|
HC HDR 1 CHANNEL
|
Facility
|
IP
|
$1,989.66
|
|
|
Service Code
|
CPT 77770
|
| Hospital Charge Code |
33300055
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$875.45 |
| Max. Negotiated Rate |
$1,790.69 |
| Rate for Payer: Aetna American Axle |
$1,293.28
|
| Rate for Payer: Aetna Commercial |
$1,691.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,293.28
|
| Rate for Payer: Cash Price |
$1,591.73
|
| Rate for Payer: Cofinity Commercial |
$1,392.76
|
| Rate for Payer: Cofinity Commercial |
$1,711.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,392.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,591.73
|
| Rate for Payer: Healthscope Commercial |
$1,790.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,392.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,492.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,691.21
|
| Rate for Payer: PHP Commercial |
$1,691.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,293.28
|
| Rate for Payer: Priority Health SBD |
$1,253.49
|
| Rate for Payer: UMR Bronson Commercial |
$875.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,492.24
|
|
|
HC HDR 2-12 CHANNELS
|
Facility
|
IP
|
$2,210.05
|
|
|
Service Code
|
CPT 77771
|
| Hospital Charge Code |
33300056
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$972.42 |
| Max. Negotiated Rate |
$1,989.04 |
| Rate for Payer: Aetna American Axle |
$1,436.53
|
| Rate for Payer: Aetna Commercial |
$1,878.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,436.53
|
| Rate for Payer: Cash Price |
$1,768.04
|
| Rate for Payer: Cofinity Commercial |
$1,547.04
|
| Rate for Payer: Cofinity Commercial |
$1,900.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,547.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,768.04
|
| Rate for Payer: Healthscope Commercial |
$1,989.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,547.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,657.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,878.54
|
| Rate for Payer: PHP Commercial |
$1,878.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,436.53
|
| Rate for Payer: Priority Health SBD |
$1,392.33
|
| Rate for Payer: UMR Bronson Commercial |
$972.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,657.54
|
|
|
HC HDR 2-12 CHANNELS
|
Facility
|
OP
|
$2,210.05
|
|
|
Service Code
|
CPT 77771
|
| Hospital Charge Code |
33300056
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$364.36 |
| Max. Negotiated Rate |
$2,136.53 |
| Rate for Payer: Aetna American Axle |
$1,436.53
|
| Rate for Payer: Aetna Commercial |
$1,878.54
|
| Rate for Payer: Aetna Medicare |
$706.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,436.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$849.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$849.72
|
| Rate for Payer: BCBS Complete |
$382.58
|
| Rate for Payer: BCBS MAPPO |
$679.78
|
| Rate for Payer: BCBS Trust/PPO |
$790.12
|
| Rate for Payer: BCN Commercial |
$790.12
|
| Rate for Payer: BCN Medicare Advantage |
$679.78
|
| Rate for Payer: Cash Price |
$1,768.04
|
| Rate for Payer: Cash Price |
$1,768.04
|
| Rate for Payer: Cash Price |
$1,768.04
|
| Rate for Payer: Cofinity Commercial |
$1,547.04
|
| Rate for Payer: Cofinity Commercial |
$1,900.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,547.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,768.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$679.78
|
| Rate for Payer: Healthscope Commercial |
$1,989.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,547.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,657.54
|
| Rate for Payer: Mclaren Medicaid |
$364.36
|
| Rate for Payer: Mclaren Medicare |
$679.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$713.77
|
| Rate for Payer: Meridian Medicaid |
$382.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$781.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,878.54
|
| Rate for Payer: Nomi Health Commercial |
$2,039.34
|
| Rate for Payer: PACE Medicare |
$645.79
|
| Rate for Payer: PACE SWMI |
$679.78
|
| Rate for Payer: PHP Commercial |
$1,878.54
|
| Rate for Payer: PHP Medicare Advantage |
$679.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,436.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,136.53
|
| Rate for Payer: Priority Health Medicare |
$679.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,709.22
|
| Rate for Payer: Priority Health SBD |
$1,392.33
|
| Rate for Payer: Railroad Medicare Medicare |
$679.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$610.94
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$679.78
|
| Rate for Payer: UHC Exchange |
$555.40
|
| Rate for Payer: UHC Medicare Advantage |
$679.78
|
| Rate for Payer: UHCCP Medicaid |
$364.36
|
| Rate for Payer: UMR Bronson Commercial |
$817.72
|
| Rate for Payer: VA VA |
$679.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,657.54
|
|
|
HC HDR IR 192 BRACHY SOURCE NSTRD
|
Facility
|
IP
|
$562.41
|
|
|
Service Code
|
HCPCS C1717
|
| Hospital Charge Code |
27800090
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$247.46 |
| Max. Negotiated Rate |
$506.17 |
| Rate for Payer: Aetna American Axle |
$365.57
|
| Rate for Payer: Aetna Commercial |
$478.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.57
|
| Rate for Payer: Cash Price |
$449.93
|
| Rate for Payer: Cofinity Commercial |
$393.69
|
| Rate for Payer: Cofinity Commercial |
$483.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$393.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.93
|
| 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: Multiplan/Beech St/PHCS Commercial |
$478.05
|
| Rate for Payer: PHP Commercial |
$478.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.57
|
| Rate for Payer: Priority Health SBD |
$354.32
|
| Rate for Payer: UMR Bronson Commercial |
$247.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.81
|
|
|
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 |
$179.81 |
| Max. Negotiated Rate |
$1,054.37 |
| 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: Aetna American Axle |
$365.57
|
| Rate for Payer: Aetna Commercial |
$478.05
|
| Rate for Payer: Aetna Medicare |
$348.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$419.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$419.34
|
| Rate for Payer: BCBS Complete |
$188.80
|
| Rate for Payer: BCBS MAPPO |
$335.47
|
| Rate for Payer: BCN Medicare Advantage |
$335.47
|
| Rate for Payer: Cash Price |
$449.93
|
| Rate for Payer: Cash Price |
$449.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$335.47
|
| 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 |
$179.81
|
| Rate for Payer: Mclaren Medicare |
$335.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$352.24
|
| Rate for Payer: Meridian Medicaid |
$188.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$385.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$478.05
|
| Rate for Payer: Nomi Health Commercial |
$1,006.41
|
| Rate for Payer: PACE Medicare |
$318.70
|
| Rate for Payer: PACE SWMI |
$335.47
|
| Rate for Payer: PHP Commercial |
$478.05
|
| Rate for Payer: PHP Medicare Advantage |
$335.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,054.37
|
| Rate for Payer: Priority Health Medicare |
$335.47
|
| Rate for Payer: Priority Health Narrow Network |
$843.50
|
| Rate for Payer: Priority Health SBD |
$354.32
|
| Rate for Payer: Railroad Medicare Medicare |
$335.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$944.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$335.47
|
| Rate for Payer: UHC Exchange |
$641.12
|
| Rate for Payer: UHC Medicare Advantage |
$335.47
|
| Rate for Payer: UHCCP Medicaid |
$179.81
|
| Rate for Payer: UMR Bronson Commercial |
$208.09
|
| Rate for Payer: VA VA |
$335.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.81
|
|
|
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 |
$364.36 |
| 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 |
$706.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,585.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$849.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$849.72
|
| Rate for Payer: BCBS Complete |
$382.58
|
| Rate for Payer: BCBS MAPPO |
$679.78
|
| Rate for Payer: BCBS Trust/PPO |
$790.12
|
| Rate for Payer: BCN Commercial |
$790.12
|
| Rate for Payer: BCN Medicare Advantage |
$679.78
|
| 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 |
$679.78
|
| 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 |
$364.36
|
| Rate for Payer: Mclaren Medicare |
$679.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$713.77
|
| Rate for Payer: Meridian Medicaid |
$382.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$781.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,073.06
|
| Rate for Payer: Nomi Health Commercial |
$2,039.34
|
| Rate for Payer: PACE Medicare |
$645.79
|
| Rate for Payer: PACE SWMI |
$679.78
|
| Rate for Payer: PHP Commercial |
$2,073.06
|
| Rate for Payer: PHP Medicare Advantage |
$679.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,585.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,136.53
|
| Rate for Payer: Priority Health Medicare |
$679.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,709.22
|
| Rate for Payer: Priority Health SBD |
$1,536.50
|
| Rate for Payer: Railroad Medicare Medicare |
$679.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$911.39
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$679.78
|
| Rate for Payer: UHC Exchange |
$828.54
|
| Rate for Payer: UHC Medicare Advantage |
$679.78
|
| Rate for Payer: UHCCP Medicaid |
$364.36
|
| Rate for Payer: UMR Bronson Commercial |
$902.39
|
| Rate for Payer: VA VA |
$679.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,829.17
|
|
|
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 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 1 CHANNEL
|
Facility
|
OP
|
$481.76
|
|
|
Service Code
|
CPT 77767
|
| Hospital Charge Code |
33300053
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$138.11 |
| 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 |
$267.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$313.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$322.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$322.08
|
| Rate for Payer: BCBS Complete |
$145.01
|
| Rate for Payer: BCBS MAPPO |
$257.66
|
| Rate for Payer: BCBS Trust/PPO |
$218.77
|
| Rate for Payer: BCN Commercial |
$218.77
|
| Rate for Payer: BCN Medicare Advantage |
$257.66
|
| 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 |
$257.66
|
| 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 |
$138.11
|
| Rate for Payer: Mclaren Medicare |
$257.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.54
|
| Rate for Payer: Meridian Medicaid |
$145.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$296.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.50
|
| Rate for Payer: Nomi Health Commercial |
$772.98
|
| Rate for Payer: PACE Medicare |
$244.78
|
| Rate for Payer: PACE SWMI |
$257.66
|
| Rate for Payer: PHP Commercial |
$409.50
|
| Rate for Payer: PHP Medicare Advantage |
$257.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$809.82
|
| Rate for Payer: Priority Health Medicare |
$257.66
|
| Rate for Payer: Priority Health Narrow Network |
$647.86
|
| Rate for Payer: Priority Health SBD |
$303.51
|
| Rate for Payer: Railroad Medicare Medicare |
$257.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.32
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.66
|
| Rate for Payer: UHC Exchange |
$227.56
|
| Rate for Payer: UHC Medicare Advantage |
$257.66
|
| Rate for Payer: UHCCP Medicaid |
$138.11
|
| Rate for Payer: UMR Bronson Commercial |
$178.25
|
| Rate for Payer: VA VA |
$257.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.32
|
|
|
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 |
$138.11 |
| 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 |
$267.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$322.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$322.08
|
| Rate for Payer: BCBS Complete |
$145.01
|
| Rate for Payer: BCBS MAPPO |
$257.66
|
| Rate for Payer: BCBS Trust/PPO |
$218.77
|
| Rate for Payer: BCN Commercial |
$218.77
|
| Rate for Payer: BCN Medicare Advantage |
$257.66
|
| 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 |
$257.66
|
| 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 |
$138.11
|
| Rate for Payer: Mclaren Medicare |
$257.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.54
|
| Rate for Payer: Meridian Medicaid |
$145.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$296.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$460.69
|
| Rate for Payer: Nomi Health Commercial |
$772.98
|
| Rate for Payer: PACE Medicare |
$244.78
|
| Rate for Payer: PACE SWMI |
$257.66
|
| Rate for Payer: PHP Commercial |
$460.69
|
| Rate for Payer: PHP Medicare Advantage |
$257.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$809.82
|
| Rate for Payer: Priority Health Medicare |
$257.66
|
| Rate for Payer: Priority Health Narrow Network |
$647.86
|
| Rate for Payer: Priority Health SBD |
$341.45
|
| Rate for Payer: Railroad Medicare Medicare |
$257.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.33
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.66
|
| Rate for Payer: UHC Exchange |
$333.03
|
| Rate for Payer: UHC Medicare Advantage |
$257.66
|
| Rate for Payer: UHCCP Medicaid |
$138.11
|
| Rate for Payer: UMR Bronson Commercial |
$200.54
|
| Rate for Payer: VA VA |
$257.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.49
|
|
|
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 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 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 |
$284.86 |
| Rate for Payer: Aetna American Axle |
$79.80
|
| Rate for Payer: Aetna Commercial |
$104.35
|
| Rate for Payer: Aetna Medicare |
$94.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.29
|
| Rate for Payer: BCBS Complete |
$51.01
|
| Rate for Payer: BCBS MAPPO |
$90.63
|
| Rate for Payer: BCN Medicare Advantage |
$90.63
|
| 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 |
$90.63
|
| 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 |
$48.58
|
| Rate for Payer: Mclaren Medicare |
$90.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.16
|
| Rate for Payer: Meridian Medicaid |
$51.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.35
|
| Rate for Payer: Nomi Health Commercial |
$271.89
|
| Rate for Payer: PACE Medicare |
$86.10
|
| Rate for Payer: PACE SWMI |
$90.63
|
| Rate for Payer: PHP Commercial |
$104.35
|
| Rate for Payer: PHP Medicare Advantage |
$90.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$284.86
|
| Rate for Payer: Priority Health Medicare |
$90.63
|
| Rate for Payer: Priority Health Narrow Network |
$227.89
|
| Rate for Payer: Priority Health SBD |
$77.35
|
| Rate for Payer: Railroad Medicare Medicare |
$90.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.63
|
| Rate for Payer: UHC Exchange |
$85.46
|
| Rate for Payer: UHC Medicare Advantage |
$90.63
|
| Rate for Payer: UHCCP Medicaid |
$48.58
|
| Rate for Payer: UMR Bronson Commercial |
$45.42
|
| Rate for Payer: VA VA |
$90.63
|
| 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 |
$19.20 |
| 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: Cash Price |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$52.79
|
| Rate for Payer: Cofinity Commercial |
$42.97
|
| 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 |
$46.04
|
| 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: UHC All Payor (Choice/PPO) |
$21.12
|
| Rate for Payer: UHC Exchange |
$19.20
|
| Rate for Payer: UMR Bronson Commercial |
$22.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.04
|
|
|
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 |
$46.04
|
| 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 |
$46.04
|
|
|
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 |
$494.78 |
| Rate for Payer: Aetna American Axle |
$79.80
|
| Rate for Payer: Aetna Commercial |
$104.35
|
| Rate for Payer: Aetna Medicare |
$163.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$196.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$196.78
|
| Rate for Payer: BCBS Complete |
$88.60
|
| Rate for Payer: BCBS MAPPO |
$157.42
|
| Rate for Payer: BCN Medicare Advantage |
$157.42
|
| 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 |
$157.42
|
| 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 |
$84.38
|
| Rate for Payer: Mclaren Medicare |
$157.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.29
|
| Rate for Payer: Meridian Medicaid |
$88.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$181.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.35
|
| Rate for Payer: Nomi Health Commercial |
$472.26
|
| Rate for Payer: PACE Medicare |
$149.55
|
| Rate for Payer: PACE SWMI |
$157.42
|
| Rate for Payer: PHP Commercial |
$104.35
|
| Rate for Payer: PHP Medicare Advantage |
$157.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$494.78
|
| Rate for Payer: Priority Health Medicare |
$157.42
|
| Rate for Payer: Priority Health Narrow Network |
$395.82
|
| Rate for Payer: Priority Health SBD |
$77.35
|
| Rate for Payer: Railroad Medicare Medicare |
$157.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.42
|
| Rate for Payer: UHC Exchange |
$57.27
|
| Rate for Payer: UHC Medicare Advantage |
$157.42
|
| Rate for Payer: UHCCP Medicaid |
$84.38
|
| Rate for Payer: UMR Bronson Commercial |
$45.42
|
| Rate for Payer: VA VA |
$157.42
|
| 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
|
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 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 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 |
$40.54
|
| 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 |
$40.54
|
|
|
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 |
$40.54
|
| 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 |
$40.54
|
|
|
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 |
$91.04
|
| 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 |
$91.04
|
|
|
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 |
$91.04
|
| 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 |
$91.04
|
|
|
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 |
$83.38
|
| 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 |
$83.38
|
|
|
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 |
$83.38
|
| 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 |
$83.38
|
|
