|
HC EPSTEIN BARR VIRUS BY PCR FLUID
|
Facility
|
OP
|
$121.73
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600171
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$109.56 |
| Rate for Payer: Aetna American Axle |
$79.12
|
| Rate for Payer: Aetna Commercial |
$103.47
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$97.38
|
| Rate for Payer: Cash Price |
$97.38
|
| Rate for Payer: Cofinity Commercial |
$85.21
|
| Rate for Payer: Cofinity Commercial |
$104.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$85.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$109.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.30
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.47
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$103.47
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.12
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$76.69
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$67.06
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$45.04
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.30
|
|
|
HC EPSTEIN BARR VIRUS PCR BLOOD
|
Facility
|
OP
|
$121.73
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600172
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.96 |
| Max. Negotiated Rate |
$120.59 |
| Rate for Payer: Aetna American Axle |
$79.12
|
| Rate for Payer: Aetna Commercial |
$103.47
|
| Rate for Payer: Aetna Medicare |
$44.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.55
|
| Rate for Payer: BCBS Complete |
$24.11
|
| Rate for Payer: BCBS MAPPO |
$42.84
|
| Rate for Payer: BCN Medicare Advantage |
$42.84
|
| Rate for Payer: Cash Price |
$97.38
|
| Rate for Payer: Cash Price |
$97.38
|
| Rate for Payer: Cofinity Commercial |
$85.21
|
| Rate for Payer: Cofinity Commercial |
$104.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$85.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.84
|
| Rate for Payer: Healthscope Commercial |
$109.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.30
|
| Rate for Payer: Mclaren Medicaid |
$22.96
|
| Rate for Payer: Mclaren Medicare |
$42.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.98
|
| Rate for Payer: Meridian Medicaid |
$24.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.47
|
| Rate for Payer: PACE Medicare |
$40.70
|
| Rate for Payer: PACE SWMI |
$42.84
|
| Rate for Payer: PHP Commercial |
$103.47
|
| Rate for Payer: PHP Medicare Advantage |
$42.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.12
|
| Rate for Payer: Priority Health Medicare |
$42.84
|
| Rate for Payer: Priority Health SBD |
$76.69
|
| Rate for Payer: Railroad Medicare Medicare |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.84
|
| Rate for Payer: UHC Exchange |
$81.87
|
| Rate for Payer: UHC Medicare Advantage |
$42.84
|
| Rate for Payer: UHCCP Medicaid |
$22.96
|
| Rate for Payer: UMR Bronson Commercial |
$45.04
|
| Rate for Payer: VA VA |
$42.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.30
|
|
|
HC EPSTEIN BARR VIRUS PCR BLOOD
|
Facility
|
IP
|
$121.73
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600172
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$53.56 |
| Max. Negotiated Rate |
$109.56 |
| Rate for Payer: Aetna American Axle |
$79.12
|
| Rate for Payer: Aetna Commercial |
$103.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.12
|
| Rate for Payer: Cash Price |
$97.38
|
| Rate for Payer: Cofinity Commercial |
$104.69
|
| Rate for Payer: Cofinity Commercial |
$85.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$85.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.38
|
| Rate for Payer: Healthscope Commercial |
$109.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.47
|
| Rate for Payer: PHP Commercial |
$103.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.12
|
| Rate for Payer: Priority Health SBD |
$76.69
|
| Rate for Payer: UMR Bronson Commercial |
$53.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.30
|
|
|
HC EP UPPER EXTREMITY SOMATOSENSO
|
Facility
|
OP
|
$1,120.29
|
|
|
Service Code
|
CPT 95925
|
| Hospital Charge Code |
92200014
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$162.78 |
| Max. Negotiated Rate |
$1,008.26 |
| Rate for Payer: Aetna American Axle |
$728.19
|
| Rate for Payer: Aetna Commercial |
$952.25
|
| Rate for Payer: Aetna Medicare |
$315.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$728.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.62
|
| Rate for Payer: BCBS Complete |
$170.92
|
| Rate for Payer: BCBS MAPPO |
$303.70
|
| Rate for Payer: BCN Medicare Advantage |
$303.70
|
| Rate for Payer: Cash Price |
$896.23
|
| Rate for Payer: Cash Price |
$896.23
|
| Rate for Payer: Cash Price |
$896.23
|
| Rate for Payer: Cofinity Commercial |
$784.20
|
| Rate for Payer: Cofinity Commercial |
$963.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$784.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$896.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.70
|
| Rate for Payer: Healthscope Commercial |
$1,008.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$784.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$840.22
|
| Rate for Payer: Mclaren Medicaid |
$162.78
|
| Rate for Payer: Mclaren Medicare |
$303.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.88
|
| Rate for Payer: Meridian Medicaid |
$170.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$952.25
|
| Rate for Payer: PACE Medicare |
$288.51
|
| Rate for Payer: PACE SWMI |
$303.70
|
| Rate for Payer: PHP Commercial |
$952.25
|
| Rate for Payer: PHP Medicare Advantage |
$303.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$728.19
|
| Rate for Payer: Priority Health Medicare |
$303.70
|
| Rate for Payer: Priority Health SBD |
$705.78
|
| Rate for Payer: Railroad Medicare Medicare |
$303.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.89
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.70
|
| Rate for Payer: UHC Exchange |
$580.40
|
| Rate for Payer: UHC Medicare Advantage |
$303.70
|
| Rate for Payer: UHCCP Medicaid |
$162.78
|
| Rate for Payer: UMR Bronson Commercial |
$414.51
|
| Rate for Payer: VA VA |
$303.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$840.22
|
|
|
HC EP UPPER EXTREMITY SOMATOSENSO
|
Facility
|
IP
|
$1,120.29
|
|
|
Service Code
|
CPT 95925
|
| Hospital Charge Code |
92200014
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$492.93 |
| Max. Negotiated Rate |
$1,008.26 |
| Rate for Payer: Aetna American Axle |
$728.19
|
| Rate for Payer: Aetna Commercial |
$952.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$728.19
|
| Rate for Payer: Cash Price |
$896.23
|
| Rate for Payer: Cofinity Commercial |
$784.20
|
| Rate for Payer: Cofinity Commercial |
$963.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$784.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$896.23
|
| Rate for Payer: Healthscope Commercial |
$1,008.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$784.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$840.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$952.25
|
| Rate for Payer: PHP Commercial |
$952.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$728.19
|
| Rate for Payer: Priority Health SBD |
$705.78
|
| Rate for Payer: UMR Bronson Commercial |
$492.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$840.22
|
|
|
HC EP UPPER/LOWER EXT. SOMATOSENSORY
|
Facility
|
OP
|
$2,506.92
|
|
|
Service Code
|
CPT 95938
|
| Hospital Charge Code |
92200025
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$277.37 |
| Max. Negotiated Rate |
$2,256.23 |
| Rate for Payer: Aetna American Axle |
$1,629.50
|
| Rate for Payer: Aetna Commercial |
$2,130.88
|
| Rate for Payer: Aetna Medicare |
$538.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,629.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$646.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$646.85
|
| Rate for Payer: BCBS Complete |
$291.24
|
| Rate for Payer: BCBS MAPPO |
$517.48
|
| Rate for Payer: BCN Medicare Advantage |
$517.48
|
| Rate for Payer: Cash Price |
$2,005.54
|
| Rate for Payer: Cash Price |
$2,005.54
|
| Rate for Payer: Cash Price |
$2,005.54
|
| Rate for Payer: Cofinity Commercial |
$1,754.84
|
| Rate for Payer: Cofinity Commercial |
$2,155.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,754.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,005.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.48
|
| Rate for Payer: Healthscope Commercial |
$2,256.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,754.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,880.19
|
| Rate for Payer: Mclaren Medicaid |
$277.37
|
| Rate for Payer: Mclaren Medicare |
$517.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$543.35
|
| Rate for Payer: Meridian Medicaid |
$291.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$595.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,130.88
|
| Rate for Payer: PACE Medicare |
$491.61
|
| Rate for Payer: PACE SWMI |
$517.48
|
| Rate for Payer: PHP Commercial |
$2,130.88
|
| Rate for Payer: PHP Medicare Advantage |
$517.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,629.50
|
| Rate for Payer: Priority Health Medicare |
$517.48
|
| Rate for Payer: Priority Health SBD |
$1,579.36
|
| Rate for Payer: Railroad Medicare Medicare |
$517.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,456.65
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$517.48
|
| Rate for Payer: UHC Exchange |
$988.96
|
| Rate for Payer: UHC Medicare Advantage |
$517.48
|
| Rate for Payer: UHCCP Medicaid |
$277.37
|
| Rate for Payer: UMR Bronson Commercial |
$927.56
|
| Rate for Payer: VA VA |
$517.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,880.19
|
|
|
HC EP UPPER/LOWER EXT. SOMATOSENSORY
|
Facility
|
IP
|
$2,506.92
|
|
|
Service Code
|
CPT 95938
|
| Hospital Charge Code |
92200025
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$1,103.04 |
| Max. Negotiated Rate |
$2,256.23 |
| Rate for Payer: Aetna American Axle |
$1,629.50
|
| Rate for Payer: Aetna Commercial |
$2,130.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,629.50
|
| Rate for Payer: Cash Price |
$2,005.54
|
| Rate for Payer: Cofinity Commercial |
$1,754.84
|
| Rate for Payer: Cofinity Commercial |
$2,155.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,754.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,005.54
|
| Rate for Payer: Healthscope Commercial |
$2,256.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,754.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,880.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,130.88
|
| Rate for Payer: PHP Commercial |
$2,130.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,629.50
|
| Rate for Payer: Priority Health SBD |
$1,579.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,103.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,880.19
|
|
|
HC EP VISUAL
|
Facility
|
IP
|
$785.92
|
|
|
Service Code
|
CPT 95930
|
| Hospital Charge Code |
92200018
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$345.80 |
| Max. Negotiated Rate |
$707.33 |
| Rate for Payer: Aetna American Axle |
$510.85
|
| Rate for Payer: Aetna Commercial |
$668.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$510.85
|
| Rate for Payer: Cash Price |
$628.74
|
| Rate for Payer: Cofinity Commercial |
$550.14
|
| Rate for Payer: Cofinity Commercial |
$675.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$550.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$628.74
|
| Rate for Payer: Healthscope Commercial |
$707.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$550.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$589.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$668.03
|
| Rate for Payer: PHP Commercial |
$668.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$510.85
|
| Rate for Payer: Priority Health SBD |
$495.13
|
| Rate for Payer: UMR Bronson Commercial |
$345.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$589.44
|
|
|
HC EP VISUAL
|
Facility
|
OP
|
$785.92
|
|
|
Service Code
|
CPT 95930
|
| Hospital Charge Code |
92200018
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$162.78 |
| Max. Negotiated Rate |
$854.89 |
| Rate for Payer: Aetna American Axle |
$510.85
|
| Rate for Payer: Aetna Commercial |
$668.03
|
| Rate for Payer: Aetna Medicare |
$315.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$510.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.62
|
| Rate for Payer: BCBS Complete |
$170.92
|
| Rate for Payer: BCBS MAPPO |
$303.70
|
| Rate for Payer: BCN Medicare Advantage |
$303.70
|
| Rate for Payer: Cash Price |
$628.74
|
| Rate for Payer: Cash Price |
$628.74
|
| Rate for Payer: Cash Price |
$628.74
|
| Rate for Payer: Cofinity Commercial |
$550.14
|
| Rate for Payer: Cofinity Commercial |
$675.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$550.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$628.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.70
|
| Rate for Payer: Healthscope Commercial |
$707.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$550.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$589.44
|
| Rate for Payer: Mclaren Medicaid |
$162.78
|
| Rate for Payer: Mclaren Medicare |
$303.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.88
|
| Rate for Payer: Meridian Medicaid |
$170.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$668.03
|
| Rate for Payer: PACE Medicare |
$288.51
|
| Rate for Payer: PACE SWMI |
$303.70
|
| Rate for Payer: PHP Commercial |
$668.03
|
| Rate for Payer: PHP Medicare Advantage |
$303.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$510.85
|
| Rate for Payer: Priority Health Medicare |
$303.70
|
| Rate for Payer: Priority Health SBD |
$495.13
|
| Rate for Payer: Railroad Medicare Medicare |
$303.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.89
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.70
|
| Rate for Payer: UHC Exchange |
$580.40
|
| Rate for Payer: UHC Medicare Advantage |
$303.70
|
| Rate for Payer: UHCCP Medicaid |
$162.78
|
| Rate for Payer: UMR Bronson Commercial |
$290.79
|
| Rate for Payer: VA VA |
$303.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$589.44
|
|
|
HC ERBE IRRIGATION
|
Facility
|
IP
|
$315.83
|
|
| Hospital Charge Code |
27000070
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$138.97 |
| Max. Negotiated Rate |
$284.25 |
| Rate for Payer: Aetna American Axle |
$205.29
|
| Rate for Payer: Aetna Commercial |
$268.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.29
|
| Rate for Payer: Cash Price |
$252.66
|
| Rate for Payer: Cofinity Commercial |
$221.08
|
| Rate for Payer: Cofinity Commercial |
$271.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$221.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.66
|
| Rate for Payer: Healthscope Commercial |
$284.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$221.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.46
|
| Rate for Payer: PHP Commercial |
$268.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.29
|
| Rate for Payer: Priority Health SBD |
$198.97
|
| Rate for Payer: UMR Bronson Commercial |
$138.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.87
|
|
|
HC ERBE IRRIGATION
|
Facility
|
OP
|
$315.83
|
|
| Hospital Charge Code |
27000070
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$116.86 |
| Max. Negotiated Rate |
$284.25 |
| Rate for Payer: Aetna American Axle |
$205.29
|
| Rate for Payer: Aetna Commercial |
$268.46
|
| Rate for Payer: Aetna Medicare |
$157.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.29
|
| Rate for Payer: BCBS Complete |
$126.33
|
| Rate for Payer: Cash Price |
$252.66
|
| Rate for Payer: Cofinity Commercial |
$221.08
|
| Rate for Payer: Cofinity Commercial |
$271.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$221.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.66
|
| Rate for Payer: Healthscope Commercial |
$284.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$221.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.46
|
| Rate for Payer: PHP Commercial |
$268.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.29
|
| Rate for Payer: Priority Health SBD |
$198.97
|
| Rate for Payer: UMR Bronson Commercial |
$116.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.87
|
|
|
HC ER BURN CARE
|
Facility
|
OP
|
$404.07
|
|
| Hospital Charge Code |
45000038
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$149.51 |
| Max. Negotiated Rate |
$363.66 |
| Rate for Payer: Aetna American Axle |
$262.65
|
| Rate for Payer: Aetna Commercial |
$343.46
|
| Rate for Payer: Aetna Medicare |
$202.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$262.65
|
| Rate for Payer: BCBS Complete |
$161.63
|
| Rate for Payer: Cash Price |
$323.26
|
| Rate for Payer: Cofinity Commercial |
$282.85
|
| Rate for Payer: Cofinity Commercial |
$347.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$282.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$323.26
|
| Rate for Payer: Healthscope Commercial |
$363.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$282.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$303.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$343.46
|
| Rate for Payer: PHP Commercial |
$343.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.65
|
| Rate for Payer: Priority Health SBD |
$254.56
|
| Rate for Payer: UMR Bronson Commercial |
$149.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$303.05
|
|
|
HC ER BURN CARE
|
Facility
|
IP
|
$404.07
|
|
| Hospital Charge Code |
45000038
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$177.79 |
| Max. Negotiated Rate |
$363.66 |
| Rate for Payer: Aetna American Axle |
$262.65
|
| Rate for Payer: Aetna Commercial |
$343.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$262.65
|
| Rate for Payer: Cash Price |
$323.26
|
| Rate for Payer: Cofinity Commercial |
$282.85
|
| Rate for Payer: Cofinity Commercial |
$347.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$282.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$323.26
|
| Rate for Payer: Healthscope Commercial |
$363.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$282.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$303.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$343.46
|
| Rate for Payer: PHP Commercial |
$343.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.65
|
| Rate for Payer: Priority Health SBD |
$254.56
|
| Rate for Payer: UMR Bronson Commercial |
$177.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$303.05
|
|
|
HC ERCP
|
Facility
|
IP
|
$3,396.96
|
|
| Hospital Charge Code |
36000039
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,494.66 |
| Max. Negotiated Rate |
$3,057.26 |
| Rate for Payer: Aetna American Axle |
$2,208.02
|
| Rate for Payer: Aetna Commercial |
$2,887.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,208.02
|
| Rate for Payer: Cash Price |
$2,717.57
|
| Rate for Payer: Cofinity Commercial |
$2,377.87
|
| Rate for Payer: Cofinity Commercial |
$2,921.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,377.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,717.57
|
| Rate for Payer: Healthscope Commercial |
$3,057.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,377.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,547.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,887.42
|
| Rate for Payer: PHP Commercial |
$2,887.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,208.02
|
| Rate for Payer: Priority Health SBD |
$2,140.08
|
| Rate for Payer: UMR Bronson Commercial |
$1,494.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,547.72
|
|
|
HC ERCP
|
Facility
|
OP
|
$3,396.96
|
|
| Hospital Charge Code |
36000039
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,256.88 |
| Max. Negotiated Rate |
$3,057.26 |
| Rate for Payer: Aetna American Axle |
$2,208.02
|
| Rate for Payer: Aetna Commercial |
$2,887.42
|
| Rate for Payer: Aetna Medicare |
$1,698.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,208.02
|
| Rate for Payer: BCBS Complete |
$1,358.78
|
| Rate for Payer: Cash Price |
$2,717.57
|
| Rate for Payer: Cofinity Commercial |
$2,377.87
|
| Rate for Payer: Cofinity Commercial |
$2,921.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,377.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,717.57
|
| Rate for Payer: Healthscope Commercial |
$3,057.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,377.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,547.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,887.42
|
| Rate for Payer: PHP Commercial |
$2,887.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,208.02
|
| Rate for Payer: Priority Health SBD |
$2,140.08
|
| Rate for Payer: UMR Bronson Commercial |
$1,256.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,547.72
|
|
|
HC ERCP SPHINCTEROTOMY
|
Facility
|
OP
|
$4,045.90
|
|
| Hospital Charge Code |
36000040
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,496.98 |
| Max. Negotiated Rate |
$3,641.31 |
| Rate for Payer: Aetna American Axle |
$2,629.84
|
| Rate for Payer: Aetna Commercial |
$3,439.01
|
| Rate for Payer: Aetna Medicare |
$2,022.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,629.84
|
| Rate for Payer: BCBS Complete |
$1,618.36
|
| Rate for Payer: Cash Price |
$3,236.72
|
| Rate for Payer: Cofinity Commercial |
$2,832.13
|
| Rate for Payer: Cofinity Commercial |
$3,479.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,832.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,236.72
|
| Rate for Payer: Healthscope Commercial |
$3,641.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,832.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,034.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,439.01
|
| Rate for Payer: PHP Commercial |
$3,439.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,629.84
|
| Rate for Payer: Priority Health SBD |
$2,548.92
|
| Rate for Payer: UMR Bronson Commercial |
$1,496.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,034.43
|
|
|
HC ERCP SPHINCTEROTOMY
|
Facility
|
IP
|
$4,045.90
|
|
| Hospital Charge Code |
36000040
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,780.20 |
| Max. Negotiated Rate |
$3,641.31 |
| Rate for Payer: Aetna American Axle |
$2,629.84
|
| Rate for Payer: Aetna Commercial |
$3,439.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,629.84
|
| Rate for Payer: Cash Price |
$3,236.72
|
| Rate for Payer: Cofinity Commercial |
$2,832.13
|
| Rate for Payer: Cofinity Commercial |
$3,479.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,832.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,236.72
|
| Rate for Payer: Healthscope Commercial |
$3,641.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,832.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,034.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,439.01
|
| Rate for Payer: PHP Commercial |
$3,439.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,629.84
|
| Rate for Payer: Priority Health SBD |
$2,548.92
|
| Rate for Payer: UMR Bronson Commercial |
$1,780.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,034.43
|
|
|
HC ER CRITICAL CARE EA ADDL 30 MIN
|
Facility
|
IP
|
$895.36
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
45000081
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$393.96 |
| Max. Negotiated Rate |
$805.82 |
| Rate for Payer: Aetna American Axle |
$581.98
|
| Rate for Payer: Aetna Commercial |
$761.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.98
|
| Rate for Payer: Cash Price |
$716.29
|
| Rate for Payer: Cofinity Commercial |
$626.75
|
| Rate for Payer: Cofinity Commercial |
$770.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$626.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$716.29
|
| Rate for Payer: Healthscope Commercial |
$805.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$626.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$671.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$761.06
|
| Rate for Payer: PHP Commercial |
$761.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$581.98
|
| Rate for Payer: Priority Health SBD |
$564.08
|
| Rate for Payer: UMR Bronson Commercial |
$393.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$671.52
|
|
|
HC ER CRITICAL CARE EA ADDL 30 MIN
|
Facility
|
OP
|
$895.36
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
45000081
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$331.28 |
| Max. Negotiated Rate |
$805.82 |
| Rate for Payer: Aetna American Axle |
$581.98
|
| Rate for Payer: Aetna Commercial |
$761.06
|
| Rate for Payer: Aetna Medicare |
$447.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.98
|
| Rate for Payer: BCBS Complete |
$358.14
|
| Rate for Payer: Cash Price |
$716.29
|
| Rate for Payer: Cofinity Commercial |
$626.75
|
| Rate for Payer: Cofinity Commercial |
$770.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$626.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$716.29
|
| Rate for Payer: Healthscope Commercial |
$805.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$626.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$671.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$761.06
|
| Rate for Payer: PHP Commercial |
$761.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$581.98
|
| Rate for Payer: Priority Health SBD |
$564.08
|
| Rate for Payer: UMR Bronson Commercial |
$331.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$671.52
|
|
|
HC ER CRITICAL CARE INITIAL 30-74 MIN
|
Facility
|
OP
|
$3,433.56
|
|
|
Service Code
|
CPT 99291
|
| Hospital Charge Code |
45000026
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$440.47 |
| Max. Negotiated Rate |
$3,090.20 |
| Rate for Payer: Aetna American Axle |
$2,231.81
|
| Rate for Payer: Aetna Commercial |
$2,918.53
|
| Rate for Payer: Aetna Medicare |
$854.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,231.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,027.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,027.22
|
| Rate for Payer: BCBS Complete |
$462.50
|
| Rate for Payer: BCBS MAPPO |
$821.78
|
| Rate for Payer: BCN Medicare Advantage |
$821.78
|
| Rate for Payer: Cash Price |
$2,746.85
|
| Rate for Payer: Cash Price |
$2,746.85
|
| Rate for Payer: Cash Price |
$2,746.85
|
| Rate for Payer: Cofinity Commercial |
$2,952.86
|
| Rate for Payer: Cofinity Commercial |
$2,403.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,403.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,746.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$821.78
|
| Rate for Payer: Healthscope Commercial |
$3,090.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,403.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,575.17
|
| Rate for Payer: Mclaren Medicaid |
$440.47
|
| Rate for Payer: Mclaren Medicare |
$821.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$862.87
|
| Rate for Payer: Meridian Medicaid |
$462.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$945.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,918.53
|
| Rate for Payer: PACE Medicare |
$780.69
|
| Rate for Payer: PACE SWMI |
$821.78
|
| Rate for Payer: PHP Commercial |
$2,918.53
|
| Rate for Payer: PHP Medicare Advantage |
$821.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,231.81
|
| Rate for Payer: Priority Health Medicare |
$821.78
|
| Rate for Payer: Priority Health SBD |
$2,163.14
|
| Rate for Payer: Railroad Medicare Medicare |
$821.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,313.23
|
| Rate for Payer: UHC Core |
$2,234.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$821.78
|
| Rate for Payer: UHC Exchange |
$1,570.50
|
| Rate for Payer: UHC Medicare Advantage |
$821.78
|
| Rate for Payer: UHCCP Medicaid |
$440.47
|
| Rate for Payer: UMR Bronson Commercial |
$1,270.42
|
| Rate for Payer: VA VA |
$821.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,575.17
|
|
|
HC ER CRITICAL CARE INITIAL 30-74 MIN
|
Facility
|
IP
|
$3,433.56
|
|
|
Service Code
|
CPT 99291
|
| Hospital Charge Code |
45000026
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,510.77 |
| Max. Negotiated Rate |
$3,090.20 |
| Rate for Payer: Aetna American Axle |
$2,231.81
|
| Rate for Payer: Aetna Commercial |
$2,918.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,231.81
|
| Rate for Payer: Cash Price |
$2,746.85
|
| Rate for Payer: Cofinity Commercial |
$2,403.49
|
| Rate for Payer: Cofinity Commercial |
$2,952.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,403.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,746.85
|
| Rate for Payer: Healthscope Commercial |
$3,090.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,403.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,575.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,918.53
|
| Rate for Payer: PHP Commercial |
$2,918.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,231.81
|
| Rate for Payer: Priority Health SBD |
$2,163.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,510.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,575.17
|
|
|
HC ER LEVEL FIVE 99285
|
Facility
|
OP
|
$2,047.66
|
|
|
Service Code
|
CPT 99285
|
| Hospital Charge Code |
45000025
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$320.50 |
| Max. Negotiated Rate |
$2,017.00 |
| Rate for Payer: Aetna American Axle |
$1,330.98
|
| Rate for Payer: Aetna Commercial |
$1,740.51
|
| Rate for Payer: Aetna Medicare |
$621.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,330.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$747.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$747.42
|
| Rate for Payer: BCBS Complete |
$336.52
|
| Rate for Payer: BCBS MAPPO |
$597.94
|
| Rate for Payer: BCN Medicare Advantage |
$597.94
|
| Rate for Payer: Cash Price |
$1,638.13
|
| Rate for Payer: Cash Price |
$1,638.13
|
| Rate for Payer: Cash Price |
$1,638.13
|
| Rate for Payer: Cofinity Commercial |
$1,760.99
|
| Rate for Payer: Cofinity Commercial |
$1,433.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,433.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,638.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.94
|
| Rate for Payer: Healthscope Commercial |
$1,842.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,433.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,535.74
|
| Rate for Payer: Mclaren Medicaid |
$320.50
|
| Rate for Payer: Mclaren Medicare |
$597.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$627.84
|
| Rate for Payer: Meridian Medicaid |
$336.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$687.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,740.51
|
| Rate for Payer: PACE Medicare |
$568.04
|
| Rate for Payer: PACE SWMI |
$597.94
|
| Rate for Payer: PHP Commercial |
$1,740.51
|
| Rate for Payer: PHP Medicare Advantage |
$597.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$320.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,330.98
|
| Rate for Payer: Priority Health Medicare |
$597.94
|
| Rate for Payer: Priority Health SBD |
$1,290.03
|
| Rate for Payer: Railroad Medicare Medicare |
$597.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,683.14
|
| Rate for Payer: UHC Core |
$2,017.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$597.94
|
| Rate for Payer: UHC Exchange |
$1,142.72
|
| Rate for Payer: UHC Medicare Advantage |
$597.94
|
| Rate for Payer: UHCCP Medicaid |
$320.50
|
| Rate for Payer: UMR Bronson Commercial |
$757.63
|
| Rate for Payer: VA VA |
$597.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,535.74
|
|
|
HC ER LEVEL FIVE 99285
|
Facility
|
IP
|
$2,047.66
|
|
|
Service Code
|
CPT 99285
|
| Hospital Charge Code |
45000025
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$900.97 |
| Max. Negotiated Rate |
$1,842.89 |
| Rate for Payer: Aetna American Axle |
$1,330.98
|
| Rate for Payer: Aetna Commercial |
$1,740.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,330.98
|
| Rate for Payer: Cash Price |
$1,638.13
|
| Rate for Payer: Cofinity Commercial |
$1,433.36
|
| Rate for Payer: Cofinity Commercial |
$1,760.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,433.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,638.13
|
| Rate for Payer: Healthscope Commercial |
$1,842.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,433.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,535.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,740.51
|
| Rate for Payer: PHP Commercial |
$1,740.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,330.98
|
| Rate for Payer: Priority Health SBD |
$1,290.03
|
| Rate for Payer: UMR Bronson Commercial |
$900.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,535.74
|
|
|
HC ER LEVEL FOUR 99284
|
Facility
|
OP
|
$1,419.01
|
|
|
Service Code
|
CPT 99284
|
| Hospital Charge Code |
45000024
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$222.60 |
| Max. Negotiated Rate |
$1,869.00 |
| Rate for Payer: Aetna American Axle |
$922.36
|
| Rate for Payer: Aetna Commercial |
$1,206.16
|
| Rate for Payer: Aetna Medicare |
$431.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$922.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$519.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$519.11
|
| Rate for Payer: BCBS Complete |
$233.73
|
| Rate for Payer: BCBS MAPPO |
$415.29
|
| Rate for Payer: BCN Medicare Advantage |
$415.29
|
| Rate for Payer: Cash Price |
$1,135.21
|
| Rate for Payer: Cash Price |
$1,135.21
|
| Rate for Payer: Cash Price |
$1,135.21
|
| Rate for Payer: Cofinity Commercial |
$993.31
|
| Rate for Payer: Cofinity Commercial |
$1,220.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$993.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,135.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$415.29
|
| Rate for Payer: Healthscope Commercial |
$1,277.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$993.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,064.26
|
| Rate for Payer: Mclaren Medicaid |
$222.60
|
| Rate for Payer: Mclaren Medicare |
$415.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$436.05
|
| Rate for Payer: Meridian Medicaid |
$233.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$477.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,206.16
|
| Rate for Payer: PACE Medicare |
$394.53
|
| Rate for Payer: PACE SWMI |
$415.29
|
| Rate for Payer: PHP Commercial |
$1,206.16
|
| Rate for Payer: PHP Medicare Advantage |
$415.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$922.36
|
| Rate for Payer: Priority Health Medicare |
$415.29
|
| Rate for Payer: Priority Health SBD |
$893.98
|
| Rate for Payer: Railroad Medicare Medicare |
$415.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,169.00
|
| Rate for Payer: UHC Core |
$1,869.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$415.29
|
| Rate for Payer: UHC Exchange |
$793.66
|
| Rate for Payer: UHC Medicare Advantage |
$415.29
|
| Rate for Payer: UHCCP Medicaid |
$222.60
|
| Rate for Payer: UMR Bronson Commercial |
$525.03
|
| Rate for Payer: VA VA |
$415.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,064.26
|
|
|
HC ER LEVEL FOUR 99284
|
Facility
|
IP
|
$1,419.01
|
|
|
Service Code
|
CPT 99284
|
| Hospital Charge Code |
45000024
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$624.36 |
| Max. Negotiated Rate |
$1,277.11 |
| Rate for Payer: Aetna American Axle |
$922.36
|
| Rate for Payer: Aetna Commercial |
$1,206.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$922.36
|
| Rate for Payer: Cash Price |
$1,135.21
|
| Rate for Payer: Cofinity Commercial |
$1,220.35
|
| Rate for Payer: Cofinity Commercial |
$993.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$993.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,135.21
|
| Rate for Payer: Healthscope Commercial |
$1,277.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$993.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,064.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,206.16
|
| Rate for Payer: PHP Commercial |
$1,206.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$922.36
|
| Rate for Payer: Priority Health SBD |
$893.98
|
| Rate for Payer: UMR Bronson Commercial |
$624.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,064.26
|
|
