|
HC RADIUM RA223 DICHLORIDE XOFIGO PER MICROCURIE
|
Facility
|
OP
|
$280.58
|
|
|
Service Code
|
HCPCS A9606
|
| Hospital Charge Code |
63600051
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$88.16 |
| Max. Negotiated Rate |
$463.76 |
| Rate for Payer: Aetna American Axle |
$182.38
|
| Rate for Payer: Aetna Commercial |
$238.49
|
| Rate for Payer: Aetna Medicare |
$167.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$201.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$201.45
|
| Rate for Payer: BCBS Complete |
$92.57
|
| Rate for Payer: BCBS MAPPO |
$161.16
|
| Rate for Payer: BCBS Trust/PPO |
$176.51
|
| Rate for Payer: BCN Medicare Advantage |
$161.16
|
| Rate for Payer: Cash Price |
$224.46
|
| Rate for Payer: Cash Price |
$224.46
|
| Rate for Payer: Cofinity Commercial |
$196.41
|
| Rate for Payer: Cofinity Commercial |
$241.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.16
|
| Rate for Payer: Healthscope Commercial |
$252.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$196.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.44
|
| Rate for Payer: Mclaren Medicaid |
$88.16
|
| Rate for Payer: Mclaren Medicare |
$161.16
|
| Rate for Payer: Meridian Medicaid |
$92.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$169.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$185.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$238.49
|
| Rate for Payer: PACE Medicare |
$153.10
|
| Rate for Payer: PACE SWMI |
$161.16
|
| Rate for Payer: PHP Commercial |
$238.49
|
| Rate for Payer: PHP Medicare Advantage |
$161.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$463.76
|
| Rate for Payer: Priority Health Medicare |
$161.16
|
| Rate for Payer: Priority Health Narrow Network |
$371.01
|
| Rate for Payer: Priority Health SBD |
$176.77
|
| Rate for Payer: Railroad Medicare Medicare |
$161.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$161.16
|
| Rate for Payer: UHC Medicare Advantage |
$166.00
|
| Rate for Payer: UMR Bronson Commercial |
$103.81
|
| Rate for Payer: VA VA |
$161.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.44
|
|
|
HC RADXF UNL ABD PERITONEUM OMENT
|
Facility
|
IP
|
$3,844.61
|
|
|
Service Code
|
CPT 49999
|
| Hospital Charge Code |
36100481
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,691.63 |
| Max. Negotiated Rate |
$3,460.15 |
| Rate for Payer: Aetna American Axle |
$2,499.00
|
| Rate for Payer: Aetna Commercial |
$3,267.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,499.00
|
| Rate for Payer: Cash Price |
$3,075.69
|
| Rate for Payer: Cofinity Commercial |
$2,691.23
|
| Rate for Payer: Cofinity Commercial |
$3,306.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,075.69
|
| Rate for Payer: Healthscope Commercial |
$3,460.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,691.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,883.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,267.92
|
| Rate for Payer: PHP Commercial |
$3,267.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,691.23
|
| Rate for Payer: Priority Health SBD |
$2,422.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,691.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,883.46
|
|
|
HC RADXF UNL ABD PERITONEUM OMENT
|
Facility
|
OP
|
$3,844.61
|
|
|
Service Code
|
CPT 49999
|
| Hospital Charge Code |
36100481
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$440.75 |
| Max. Negotiated Rate |
$3,460.15 |
| Rate for Payer: Aetna American Axle |
$2,499.00
|
| Rate for Payer: Aetna Commercial |
$3,267.92
|
| Rate for Payer: Aetna Medicare |
$837.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,499.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,007.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,007.19
|
| Rate for Payer: BCBS Complete |
$462.82
|
| Rate for Payer: BCBS MAPPO |
$805.75
|
| Rate for Payer: BCBS Trust/PPO |
$623.16
|
| Rate for Payer: BCN Medicare Advantage |
$805.75
|
| Rate for Payer: Cash Price |
$3,075.69
|
| Rate for Payer: Cash Price |
$3,075.69
|
| Rate for Payer: Cofinity Commercial |
$2,691.23
|
| Rate for Payer: Cofinity Commercial |
$3,306.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,075.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$805.75
|
| Rate for Payer: Healthscope Commercial |
$3,460.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,691.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,883.46
|
| Rate for Payer: Mclaren Medicaid |
$440.75
|
| Rate for Payer: Mclaren Medicare |
$805.75
|
| Rate for Payer: Meridian Medicaid |
$462.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$846.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$926.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,267.92
|
| Rate for Payer: PACE Medicare |
$765.46
|
| Rate for Payer: PACE SWMI |
$805.75
|
| Rate for Payer: PHP Commercial |
$3,267.92
|
| Rate for Payer: PHP Medicare Advantage |
$805.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,691.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,536.56
|
| Rate for Payer: Priority Health Medicare |
$805.75
|
| Rate for Payer: Priority Health Narrow Network |
$2,029.25
|
| Rate for Payer: Priority Health SBD |
$2,422.10
|
| Rate for Payer: Railroad Medicare Medicare |
$805.75
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$805.75
|
| Rate for Payer: UHC Medicare Advantage |
$829.92
|
| Rate for Payer: UMR Bronson Commercial |
$1,422.51
|
| Rate for Payer: VA VA |
$805.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,883.46
|
|
|
HC RADXF UNL COMPUTED TOMO 76497
|
Facility
|
IP
|
$267.00
|
|
|
Service Code
|
CPT 76497
|
| Hospital Charge Code |
35000027
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$117.48 |
| Max. Negotiated Rate |
$240.30 |
| Rate for Payer: Aetna American Axle |
$173.55
|
| Rate for Payer: Aetna Commercial |
$226.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.55
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cofinity Commercial |
$229.62
|
| Rate for Payer: Cofinity Commercial |
$186.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.60
|
| Rate for Payer: Healthscope Commercial |
$240.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$186.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$226.95
|
| Rate for Payer: PHP Commercial |
$226.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.90
|
| Rate for Payer: Priority Health SBD |
$168.21
|
| Rate for Payer: UMR Bronson Commercial |
$117.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.25
|
|
|
HC RADXF UNL COMPUTED TOMO 76497
|
Facility
|
OP
|
$267.00
|
|
|
Service Code
|
CPT 76497
|
| Hospital Charge Code |
35000027
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$1,048.00 |
| Rate for Payer: Aetna American Axle |
$173.55
|
| Rate for Payer: Aetna Commercial |
$226.95
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cofinity Commercial |
$186.90
|
| Rate for Payer: Cofinity Commercial |
$229.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$240.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$186.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.25
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$226.95
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$226.95
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.27
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$203.42
|
| Rate for Payer: Priority Health SBD |
$168.21
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$98.79
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.25
|
|
|
HC RADXF UNL DIAGNOSTIC RAD 76499
|
Facility
|
IP
|
$88.16
|
|
|
Service Code
|
CPT 76499
|
| Hospital Charge Code |
32000242
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$38.79 |
| Max. Negotiated Rate |
$79.34 |
| Rate for Payer: Aetna American Axle |
$57.30
|
| Rate for Payer: Aetna Commercial |
$74.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.30
|
| Rate for Payer: Cash Price |
$70.53
|
| Rate for Payer: Cofinity Commercial |
$61.71
|
| Rate for Payer: Cofinity Commercial |
$75.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.53
|
| Rate for Payer: Healthscope Commercial |
$79.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$74.94
|
| Rate for Payer: PHP Commercial |
$74.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.71
|
| Rate for Payer: Priority Health SBD |
$55.54
|
| Rate for Payer: UMR Bronson Commercial |
$38.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.12
|
|
|
HC RADXF UNL DIAGNOSTIC RAD 76499
|
Facility
|
OP
|
$88.16
|
|
|
Service Code
|
CPT 76499
|
| Hospital Charge Code |
32000242
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.62 |
| Max. Negotiated Rate |
$262.00 |
| Rate for Payer: Aetna American Axle |
$57.30
|
| Rate for Payer: Aetna Commercial |
$74.94
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$70.53
|
| Rate for Payer: Cash Price |
$70.53
|
| Rate for Payer: Cofinity Commercial |
$75.82
|
| Rate for Payer: Cofinity Commercial |
$61.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$79.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.12
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$74.94
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$74.94
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.27
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$203.42
|
| Rate for Payer: Priority Health SBD |
$55.54
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$32.62
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.12
|
|
|
HC RADXF UNL FLUORO IR 76496
|
Facility
|
OP
|
$281.68
|
|
|
Service Code
|
CPT 76496
|
| Hospital Charge Code |
32000240
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$262.00 |
| Rate for Payer: Aetna American Axle |
$183.09
|
| Rate for Payer: Aetna Commercial |
$239.43
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$225.34
|
| Rate for Payer: Cash Price |
$225.34
|
| Rate for Payer: Cofinity Commercial |
$242.24
|
| Rate for Payer: Cofinity Commercial |
$197.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$253.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$197.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$211.26
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$239.43
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$239.43
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$197.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.27
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$203.42
|
| Rate for Payer: Priority Health SBD |
$177.46
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$104.22
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$211.26
|
|
|
HC RADXF UNL FLUORO IR 76496
|
Facility
|
IP
|
$281.68
|
|
|
Service Code
|
CPT 76496
|
| Hospital Charge Code |
32000240
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$123.94 |
| Max. Negotiated Rate |
$253.51 |
| Rate for Payer: Aetna American Axle |
$183.09
|
| Rate for Payer: Aetna Commercial |
$239.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.09
|
| Rate for Payer: Cash Price |
$225.34
|
| Rate for Payer: Cofinity Commercial |
$197.18
|
| Rate for Payer: Cofinity Commercial |
$242.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.34
|
| Rate for Payer: Healthscope Commercial |
$253.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$197.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$211.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$239.43
|
| Rate for Payer: PHP Commercial |
$239.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$197.18
|
| Rate for Payer: Priority Health SBD |
$177.46
|
| Rate for Payer: UMR Bronson Commercial |
$123.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$211.26
|
|
|
HC RADXF UNL MAG RES IMAGING 76498
|
Facility
|
IP
|
$937.20
|
|
|
Service Code
|
CPT 76498
|
| Hospital Charge Code |
61000050
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$412.37 |
| Max. Negotiated Rate |
$843.48 |
| Rate for Payer: Aetna American Axle |
$609.18
|
| Rate for Payer: Aetna Commercial |
$796.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$609.18
|
| Rate for Payer: Cash Price |
$749.76
|
| Rate for Payer: Cofinity Commercial |
$656.04
|
| Rate for Payer: Cofinity Commercial |
$805.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$749.76
|
| Rate for Payer: Healthscope Commercial |
$843.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$656.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$702.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$796.62
|
| Rate for Payer: PHP Commercial |
$796.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$656.04
|
| Rate for Payer: Priority Health SBD |
$590.44
|
| Rate for Payer: UMR Bronson Commercial |
$412.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$702.90
|
|
|
HC RADXF UNL MAG RES IMAGING 76498
|
Facility
|
OP
|
$937.20
|
|
|
Service Code
|
CPT 76498
|
| Hospital Charge Code |
61000050
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$609.18
|
| Rate for Payer: Aetna Commercial |
$796.62
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$609.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$749.76
|
| Rate for Payer: Cash Price |
$749.76
|
| Rate for Payer: Cofinity Commercial |
$805.99
|
| Rate for Payer: Cofinity Commercial |
$656.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$749.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$843.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$656.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$702.90
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$796.62
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$796.62
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$656.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.27
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$203.42
|
| Rate for Payer: Priority Health SBD |
$590.44
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$346.76
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$702.90
|
|
|
HC RADXF UNL NM CARDIOVASC 78499
|
Facility
|
OP
|
$787.76
|
|
|
Service Code
|
CPT 78499
|
| Hospital Charge Code |
34100031
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$1,154.12 |
| Rate for Payer: Aetna American Axle |
$512.04
|
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: Aetna Medicare |
$381.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$551.43
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$551.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.12
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$923.30
|
| Rate for Payer: Priority Health SBD |
$496.29
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.61
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: UMR Bronson Commercial |
$291.47
|
| Rate for Payer: VA VA |
$366.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM CARDIOVASC 78499
|
Facility
|
IP
|
$787.76
|
|
|
Service Code
|
CPT 78499
|
| Hospital Charge Code |
34100031
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$346.61 |
| Max. Negotiated Rate |
$708.98 |
| Rate for Payer: Aetna American Axle |
$512.04
|
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.04
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$551.43
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$551.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health SBD |
$496.29
|
| Rate for Payer: UMR Bronson Commercial |
$346.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM CNS 78699
|
Facility
|
OP
|
$787.76
|
|
|
Service Code
|
CPT 78699
|
| Hospital Charge Code |
34100043
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$1,154.12 |
| Rate for Payer: Aetna American Axle |
$512.04
|
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: Aetna Medicare |
$381.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Cofinity Commercial |
$551.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$551.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.12
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$923.30
|
| Rate for Payer: Priority Health SBD |
$496.29
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.61
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: UMR Bronson Commercial |
$291.47
|
| Rate for Payer: VA VA |
$366.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM CNS 78699
|
Facility
|
IP
|
$787.76
|
|
|
Service Code
|
CPT 78699
|
| Hospital Charge Code |
34100043
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$346.61 |
| Max. Negotiated Rate |
$708.98 |
| Rate for Payer: Aetna American Axle |
$512.04
|
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.04
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$551.43
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$551.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health SBD |
$496.29
|
| Rate for Payer: UMR Bronson Commercial |
$346.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM ENDOCR 78099
|
Facility
|
IP
|
$787.76
|
|
|
Service Code
|
CPT 78099
|
| Hospital Charge Code |
34100008
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$346.61 |
| Max. Negotiated Rate |
$708.98 |
| Rate for Payer: Aetna American Axle |
$512.04
|
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.04
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$551.43
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$551.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health SBD |
$496.29
|
| Rate for Payer: UMR Bronson Commercial |
$346.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM ENDOCR 78099
|
Facility
|
OP
|
$787.76
|
|
|
Service Code
|
CPT 78099
|
| Hospital Charge Code |
34100008
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$1,154.12 |
| Rate for Payer: Aetna American Axle |
$512.04
|
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: Aetna Medicare |
$381.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$551.43
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$551.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.12
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$923.30
|
| Rate for Payer: Priority Health SBD |
$496.29
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.61
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: UMR Bronson Commercial |
$291.47
|
| Rate for Payer: VA VA |
$366.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM GI PROC 78299
|
Facility
|
OP
|
$787.76
|
|
|
Service Code
|
CPT 78299
|
| Hospital Charge Code |
34100022
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$1,154.12 |
| Rate for Payer: Aetna American Axle |
$512.04
|
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: Aetna Medicare |
$381.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$551.43
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$551.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.12
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$923.30
|
| Rate for Payer: Priority Health SBD |
$496.29
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.61
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: UMR Bronson Commercial |
$291.47
|
| Rate for Payer: VA VA |
$366.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM GI PROC 78299
|
Facility
|
IP
|
$787.76
|
|
|
Service Code
|
CPT 78299
|
| Hospital Charge Code |
34100022
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$346.61 |
| Max. Negotiated Rate |
$708.98 |
| Rate for Payer: Aetna American Axle |
$512.04
|
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.04
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Cofinity Commercial |
$551.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$551.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health SBD |
$496.29
|
| Rate for Payer: UMR Bronson Commercial |
$346.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM GU 78799
|
Facility
|
IP
|
$787.76
|
|
|
Service Code
|
CPT 78799
|
| Hospital Charge Code |
34100051
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$346.61 |
| Max. Negotiated Rate |
$708.98 |
| Rate for Payer: Aetna American Axle |
$512.04
|
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.04
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$551.43
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$551.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health SBD |
$496.29
|
| Rate for Payer: UMR Bronson Commercial |
$346.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM GU 78799
|
Facility
|
OP
|
$787.76
|
|
|
Service Code
|
CPT 78799
|
| Hospital Charge Code |
34100051
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$1,154.12 |
| Rate for Payer: Aetna American Axle |
$512.04
|
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: Aetna Medicare |
$381.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$551.43
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$551.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.12
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$923.30
|
| Rate for Payer: Priority Health SBD |
$496.29
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.61
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: UMR Bronson Commercial |
$291.47
|
| Rate for Payer: VA VA |
$366.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM H R L 78199
|
Facility
|
IP
|
$735.63
|
|
|
Service Code
|
CPT 78199
|
| Hospital Charge Code |
34100013
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$323.68 |
| Max. Negotiated Rate |
$662.07 |
| Rate for Payer: Aetna American Axle |
$478.16
|
| Rate for Payer: Aetna Commercial |
$625.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$478.16
|
| Rate for Payer: Cash Price |
$588.50
|
| Rate for Payer: Cofinity Commercial |
$514.94
|
| Rate for Payer: Cofinity Commercial |
$632.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.50
|
| Rate for Payer: Healthscope Commercial |
$662.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$514.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$551.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$625.29
|
| Rate for Payer: PHP Commercial |
$625.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$514.94
|
| Rate for Payer: Priority Health SBD |
$463.45
|
| Rate for Payer: UMR Bronson Commercial |
$323.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$551.72
|
|
|
HC RADXF UNL NM H R L 78199
|
Facility
|
OP
|
$735.63
|
|
|
Service Code
|
CPT 78199
|
| Hospital Charge Code |
34100013
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$1,154.12 |
| Rate for Payer: Aetna American Axle |
$478.16
|
| Rate for Payer: Aetna Commercial |
$625.29
|
| Rate for Payer: Aetna Medicare |
$381.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$478.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$588.50
|
| Rate for Payer: Cash Price |
$588.50
|
| Rate for Payer: Cofinity Commercial |
$514.94
|
| Rate for Payer: Cofinity Commercial |
$632.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$662.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$514.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$551.72
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$625.29
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$625.29
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$514.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.12
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$923.30
|
| Rate for Payer: Priority Health SBD |
$463.45
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.61
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: UMR Bronson Commercial |
$272.18
|
| Rate for Payer: VA VA |
$366.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$551.72
|
|
|
HC RADXF UNL NM MUSCSKL 78399
|
Facility
|
IP
|
$1,885.39
|
|
|
Service Code
|
CPT 78399
|
| Hospital Charge Code |
34100028
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$829.57 |
| Max. Negotiated Rate |
$1,696.85 |
| Rate for Payer: Aetna American Axle |
$1,225.50
|
| Rate for Payer: Aetna Commercial |
$1,602.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,225.50
|
| Rate for Payer: Cash Price |
$1,508.31
|
| Rate for Payer: Cofinity Commercial |
$1,319.77
|
| Rate for Payer: Cofinity Commercial |
$1,621.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,508.31
|
| Rate for Payer: Healthscope Commercial |
$1,696.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,319.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,414.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,602.58
|
| Rate for Payer: PHP Commercial |
$1,602.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,319.77
|
| Rate for Payer: Priority Health SBD |
$1,187.80
|
| Rate for Payer: UMR Bronson Commercial |
$829.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,414.04
|
|
|
HC RADXF UNL NM MUSCSKL 78399
|
Facility
|
OP
|
$1,885.39
|
|
|
Service Code
|
CPT 78399
|
| Hospital Charge Code |
34100028
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$1,696.85 |
| Rate for Payer: Aetna American Axle |
$1,225.50
|
| Rate for Payer: Aetna Commercial |
$1,602.58
|
| Rate for Payer: Aetna Medicare |
$381.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,225.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$1,508.31
|
| Rate for Payer: Cash Price |
$1,508.31
|
| Rate for Payer: Cofinity Commercial |
$1,621.44
|
| Rate for Payer: Cofinity Commercial |
$1,319.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,508.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$1,696.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,319.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,414.04
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,602.58
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$1,602.58
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,319.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.12
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$923.30
|
| Rate for Payer: Priority Health SBD |
$1,187.80
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.61
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: UMR Bronson Commercial |
$697.59
|
| Rate for Payer: VA VA |
$366.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,414.04
|
|
