Facility
|
OP
|
$3,723.00
|
|
| Hospital Charge Code |
27000642
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,377.51 |
| Max. Negotiated Rate |
$3,350.70 |
| Rate for Payer: Aetna American Axle |
$2,419.95
|
| Rate for Payer: Aetna Commercial |
$3,164.55
|
| Rate for Payer: Aetna Medicare |
$1,861.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,419.95
|
| Rate for Payer: BCBS Complete |
$1,489.20
|
| Rate for Payer: Cash Price |
$2,978.40
|
| Rate for Payer: Cofinity Commercial |
$2,606.10
|
| Rate for Payer: Cofinity Commercial |
$3,201.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,606.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,978.40
|
| Rate for Payer: Healthscope Commercial |
$3,350.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,606.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,792.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,164.55
|
| Rate for Payer: PHP Commercial |
$3,164.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,419.95
|
| Rate for Payer: Priority Health SBD |
$2,345.49
|
| Rate for Payer: UMR Bronson Commercial |
$1,377.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,792.25
|
|
|
HC DEVICE NOT RETURNED CADD PUMP
|
Facility
|
IP
|
$3,723.00
|
|
| Hospital Charge Code |
27000642
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,638.12 |
| Max. Negotiated Rate |
$3,350.70 |
| Rate for Payer: Aetna American Axle |
$2,419.95
|
| Rate for Payer: Aetna Commercial |
$3,164.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,419.95
|
| Rate for Payer: Cash Price |
$2,978.40
|
| Rate for Payer: Cofinity Commercial |
$2,606.10
|
| Rate for Payer: Cofinity Commercial |
$3,201.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,606.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,978.40
|
| Rate for Payer: Healthscope Commercial |
$3,350.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,606.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,792.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,164.55
|
| Rate for Payer: PHP Commercial |
$3,164.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,419.95
|
| Rate for Payer: Priority Health SBD |
$2,345.49
|
| Rate for Payer: UMR Bronson Commercial |
$1,638.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,792.25
|
|
|
HC DEVICE NOT RETURNED HOLTER MONITOR
|
Facility
|
IP
|
$652.00
|
|
| Hospital Charge Code |
27000705
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$286.88 |
| Max. Negotiated Rate |
$586.80 |
| Rate for Payer: Aetna American Axle |
$423.80
|
| Rate for Payer: Aetna Commercial |
$554.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$423.80
|
| Rate for Payer: Cash Price |
$521.60
|
| Rate for Payer: Cofinity Commercial |
$456.40
|
| Rate for Payer: Cofinity Commercial |
$560.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$456.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$521.60
|
| Rate for Payer: Healthscope Commercial |
$586.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$456.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$489.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$554.20
|
| Rate for Payer: PHP Commercial |
$554.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$423.80
|
| Rate for Payer: Priority Health SBD |
$410.76
|
| Rate for Payer: UMR Bronson Commercial |
$286.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$489.00
|
|
|
HC DEVICE NOT RETURNED HOLTER MONITOR
|
Facility
|
OP
|
$652.00
|
|
| Hospital Charge Code |
27000705
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$241.24 |
| Max. Negotiated Rate |
$586.80 |
| Rate for Payer: Aetna American Axle |
$423.80
|
| Rate for Payer: Aetna Commercial |
$554.20
|
| Rate for Payer: Aetna Medicare |
$326.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$423.80
|
| Rate for Payer: BCBS Complete |
$260.80
|
| Rate for Payer: Cash Price |
$521.60
|
| Rate for Payer: Cofinity Commercial |
$456.40
|
| Rate for Payer: Cofinity Commercial |
$560.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$456.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$521.60
|
| Rate for Payer: Healthscope Commercial |
$586.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$456.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$489.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$554.20
|
| Rate for Payer: PHP Commercial |
$554.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$423.80
|
| Rate for Payer: Priority Health SBD |
$410.76
|
| Rate for Payer: UMR Bronson Commercial |
$241.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$489.00
|
|
|
HC DEVICE NOT RETURNED RU SLEEPING
|
Facility
|
IP
|
$495.00
|
|
| Hospital Charge Code |
27000614
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$217.80 |
| Max. Negotiated Rate |
$445.50 |
| Rate for Payer: Aetna American Axle |
$321.75
|
| Rate for Payer: Aetna Commercial |
$420.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.75
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cofinity Commercial |
$346.50
|
| Rate for Payer: Cofinity Commercial |
$425.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$346.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.00
|
| Rate for Payer: Healthscope Commercial |
$445.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$346.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.75
|
| Rate for Payer: PHP Commercial |
$420.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.75
|
| Rate for Payer: Priority Health SBD |
$311.85
|
| Rate for Payer: UMR Bronson Commercial |
$217.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.25
|
|
|
HC DEVICE NOT RETURNED RU SLEEPING
|
Facility
|
OP
|
$495.00
|
|
| Hospital Charge Code |
27000614
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$183.15 |
| Max. Negotiated Rate |
$445.50 |
| Rate for Payer: Aetna American Axle |
$321.75
|
| Rate for Payer: Aetna Commercial |
$420.75
|
| Rate for Payer: Aetna Medicare |
$247.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.75
|
| Rate for Payer: BCBS Complete |
$198.00
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cofinity Commercial |
$346.50
|
| Rate for Payer: Cofinity Commercial |
$425.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$346.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.00
|
| Rate for Payer: Healthscope Commercial |
$445.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$346.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.75
|
| Rate for Payer: PHP Commercial |
$420.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.75
|
| Rate for Payer: Priority Health SBD |
$311.85
|
| Rate for Payer: UMR Bronson Commercial |
$183.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.25
|
|
|
HC DEVICE NOT RETURNED RU SLEEPING
|
Professional
|
Both
|
$505.00
|
|
|
Service Code
|
HCPCS 00614
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$202.00 |
| Max. Negotiated Rate |
$328.25 |
| Rate for Payer: Aetna Medicare |
$252.50
|
| Rate for Payer: BCBS Complete |
$202.00
|
| Rate for Payer: Cash Price |
$404.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$328.25
|
| Rate for Payer: UMR Bronson Commercial |
$232.30
|
|
|
HC DEVICE NOT RETURNED RU SLEEPING
|
Professional
|
Both
|
$505.00
|
|
|
Service Code
|
HCPCS 00614
|
| Hospital Charge Code |
27000614
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$202.00 |
| Max. Negotiated Rate |
$328.25 |
| Rate for Payer: Aetna Medicare |
$252.50
|
| Rate for Payer: BCBS Complete |
$202.00
|
| Rate for Payer: Cash Price |
$404.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$328.25
|
| Rate for Payer: UMR Bronson Commercial |
$232.30
|
|
|
HC DEVICE NOT RETURNED WATCHPAT
|
Professional
|
Both
|
$5,049.00
|
|
|
Service Code
|
HCPCS 00604
|
| Hospital Charge Code |
27000604
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2,019.60 |
| Max. Negotiated Rate |
$3,281.85 |
| Rate for Payer: Aetna Medicare |
$2,524.50
|
| Rate for Payer: BCBS Complete |
$2,019.60
|
| Rate for Payer: Cash Price |
$4,039.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,281.85
|
| Rate for Payer: UMR Bronson Commercial |
$2,322.54
|
|
|
HC DEVICE NOT RETURNED WATCHPAT
|
Facility
|
IP
|
$4,950.00
|
|
| Hospital Charge Code |
27000604
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2,178.00 |
| Max. Negotiated Rate |
$4,455.00 |
| Rate for Payer: Aetna American Axle |
$3,217.50
|
| Rate for Payer: Aetna Commercial |
$4,207.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,217.50
|
| Rate for Payer: Cash Price |
$3,960.00
|
| Rate for Payer: Cofinity Commercial |
$3,465.00
|
| Rate for Payer: Cofinity Commercial |
$4,257.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,465.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,960.00
|
| Rate for Payer: Healthscope Commercial |
$4,455.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,465.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,712.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,207.50
|
| Rate for Payer: PHP Commercial |
$4,207.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,217.50
|
| Rate for Payer: Priority Health SBD |
$3,118.50
|
| Rate for Payer: UMR Bronson Commercial |
$2,178.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,712.50
|
|
|
HC DEVICE NOT RETURNED WATCHPAT
|
Facility
|
OP
|
$4,950.00
|
|
| Hospital Charge Code |
27000604
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,831.50 |
| Max. Negotiated Rate |
$4,455.00 |
| Rate for Payer: Aetna American Axle |
$3,217.50
|
| Rate for Payer: Aetna Commercial |
$4,207.50
|
| Rate for Payer: Aetna Medicare |
$2,475.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,217.50
|
| Rate for Payer: BCBS Complete |
$1,980.00
|
| Rate for Payer: Cash Price |
$3,960.00
|
| Rate for Payer: Cofinity Commercial |
$3,465.00
|
| Rate for Payer: Cofinity Commercial |
$4,257.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,465.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,960.00
|
| Rate for Payer: Healthscope Commercial |
$4,455.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,465.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,712.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,207.50
|
| Rate for Payer: PHP Commercial |
$4,207.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,217.50
|
| Rate for Payer: Priority Health SBD |
$3,118.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,831.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,712.50
|
|
|
HC DEVICE NOT RETURNED WATCHPAT
|
Professional
|
Both
|
$5,049.00
|
|
|
Service Code
|
HCPCS 00604
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2,019.60 |
| Max. Negotiated Rate |
$3,281.85 |
| Rate for Payer: Aetna Medicare |
$2,524.50
|
| Rate for Payer: BCBS Complete |
$2,019.60
|
| Rate for Payer: Cash Price |
$4,039.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,281.85
|
| Rate for Payer: UMR Bronson Commercial |
$2,322.54
|
|
|
HC DEXA BONE DENSITY
|
Facility
|
IP
|
$541.62
|
|
|
Service Code
|
CPT 77080
|
| Hospital Charge Code |
32000260
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$238.31 |
| Max. Negotiated Rate |
$487.46 |
| Rate for Payer: Aetna American Axle |
$352.05
|
| Rate for Payer: Aetna Commercial |
$460.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.05
|
| Rate for Payer: Cash Price |
$433.30
|
| Rate for Payer: Cofinity Commercial |
$379.13
|
| Rate for Payer: Cofinity Commercial |
$465.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$379.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.30
|
| Rate for Payer: Healthscope Commercial |
$487.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$379.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$460.38
|
| Rate for Payer: PHP Commercial |
$460.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.05
|
| Rate for Payer: Priority Health SBD |
$341.22
|
| Rate for Payer: UMR Bronson Commercial |
$238.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.21
|
|
|
HC DEXA BONE DENSITY
|
Facility
|
OP
|
$541.62
|
|
|
Service Code
|
CPT 77080
|
| Hospital Charge Code |
32000260
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$487.46 |
| Rate for Payer: Aetna American Axle |
$352.05
|
| Rate for Payer: Aetna Commercial |
$460.38
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$433.30
|
| Rate for Payer: Cash Price |
$433.30
|
| Rate for Payer: Cofinity Commercial |
$465.79
|
| Rate for Payer: Cofinity Commercial |
$379.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$379.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$487.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$379.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.21
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$460.38
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$460.38
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.05
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$341.22
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$200.40
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.21
|
|
|
HC DEXA BONE DENSITY APPENDICULAR
|
Facility
|
OP
|
$204.23
|
|
|
Service Code
|
CPT 77081
|
| Hospital Charge Code |
32000261
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$262.00 |
| Rate for Payer: Aetna American Axle |
$132.75
|
| Rate for Payer: Aetna Commercial |
$173.60
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$163.38
|
| Rate for Payer: Cash Price |
$163.38
|
| Rate for Payer: Cofinity Commercial |
$175.64
|
| Rate for Payer: Cofinity Commercial |
$142.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$142.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$183.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$142.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.17
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.60
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$173.60
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.75
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$128.66
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$164.11
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: UMR Bronson Commercial |
$75.57
|
| Rate for Payer: VA VA |
$85.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.17
|
|
|
HC DEXA BONE DENSITY APPENDICULAR
|
Facility
|
IP
|
$204.23
|
|
|
Service Code
|
CPT 77081
|
| Hospital Charge Code |
32000261
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$89.86 |
| Max. Negotiated Rate |
$183.81 |
| Rate for Payer: Aetna American Axle |
$132.75
|
| Rate for Payer: Aetna Commercial |
$173.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.75
|
| Rate for Payer: Cash Price |
$163.38
|
| Rate for Payer: Cofinity Commercial |
$142.96
|
| Rate for Payer: Cofinity Commercial |
$175.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$142.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.38
|
| Rate for Payer: Healthscope Commercial |
$183.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$142.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.60
|
| Rate for Payer: PHP Commercial |
$173.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.75
|
| Rate for Payer: Priority Health SBD |
$128.66
|
| Rate for Payer: UMR Bronson Commercial |
$89.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.17
|
|
|
HC DEXAMETHASONE DEXA
|
Facility
|
OP
|
$150.43
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100751
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$135.39 |
| Rate for Payer: Aetna American Axle |
$97.78
|
| Rate for Payer: Aetna Commercial |
$127.87
|
| Rate for Payer: Aetna Medicare |
$19.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: BCBS Complete |
$10.49
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$120.34
|
| Rate for Payer: Cash Price |
$120.34
|
| Rate for Payer: Cofinity Commercial |
$129.37
|
| Rate for Payer: Cofinity Commercial |
$105.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$105.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$135.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.82
|
| Rate for Payer: Mclaren Medicaid |
$9.99
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: Meridian Medicaid |
$10.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.87
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$127.87
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.78
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health SBD |
$94.77
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.64
|
| Rate for Payer: UHC Exchange |
$35.62
|
| Rate for Payer: UHC Medicare Advantage |
$18.64
|
| Rate for Payer: UHCCP Medicaid |
$9.99
|
| Rate for Payer: UMR Bronson Commercial |
$55.66
|
| Rate for Payer: VA VA |
$18.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.82
|
|
|
HC DEXAMETHASONE DEXA
|
Facility
|
IP
|
$150.43
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100751
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$66.19 |
| Max. Negotiated Rate |
$135.39 |
| Rate for Payer: Aetna American Axle |
$97.78
|
| Rate for Payer: Aetna Commercial |
$127.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.78
|
| Rate for Payer: Cash Price |
$120.34
|
| Rate for Payer: Cofinity Commercial |
$105.30
|
| Rate for Payer: Cofinity Commercial |
$129.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$105.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.34
|
| Rate for Payer: Healthscope Commercial |
$135.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.87
|
| Rate for Payer: PHP Commercial |
$127.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.78
|
| Rate for Payer: Priority Health SBD |
$94.77
|
| Rate for Payer: UMR Bronson Commercial |
$66.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.82
|
|
|
HC DEXAMETHASONE SODIUM PHOS, PER 1 MG
|
Facility
|
IP
|
$10.40
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
63600138
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.58 |
| Max. Negotiated Rate |
$9.36 |
| Rate for Payer: Aetna American Axle |
$6.76
|
| Rate for Payer: Aetna Commercial |
$8.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.76
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cofinity Commercial |
$7.28
|
| Rate for Payer: Cofinity Commercial |
$8.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.32
|
| Rate for Payer: Healthscope Commercial |
$9.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.84
|
| Rate for Payer: PHP Commercial |
$8.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.76
|
| Rate for Payer: Priority Health SBD |
$6.55
|
| Rate for Payer: UMR Bronson Commercial |
$4.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.80
|
|
|
HC DEXAMETHASONE SODIUM PHOS, PER 1 MG
|
Facility
|
OP
|
$10.40
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
63600138
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$9.36 |
| Rate for Payer: Aetna American Axle |
$6.76
|
| Rate for Payer: Aetna Commercial |
$8.84
|
| Rate for Payer: Aetna Medicare |
$5.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.76
|
| Rate for Payer: BCBS Complete |
$4.16
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cofinity Commercial |
$7.28
|
| Rate for Payer: Cofinity Commercial |
$8.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.32
|
| Rate for Payer: Healthscope Commercial |
$9.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.84
|
| Rate for Payer: PHP Commercial |
$8.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.76
|
| Rate for Payer: Priority Health SBD |
$6.55
|
| Rate for Payer: UMR Bronson Commercial |
$3.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.80
|
|
