|
HC HDR IR 192 BRACHY SOURCE NSTRD
|
Facility
|
OP
|
$562.41
|
|
|
Service Code
|
HCPCS C1717
|
| Hospital Charge Code |
27800090
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$178.99 |
| Max. Negotiated Rate |
$939.98 |
| Rate for Payer: Aetna American Axle |
$365.57
|
| Rate for Payer: Aetna Commercial |
$478.05
|
| Rate for Payer: Aetna Medicare |
$347.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$417.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$417.41
|
| Rate for Payer: BCBS Complete |
$187.94
|
| Rate for Payer: BCBS MAPPO |
$333.93
|
| Rate for Payer: BCN Medicare Advantage |
$333.93
|
| Rate for Payer: Cash Price |
$449.93
|
| Rate for Payer: Cash Price |
$449.93
|
| Rate for Payer: Cofinity Commercial |
$483.67
|
| Rate for Payer: Cofinity Commercial |
$393.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$393.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$333.93
|
| Rate for Payer: Healthscope Commercial |
$506.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$393.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.81
|
| Rate for Payer: Mclaren Medicaid |
$178.99
|
| Rate for Payer: Mclaren Medicare |
$333.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$350.63
|
| Rate for Payer: Meridian Medicaid |
$187.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$384.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$478.05
|
| Rate for Payer: PACE Medicare |
$317.23
|
| Rate for Payer: PACE SWMI |
$333.93
|
| Rate for Payer: PHP Commercial |
$478.05
|
| Rate for Payer: PHP Medicare Advantage |
$333.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$178.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.57
|
| Rate for Payer: Priority Health Medicare |
$333.93
|
| Rate for Payer: Priority Health SBD |
$354.32
|
| Rate for Payer: Railroad Medicare Medicare |
$333.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$939.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$333.93
|
| Rate for Payer: UHC Exchange |
$638.17
|
| Rate for Payer: UHC Medicare Advantage |
$333.93
|
| Rate for Payer: UHCCP Medicaid |
$178.99
|
| Rate for Payer: UMR Bronson Commercial |
$208.09
|
| Rate for Payer: VA VA |
$333.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.81
|
|
|
HC HDR OVER 12 CHANNELS
|
Facility
|
IP
|
$2,438.89
|
|
|
Service Code
|
CPT 77772
|
| Hospital Charge Code |
33300057
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,073.11 |
| Max. Negotiated Rate |
$2,195.00 |
| Rate for Payer: Aetna American Axle |
$1,585.28
|
| Rate for Payer: Aetna Commercial |
$2,073.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,585.28
|
| Rate for Payer: Cash Price |
$1,951.11
|
| Rate for Payer: Cofinity Commercial |
$1,707.22
|
| Rate for Payer: Cofinity Commercial |
$2,097.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,707.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,951.11
|
| Rate for Payer: Healthscope Commercial |
$2,195.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,707.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,829.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,073.06
|
| Rate for Payer: PHP Commercial |
$2,073.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,585.28
|
| Rate for Payer: Priority Health SBD |
$1,536.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,073.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,829.17
|
|
|
HC HDR OVER 12 CHANNELS
|
Facility
|
OP
|
$2,438.89
|
|
|
Service Code
|
CPT 77772
|
| Hospital Charge Code |
33300057
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$362.69 |
| Max. Negotiated Rate |
$2,195.00 |
| Rate for Payer: Aetna American Axle |
$1,585.28
|
| Rate for Payer: Aetna Commercial |
$2,073.06
|
| Rate for Payer: Aetna Medicare |
$703.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,585.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$845.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$845.83
|
| Rate for Payer: BCBS Complete |
$380.82
|
| Rate for Payer: BCBS MAPPO |
$676.66
|
| Rate for Payer: BCN Medicare Advantage |
$676.66
|
| Rate for Payer: Cash Price |
$1,951.11
|
| Rate for Payer: Cash Price |
$1,951.11
|
| Rate for Payer: Cash Price |
$1,951.11
|
| Rate for Payer: Cofinity Commercial |
$1,707.22
|
| Rate for Payer: Cofinity Commercial |
$2,097.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,707.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,951.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$676.66
|
| Rate for Payer: Healthscope Commercial |
$2,195.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,707.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,829.17
|
| Rate for Payer: Mclaren Medicaid |
$362.69
|
| Rate for Payer: Mclaren Medicare |
$676.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$710.49
|
| Rate for Payer: Meridian Medicaid |
$380.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$778.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,073.06
|
| Rate for Payer: PACE Medicare |
$642.83
|
| Rate for Payer: PACE SWMI |
$676.66
|
| Rate for Payer: PHP Commercial |
$2,073.06
|
| Rate for Payer: PHP Medicare Advantage |
$676.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,585.28
|
| Rate for Payer: Priority Health Medicare |
$676.66
|
| Rate for Payer: Priority Health SBD |
$1,536.50
|
| Rate for Payer: Railroad Medicare Medicare |
$676.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,904.73
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$676.66
|
| Rate for Payer: UHC Exchange |
$1,293.16
|
| Rate for Payer: UHC Medicare Advantage |
$676.66
|
| Rate for Payer: UHCCP Medicaid |
$362.69
|
| Rate for Payer: UMR Bronson Commercial |
$902.39
|
| Rate for Payer: VA VA |
$676.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,829.17
|
|
|
HC HDR SKIN SURFACE 1 CHANNEL
|
Facility
|
OP
|
$481.76
|
|
|
Service Code
|
CPT 77767
|
| Hospital Charge Code |
33300053
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$137.47 |
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$313.14
|
| Rate for Payer: Aetna Commercial |
$409.50
|
| Rate for Payer: Aetna Medicare |
$266.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$313.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$320.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$320.60
|
| Rate for Payer: BCBS Complete |
$144.35
|
| Rate for Payer: BCBS MAPPO |
$256.48
|
| Rate for Payer: BCN Medicare Advantage |
$256.48
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cofinity Commercial |
$337.23
|
| Rate for Payer: Cofinity Commercial |
$414.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$337.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$256.48
|
| Rate for Payer: Healthscope Commercial |
$433.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$337.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.32
|
| Rate for Payer: Mclaren Medicaid |
$137.47
|
| Rate for Payer: Mclaren Medicare |
$256.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$269.30
|
| Rate for Payer: Meridian Medicaid |
$144.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$294.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.50
|
| Rate for Payer: PACE Medicare |
$243.66
|
| Rate for Payer: PACE SWMI |
$256.48
|
| Rate for Payer: PHP Commercial |
$409.50
|
| Rate for Payer: PHP Medicare Advantage |
$256.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$137.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.14
|
| Rate for Payer: Priority Health Medicare |
$256.48
|
| Rate for Payer: Priority Health SBD |
$303.51
|
| Rate for Payer: Railroad Medicare Medicare |
$256.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$721.97
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$256.48
|
| Rate for Payer: UHC Exchange |
$490.16
|
| Rate for Payer: UHC Medicare Advantage |
$256.48
|
| Rate for Payer: UHCCP Medicaid |
$137.47
|
| Rate for Payer: UMR Bronson Commercial |
$178.25
|
| Rate for Payer: VA VA |
$256.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.32
|
|
|
HC HDR SKIN SURFACE 1 CHANNEL
|
Facility
|
IP
|
$481.76
|
|
|
Service Code
|
CPT 77767
|
| Hospital Charge Code |
33300053
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$211.97 |
| Max. Negotiated Rate |
$433.58 |
| Rate for Payer: Aetna American Axle |
$313.14
|
| Rate for Payer: Aetna Commercial |
$409.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$313.14
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cofinity Commercial |
$337.23
|
| Rate for Payer: Cofinity Commercial |
$414.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$337.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.41
|
| Rate for Payer: Healthscope Commercial |
$433.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$337.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.50
|
| Rate for Payer: PHP Commercial |
$409.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.14
|
| Rate for Payer: Priority Health SBD |
$303.51
|
| Rate for Payer: UMR Bronson Commercial |
$211.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.32
|
|
|
HC HDR SKIN SURFACE 2 OR MORE CHANNELS
|
Facility
|
IP
|
$541.99
|
|
|
Service Code
|
CPT 77768
|
| Hospital Charge Code |
33300054
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$238.48 |
| Max. Negotiated Rate |
$487.79 |
| Rate for Payer: Aetna American Axle |
$352.29
|
| Rate for Payer: Aetna Commercial |
$460.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.29
|
| Rate for Payer: Cash Price |
$433.59
|
| Rate for Payer: Cofinity Commercial |
$379.39
|
| Rate for Payer: Cofinity Commercial |
$466.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$379.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.59
|
| Rate for Payer: Healthscope Commercial |
$487.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$379.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$460.69
|
| Rate for Payer: PHP Commercial |
$460.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.29
|
| Rate for Payer: Priority Health SBD |
$341.45
|
| Rate for Payer: UMR Bronson Commercial |
$238.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.49
|
|
|
HC HDR SKIN SURFACE 2 OR MORE CHANNELS
|
Facility
|
OP
|
$541.99
|
|
|
Service Code
|
CPT 77768
|
| Hospital Charge Code |
33300054
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$137.47 |
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$352.29
|
| Rate for Payer: Aetna Commercial |
$460.69
|
| Rate for Payer: Aetna Medicare |
$266.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$320.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$320.60
|
| Rate for Payer: BCBS Complete |
$144.35
|
| Rate for Payer: BCBS MAPPO |
$256.48
|
| Rate for Payer: BCN Medicare Advantage |
$256.48
|
| Rate for Payer: Cash Price |
$433.59
|
| Rate for Payer: Cash Price |
$433.59
|
| Rate for Payer: Cash Price |
$433.59
|
| Rate for Payer: Cofinity Commercial |
$379.39
|
| Rate for Payer: Cofinity Commercial |
$466.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$379.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$256.48
|
| Rate for Payer: Healthscope Commercial |
$487.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$379.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.49
|
| Rate for Payer: Mclaren Medicaid |
$137.47
|
| Rate for Payer: Mclaren Medicare |
$256.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$269.30
|
| Rate for Payer: Meridian Medicaid |
$144.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$294.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$460.69
|
| Rate for Payer: PACE Medicare |
$243.66
|
| Rate for Payer: PACE SWMI |
$256.48
|
| Rate for Payer: PHP Commercial |
$460.69
|
| Rate for Payer: PHP Medicare Advantage |
$256.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$137.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.29
|
| Rate for Payer: Priority Health Medicare |
$256.48
|
| Rate for Payer: Priority Health SBD |
$341.45
|
| Rate for Payer: Railroad Medicare Medicare |
$256.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$721.97
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$256.48
|
| Rate for Payer: UHC Exchange |
$490.16
|
| Rate for Payer: UHC Medicare Advantage |
$256.48
|
| Rate for Payer: UHCCP Medicaid |
$137.47
|
| Rate for Payer: UMR Bronson Commercial |
$200.54
|
| Rate for Payer: VA VA |
$256.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.49
|
|
|
HC HEALTH & BEHAV ASSESS OR REASSESS
|
Facility
|
OP
|
$122.77
|
|
|
Service Code
|
CPT 96156
|
| Hospital Charge Code |
91400009
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$45.42 |
| Max. Negotiated Rate |
$253.93 |
| Rate for Payer: Aetna American Axle |
$79.80
|
| Rate for Payer: Aetna Commercial |
$104.35
|
| Rate for Payer: Aetna Medicare |
$93.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$112.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$112.76
|
| Rate for Payer: BCBS Complete |
$50.77
|
| Rate for Payer: BCBS MAPPO |
$90.21
|
| Rate for Payer: BCN Medicare Advantage |
$90.21
|
| Rate for Payer: Cash Price |
$98.22
|
| Rate for Payer: Cash Price |
$98.22
|
| Rate for Payer: Cofinity Commercial |
$85.94
|
| Rate for Payer: Cofinity Commercial |
$105.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$85.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.21
|
| Rate for Payer: Healthscope Commercial |
$110.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.08
|
| Rate for Payer: Mclaren Medicaid |
$48.35
|
| Rate for Payer: Mclaren Medicare |
$90.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.72
|
| Rate for Payer: Meridian Medicaid |
$50.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.35
|
| Rate for Payer: PACE Medicare |
$85.70
|
| Rate for Payer: PACE SWMI |
$90.21
|
| Rate for Payer: PHP Commercial |
$104.35
|
| Rate for Payer: PHP Medicare Advantage |
$90.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.80
|
| Rate for Payer: Priority Health Medicare |
$90.21
|
| Rate for Payer: Priority Health SBD |
$77.35
|
| Rate for Payer: Railroad Medicare Medicare |
$90.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$253.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.21
|
| Rate for Payer: UHC Exchange |
$172.40
|
| Rate for Payer: UHC Medicare Advantage |
$90.21
|
| Rate for Payer: UHCCP Medicaid |
$48.35
|
| Rate for Payer: UMR Bronson Commercial |
$45.42
|
| Rate for Payer: VA VA |
$90.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.08
|
|
|
HC HEALTH & BEHAV ASSESS OR REASSESS
|
Facility
|
IP
|
$122.77
|
|
|
Service Code
|
CPT 96156
|
| Hospital Charge Code |
91400009
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$54.02 |
| Max. Negotiated Rate |
$110.49 |
| Rate for Payer: Aetna American Axle |
$79.80
|
| Rate for Payer: Aetna Commercial |
$104.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.80
|
| Rate for Payer: Cash Price |
$98.22
|
| Rate for Payer: Cofinity Commercial |
$105.58
|
| Rate for Payer: Cofinity Commercial |
$85.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$85.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.22
|
| Rate for Payer: Healthscope Commercial |
$110.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.35
|
| Rate for Payer: PHP Commercial |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.80
|
| Rate for Payer: Priority Health SBD |
$77.35
|
| Rate for Payer: UMR Bronson Commercial |
$54.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.08
|
|
|
HC HEALTH & BEHAV INTERVENT INDIV EA ADD 15 MIN
|
Facility
|
OP
|
$61.38
|
|
|
Service Code
|
CPT 96159
|
| Hospital Charge Code |
91400011
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$22.71 |
| Max. Negotiated Rate |
$55.24 |
| Rate for Payer: Aetna American Axle |
$39.90
|
| Rate for Payer: Aetna Commercial |
$52.17
|
| Rate for Payer: Aetna Medicare |
$30.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.90
|
| Rate for Payer: BCBS Complete |
$24.55
|
| Rate for Payer: Cash Price |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$42.97
|
| Rate for Payer: Cofinity Commercial |
$52.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.10
|
| Rate for Payer: Healthscope Commercial |
$55.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.17
|
| Rate for Payer: PHP Commercial |
$52.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: Priority Health SBD |
$38.67
|
| Rate for Payer: UMR Bronson Commercial |
$22.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.03
|
|
|
HC HEALTH & BEHAV INTERVENT INDIV EA ADD 15 MIN
|
Facility
|
IP
|
$61.38
|
|
|
Service Code
|
CPT 96159
|
| Hospital Charge Code |
91400011
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$27.01 |
| Max. Negotiated Rate |
$55.24 |
| Rate for Payer: Aetna American Axle |
$39.90
|
| Rate for Payer: Aetna Commercial |
$52.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.90
|
| Rate for Payer: Cash Price |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$42.97
|
| Rate for Payer: Cofinity Commercial |
$52.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.10
|
| Rate for Payer: Healthscope Commercial |
$55.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.17
|
| Rate for Payer: PHP Commercial |
$52.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: Priority Health SBD |
$38.67
|
| Rate for Payer: UMR Bronson Commercial |
$27.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.03
|
|
|
HC HEALTH & BEHAV INTERVENT INDIV INIT 30 MIN
|
Facility
|
OP
|
$122.77
|
|
|
Service Code
|
CPT 96158
|
| Hospital Charge Code |
91400010
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$45.42 |
| Max. Negotiated Rate |
$441.09 |
| Rate for Payer: Aetna American Axle |
$79.80
|
| Rate for Payer: Aetna Commercial |
$104.35
|
| Rate for Payer: Aetna Medicare |
$162.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$195.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$195.88
|
| Rate for Payer: BCBS Complete |
$88.19
|
| Rate for Payer: BCBS MAPPO |
$156.70
|
| Rate for Payer: BCN Medicare Advantage |
$156.70
|
| Rate for Payer: Cash Price |
$98.22
|
| Rate for Payer: Cash Price |
$98.22
|
| Rate for Payer: Cofinity Commercial |
$85.94
|
| Rate for Payer: Cofinity Commercial |
$105.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$85.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.70
|
| Rate for Payer: Healthscope Commercial |
$110.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.08
|
| Rate for Payer: Mclaren Medicaid |
$83.99
|
| Rate for Payer: Mclaren Medicare |
$156.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.53
|
| Rate for Payer: Meridian Medicaid |
$88.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$180.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.35
|
| Rate for Payer: PACE Medicare |
$148.87
|
| Rate for Payer: PACE SWMI |
$156.70
|
| Rate for Payer: PHP Commercial |
$104.35
|
| Rate for Payer: PHP Medicare Advantage |
$156.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.80
|
| Rate for Payer: Priority Health Medicare |
$156.70
|
| Rate for Payer: Priority Health SBD |
$77.35
|
| Rate for Payer: Railroad Medicare Medicare |
$156.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$441.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.70
|
| Rate for Payer: UHC Exchange |
$299.47
|
| Rate for Payer: UHC Medicare Advantage |
$156.70
|
| Rate for Payer: UHCCP Medicaid |
$83.99
|
| Rate for Payer: UMR Bronson Commercial |
$45.42
|
| Rate for Payer: VA VA |
$156.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.08
|
|
|
HC HEALTH & BEHAV INTERVENT INDIV INIT 30 MIN
|
Facility
|
IP
|
$122.77
|
|
|
Service Code
|
CPT 96158
|
| Hospital Charge Code |
91400010
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$54.02 |
| Max. Negotiated Rate |
$110.49 |
| Rate for Payer: Aetna American Axle |
$79.80
|
| Rate for Payer: Aetna Commercial |
$104.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.80
|
| Rate for Payer: Cash Price |
$98.22
|
| Rate for Payer: Cofinity Commercial |
$105.58
|
| Rate for Payer: Cofinity Commercial |
$85.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$85.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.22
|
| Rate for Payer: Healthscope Commercial |
$110.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.35
|
| Rate for Payer: PHP Commercial |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.80
|
| Rate for Payer: Priority Health SBD |
$77.35
|
| Rate for Payer: UMR Bronson Commercial |
$54.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.08
|
|
|
HC HEARING AID CHECK BINAURAL
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 92593
|
| Hospital Charge Code |
76100499
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$26.93 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna American Axle |
$39.78
|
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health SBD |
$38.56
|
| Rate for Payer: UMR Bronson Commercial |
$26.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC HEARING AID CHECK BINAURAL
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 92593
|
| Hospital Charge Code |
76100499
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$22.64 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$39.78
|
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$30.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: BCBS Complete |
$24.48
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health SBD |
$38.56
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$22.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC HEARING AID CHECK MONAURAL
|
Facility
|
OP
|
$54.06
|
|
|
Service Code
|
CPT 92592
|
| Hospital Charge Code |
47100402
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$35.14
|
| Rate for Payer: Aetna Commercial |
$45.95
|
| Rate for Payer: Aetna Medicare |
$27.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.14
|
| Rate for Payer: BCBS Complete |
$21.62
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cofinity Commercial |
$46.49
|
| Rate for Payer: Cofinity Commercial |
$37.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.25
|
| Rate for Payer: Healthscope Commercial |
$48.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.95
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.14
|
| Rate for Payer: Priority Health SBD |
$34.06
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$20.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.55
|
|
|
HC HEARING AID CHECK MONAURAL
|
Facility
|
IP
|
$54.06
|
|
|
Service Code
|
CPT 92592
|
| Hospital Charge Code |
47100402
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$23.79 |
| Max. Negotiated Rate |
$48.65 |
| Rate for Payer: Aetna American Axle |
$35.14
|
| Rate for Payer: Aetna Commercial |
$45.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.14
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cofinity Commercial |
$37.84
|
| Rate for Payer: Cofinity Commercial |
$46.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.25
|
| Rate for Payer: Healthscope Commercial |
$48.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.95
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.14
|
| Rate for Payer: Priority Health SBD |
$34.06
|
| Rate for Payer: UMR Bronson Commercial |
$23.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.55
|
|
|
HC HEARING AID EXAM BOTH EARS
|
Facility
|
IP
|
$121.38
|
|
|
Service Code
|
CPT 92591
|
| Hospital Charge Code |
76100504
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$53.41 |
| Max. Negotiated Rate |
$109.24 |
| Rate for Payer: Aetna American Axle |
$78.90
|
| Rate for Payer: Aetna Commercial |
$103.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.90
|
| Rate for Payer: Cash Price |
$97.10
|
| Rate for Payer: Cofinity Commercial |
$104.39
|
| Rate for Payer: Cofinity Commercial |
$84.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$84.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.10
|
| Rate for Payer: Healthscope Commercial |
$109.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.17
|
| Rate for Payer: PHP Commercial |
$103.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.90
|
| Rate for Payer: Priority Health SBD |
$76.47
|
| Rate for Payer: UMR Bronson Commercial |
$53.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.03
|
|
|
HC HEARING AID EXAM BOTH EARS
|
Facility
|
OP
|
$121.38
|
|
|
Service Code
|
CPT 92591
|
| Hospital Charge Code |
76100504
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$44.91 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$78.90
|
| Rate for Payer: Aetna Commercial |
$103.17
|
| Rate for Payer: Aetna Medicare |
$60.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.90
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: Cash Price |
$97.10
|
| Rate for Payer: Cash Price |
$97.10
|
| Rate for Payer: Cofinity Commercial |
$84.97
|
| Rate for Payer: Cofinity Commercial |
$104.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$84.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.10
|
| Rate for Payer: Healthscope Commercial |
$109.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.17
|
| Rate for Payer: PHP Commercial |
$103.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.90
|
| Rate for Payer: Priority Health SBD |
$76.47
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$44.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.03
|
|
|
HC HEARING AID EXAM ONE EAR
|
Facility
|
IP
|
$111.18
|
|
|
Service Code
|
CPT 92590
|
| Hospital Charge Code |
76100505
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$48.92 |
| Max. Negotiated Rate |
$100.06 |
| Rate for Payer: Aetna American Axle |
$72.27
|
| Rate for Payer: Aetna Commercial |
$94.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.27
|
| Rate for Payer: Cash Price |
$88.94
|
| Rate for Payer: Cofinity Commercial |
$77.83
|
| Rate for Payer: Cofinity Commercial |
$95.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.94
|
| Rate for Payer: Healthscope Commercial |
$100.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.50
|
| Rate for Payer: PHP Commercial |
$94.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.27
|
| Rate for Payer: Priority Health SBD |
$70.04
|
| Rate for Payer: UMR Bronson Commercial |
$48.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.39
|
|
|
HC HEARING AID EXAM ONE EAR
|
Facility
|
OP
|
$111.18
|
|
|
Service Code
|
CPT 92590
|
| Hospital Charge Code |
76100505
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$41.14 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$72.27
|
| Rate for Payer: Aetna Commercial |
$94.50
|
| Rate for Payer: Aetna Medicare |
$55.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.27
|
| Rate for Payer: BCBS Complete |
$44.47
|
| Rate for Payer: Cash Price |
$88.94
|
| Rate for Payer: Cash Price |
$88.94
|
| Rate for Payer: Cofinity Commercial |
$95.61
|
| Rate for Payer: Cofinity Commercial |
$77.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.94
|
| Rate for Payer: Healthscope Commercial |
$100.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.50
|
| Rate for Payer: PHP Commercial |
$94.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.27
|
| Rate for Payer: Priority Health SBD |
$70.04
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$41.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.39
|
|
|
HC HEART CATH CORONARIES CABG'S
|
Facility
|
OP
|
$12,212.39
|
|
|
Service Code
|
CPT 93459
|
| Hospital Charge Code |
48100018
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,681.38 |
| Max. Negotiated Rate |
$10,991.15 |
| Rate for Payer: Aetna American Axle |
$7,938.05
|
| Rate for Payer: Aetna Commercial |
$10,380.53
|
| Rate for Payer: Aetna Medicare |
$3,262.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,938.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,921.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,921.12
|
| Rate for Payer: BCBS Complete |
$1,765.45
|
| Rate for Payer: BCBS MAPPO |
$3,136.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,136.90
|
| Rate for Payer: Cash Price |
$9,769.91
|
| Rate for Payer: Cash Price |
$9,769.91
|
| Rate for Payer: Cofinity Commercial |
$8,548.67
|
| Rate for Payer: Cofinity Commercial |
$10,502.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,548.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,769.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,136.90
|
| Rate for Payer: Healthscope Commercial |
$10,991.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,548.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,159.29
|
| Rate for Payer: Mclaren Medicaid |
$1,681.38
|
| Rate for Payer: Mclaren Medicare |
$3,136.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,293.74
|
| Rate for Payer: Meridian Medicaid |
$1,765.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,607.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,380.53
|
| Rate for Payer: PACE Medicare |
$2,980.05
|
| Rate for Payer: PACE SWMI |
$3,136.90
|
| Rate for Payer: PHP Commercial |
$10,380.53
|
| Rate for Payer: PHP Medicare Advantage |
$3,136.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,681.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,938.05
|
| Rate for Payer: Priority Health Medicare |
$3,136.90
|
| Rate for Payer: Priority Health SBD |
$7,693.81
|
| Rate for Payer: Railroad Medicare Medicare |
$3,136.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,830.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,136.90
|
| Rate for Payer: UHC Exchange |
$5,994.93
|
| Rate for Payer: UHC Medicare Advantage |
$3,136.90
|
| Rate for Payer: UHCCP Medicaid |
$1,681.38
|
| Rate for Payer: UMR Bronson Commercial |
$4,518.58
|
| Rate for Payer: VA VA |
$3,136.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,159.29
|
|
|
HC HEART CATH CORONARIES CABG'S
|
Facility
|
IP
|
$12,212.39
|
|
|
Service Code
|
CPT 93459
|
| Hospital Charge Code |
48100018
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,373.45 |
| Max. Negotiated Rate |
$10,991.15 |
| Rate for Payer: Aetna American Axle |
$7,938.05
|
| Rate for Payer: Aetna Commercial |
$10,380.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,938.05
|
| Rate for Payer: Cash Price |
$9,769.91
|
| Rate for Payer: Cofinity Commercial |
$10,502.66
|
| Rate for Payer: Cofinity Commercial |
$8,548.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,548.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,769.91
|
| Rate for Payer: Healthscope Commercial |
$10,991.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,548.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,159.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,380.53
|
| Rate for Payer: PHP Commercial |
$10,380.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,938.05
|
| Rate for Payer: Priority Health SBD |
$7,693.81
|
| Rate for Payer: UMR Bronson Commercial |
$5,373.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,159.29
|
|
|
HC HEART CATH EXCHANGE WIRE
|
Facility
|
IP
|
$54.58
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200047
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.02 |
| Max. Negotiated Rate |
$49.12 |
| Rate for Payer: Aetna American Axle |
$35.48
|
| Rate for Payer: Aetna Commercial |
$46.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.48
|
| Rate for Payer: Cash Price |
$43.66
|
| Rate for Payer: Cofinity Commercial |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$46.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.66
|
| Rate for Payer: Healthscope Commercial |
$49.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.39
|
| Rate for Payer: PHP Commercial |
$46.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.48
|
| Rate for Payer: Priority Health SBD |
$34.39
|
| Rate for Payer: UMR Bronson Commercial |
$24.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.94
|
|
|
HC HEART CATH EXCHANGE WIRE
|
Facility
|
OP
|
$54.58
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200047
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.19 |
| Max. Negotiated Rate |
$49.12 |
| Rate for Payer: Aetna American Axle |
$35.48
|
| Rate for Payer: Aetna Commercial |
$46.39
|
| Rate for Payer: Aetna Medicare |
$27.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.48
|
| Rate for Payer: BCBS Complete |
$21.83
|
| Rate for Payer: Cash Price |
$43.66
|
| Rate for Payer: Cofinity Commercial |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$46.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.66
|
| Rate for Payer: Healthscope Commercial |
$49.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.39
|
| Rate for Payer: PHP Commercial |
$46.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.48
|
| Rate for Payer: Priority Health SBD |
$34.39
|
| Rate for Payer: UMR Bronson Commercial |
$20.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.94
|
|
