|
HC EMBOLIZATION URETER
|
Facility
|
IP
|
$428.76
|
|
|
Service Code
|
CPT 50705
|
| Hospital Charge Code |
36100511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$188.65 |
| Max. Negotiated Rate |
$385.88 |
| Rate for Payer: Aetna American Axle |
$278.69
|
| Rate for Payer: Aetna Commercial |
$364.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.69
|
| Rate for Payer: Cash Price |
$343.01
|
| Rate for Payer: Cofinity Commercial |
$300.13
|
| Rate for Payer: Cofinity Commercial |
$368.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$300.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.01
|
| Rate for Payer: Healthscope Commercial |
$385.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$300.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.45
|
| Rate for Payer: PHP Commercial |
$364.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.69
|
| Rate for Payer: Priority Health SBD |
$270.12
|
| Rate for Payer: UMR Bronson Commercial |
$188.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.57
|
|
|
HC EMBOLIZATION VENOUS OTHER THAN HEMORRHAGE
|
Facility
|
OP
|
$21,556.74
|
|
|
Service Code
|
CPT 37241
|
| Hospital Charge Code |
36100428
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,928.28 |
| Max. Negotiated Rate |
$31,133.44 |
| Rate for Payer: Aetna American Axle |
$14,011.88
|
| Rate for Payer: Aetna Commercial |
$18,323.23
|
| Rate for Payer: Aetna Medicare |
$11,502.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14,011.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,825.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,825.29
|
| Rate for Payer: BCBS Complete |
$6,224.70
|
| Rate for Payer: BCBS MAPPO |
$11,060.23
|
| Rate for Payer: BCN Medicare Advantage |
$11,060.23
|
| Rate for Payer: Cash Price |
$17,245.39
|
| Rate for Payer: Cash Price |
$17,245.39
|
| Rate for Payer: Cofinity Commercial |
$18,538.80
|
| Rate for Payer: Cofinity Commercial |
$15,089.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$15,089.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,245.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,060.23
|
| Rate for Payer: Healthscope Commercial |
$19,401.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15,089.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16,167.56
|
| Rate for Payer: Mclaren Medicaid |
$5,928.28
|
| Rate for Payer: Mclaren Medicare |
$11,060.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,613.24
|
| Rate for Payer: Meridian Medicaid |
$6,224.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,719.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,323.23
|
| Rate for Payer: PACE Medicare |
$10,507.22
|
| Rate for Payer: PACE SWMI |
$11,060.23
|
| Rate for Payer: PHP Commercial |
$18,323.23
|
| Rate for Payer: PHP Medicare Advantage |
$11,060.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,928.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,011.88
|
| Rate for Payer: Priority Health Medicare |
$11,060.23
|
| Rate for Payer: Priority Health SBD |
$13,580.75
|
| Rate for Payer: Railroad Medicare Medicare |
$11,060.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,133.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,060.23
|
| Rate for Payer: UHC Exchange |
$21,137.21
|
| Rate for Payer: UHC Medicare Advantage |
$11,060.23
|
| Rate for Payer: UHCCP Medicaid |
$5,928.28
|
| Rate for Payer: UMR Bronson Commercial |
$7,975.99
|
| Rate for Payer: VA VA |
$11,060.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16,167.56
|
|
|
HC EMBOLIZATION VENOUS OTHER THAN HEMORRHAGE
|
Facility
|
IP
|
$21,556.74
|
|
|
Service Code
|
CPT 37241
|
| Hospital Charge Code |
36100428
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,484.97 |
| Max. Negotiated Rate |
$19,401.07 |
| Rate for Payer: Aetna American Axle |
$14,011.88
|
| Rate for Payer: Aetna Commercial |
$18,323.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14,011.88
|
| Rate for Payer: Cash Price |
$17,245.39
|
| Rate for Payer: Cofinity Commercial |
$15,089.72
|
| Rate for Payer: Cofinity Commercial |
$18,538.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$15,089.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,245.39
|
| Rate for Payer: Healthscope Commercial |
$19,401.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15,089.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16,167.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,323.23
|
| Rate for Payer: PHP Commercial |
$18,323.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,011.88
|
| Rate for Payer: Priority Health SBD |
$13,580.75
|
| Rate for Payer: UMR Bronson Commercial |
$9,484.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16,167.56
|
|
|
HC EMBOSHIELD SYSTEM
|
Facility
|
IP
|
$5,902.41
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800010
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,597.06 |
| Max. Negotiated Rate |
$5,312.17 |
| Rate for Payer: Aetna American Axle |
$3,836.57
|
| Rate for Payer: Aetna Commercial |
$5,017.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,836.57
|
| Rate for Payer: Cash Price |
$4,721.93
|
| Rate for Payer: Cofinity Commercial |
$4,131.69
|
| Rate for Payer: Cofinity Commercial |
$5,076.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,131.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,721.93
|
| Rate for Payer: Healthscope Commercial |
$5,312.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,131.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,426.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,017.05
|
| Rate for Payer: PHP Commercial |
$5,017.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,836.57
|
| Rate for Payer: Priority Health SBD |
$3,718.52
|
| Rate for Payer: UMR Bronson Commercial |
$2,597.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,426.81
|
|
|
HC EMBOSHIELD SYSTEM
|
Facility
|
OP
|
$5,902.41
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800010
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,183.89 |
| Max. Negotiated Rate |
$5,312.17 |
| Rate for Payer: Aetna American Axle |
$3,836.57
|
| Rate for Payer: Aetna Commercial |
$5,017.05
|
| Rate for Payer: Aetna Medicare |
$2,951.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,836.57
|
| Rate for Payer: BCBS Complete |
$2,360.96
|
| Rate for Payer: Cash Price |
$4,721.93
|
| Rate for Payer: Cofinity Commercial |
$4,131.69
|
| Rate for Payer: Cofinity Commercial |
$5,076.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,131.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,721.93
|
| Rate for Payer: Healthscope Commercial |
$5,312.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,131.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,426.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,017.05
|
| Rate for Payer: PHP Commercial |
$5,017.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,836.57
|
| Rate for Payer: Priority Health SBD |
$3,718.52
|
| Rate for Payer: UMR Bronson Commercial |
$2,183.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,426.81
|
|
|
HC EMCU OBSERVATION PER HOUR
|
Facility
|
OP
|
$140.97
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200022
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$52.16 |
| Max. Negotiated Rate |
$4,092.00 |
| Rate for Payer: Aetna American Axle |
$91.63
|
| Rate for Payer: Aetna Commercial |
$119.82
|
| Rate for Payer: Aetna Medicare |
$70.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.63
|
| Rate for Payer: BCBS Complete |
$56.39
|
| Rate for Payer: Cash Price |
$112.78
|
| Rate for Payer: Cash Price |
$112.78
|
| Rate for Payer: Cofinity Commercial |
$98.68
|
| Rate for Payer: Cofinity Commercial |
$121.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$98.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.78
|
| Rate for Payer: Healthscope Commercial |
$126.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.73
|
| Rate for Payer: Meridian Medicaid |
$1,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.82
|
| Rate for Payer: PHP Commercial |
$119.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.63
|
| Rate for Payer: Priority Health SBD |
$88.81
|
| Rate for Payer: UHC Core |
$4,092.00
|
| Rate for Payer: UMR Bronson Commercial |
$52.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.73
|
|
|
HC EMCU OBSERVATION PER HOUR
|
Facility
|
IP
|
$140.97
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200022
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$62.03 |
| Max. Negotiated Rate |
$126.87 |
| Rate for Payer: Aetna American Axle |
$91.63
|
| Rate for Payer: Aetna Commercial |
$119.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.63
|
| Rate for Payer: Cash Price |
$112.78
|
| Rate for Payer: Cofinity Commercial |
$121.23
|
| Rate for Payer: Cofinity Commercial |
$98.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$98.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.78
|
| Rate for Payer: Healthscope Commercial |
$126.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.82
|
| Rate for Payer: PHP Commercial |
$119.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.63
|
| Rate for Payer: Priority Health SBD |
$88.81
|
| Rate for Payer: UMR Bronson Commercial |
$62.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.73
|
|
|
HC EMG ANAL SPHINCTER
|
Facility
|
OP
|
$351.04
|
|
|
Service Code
|
CPT 51785
|
| Hospital Charge Code |
92000002
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$127.14 |
| Max. Negotiated Rate |
$667.69 |
| Rate for Payer: Aetna American Axle |
$228.18
|
| Rate for Payer: Aetna Commercial |
$298.38
|
| Rate for Payer: Aetna Medicare |
$246.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.50
|
| Rate for Payer: BCBS Complete |
$133.50
|
| Rate for Payer: BCBS MAPPO |
$237.20
|
| Rate for Payer: BCN Medicare Advantage |
$237.20
|
| Rate for Payer: Cash Price |
$280.83
|
| Rate for Payer: Cash Price |
$280.83
|
| Rate for Payer: Cash Price |
$280.83
|
| Rate for Payer: Cofinity Commercial |
$245.73
|
| Rate for Payer: Cofinity Commercial |
$301.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$245.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.20
|
| Rate for Payer: Healthscope Commercial |
$315.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.28
|
| Rate for Payer: Mclaren Medicaid |
$127.14
|
| Rate for Payer: Mclaren Medicare |
$237.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.06
|
| Rate for Payer: Meridian Medicaid |
$133.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.38
|
| Rate for Payer: PACE Medicare |
$225.34
|
| Rate for Payer: PACE SWMI |
$237.20
|
| Rate for Payer: PHP Commercial |
$298.38
|
| Rate for Payer: PHP Medicare Advantage |
$237.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.18
|
| Rate for Payer: Priority Health Medicare |
$237.20
|
| Rate for Payer: Priority Health SBD |
$221.16
|
| Rate for Payer: Railroad Medicare Medicare |
$237.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$667.69
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.20
|
| Rate for Payer: UHC Exchange |
$453.31
|
| Rate for Payer: UHC Medicare Advantage |
$237.20
|
| Rate for Payer: UHCCP Medicaid |
$127.14
|
| Rate for Payer: UMR Bronson Commercial |
$129.88
|
| Rate for Payer: VA VA |
$237.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.28
|
|
|
HC EMG ANAL SPHINCTER
|
Facility
|
IP
|
$351.04
|
|
|
Service Code
|
CPT 51785
|
| Hospital Charge Code |
92000002
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$154.46 |
| Max. Negotiated Rate |
$315.94 |
| Rate for Payer: Aetna American Axle |
$228.18
|
| Rate for Payer: Aetna Commercial |
$298.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.18
|
| Rate for Payer: Cash Price |
$280.83
|
| Rate for Payer: Cofinity Commercial |
$245.73
|
| Rate for Payer: Cofinity Commercial |
$301.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$245.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.83
|
| Rate for Payer: Healthscope Commercial |
$315.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.38
|
| Rate for Payer: PHP Commercial |
$298.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.18
|
| Rate for Payer: Priority Health SBD |
$221.16
|
| Rate for Payer: UMR Bronson Commercial |
$154.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.28
|
|
|
HC EMG BLADDER
|
Facility
|
OP
|
$365.12
|
|
|
Service Code
|
CPT 51784
|
| Hospital Charge Code |
92000001
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$429.53 |
| Rate for Payer: Aetna American Axle |
$237.33
|
| Rate for Payer: Aetna Commercial |
$310.35
|
| Rate for Payer: Aetna Medicare |
$158.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$292.10
|
| Rate for Payer: Cash Price |
$292.10
|
| Rate for Payer: Cash Price |
$292.10
|
| Rate for Payer: Cofinity Commercial |
$255.58
|
| Rate for Payer: Cofinity Commercial |
$314.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$255.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$328.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$255.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.84
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.35
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$310.35
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.33
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health SBD |
$230.03
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.53
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$291.61
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$81.79
|
| Rate for Payer: UMR Bronson Commercial |
$135.09
|
| Rate for Payer: VA VA |
$152.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.84
|
|
|
HC EMG BLADDER
|
Facility
|
IP
|
$365.12
|
|
|
Service Code
|
CPT 51784
|
| Hospital Charge Code |
92000001
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$160.65 |
| Max. Negotiated Rate |
$328.61 |
| Rate for Payer: Aetna American Axle |
$237.33
|
| Rate for Payer: Aetna Commercial |
$310.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.33
|
| Rate for Payer: Cash Price |
$292.10
|
| Rate for Payer: Cofinity Commercial |
$255.58
|
| Rate for Payer: Cofinity Commercial |
$314.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$255.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.10
|
| Rate for Payer: Healthscope Commercial |
$328.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$255.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.35
|
| Rate for Payer: PHP Commercial |
$310.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.33
|
| Rate for Payer: Priority Health SBD |
$230.03
|
| Rate for Payer: UMR Bronson Commercial |
$160.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.84
|
|
|
HC EMG BLINK REFLEX
|
Facility
|
OP
|
$246.37
|
|
|
Service Code
|
CPT 95933
|
| Hospital Charge Code |
92200019
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Aetna American Axle |
$160.14
|
| Rate for Payer: Aetna Commercial |
$209.41
|
| Rate for Payer: Aetna Medicare |
$60.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.14
|
| 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 |
$197.10
|
| Rate for Payer: Cash Price |
$197.10
|
| Rate for Payer: Cash Price |
$197.10
|
| Rate for Payer: Cofinity Commercial |
$172.46
|
| Rate for Payer: Cofinity Commercial |
$211.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$172.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.93
|
| Rate for Payer: Healthscope Commercial |
$221.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$172.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$184.78
|
| 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 |
$209.41
|
| Rate for Payer: PACE Medicare |
$55.03
|
| Rate for Payer: PACE SWMI |
$57.93
|
| Rate for Payer: PHP Commercial |
$209.41
|
| 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 |
$160.14
|
| Rate for Payer: Priority Health Medicare |
$57.93
|
| Rate for Payer: Priority Health SBD |
$155.21
|
| Rate for Payer: Railroad Medicare Medicare |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.07
|
| Rate for Payer: UHC Core |
$522.00
|
| 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 |
$91.16
|
| Rate for Payer: VA VA |
$57.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$184.78
|
|
|
HC EMG BLINK REFLEX
|
Facility
|
IP
|
$246.37
|
|
|
Service Code
|
CPT 95933
|
| Hospital Charge Code |
92200019
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$108.40 |
| Max. Negotiated Rate |
$221.73 |
| Rate for Payer: Aetna American Axle |
$160.14
|
| Rate for Payer: Aetna Commercial |
$209.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.14
|
| Rate for Payer: Cash Price |
$197.10
|
| Rate for Payer: Cofinity Commercial |
$172.46
|
| Rate for Payer: Cofinity Commercial |
$211.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$172.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.10
|
| Rate for Payer: Healthscope Commercial |
$221.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$172.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$184.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.41
|
| Rate for Payer: PHP Commercial |
$209.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.14
|
| Rate for Payer: Priority Health SBD |
$155.21
|
| Rate for Payer: UMR Bronson Commercial |
$108.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$184.78
|
|
|
HC EMG CRANIAL CERV THOR LUMB PARASPINE NDL EXAM W NCS UNI
|
Facility
|
IP
|
$612.05
|
|
|
Service Code
|
CPT 95887
|
| Hospital Charge Code |
92200024
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$269.30 |
| Max. Negotiated Rate |
$550.85 |
| Rate for Payer: Aetna American Axle |
$397.83
|
| Rate for Payer: Aetna Commercial |
$520.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.83
|
| Rate for Payer: Cash Price |
$489.64
|
| Rate for Payer: Cofinity Commercial |
$428.44
|
| Rate for Payer: Cofinity Commercial |
$526.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$428.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.64
|
| Rate for Payer: Healthscope Commercial |
$550.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$428.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.24
|
| Rate for Payer: PHP Commercial |
$520.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.83
|
| Rate for Payer: Priority Health SBD |
$385.59
|
| Rate for Payer: UMR Bronson Commercial |
$269.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.04
|
|
|
HC EMG CRANIAL CERV THOR LUMB PARASPINE NDL EXAM W NCS UNI
|
Facility
|
OP
|
$612.05
|
|
|
Service Code
|
CPT 95887
|
| Hospital Charge Code |
92200024
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$226.46 |
| Max. Negotiated Rate |
$550.85 |
| Rate for Payer: Aetna American Axle |
$397.83
|
| Rate for Payer: Aetna Commercial |
$520.24
|
| Rate for Payer: Aetna Medicare |
$306.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.83
|
| Rate for Payer: BCBS Complete |
$244.82
|
| Rate for Payer: Cash Price |
$489.64
|
| Rate for Payer: Cash Price |
$489.64
|
| Rate for Payer: Cofinity Commercial |
$526.36
|
| Rate for Payer: Cofinity Commercial |
$428.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$428.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.64
|
| Rate for Payer: Healthscope Commercial |
$550.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$428.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.24
|
| Rate for Payer: PHP Commercial |
$520.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.83
|
| Rate for Payer: Priority Health SBD |
$385.59
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UMR Bronson Commercial |
$226.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.04
|
|
|
HC EMG NDL GUIDANCE NERVE DEST WITH CHEMODENERVATION
|
Facility
|
IP
|
$187.38
|
|
|
Service Code
|
CPT 95874
|
| Hospital Charge Code |
92200034
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$82.45 |
| Max. Negotiated Rate |
$168.64 |
| Rate for Payer: Aetna American Axle |
$121.80
|
| Rate for Payer: Aetna Commercial |
$159.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.80
|
| Rate for Payer: Cash Price |
$149.90
|
| Rate for Payer: Cofinity Commercial |
$131.17
|
| Rate for Payer: Cofinity Commercial |
$161.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$131.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.90
|
| Rate for Payer: Healthscope Commercial |
$168.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$131.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.27
|
| Rate for Payer: PHP Commercial |
$159.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.80
|
| Rate for Payer: Priority Health SBD |
$118.05
|
| Rate for Payer: UMR Bronson Commercial |
$82.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.53
|
|
|
HC EMG NDL GUIDANCE NERVE DEST WITH CHEMODENERVATION
|
Facility
|
OP
|
$187.38
|
|
|
Service Code
|
CPT 95874
|
| Hospital Charge Code |
92200034
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Aetna American Axle |
$121.80
|
| Rate for Payer: Aetna Commercial |
$159.27
|
| Rate for Payer: Aetna Medicare |
$93.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.80
|
| Rate for Payer: BCBS Complete |
$74.95
|
| Rate for Payer: Cash Price |
$149.90
|
| Rate for Payer: Cash Price |
$149.90
|
| Rate for Payer: Cofinity Commercial |
$161.15
|
| Rate for Payer: Cofinity Commercial |
$131.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$131.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.90
|
| Rate for Payer: Healthscope Commercial |
$168.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$131.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.27
|
| Rate for Payer: PHP Commercial |
$159.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.80
|
| Rate for Payer: Priority Health SBD |
$118.05
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UMR Bronson Commercial |
$69.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.53
|
|
|
HC EMG NEEDLE EXAM-1 EXT.
|
Facility
|
IP
|
$597.18
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
92200001
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$262.76 |
| Max. Negotiated Rate |
$537.46 |
| Rate for Payer: Aetna American Axle |
$388.17
|
| Rate for Payer: Aetna Commercial |
$507.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$388.17
|
| Rate for Payer: Cash Price |
$477.74
|
| Rate for Payer: Cofinity Commercial |
$418.03
|
| Rate for Payer: Cofinity Commercial |
$513.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$418.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.74
|
| Rate for Payer: Healthscope Commercial |
$537.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$418.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.60
|
| Rate for Payer: PHP Commercial |
$507.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.17
|
| Rate for Payer: Priority Health SBD |
$376.22
|
| Rate for Payer: UMR Bronson Commercial |
$262.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.88
|
|
|
HC EMG NEEDLE EXAM-1 EXT.
|
Facility
|
OP
|
$597.18
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
92200001
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$537.46 |
| Rate for Payer: Aetna American Axle |
$388.17
|
| Rate for Payer: Aetna Commercial |
$507.60
|
| Rate for Payer: Aetna Medicare |
$130.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$388.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$477.74
|
| Rate for Payer: Cash Price |
$477.74
|
| Rate for Payer: Cash Price |
$477.74
|
| Rate for Payer: Cofinity Commercial |
$418.03
|
| Rate for Payer: Cofinity Commercial |
$513.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$418.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$537.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$418.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.88
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.60
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$507.60
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.17
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health SBD |
$376.22
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.86
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$240.24
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: UMR Bronson Commercial |
$220.96
|
| Rate for Payer: VA VA |
$125.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.88
|
|
|
HC EMG NEEDLE EXAM 2 EXT
|
Facility
|
IP
|
$704.60
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
92200002
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$310.02 |
| Max. Negotiated Rate |
$634.14 |
| Rate for Payer: Aetna American Axle |
$457.99
|
| Rate for Payer: Aetna Commercial |
$598.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$457.99
|
| Rate for Payer: Cash Price |
$563.68
|
| Rate for Payer: Cofinity Commercial |
$493.22
|
| Rate for Payer: Cofinity Commercial |
$605.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.68
|
| Rate for Payer: Healthscope Commercial |
$634.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$493.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$528.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$598.91
|
| Rate for Payer: PHP Commercial |
$598.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$457.99
|
| Rate for Payer: Priority Health SBD |
$443.90
|
| Rate for Payer: UMR Bronson Commercial |
$310.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$528.45
|
|
|
HC EMG NEEDLE EXAM 2 EXT
|
Facility
|
OP
|
$704.60
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
92200002
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$634.14 |
| Rate for Payer: Aetna American Axle |
$457.99
|
| Rate for Payer: Aetna Commercial |
$598.91
|
| Rate for Payer: Aetna Medicare |
$130.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$457.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$563.68
|
| Rate for Payer: Cash Price |
$563.68
|
| Rate for Payer: Cash Price |
$563.68
|
| Rate for Payer: Cofinity Commercial |
$493.22
|
| Rate for Payer: Cofinity Commercial |
$605.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$634.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$493.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$528.45
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$598.91
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$598.91
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$457.99
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health SBD |
$443.90
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.86
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$240.24
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: UMR Bronson Commercial |
$260.70
|
| Rate for Payer: VA VA |
$125.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$528.45
|
|
|
HC EMG NEEDLE EXAM 3 EXT
|
Facility
|
IP
|
$651.13
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
92200003
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$286.50 |
| Max. Negotiated Rate |
$586.02 |
| Rate for Payer: Aetna American Axle |
$423.23
|
| Rate for Payer: Aetna Commercial |
$553.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$423.23
|
| Rate for Payer: Cash Price |
$520.90
|
| Rate for Payer: Cofinity Commercial |
$455.79
|
| Rate for Payer: Cofinity Commercial |
$559.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$455.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.90
|
| Rate for Payer: Healthscope Commercial |
$586.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$455.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$488.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$553.46
|
| Rate for Payer: PHP Commercial |
$553.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$423.23
|
| Rate for Payer: Priority Health SBD |
$410.21
|
| Rate for Payer: UMR Bronson Commercial |
$286.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$488.35
|
|
|
HC EMG NEEDLE EXAM 3 EXT
|
Facility
|
OP
|
$651.13
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
92200003
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$586.02 |
| Rate for Payer: Aetna American Axle |
$423.23
|
| Rate for Payer: Aetna Commercial |
$553.46
|
| Rate for Payer: Aetna Medicare |
$158.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$423.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$520.90
|
| Rate for Payer: Cash Price |
$520.90
|
| Rate for Payer: Cash Price |
$520.90
|
| Rate for Payer: Cofinity Commercial |
$455.79
|
| Rate for Payer: Cofinity Commercial |
$559.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$455.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$586.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$455.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$488.35
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$553.46
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$553.46
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$423.23
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health SBD |
$410.21
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.53
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$291.61
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$81.79
|
| Rate for Payer: UMR Bronson Commercial |
$240.92
|
| Rate for Payer: VA VA |
$152.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$488.35
|
|
|
HC EMG NEEDLE EXAM 4 EXT
|
Facility
|
IP
|
$816.54
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
92200004
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$359.28 |
| Max. Negotiated Rate |
$734.89 |
| Rate for Payer: Aetna American Axle |
$530.75
|
| Rate for Payer: Aetna Commercial |
$694.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.75
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$571.58
|
| Rate for Payer: Cofinity Commercial |
$702.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$571.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Healthscope Commercial |
$734.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$571.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$612.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: PHP Commercial |
$694.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health SBD |
$514.42
|
| Rate for Payer: UMR Bronson Commercial |
$359.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$612.40
|
|
|
HC EMG NEEDLE EXAM 4 EXT
|
Facility
|
OP
|
$816.54
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
92200004
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$734.89 |
| Rate for Payer: Aetna American Axle |
$530.75
|
| Rate for Payer: Aetna Commercial |
$694.06
|
| Rate for Payer: Aetna Medicare |
$158.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$571.58
|
| Rate for Payer: Cofinity Commercial |
$702.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$571.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$734.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$571.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$612.40
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$694.06
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health SBD |
$514.42
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.53
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$291.61
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$81.79
|
| Rate for Payer: UMR Bronson Commercial |
$302.12
|
| Rate for Payer: VA VA |
$152.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$612.40
|
|
