|
HC EBV ANTIBODY PANEL, S
|
Facility
|
OP
|
$37.02
|
|
|
Service Code
|
CPT 86664
|
| Hospital Charge Code |
30200507
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.20 |
| Max. Negotiated Rate |
$43.04 |
| Rate for Payer: Aetna American Axle |
$24.06
|
| Rate for Payer: Aetna Commercial |
$31.47
|
| Rate for Payer: Aetna Medicare |
$15.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.11
|
| Rate for Payer: BCBS Complete |
$8.61
|
| Rate for Payer: BCBS MAPPO |
$15.29
|
| Rate for Payer: BCN Medicare Advantage |
$15.29
|
| Rate for Payer: Cash Price |
$29.62
|
| Rate for Payer: Cash Price |
$29.62
|
| Rate for Payer: Cofinity Commercial |
$31.84
|
| Rate for Payer: Cofinity Commercial |
$25.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.29
|
| Rate for Payer: Healthscope Commercial |
$33.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.77
|
| Rate for Payer: Mclaren Medicaid |
$8.20
|
| Rate for Payer: Mclaren Medicare |
$15.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.05
|
| Rate for Payer: Meridian Medicaid |
$8.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.47
|
| Rate for Payer: PACE Medicare |
$14.53
|
| Rate for Payer: PACE SWMI |
$15.29
|
| Rate for Payer: PHP Commercial |
$31.47
|
| Rate for Payer: PHP Medicare Advantage |
$15.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.06
|
| Rate for Payer: Priority Health Medicare |
$15.29
|
| Rate for Payer: Priority Health SBD |
$23.32
|
| Rate for Payer: Railroad Medicare Medicare |
$15.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.29
|
| Rate for Payer: UHC Exchange |
$29.22
|
| Rate for Payer: UHC Medicare Advantage |
$15.29
|
| Rate for Payer: UHCCP Medicaid |
$8.20
|
| Rate for Payer: UMR Bronson Commercial |
$13.70
|
| Rate for Payer: VA VA |
$15.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.77
|
|
|
HC EBV HETEROPHILE AB
|
Facility
|
OP
|
$37.45
|
|
|
Service Code
|
CPT 86309
|
| Hospital Charge Code |
30000169
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Aetna American Axle |
$24.34
|
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$3.64
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Commercial |
$32.21
|
| Rate for Payer: Cofinity Commercial |
$26.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$33.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.09
|
| Rate for Payer: Mclaren Medicaid |
$3.47
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: Meridian Medicaid |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$31.83
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.34
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health SBD |
$23.59
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.47
|
| Rate for Payer: UHC Exchange |
$12.36
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$3.47
|
| Rate for Payer: UMR Bronson Commercial |
$13.86
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.09
|
|
|
HC EBV HETEROPHILE AB
|
Facility
|
IP
|
$37.45
|
|
|
Service Code
|
CPT 86309
|
| Hospital Charge Code |
30000169
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.48 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Aetna American Axle |
$24.34
|
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.34
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Commercial |
$26.21
|
| Rate for Payer: Cofinity Commercial |
$32.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Healthscope Commercial |
$33.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: PHP Commercial |
$31.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.34
|
| Rate for Payer: Priority Health SBD |
$23.59
|
| Rate for Payer: UMR Bronson Commercial |
$16.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.09
|
|
|
HC ECG 1-3 LEADS TRACING ONLY
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 93041
|
| Hospital Charge Code |
73000003
|
|
Hospital Revenue Code
|
730
|
| 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: Cofinity Medicare Advantage |
$36.41
|
| 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 Commercial |
$44.22
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| 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
|
|
|
HC ECG 1-3 LEADS TRACING ONLY
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 93041
|
| Hospital Charge Code |
73000003
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$19.25 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$60.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.41
|
| Rate for Payer: BCBS Complete |
$32.60
|
| Rate for Payer: BCBS MAPPO |
$57.93
|
| Rate for Payer: BCN Medicare Advantage |
$57.93
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.93
|
| 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: Mclaren Medicaid |
$31.05
|
| Rate for Payer: Mclaren Medicare |
$57.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.83
|
| Rate for Payer: Meridian Medicaid |
$32.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PACE Medicare |
$55.03
|
| Rate for Payer: PACE SWMI |
$57.93
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health Medicare |
$57.93
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: Railroad Medicare Medicare |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.07
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.93
|
| Rate for Payer: UHC Exchange |
$110.71
|
| Rate for Payer: UHC Medicare Advantage |
$57.93
|
| Rate for Payer: UHCCP Medicaid |
$31.05
|
| Rate for Payer: UMR Bronson Commercial |
$19.25
|
| Rate for Payer: VA VA |
$57.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC ECHO, 2D, DOPPLER, COLOR FLOW
|
Facility
|
OP
|
$2,008.38
|
|
|
Service Code
|
CPT 93306
|
| Hospital Charge Code |
48300001
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$286.63 |
| Max. Negotiated Rate |
$1,807.54 |
| Rate for Payer: Aetna American Axle |
$1,305.45
|
| Rate for Payer: Aetna Commercial |
$1,707.12
|
| Rate for Payer: Aetna Medicare |
$556.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,305.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$668.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$668.44
|
| Rate for Payer: BCBS Complete |
$300.96
|
| Rate for Payer: BCBS MAPPO |
$534.75
|
| Rate for Payer: BCN Medicare Advantage |
$534.75
|
| Rate for Payer: Cash Price |
$1,606.70
|
| Rate for Payer: Cash Price |
$1,606.70
|
| Rate for Payer: Cash Price |
$1,606.70
|
| Rate for Payer: Cofinity Commercial |
$1,405.87
|
| Rate for Payer: Cofinity Commercial |
$1,727.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,405.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,606.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$534.75
|
| Rate for Payer: Healthscope Commercial |
$1,807.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,405.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,506.29
|
| Rate for Payer: Mclaren Medicaid |
$286.63
|
| Rate for Payer: Mclaren Medicare |
$534.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$561.49
|
| Rate for Payer: Meridian Medicaid |
$300.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$614.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,707.12
|
| Rate for Payer: PACE Medicare |
$508.01
|
| Rate for Payer: PACE SWMI |
$534.75
|
| Rate for Payer: PHP Commercial |
$1,707.12
|
| Rate for Payer: PHP Medicare Advantage |
$534.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,305.45
|
| Rate for Payer: Priority Health Medicare |
$534.75
|
| Rate for Payer: Priority Health SBD |
$1,265.28
|
| Rate for Payer: Railroad Medicare Medicare |
$534.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,505.27
|
| Rate for Payer: UHC Core |
$816.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$534.75
|
| Rate for Payer: UHC Exchange |
$1,021.96
|
| Rate for Payer: UHC Medicare Advantage |
$534.75
|
| Rate for Payer: UHCCP Medicaid |
$286.63
|
| Rate for Payer: UMR Bronson Commercial |
$743.10
|
| Rate for Payer: VA VA |
$534.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,506.29
|
|
|
HC ECHO, 2D, DOPPLER, COLOR FLOW
|
Facility
|
IP
|
$2,008.38
|
|
|
Service Code
|
CPT 93306
|
| Hospital Charge Code |
48300001
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$883.69 |
| Max. Negotiated Rate |
$1,807.54 |
| Rate for Payer: Aetna American Axle |
$1,305.45
|
| Rate for Payer: Aetna Commercial |
$1,707.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,305.45
|
| Rate for Payer: Cash Price |
$1,606.70
|
| Rate for Payer: Cofinity Commercial |
$1,405.87
|
| Rate for Payer: Cofinity Commercial |
$1,727.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,405.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,606.70
|
| Rate for Payer: Healthscope Commercial |
$1,807.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,405.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,506.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,707.12
|
| Rate for Payer: PHP Commercial |
$1,707.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,305.45
|
| Rate for Payer: Priority Health SBD |
$1,265.28
|
| Rate for Payer: UMR Bronson Commercial |
$883.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,506.29
|
|
|
HC ECHO COMPLETE W/DEFINITY
|
Facility
|
IP
|
$2,008.38
|
|
|
Service Code
|
HCPCS C8929
|
| Hospital Charge Code |
48300003
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$883.69 |
| Max. Negotiated Rate |
$1,807.54 |
| Rate for Payer: Aetna American Axle |
$1,305.45
|
| Rate for Payer: Aetna Commercial |
$1,707.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,305.45
|
| Rate for Payer: Cash Price |
$1,606.70
|
| Rate for Payer: Cofinity Commercial |
$1,405.87
|
| Rate for Payer: Cofinity Commercial |
$1,727.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,405.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,606.70
|
| Rate for Payer: Healthscope Commercial |
$1,807.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,405.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,506.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,707.12
|
| Rate for Payer: PHP Commercial |
$1,707.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,305.45
|
| Rate for Payer: Priority Health SBD |
$1,265.28
|
| Rate for Payer: UMR Bronson Commercial |
$883.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,506.29
|
|
|
HC ECHO COMPLETE W/DEFINITY
|
Facility
|
OP
|
$2,008.38
|
|
|
Service Code
|
HCPCS C8929
|
| Hospital Charge Code |
48300003
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$413.00 |
| Max. Negotiated Rate |
$2,168.96 |
| Rate for Payer: Aetna American Axle |
$1,305.45
|
| Rate for Payer: Aetna Commercial |
$1,707.12
|
| Rate for Payer: Aetna Medicare |
$801.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,305.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$963.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$963.16
|
| Rate for Payer: BCBS Complete |
$433.65
|
| Rate for Payer: BCBS MAPPO |
$770.53
|
| Rate for Payer: BCN Medicare Advantage |
$770.53
|
| Rate for Payer: Cash Price |
$1,606.70
|
| Rate for Payer: Cash Price |
$1,606.70
|
| Rate for Payer: Cash Price |
$1,606.70
|
| Rate for Payer: Cofinity Commercial |
$1,405.87
|
| Rate for Payer: Cofinity Commercial |
$1,727.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,405.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,606.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$770.53
|
| Rate for Payer: Healthscope Commercial |
$1,807.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,405.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,506.29
|
| Rate for Payer: Mclaren Medicaid |
$413.00
|
| Rate for Payer: Mclaren Medicare |
$770.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.06
|
| Rate for Payer: Meridian Medicaid |
$433.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$886.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,707.12
|
| Rate for Payer: PACE Medicare |
$732.00
|
| Rate for Payer: PACE SWMI |
$770.53
|
| Rate for Payer: PHP Commercial |
$1,707.12
|
| Rate for Payer: PHP Medicare Advantage |
$770.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,305.45
|
| Rate for Payer: Priority Health Medicare |
$770.53
|
| Rate for Payer: Priority Health SBD |
$1,265.28
|
| Rate for Payer: Railroad Medicare Medicare |
$770.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,168.96
|
| Rate for Payer: UHC Core |
$816.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$770.53
|
| Rate for Payer: UHC Exchange |
$1,472.56
|
| Rate for Payer: UHC Medicare Advantage |
$770.53
|
| Rate for Payer: UHCCP Medicaid |
$413.00
|
| Rate for Payer: UMR Bronson Commercial |
$743.10
|
| Rate for Payer: VA VA |
$770.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,506.29
|
|
|
HC ECHO CONGENITAL
|
Facility
|
IP
|
$1,638.94
|
|
|
Service Code
|
CPT 93303
|
| Hospital Charge Code |
48000004
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$721.13 |
| Max. Negotiated Rate |
$1,475.05 |
| Rate for Payer: Aetna American Axle |
$1,065.31
|
| Rate for Payer: Aetna Commercial |
$1,393.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,065.31
|
| Rate for Payer: Cash Price |
$1,311.15
|
| Rate for Payer: Cofinity Commercial |
$1,147.26
|
| Rate for Payer: Cofinity Commercial |
$1,409.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,147.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,311.15
|
| Rate for Payer: Healthscope Commercial |
$1,475.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,147.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,229.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,393.10
|
| Rate for Payer: PHP Commercial |
$1,393.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,065.31
|
| Rate for Payer: Priority Health SBD |
$1,032.53
|
| Rate for Payer: UMR Bronson Commercial |
$721.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,229.20
|
|
|
HC ECHO CONGENITAL
|
Facility
|
OP
|
$1,638.94
|
|
|
Service Code
|
CPT 93303
|
| Hospital Charge Code |
48000004
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$286.63 |
| Max. Negotiated Rate |
$1,505.27 |
| Rate for Payer: Aetna American Axle |
$1,065.31
|
| Rate for Payer: Aetna Commercial |
$1,393.10
|
| Rate for Payer: Aetna Medicare |
$556.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,065.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$668.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$668.44
|
| Rate for Payer: BCBS Complete |
$300.96
|
| Rate for Payer: BCBS MAPPO |
$534.75
|
| Rate for Payer: BCN Medicare Advantage |
$534.75
|
| Rate for Payer: Cash Price |
$1,311.15
|
| Rate for Payer: Cash Price |
$1,311.15
|
| Rate for Payer: Cash Price |
$1,311.15
|
| Rate for Payer: Cofinity Commercial |
$1,147.26
|
| Rate for Payer: Cofinity Commercial |
$1,409.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,147.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,311.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$534.75
|
| Rate for Payer: Healthscope Commercial |
$1,475.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,147.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,229.20
|
| Rate for Payer: Mclaren Medicaid |
$286.63
|
| Rate for Payer: Mclaren Medicare |
$534.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$561.49
|
| Rate for Payer: Meridian Medicaid |
$300.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$614.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,393.10
|
| Rate for Payer: PACE Medicare |
$508.01
|
| Rate for Payer: PACE SWMI |
$534.75
|
| Rate for Payer: PHP Commercial |
$1,393.10
|
| Rate for Payer: PHP Medicare Advantage |
$534.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,065.31
|
| Rate for Payer: Priority Health Medicare |
$534.75
|
| Rate for Payer: Priority Health SBD |
$1,032.53
|
| Rate for Payer: Railroad Medicare Medicare |
$534.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,505.27
|
| Rate for Payer: UHC Core |
$816.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$534.75
|
| Rate for Payer: UHC Exchange |
$1,021.96
|
| Rate for Payer: UHC Medicare Advantage |
$534.75
|
| Rate for Payer: UHCCP Medicaid |
$286.63
|
| Rate for Payer: UMR Bronson Commercial |
$606.41
|
| Rate for Payer: VA VA |
$534.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,229.20
|
|
|
HC ECHO CONGENITAL LMTD
|
Facility
|
OP
|
$1,144.66
|
|
|
Service Code
|
CPT 93304
|
| Hospital Charge Code |
48000005
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$286.63 |
| Max. Negotiated Rate |
$1,505.27 |
| Rate for Payer: Aetna American Axle |
$744.03
|
| Rate for Payer: Aetna Commercial |
$972.96
|
| Rate for Payer: Aetna Medicare |
$556.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$744.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$668.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$668.44
|
| Rate for Payer: BCBS Complete |
$300.96
|
| Rate for Payer: BCBS MAPPO |
$534.75
|
| Rate for Payer: BCN Medicare Advantage |
$534.75
|
| Rate for Payer: Cash Price |
$915.73
|
| Rate for Payer: Cash Price |
$915.73
|
| Rate for Payer: Cash Price |
$915.73
|
| Rate for Payer: Cofinity Commercial |
$801.26
|
| Rate for Payer: Cofinity Commercial |
$984.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$801.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$915.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$534.75
|
| Rate for Payer: Healthscope Commercial |
$1,030.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$801.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.50
|
| Rate for Payer: Mclaren Medicaid |
$286.63
|
| Rate for Payer: Mclaren Medicare |
$534.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$561.49
|
| Rate for Payer: Meridian Medicaid |
$300.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$614.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$972.96
|
| Rate for Payer: PACE Medicare |
$508.01
|
| Rate for Payer: PACE SWMI |
$534.75
|
| Rate for Payer: PHP Commercial |
$972.96
|
| Rate for Payer: PHP Medicare Advantage |
$534.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.03
|
| Rate for Payer: Priority Health Medicare |
$534.75
|
| Rate for Payer: Priority Health SBD |
$721.14
|
| Rate for Payer: Railroad Medicare Medicare |
$534.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,505.27
|
| Rate for Payer: UHC Core |
$816.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$534.75
|
| Rate for Payer: UHC Exchange |
$1,021.96
|
| Rate for Payer: UHC Medicare Advantage |
$534.75
|
| Rate for Payer: UHCCP Medicaid |
$286.63
|
| Rate for Payer: UMR Bronson Commercial |
$423.52
|
| Rate for Payer: VA VA |
$534.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.50
|
|
|
HC ECHO CONGENITAL LMTD
|
Facility
|
IP
|
$1,144.66
|
|
|
Service Code
|
CPT 93304
|
| Hospital Charge Code |
48000005
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$503.65 |
| Max. Negotiated Rate |
$1,030.19 |
| Rate for Payer: Aetna American Axle |
$744.03
|
| Rate for Payer: Aetna Commercial |
$972.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$744.03
|
| Rate for Payer: Cash Price |
$915.73
|
| Rate for Payer: Cofinity Commercial |
$801.26
|
| Rate for Payer: Cofinity Commercial |
$984.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$801.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$915.73
|
| Rate for Payer: Healthscope Commercial |
$1,030.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$801.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$972.96
|
| Rate for Payer: PHP Commercial |
$972.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.03
|
| Rate for Payer: Priority Health SBD |
$721.14
|
| Rate for Payer: UMR Bronson Commercial |
$503.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.50
|
|
|
HC ECHO FETAL COMPLETE
|
Facility
|
OP
|
$966.85
|
|
|
Service Code
|
CPT 76825
|
| Hospital Charge Code |
40200030
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$286.63 |
| Max. Negotiated Rate |
$1,505.27 |
| Rate for Payer: Aetna American Axle |
$628.45
|
| Rate for Payer: Aetna Commercial |
$821.82
|
| Rate for Payer: Aetna Medicare |
$556.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$628.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$668.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$668.44
|
| Rate for Payer: BCBS Complete |
$300.96
|
| Rate for Payer: BCBS MAPPO |
$534.75
|
| Rate for Payer: BCN Medicare Advantage |
$534.75
|
| Rate for Payer: Cash Price |
$773.48
|
| Rate for Payer: Cash Price |
$773.48
|
| Rate for Payer: Cofinity Commercial |
$831.49
|
| Rate for Payer: Cofinity Commercial |
$676.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$676.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$773.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$534.75
|
| Rate for Payer: Healthscope Commercial |
$870.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$676.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$725.14
|
| Rate for Payer: Mclaren Medicaid |
$286.63
|
| Rate for Payer: Mclaren Medicare |
$534.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$561.49
|
| Rate for Payer: Meridian Medicaid |
$300.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$614.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$821.82
|
| Rate for Payer: PACE Medicare |
$508.01
|
| Rate for Payer: PACE SWMI |
$534.75
|
| Rate for Payer: PHP Commercial |
$821.82
|
| Rate for Payer: PHP Medicare Advantage |
$534.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$628.45
|
| Rate for Payer: Priority Health Medicare |
$534.75
|
| Rate for Payer: Priority Health SBD |
$609.12
|
| Rate for Payer: Railroad Medicare Medicare |
$534.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,505.27
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$534.75
|
| Rate for Payer: UHC Exchange |
$1,021.96
|
| Rate for Payer: UHC Medicare Advantage |
$534.75
|
| Rate for Payer: UHCCP Medicaid |
$286.63
|
| Rate for Payer: UMR Bronson Commercial |
$357.73
|
| Rate for Payer: VA VA |
$534.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$725.14
|
|
|
HC ECHO FETAL COMPLETE
|
Facility
|
IP
|
$966.85
|
|
|
Service Code
|
CPT 76825
|
| Hospital Charge Code |
40200030
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$425.41 |
| Max. Negotiated Rate |
$870.16 |
| Rate for Payer: Aetna American Axle |
$628.45
|
| Rate for Payer: Aetna Commercial |
$821.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$628.45
|
| Rate for Payer: Cash Price |
$773.48
|
| Rate for Payer: Cofinity Commercial |
$676.79
|
| Rate for Payer: Cofinity Commercial |
$831.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$676.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$773.48
|
| Rate for Payer: Healthscope Commercial |
$870.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$676.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$725.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$821.82
|
| Rate for Payer: PHP Commercial |
$821.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$628.45
|
| Rate for Payer: Priority Health SBD |
$609.12
|
| Rate for Payer: UMR Bronson Commercial |
$425.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$725.14
|
|
|
HC ECHO FETAL FOLLOWUP/REPEAT
|
Facility
|
IP
|
$736.60
|
|
|
Service Code
|
CPT 76826
|
| Hospital Charge Code |
40200077
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$324.10 |
| Max. Negotiated Rate |
$662.94 |
| Rate for Payer: Aetna American Axle |
$478.79
|
| Rate for Payer: Aetna Commercial |
$626.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$478.79
|
| Rate for Payer: Cash Price |
$589.28
|
| Rate for Payer: Cofinity Commercial |
$515.62
|
| Rate for Payer: Cofinity Commercial |
$633.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$515.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$589.28
|
| Rate for Payer: Healthscope Commercial |
$662.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$515.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$552.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$626.11
|
| Rate for Payer: PHP Commercial |
$626.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.79
|
| Rate for Payer: Priority Health SBD |
$464.06
|
| Rate for Payer: UMR Bronson Commercial |
$324.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$552.45
|
|
|
HC ECHO FETAL FOLLOWUP/REPEAT
|
Facility
|
OP
|
$736.60
|
|
|
Service Code
|
CPT 76826
|
| Hospital Charge Code |
40200077
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$663.58 |
| Rate for Payer: Aetna American Axle |
$478.79
|
| Rate for Payer: Aetna Commercial |
$626.11
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$478.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$589.28
|
| Rate for Payer: Cash Price |
$589.28
|
| Rate for Payer: Cofinity Commercial |
$633.48
|
| Rate for Payer: Cofinity Commercial |
$515.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$515.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$589.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$662.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$515.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$552.45
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$626.11
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$626.11
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.79
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$464.06
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$450.52
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: UMR Bronson Commercial |
$272.54
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$552.45
|
|
|
HC ECHO FETAL FOLLOW UP SPECTRAL
|
Facility
|
IP
|
$425.52
|
|
|
Service Code
|
CPT 76828
|
| Hospital Charge Code |
40200079
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$187.23 |
| Max. Negotiated Rate |
$382.97 |
| Rate for Payer: Aetna American Axle |
$276.59
|
| Rate for Payer: Aetna Commercial |
$361.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.59
|
| Rate for Payer: Cash Price |
$340.42
|
| Rate for Payer: Cofinity Commercial |
$297.86
|
| Rate for Payer: Cofinity Commercial |
$365.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$297.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$340.42
|
| Rate for Payer: Healthscope Commercial |
$382.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$297.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$319.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$361.69
|
| Rate for Payer: PHP Commercial |
$361.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.59
|
| Rate for Payer: Priority Health SBD |
$268.08
|
| Rate for Payer: UMR Bronson Commercial |
$187.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$319.14
|
|
|
HC ECHO FETAL FOLLOW UP SPECTRAL
|
Facility
|
OP
|
$425.52
|
|
|
Service Code
|
CPT 76828
|
| Hospital Charge Code |
40200079
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$382.97 |
| Rate for Payer: Aetna American Axle |
$276.59
|
| Rate for Payer: Aetna Commercial |
$361.69
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.59
|
| 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 |
$340.42
|
| Rate for Payer: Cash Price |
$340.42
|
| Rate for Payer: Cofinity Commercial |
$365.95
|
| Rate for Payer: Cofinity Commercial |
$297.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$297.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$340.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$382.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$297.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$319.14
|
| 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 |
$361.69
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$361.69
|
| 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 |
$276.59
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$268.08
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$367.00
|
| 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 |
$157.44
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$319.14
|
|
|
HC ECHO FETAL SPECTRAL
|
Facility
|
OP
|
$701.23
|
|
|
Service Code
|
CPT 76827
|
| Hospital Charge Code |
40200078
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$631.11 |
| Rate for Payer: Aetna American Axle |
$455.80
|
| Rate for Payer: Aetna Commercial |
$596.05
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.80
|
| 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 |
$560.98
|
| Rate for Payer: Cash Price |
$560.98
|
| Rate for Payer: Cofinity Commercial |
$603.06
|
| Rate for Payer: Cofinity Commercial |
$490.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$490.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$560.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$631.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$490.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$525.92
|
| 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 |
$596.05
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$596.05
|
| 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 |
$455.80
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$441.77
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$367.00
|
| 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 |
$259.46
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$525.92
|
|
|
HC ECHO FETAL SPECTRAL
|
Facility
|
IP
|
$701.23
|
|
|
Service Code
|
CPT 76827
|
| Hospital Charge Code |
40200078
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$308.54 |
| Max. Negotiated Rate |
$631.11 |
| Rate for Payer: Aetna American Axle |
$455.80
|
| Rate for Payer: Aetna Commercial |
$596.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.80
|
| Rate for Payer: Cash Price |
$560.98
|
| Rate for Payer: Cofinity Commercial |
$490.86
|
| Rate for Payer: Cofinity Commercial |
$603.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$490.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$560.98
|
| Rate for Payer: Healthscope Commercial |
$631.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$490.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$525.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$596.05
|
| Rate for Payer: PHP Commercial |
$596.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$455.80
|
| Rate for Payer: Priority Health SBD |
$441.77
|
| Rate for Payer: UMR Bronson Commercial |
$308.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$525.92
|
|
|
HC ECHO LIMITED W/DEFINITY
|
Facility
|
OP
|
$921.85
|
|
|
Service Code
|
HCPCS C8924
|
| Hospital Charge Code |
48300007
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$980.43 |
| Rate for Payer: Aetna American Axle |
$599.20
|
| Rate for Payer: Aetna Commercial |
$783.57
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$599.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$737.48
|
| Rate for Payer: Cash Price |
$737.48
|
| Rate for Payer: Cash Price |
$737.48
|
| Rate for Payer: Cofinity Commercial |
$645.29
|
| Rate for Payer: Cofinity Commercial |
$792.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$645.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$829.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$645.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$691.39
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.57
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$783.57
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.20
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$580.77
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$816.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$665.64
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: UMR Bronson Commercial |
$341.08
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$691.39
|
|
|
HC ECHO LIMITED W/DEFINITY
|
Facility
|
IP
|
$921.85
|
|
|
Service Code
|
HCPCS C8924
|
| Hospital Charge Code |
48300007
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$405.61 |
| Max. Negotiated Rate |
$829.66 |
| Rate for Payer: Aetna American Axle |
$599.20
|
| Rate for Payer: Aetna Commercial |
$783.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$599.20
|
| Rate for Payer: Cash Price |
$737.48
|
| Rate for Payer: Cofinity Commercial |
$645.29
|
| Rate for Payer: Cofinity Commercial |
$792.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$645.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.48
|
| Rate for Payer: Healthscope Commercial |
$829.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$645.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$691.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.57
|
| Rate for Payer: PHP Commercial |
$783.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.20
|
| Rate for Payer: Priority Health SBD |
$580.77
|
| Rate for Payer: UMR Bronson Commercial |
$405.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$691.39
|
|
|
HC ECHO/STRESS W DEFINITY.
|
Facility
|
OP
|
$1,488.15
|
|
|
Service Code
|
HCPCS C8928
|
| Hospital Charge Code |
48300008
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$413.00 |
| Max. Negotiated Rate |
$2,168.96 |
| Rate for Payer: Aetna American Axle |
$967.30
|
| Rate for Payer: Aetna Commercial |
$1,264.93
|
| Rate for Payer: Aetna Medicare |
$801.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$967.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$963.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$963.16
|
| Rate for Payer: BCBS Complete |
$433.65
|
| Rate for Payer: BCBS MAPPO |
$770.53
|
| Rate for Payer: BCN Medicare Advantage |
$770.53
|
| Rate for Payer: Cash Price |
$1,190.52
|
| Rate for Payer: Cash Price |
$1,190.52
|
| Rate for Payer: Cash Price |
$1,190.52
|
| Rate for Payer: Cofinity Commercial |
$1,041.70
|
| Rate for Payer: Cofinity Commercial |
$1,279.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,041.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,190.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$770.53
|
| Rate for Payer: Healthscope Commercial |
$1,339.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,041.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,116.11
|
| Rate for Payer: Mclaren Medicaid |
$413.00
|
| Rate for Payer: Mclaren Medicare |
$770.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.06
|
| Rate for Payer: Meridian Medicaid |
$433.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$886.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,264.93
|
| Rate for Payer: PACE Medicare |
$732.00
|
| Rate for Payer: PACE SWMI |
$770.53
|
| Rate for Payer: PHP Commercial |
$1,264.93
|
| Rate for Payer: PHP Medicare Advantage |
$770.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$967.30
|
| Rate for Payer: Priority Health Medicare |
$770.53
|
| Rate for Payer: Priority Health SBD |
$937.53
|
| Rate for Payer: Railroad Medicare Medicare |
$770.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,168.96
|
| Rate for Payer: UHC Core |
$816.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$770.53
|
| Rate for Payer: UHC Exchange |
$1,472.56
|
| Rate for Payer: UHC Medicare Advantage |
$770.53
|
| Rate for Payer: UHCCP Medicaid |
$413.00
|
| Rate for Payer: UMR Bronson Commercial |
$550.62
|
| Rate for Payer: VA VA |
$770.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,116.11
|
|
|
HC ECHO/STRESS W DEFINITY.
|
Facility
|
IP
|
$1,488.15
|
|
|
Service Code
|
HCPCS C8928
|
| Hospital Charge Code |
48300008
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$654.79 |
| Max. Negotiated Rate |
$1,339.34 |
| Rate for Payer: Aetna American Axle |
$967.30
|
| Rate for Payer: Aetna Commercial |
$1,264.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$967.30
|
| Rate for Payer: Cash Price |
$1,190.52
|
| Rate for Payer: Cofinity Commercial |
$1,041.70
|
| Rate for Payer: Cofinity Commercial |
$1,279.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,041.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,190.52
|
| Rate for Payer: Healthscope Commercial |
$1,339.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,041.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,116.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,264.93
|
| Rate for Payer: PHP Commercial |
$1,264.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$967.30
|
| Rate for Payer: Priority Health SBD |
$937.53
|
| Rate for Payer: UMR Bronson Commercial |
$654.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,116.11
|
|
