|
HC PTCRAWDES VES/BRANCH
|
Facility
|
IP
|
$28,586.86
|
|
|
Service Code
|
CPT C9602
|
| Hospital Charge Code |
48100079
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$12,578.22 |
| Max. Negotiated Rate |
$25,728.17 |
| Rate for Payer: Aetna American Axle |
$18,581.46
|
| Rate for Payer: Aetna Commercial |
$24,298.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,581.46
|
| Rate for Payer: Cash Price |
$22,869.49
|
| Rate for Payer: Cofinity Commercial |
$24,584.70
|
| Rate for Payer: Cofinity Commercial |
$20,010.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,869.49
|
| Rate for Payer: Healthscope Commercial |
$25,728.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,010.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,440.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,298.83
|
| Rate for Payer: PHP Commercial |
$24,298.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,010.80
|
| Rate for Payer: Priority Health SBD |
$18,009.72
|
| Rate for Payer: UMR Bronson Commercial |
$12,578.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,440.14
|
|
|
HC PTCRAWPTCA ADD.BRANCH
|
Facility
|
OP
|
$11,706.18
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
48100097
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$832.00 |
| Max. Negotiated Rate |
$13,752.00 |
| Rate for Payer: Aetna American Axle |
$7,609.02
|
| Rate for Payer: Aetna Commercial |
$9,950.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,609.02
|
| Rate for Payer: BCBS Complete |
$4,682.47
|
| Rate for Payer: BCBS Trust/PPO |
$832.00
|
| Rate for Payer: Cash Price |
$9,364.94
|
| Rate for Payer: Cash Price |
$9,364.94
|
| Rate for Payer: Cofinity Commercial |
$8,194.33
|
| Rate for Payer: Cofinity Commercial |
$10,067.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,364.94
|
| Rate for Payer: Healthscope Commercial |
$10,535.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,194.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,779.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,950.25
|
| Rate for Payer: PHP Commercial |
$9,950.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,194.33
|
| Rate for Payer: Priority Health SBD |
$7,374.89
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UMR Bronson Commercial |
$4,331.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,779.64
|
|
|
HC PTCRAWPTCA ADD.BRANCH
|
Facility
|
IP
|
$11,706.18
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
48100097
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,150.72 |
| Max. Negotiated Rate |
$10,535.56 |
| Rate for Payer: Aetna American Axle |
$7,609.02
|
| Rate for Payer: Aetna Commercial |
$9,950.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,609.02
|
| Rate for Payer: Cash Price |
$9,364.94
|
| Rate for Payer: Cofinity Commercial |
$10,067.31
|
| Rate for Payer: Cofinity Commercial |
$8,194.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,364.94
|
| Rate for Payer: Healthscope Commercial |
$10,535.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,194.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,779.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,950.25
|
| Rate for Payer: PHP Commercial |
$9,950.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,194.33
|
| Rate for Payer: Priority Health SBD |
$7,374.89
|
| Rate for Payer: UMR Bronson Commercial |
$5,150.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,779.64
|
|
|
HC PTCRAWPTCA VES/BRANCH
|
Facility
|
IP
|
$15,389.41
|
|
|
Service Code
|
CPT 92924
|
| Hospital Charge Code |
48100096
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,771.34 |
| Max. Negotiated Rate |
$13,850.47 |
| Rate for Payer: Aetna American Axle |
$10,003.12
|
| Rate for Payer: Aetna Commercial |
$13,081.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,003.12
|
| Rate for Payer: Cash Price |
$12,311.53
|
| Rate for Payer: Cofinity Commercial |
$10,772.59
|
| Rate for Payer: Cofinity Commercial |
$13,234.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,311.53
|
| Rate for Payer: Healthscope Commercial |
$13,850.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,772.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,542.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13,081.00
|
| Rate for Payer: PHP Commercial |
$13,081.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,772.59
|
| Rate for Payer: Priority Health SBD |
$9,695.33
|
| Rate for Payer: UMR Bronson Commercial |
$6,771.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,542.06
|
|
|
HC PTCRAWPTCA VES/BRANCH
|
Facility
|
OP
|
$15,389.41
|
|
|
Service Code
|
CPT 92924
|
| Hospital Charge Code |
48100096
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$603.48 |
| Max. Negotiated Rate |
$30,783.77 |
| Rate for Payer: Aetna American Axle |
$10,003.12
|
| Rate for Payer: Aetna Commercial |
$13,081.00
|
| Rate for Payer: Aetna Medicare |
$10,169.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,003.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,223.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,223.36
|
| Rate for Payer: BCBS Complete |
$5,616.88
|
| Rate for Payer: BCBS MAPPO |
$9,778.69
|
| Rate for Payer: BCBS Trust/PPO |
$675.25
|
| Rate for Payer: BCN Medicare Advantage |
$9,778.69
|
| Rate for Payer: Cash Price |
$12,311.53
|
| Rate for Payer: Cash Price |
$12,311.53
|
| Rate for Payer: Cofinity Commercial |
$10,772.59
|
| Rate for Payer: Cofinity Commercial |
$13,234.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,311.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,778.69
|
| Rate for Payer: Healthscope Commercial |
$13,850.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,772.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,542.06
|
| Rate for Payer: Mclaren Medicaid |
$5,348.94
|
| Rate for Payer: Mclaren Medicare |
$9,778.69
|
| Rate for Payer: Meridian Medicaid |
$5,616.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,267.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,245.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13,081.00
|
| Rate for Payer: PACE Medicare |
$9,289.76
|
| Rate for Payer: PACE SWMI |
$9,778.69
|
| Rate for Payer: PHP Commercial |
$13,081.00
|
| Rate for Payer: PHP Medicare Advantage |
$9,778.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,348.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,772.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30,783.77
|
| Rate for Payer: Priority Health Medicare |
$9,778.69
|
| Rate for Payer: Priority Health Narrow Network |
$24,627.02
|
| Rate for Payer: Priority Health SBD |
$9,695.33
|
| Rate for Payer: Railroad Medicare Medicare |
$9,778.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.83
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,778.69
|
| Rate for Payer: UHC Exchange |
$603.48
|
| Rate for Payer: UHC Medicare Advantage |
$10,072.05
|
| Rate for Payer: UMR Bronson Commercial |
$5,694.08
|
| Rate for Payer: VA VA |
$9,778.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,542.06
|
|
|
HC PTCRAWSTENT ADD.BRANCH
|
Facility
|
OP
|
$18,727.35
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
48100078
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$870.00 |
| Max. Negotiated Rate |
$16,854.62 |
| Rate for Payer: Aetna American Axle |
$12,172.78
|
| Rate for Payer: Aetna Commercial |
$15,918.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,172.78
|
| Rate for Payer: BCBS Complete |
$7,490.94
|
| Rate for Payer: BCBS Trust/PPO |
$870.00
|
| Rate for Payer: Cash Price |
$14,981.88
|
| Rate for Payer: Cash Price |
$14,981.88
|
| Rate for Payer: Cofinity Commercial |
$16,105.52
|
| Rate for Payer: Cofinity Commercial |
$13,109.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,981.88
|
| Rate for Payer: Healthscope Commercial |
$16,854.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,109.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,045.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,918.25
|
| Rate for Payer: PHP Commercial |
$15,918.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,109.14
|
| Rate for Payer: Priority Health SBD |
$11,798.23
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UMR Bronson Commercial |
$6,929.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,045.51
|
|
|
HC PTCRAWSTENT ADD.BRANCH
|
Facility
|
IP
|
$18,727.35
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
48100078
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,240.03 |
| Max. Negotiated Rate |
$16,854.62 |
| Rate for Payer: Aetna American Axle |
$12,172.78
|
| Rate for Payer: Aetna Commercial |
$15,918.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,172.78
|
| Rate for Payer: Cash Price |
$14,981.88
|
| Rate for Payer: Cofinity Commercial |
$16,105.52
|
| Rate for Payer: Cofinity Commercial |
$13,109.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,981.88
|
| Rate for Payer: Healthscope Commercial |
$16,854.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,109.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,045.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,918.25
|
| Rate for Payer: PHP Commercial |
$15,918.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,109.14
|
| Rate for Payer: Priority Health SBD |
$11,798.23
|
| Rate for Payer: UMR Bronson Commercial |
$8,240.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,045.51
|
|
|
HC PTCRAWSTENT VES/BRANCH
|
Facility
|
IP
|
$28,586.86
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
48100077
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$12,578.22 |
| Max. Negotiated Rate |
$25,728.17 |
| Rate for Payer: Aetna American Axle |
$18,581.46
|
| Rate for Payer: Aetna Commercial |
$24,298.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,581.46
|
| Rate for Payer: Cash Price |
$22,869.49
|
| Rate for Payer: Cofinity Commercial |
$20,010.80
|
| Rate for Payer: Cofinity Commercial |
$24,584.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,869.49
|
| Rate for Payer: Healthscope Commercial |
$25,728.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,010.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,440.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,298.83
|
| Rate for Payer: PHP Commercial |
$24,298.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,010.80
|
| Rate for Payer: Priority Health SBD |
$18,009.72
|
| Rate for Payer: UMR Bronson Commercial |
$12,578.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,440.14
|
|
|
HC PTCRAWSTENT VES/BRANCH
|
Facility
|
OP
|
$28,586.86
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
48100077
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$631.31 |
| Max. Negotiated Rate |
$49,067.27 |
| Rate for Payer: Aetna American Axle |
$18,581.46
|
| Rate for Payer: Aetna Commercial |
$24,298.83
|
| Rate for Payer: Aetna Medicare |
$16,210.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,581.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,483.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,483.22
|
| Rate for Payer: BCBS Complete |
$8,952.93
|
| Rate for Payer: BCBS MAPPO |
$15,586.58
|
| Rate for Payer: BCBS Trust/PPO |
$705.42
|
| Rate for Payer: BCN Medicare Advantage |
$15,586.58
|
| Rate for Payer: Cash Price |
$22,869.49
|
| Rate for Payer: Cash Price |
$22,869.49
|
| Rate for Payer: Cofinity Commercial |
$24,584.70
|
| Rate for Payer: Cofinity Commercial |
$20,010.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,869.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,586.58
|
| Rate for Payer: Healthscope Commercial |
$25,728.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,010.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,440.14
|
| Rate for Payer: Mclaren Medicaid |
$8,525.86
|
| Rate for Payer: Mclaren Medicare |
$15,586.58
|
| Rate for Payer: Meridian Medicaid |
$8,952.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,365.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,924.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,298.83
|
| Rate for Payer: PACE Medicare |
$14,807.25
|
| Rate for Payer: PACE SWMI |
$15,586.58
|
| Rate for Payer: PHP Commercial |
$24,298.83
|
| Rate for Payer: PHP Medicare Advantage |
$15,586.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,525.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,010.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49,067.27
|
| Rate for Payer: Priority Health Medicare |
$15,586.58
|
| Rate for Payer: Priority Health Narrow Network |
$39,253.82
|
| Rate for Payer: Priority Health SBD |
$18,009.72
|
| Rate for Payer: Railroad Medicare Medicare |
$15,586.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$694.44
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,586.58
|
| Rate for Payer: UHC Exchange |
$631.31
|
| Rate for Payer: UHC Medicare Advantage |
$16,054.18
|
| Rate for Payer: UMR Bronson Commercial |
$10,577.14
|
| Rate for Payer: VA VA |
$15,586.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,440.14
|
|
|
HC PT EVAL HIGH COMPLEXITY
|
Facility
|
IP
|
$308.55
|
|
|
Service Code
|
CPT 97163
|
| Hospital Charge Code |
42400008
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$135.76 |
| Max. Negotiated Rate |
$277.70 |
| Rate for Payer: Aetna American Axle |
$200.56
|
| Rate for Payer: Aetna Commercial |
$262.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.56
|
| Rate for Payer: Cash Price |
$246.84
|
| Rate for Payer: Cofinity Commercial |
$215.98
|
| Rate for Payer: Cofinity Commercial |
$265.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$246.84
|
| Rate for Payer: Healthscope Commercial |
$277.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$215.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$262.27
|
| Rate for Payer: PHP Commercial |
$262.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.98
|
| Rate for Payer: Priority Health SBD |
$194.39
|
| Rate for Payer: UMR Bronson Commercial |
$135.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.41
|
|
|
HC PT EVAL HIGH COMPLEXITY
|
Facility
|
OP
|
$308.55
|
|
|
Service Code
|
CPT 97163
|
| Hospital Charge Code |
42400008
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$58.71 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$200.56
|
| Rate for Payer: Aetna Commercial |
$262.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.56
|
| Rate for Payer: BCBS Complete |
$123.42
|
| Rate for Payer: BCBS Trust/PPO |
$58.71
|
| Rate for Payer: Cash Price |
$246.84
|
| Rate for Payer: Cash Price |
$246.84
|
| Rate for Payer: Cash Price |
$246.84
|
| Rate for Payer: Cofinity Commercial |
$215.98
|
| Rate for Payer: Cofinity Commercial |
$265.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$246.84
|
| Rate for Payer: Healthscope Commercial |
$277.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$215.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$262.27
|
| Rate for Payer: PHP Commercial |
$262.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.00
|
| Rate for Payer: Priority Health Narrow Network |
$60.80
|
| Rate for Payer: Priority Health SBD |
$194.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.42
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$98.56
|
| Rate for Payer: UMR Bronson Commercial |
$114.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.41
|
|
|
HC PT EVAL LOW COMPLEXITY
|
Facility
|
OP
|
$252.45
|
|
|
Service Code
|
CPT 97161
|
| Hospital Charge Code |
42400006
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$58.71 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$164.09
|
| Rate for Payer: Aetna Commercial |
$214.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.09
|
| Rate for Payer: BCBS Complete |
$100.98
|
| Rate for Payer: BCBS Trust/PPO |
$58.71
|
| Rate for Payer: Cash Price |
$201.96
|
| Rate for Payer: Cash Price |
$201.96
|
| Rate for Payer: Cash Price |
$201.96
|
| Rate for Payer: Cofinity Commercial |
$217.11
|
| Rate for Payer: Cofinity Commercial |
$176.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.96
|
| Rate for Payer: Healthscope Commercial |
$227.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$176.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$214.58
|
| Rate for Payer: PHP Commercial |
$214.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.00
|
| Rate for Payer: Priority Health Narrow Network |
$60.80
|
| Rate for Payer: Priority Health SBD |
$159.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.42
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$98.56
|
| Rate for Payer: UMR Bronson Commercial |
$93.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.34
|
|
|
HC PT EVAL LOW COMPLEXITY
|
Facility
|
IP
|
$252.45
|
|
|
Service Code
|
CPT 97161
|
| Hospital Charge Code |
42400006
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$111.08 |
| Max. Negotiated Rate |
$227.20 |
| Rate for Payer: Aetna American Axle |
$164.09
|
| Rate for Payer: Aetna Commercial |
$214.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.09
|
| Rate for Payer: Cash Price |
$201.96
|
| Rate for Payer: Cofinity Commercial |
$217.11
|
| Rate for Payer: Cofinity Commercial |
$176.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.96
|
| Rate for Payer: Healthscope Commercial |
$227.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$176.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$214.58
|
| Rate for Payer: PHP Commercial |
$214.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.72
|
| Rate for Payer: Priority Health SBD |
$159.04
|
| Rate for Payer: UMR Bronson Commercial |
$111.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.34
|
|
|
HC PT EVAL MODERATE COMPLEXITY
|
Facility
|
IP
|
$280.50
|
|
|
Service Code
|
CPT 97162
|
| Hospital Charge Code |
42400007
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$123.42 |
| Max. Negotiated Rate |
$252.45 |
| Rate for Payer: Aetna American Axle |
$182.32
|
| Rate for Payer: Aetna Commercial |
$238.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.32
|
| Rate for Payer: Cash Price |
$224.40
|
| Rate for Payer: Cofinity Commercial |
$196.35
|
| Rate for Payer: Cofinity Commercial |
$241.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.40
|
| Rate for Payer: Healthscope Commercial |
$252.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$196.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$238.42
|
| Rate for Payer: PHP Commercial |
$238.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.35
|
| Rate for Payer: Priority Health SBD |
$176.72
|
| Rate for Payer: UMR Bronson Commercial |
$123.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.38
|
|
|
HC PT EVAL MODERATE COMPLEXITY
|
Facility
|
OP
|
$280.50
|
|
|
Service Code
|
CPT 97162
|
| Hospital Charge Code |
42400007
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$58.71 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$182.32
|
| Rate for Payer: Aetna Commercial |
$238.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.32
|
| Rate for Payer: BCBS Complete |
$112.20
|
| Rate for Payer: BCBS Trust/PPO |
$58.71
|
| Rate for Payer: Cash Price |
$224.40
|
| Rate for Payer: Cash Price |
$224.40
|
| Rate for Payer: Cash Price |
$224.40
|
| Rate for Payer: Cofinity Commercial |
$196.35
|
| Rate for Payer: Cofinity Commercial |
$241.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.40
|
| Rate for Payer: Healthscope Commercial |
$252.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$196.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$238.42
|
| Rate for Payer: PHP Commercial |
$238.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.00
|
| Rate for Payer: Priority Health Narrow Network |
$60.80
|
| Rate for Payer: Priority Health SBD |
$176.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.42
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$98.56
|
| Rate for Payer: UMR Bronson Commercial |
$103.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.38
|
|
|
HC PT MIX 1:1
|
Facility
|
IP
|
$69.06
|
|
|
Service Code
|
CPT 85611
|
| Hospital Charge Code |
30500107
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$30.39 |
| Max. Negotiated Rate |
$62.15 |
| Rate for Payer: Aetna American Axle |
$44.89
|
| Rate for Payer: Aetna Commercial |
$58.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.89
|
| Rate for Payer: Cash Price |
$55.25
|
| Rate for Payer: Cofinity Commercial |
$59.39
|
| Rate for Payer: Cofinity Commercial |
$48.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.25
|
| Rate for Payer: Healthscope Commercial |
$62.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.70
|
| Rate for Payer: PHP Commercial |
$58.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.34
|
| Rate for Payer: Priority Health SBD |
$43.51
|
| Rate for Payer: UMR Bronson Commercial |
$30.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.80
|
|
|
HC PT MIX 1:1
|
Facility
|
OP
|
$69.06
|
|
|
Service Code
|
CPT 85611
|
| Hospital Charge Code |
30500107
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.16 |
| Max. Negotiated Rate |
$62.15 |
| Rate for Payer: Aetna American Axle |
$44.89
|
| Rate for Payer: Aetna Commercial |
$58.70
|
| Rate for Payer: Aetna Medicare |
$4.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.92
|
| Rate for Payer: BCBS Complete |
$2.26
|
| Rate for Payer: BCBS MAPPO |
$3.94
|
| Rate for Payer: BCBS Trust/PPO |
$3.55
|
| Rate for Payer: BCN Medicare Advantage |
$3.94
|
| Rate for Payer: Cash Price |
$55.25
|
| Rate for Payer: Cash Price |
$55.25
|
| Rate for Payer: Cofinity Commercial |
$48.34
|
| Rate for Payer: Cofinity Commercial |
$59.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.94
|
| Rate for Payer: Healthscope Commercial |
$62.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.80
|
| Rate for Payer: Mclaren Medicaid |
$2.16
|
| Rate for Payer: Mclaren Medicare |
$3.94
|
| Rate for Payer: Meridian Medicaid |
$2.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.70
|
| Rate for Payer: PACE Medicare |
$3.74
|
| Rate for Payer: PACE SWMI |
$3.94
|
| Rate for Payer: PHP Commercial |
$58.70
|
| Rate for Payer: PHP Medicare Advantage |
$3.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.41
|
| Rate for Payer: Priority Health Medicare |
$3.94
|
| Rate for Payer: Priority Health Narrow Network |
$4.33
|
| Rate for Payer: Priority Health SBD |
$43.51
|
| Rate for Payer: Railroad Medicare Medicare |
$3.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.73
|
| Rate for Payer: UHC Core |
$6.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.94
|
| Rate for Payer: UHC Exchange |
$3.94
|
| Rate for Payer: UHC Medicare Advantage |
$4.06
|
| Rate for Payer: UMR Bronson Commercial |
$25.55
|
| Rate for Payer: VA VA |
$3.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.80
|
|
|
HC PT NEUROSTIM
|
Facility
|
IP
|
$95.24
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
42000007
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$41.91 |
| Max. Negotiated Rate |
$85.72 |
| Rate for Payer: Aetna American Axle |
$61.91
|
| Rate for Payer: Aetna Commercial |
$80.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.91
|
| Rate for Payer: Cash Price |
$76.19
|
| Rate for Payer: Cofinity Commercial |
$66.67
|
| Rate for Payer: Cofinity Commercial |
$81.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.19
|
| Rate for Payer: Healthscope Commercial |
$85.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.95
|
| Rate for Payer: PHP Commercial |
$80.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.67
|
| Rate for Payer: Priority Health SBD |
$60.00
|
| Rate for Payer: UMR Bronson Commercial |
$41.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.43
|
|
|
HC PT NEUROSTIM
|
Facility
|
OP
|
$95.24
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
42000007
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$10.09 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$61.91
|
| Rate for Payer: Aetna Commercial |
$80.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.91
|
| Rate for Payer: BCBS Complete |
$38.10
|
| Rate for Payer: BCBS Trust/PPO |
$10.09
|
| Rate for Payer: Cash Price |
$76.19
|
| Rate for Payer: Cash Price |
$76.19
|
| Rate for Payer: Cash Price |
$76.19
|
| Rate for Payer: Cofinity Commercial |
$81.91
|
| Rate for Payer: Cofinity Commercial |
$66.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.19
|
| Rate for Payer: Healthscope Commercial |
$85.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.95
|
| Rate for Payer: PHP Commercial |
$80.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.00
|
| Rate for Payer: Priority Health Narrow Network |
$12.80
|
| Rate for Payer: Priority Health SBD |
$60.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.49
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$14.08
|
| Rate for Payer: UMR Bronson Commercial |
$35.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.43
|
|
|
HC PT RE-EVALUATION
|
Facility
|
IP
|
$125.65
|
|
|
Service Code
|
CPT 97164
|
| Hospital Charge Code |
42400009
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$55.29 |
| Max. Negotiated Rate |
$113.08 |
| Rate for Payer: Aetna American Axle |
$81.67
|
| Rate for Payer: Aetna Commercial |
$106.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.67
|
| Rate for Payer: Cash Price |
$100.52
|
| Rate for Payer: Cofinity Commercial |
$108.06
|
| Rate for Payer: Cofinity Commercial |
$87.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.52
|
| Rate for Payer: Healthscope Commercial |
$113.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$106.80
|
| Rate for Payer: PHP Commercial |
$106.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.96
|
| Rate for Payer: Priority Health SBD |
$79.16
|
| Rate for Payer: UMR Bronson Commercial |
$55.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.24
|
|
|
HC PT RE-EVALUATION
|
Facility
|
OP
|
$125.65
|
|
|
Service Code
|
CPT 97164
|
| Hospital Charge Code |
42400009
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$30.40 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$81.67
|
| Rate for Payer: Aetna Commercial |
$106.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.67
|
| Rate for Payer: BCBS Complete |
$50.26
|
| Rate for Payer: BCBS Trust/PPO |
$40.35
|
| Rate for Payer: Cash Price |
$100.52
|
| Rate for Payer: Cash Price |
$100.52
|
| Rate for Payer: Cash Price |
$100.52
|
| Rate for Payer: Cofinity Commercial |
$87.96
|
| Rate for Payer: Cofinity Commercial |
$108.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.52
|
| Rate for Payer: Healthscope Commercial |
$113.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$106.80
|
| Rate for Payer: PHP Commercial |
$106.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.00
|
| Rate for Payer: Priority Health Narrow Network |
$30.40
|
| Rate for Payer: Priority Health SBD |
$79.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.28
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$68.44
|
| Rate for Payer: UMR Bronson Commercial |
$46.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.24
|
|
|
HC PULM EXER FUNCTION INDIV 15 MIN
|
Facility
|
IP
|
$85.96
|
|
|
Service Code
|
HCPCS G0238
|
| Hospital Charge Code |
41000045
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$37.82 |
| Max. Negotiated Rate |
$77.36 |
| Rate for Payer: Aetna American Axle |
$55.87
|
| Rate for Payer: Aetna Commercial |
$73.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.87
|
| Rate for Payer: Cash Price |
$68.77
|
| Rate for Payer: Cofinity Commercial |
$73.93
|
| Rate for Payer: Cofinity Commercial |
$60.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.77
|
| Rate for Payer: Healthscope Commercial |
$77.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$73.07
|
| Rate for Payer: PHP Commercial |
$73.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.17
|
| Rate for Payer: Priority Health SBD |
$54.15
|
| Rate for Payer: UMR Bronson Commercial |
$37.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.47
|
|
|
HC PULM EXER FUNCTION INDIV 15 MIN
|
Facility
|
OP
|
$85.96
|
|
|
Service Code
|
HCPCS G0238
|
| Hospital Charge Code |
41000045
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$10.15 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$55.87
|
| Rate for Payer: Aetna Commercial |
$73.07
|
| Rate for Payer: Aetna Medicare |
$27.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.09
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$26.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.89
|
| Rate for Payer: BCN Medicare Advantage |
$26.47
|
| Rate for Payer: Cash Price |
$68.77
|
| Rate for Payer: Cash Price |
$68.77
|
| Rate for Payer: Cash Price |
$68.77
|
| Rate for Payer: Cofinity Commercial |
$60.17
|
| Rate for Payer: Cofinity Commercial |
$73.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.47
|
| Rate for Payer: Healthscope Commercial |
$77.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.47
|
| Rate for Payer: Mclaren Medicaid |
$14.48
|
| Rate for Payer: Mclaren Medicare |
$26.47
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$73.07
|
| Rate for Payer: PACE Medicare |
$25.15
|
| Rate for Payer: PACE SWMI |
$26.47
|
| Rate for Payer: PHP Commercial |
$73.07
|
| Rate for Payer: PHP Medicare Advantage |
$26.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.33
|
| Rate for Payer: Priority Health Medicare |
$26.47
|
| Rate for Payer: Priority Health Narrow Network |
$66.66
|
| Rate for Payer: Priority Health SBD |
$54.15
|
| Rate for Payer: Railroad Medicare Medicare |
$26.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.16
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.47
|
| Rate for Payer: UHC Exchange |
$10.15
|
| Rate for Payer: UHC Medicare Advantage |
$27.26
|
| Rate for Payer: UMR Bronson Commercial |
$31.81
|
| Rate for Payer: VA VA |
$26.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.47
|
|
|
HC PULMONARY ARTERIOGRAM NONSELECTIVE
|
Facility
|
OP
|
$1,667.83
|
|
|
Service Code
|
CPT 75746
|
| Hospital Charge Code |
32000197
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$132.29 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$1,084.09
|
| Rate for Payer: Aetna Commercial |
$1,417.66
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,084.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$156.47
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$1,334.26
|
| Rate for Payer: Cash Price |
$1,334.26
|
| Rate for Payer: Cofinity Commercial |
$1,167.48
|
| Rate for Payer: Cofinity Commercial |
$1,434.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,334.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$1,501.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,167.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,250.87
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,417.66
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$1,417.66
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,167.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$1,050.73
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.52
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$132.29
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$617.10
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,250.87
|
|
|
HC PULMONARY ARTERIOGRAM NONSELECTIVE
|
Facility
|
IP
|
$1,667.83
|
|
|
Service Code
|
CPT 75746
|
| Hospital Charge Code |
32000197
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$733.85 |
| Max. Negotiated Rate |
$1,501.05 |
| Rate for Payer: Aetna American Axle |
$1,084.09
|
| Rate for Payer: Aetna Commercial |
$1,417.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,084.09
|
| Rate for Payer: Cash Price |
$1,334.26
|
| Rate for Payer: Cofinity Commercial |
$1,167.48
|
| Rate for Payer: Cofinity Commercial |
$1,434.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,334.26
|
| Rate for Payer: Healthscope Commercial |
$1,501.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,167.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,250.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,417.66
|
| Rate for Payer: PHP Commercial |
$1,417.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,167.48
|
| Rate for Payer: Priority Health SBD |
$1,050.73
|
| Rate for Payer: UMR Bronson Commercial |
$733.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,250.87
|
|
