|
HC RNA POLYMERASE III AB IGG
|
Facility
|
IP
|
$70.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200413
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Aetna American Axle |
$45.50
|
| Rate for Payer: Aetna Commercial |
$59.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.50
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cofinity Commercial |
$49.00
|
| Rate for Payer: Cofinity Commercial |
$60.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.00
|
| Rate for Payer: Healthscope Commercial |
$63.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$59.50
|
| Rate for Payer: PHP Commercial |
$59.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.00
|
| Rate for Payer: Priority Health SBD |
$44.10
|
| Rate for Payer: UMR Bronson Commercial |
$30.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.50
|
|
|
HC RNP 70 ANTIBODY
|
Facility
|
OP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200164
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.81 |
| Max. Negotiated Rate |
$31.03 |
| Rate for Payer: Aetna American Axle |
$22.41
|
| Rate for Payer: Aetna Commercial |
$29.31
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$10.30
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$16.13
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$24.14
|
| Rate for Payer: Cofinity Commercial |
$29.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$31.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
| Rate for Payer: Mclaren Medicaid |
$9.81
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Medicaid |
$10.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$29.31
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.91
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$15.93
|
| Rate for Payer: Priority Health SBD |
$21.72
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.52
|
| Rate for Payer: UHC Core |
$29.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$17.93
|
| Rate for Payer: UHC Medicare Advantage |
$18.47
|
| Rate for Payer: UMR Bronson Commercial |
$12.76
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
|
HC RNP 70 ANTIBODY
|
Facility
|
IP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200164
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.17 |
| Max. Negotiated Rate |
$31.03 |
| Rate for Payer: Aetna American Axle |
$22.41
|
| Rate for Payer: Aetna Commercial |
$29.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.41
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$24.14
|
| Rate for Payer: Cofinity Commercial |
$29.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Healthscope Commercial |
$31.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PHP Commercial |
$29.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health SBD |
$21.72
|
| Rate for Payer: UMR Bronson Commercial |
$15.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
|
HC RNP ANTIBODIES, IGG
|
Facility
|
OP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200434
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.81 |
| Max. Negotiated Rate |
$31.03 |
| Rate for Payer: Aetna American Axle |
$22.41
|
| Rate for Payer: Aetna Commercial |
$29.31
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$10.30
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$16.13
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$29.65
|
| Rate for Payer: Cofinity Commercial |
$24.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$31.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
| Rate for Payer: Mclaren Medicaid |
$9.81
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Medicaid |
$10.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$29.31
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.91
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$15.93
|
| Rate for Payer: Priority Health SBD |
$21.72
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.52
|
| Rate for Payer: UHC Core |
$29.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$17.93
|
| Rate for Payer: UHC Medicare Advantage |
$18.47
|
| Rate for Payer: UMR Bronson Commercial |
$12.76
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
|
HC RNP ANTIBODIES, IGG
|
Facility
|
IP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200434
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.17 |
| Max. Negotiated Rate |
$31.03 |
| Rate for Payer: Aetna American Axle |
$22.41
|
| Rate for Payer: Aetna Commercial |
$29.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.41
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$24.14
|
| Rate for Payer: Cofinity Commercial |
$29.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Healthscope Commercial |
$31.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PHP Commercial |
$29.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health SBD |
$21.72
|
| Rate for Payer: UMR Bronson Commercial |
$15.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
|
HC RNP U1 ANTIBODY
|
Facility
|
IP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200166
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.17 |
| Max. Negotiated Rate |
$31.03 |
| Rate for Payer: Aetna American Axle |
$22.41
|
| Rate for Payer: Aetna Commercial |
$29.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.41
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$24.14
|
| Rate for Payer: Cofinity Commercial |
$29.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Healthscope Commercial |
$31.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PHP Commercial |
$29.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health SBD |
$21.72
|
| Rate for Payer: UMR Bronson Commercial |
$15.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
|
HC RNP U1 ANTIBODY
|
Facility
|
OP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200166
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.81 |
| Max. Negotiated Rate |
$31.03 |
| Rate for Payer: Aetna American Axle |
$22.41
|
| Rate for Payer: Aetna Commercial |
$29.31
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$10.30
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$16.13
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$29.65
|
| Rate for Payer: Cofinity Commercial |
$24.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$31.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
| Rate for Payer: Mclaren Medicaid |
$9.81
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Medicaid |
$10.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$29.31
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.91
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$15.93
|
| Rate for Payer: Priority Health SBD |
$21.72
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.52
|
| Rate for Payer: UHC Core |
$29.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$17.93
|
| Rate for Payer: UHC Medicare Advantage |
$18.47
|
| Rate for Payer: UMR Bronson Commercial |
$12.76
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
|
HC RO GUIDE LOC TARGET VOL TX DEL
|
Facility
|
IP
|
$219.40
|
|
|
Service Code
|
CPT 77387
|
| Hospital Charge Code |
33300061
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$96.54 |
| Max. Negotiated Rate |
$197.46 |
| Rate for Payer: Aetna American Axle |
$142.61
|
| Rate for Payer: Aetna American Axle |
$692.25
|
| Rate for Payer: Aetna Commercial |
$905.25
|
| Rate for Payer: Aetna Commercial |
$186.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$692.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.61
|
| Rate for Payer: Cash Price |
$852.00
|
| Rate for Payer: Cash Price |
$175.52
|
| Rate for Payer: Cofinity Commercial |
$188.68
|
| Rate for Payer: Cofinity Commercial |
$153.58
|
| Rate for Payer: Cofinity Commercial |
$915.90
|
| Rate for Payer: Cofinity Commercial |
$745.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$852.00
|
| Rate for Payer: Healthscope Commercial |
$958.50
|
| Rate for Payer: Healthscope Commercial |
$197.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$745.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$153.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$798.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$186.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$905.25
|
| Rate for Payer: PHP Commercial |
$186.49
|
| Rate for Payer: PHP Commercial |
$905.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$745.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.58
|
| Rate for Payer: Priority Health SBD |
$138.22
|
| Rate for Payer: Priority Health SBD |
$670.95
|
| Rate for Payer: UMR Bronson Commercial |
$468.60
|
| Rate for Payer: UMR Bronson Commercial |
$96.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$798.75
|
|
|
HC RO GUIDE LOC TARGET VOL TX DEL
|
Facility
|
OP
|
$219.40
|
|
|
Service Code
|
CPT 77387
|
| Hospital Charge Code |
33300061
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$81.18 |
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$142.61
|
| Rate for Payer: Aetna American Axle |
$692.25
|
| Rate for Payer: Aetna Commercial |
$186.49
|
| Rate for Payer: Aetna Commercial |
$905.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$692.25
|
| Rate for Payer: BCBS Complete |
$426.00
|
| Rate for Payer: BCBS Complete |
$87.76
|
| Rate for Payer: BCBS Trust/PPO |
$135.62
|
| Rate for Payer: BCBS Trust/PPO |
$135.62
|
| Rate for Payer: Cash Price |
$852.00
|
| Rate for Payer: Cash Price |
$852.00
|
| Rate for Payer: Cash Price |
$852.00
|
| Rate for Payer: Cash Price |
$175.52
|
| Rate for Payer: Cash Price |
$175.52
|
| Rate for Payer: Cash Price |
$175.52
|
| Rate for Payer: Cofinity Commercial |
$745.50
|
| Rate for Payer: Cofinity Commercial |
$188.68
|
| Rate for Payer: Cofinity Commercial |
$915.90
|
| Rate for Payer: Cofinity Commercial |
$153.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$852.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.52
|
| Rate for Payer: Healthscope Commercial |
$958.50
|
| Rate for Payer: Healthscope Commercial |
$197.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$153.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$745.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$798.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$905.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$186.49
|
| Rate for Payer: PHP Commercial |
$186.49
|
| Rate for Payer: PHP Commercial |
$905.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$745.50
|
| Rate for Payer: Priority Health SBD |
$138.22
|
| Rate for Payer: Priority Health SBD |
$670.95
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UMR Bronson Commercial |
$81.18
|
| Rate for Payer: UMR Bronson Commercial |
$394.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$798.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.55
|
|
|
HC RO IMRT DEL COMPLEX
|
Facility
|
IP
|
$3,223.53
|
|
|
Service Code
|
CPT 77386
|
| Hospital Charge Code |
33300051
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,418.35 |
| Max. Negotiated Rate |
$2,901.18 |
| Rate for Payer: Aetna American Axle |
$2,095.29
|
| Rate for Payer: Aetna American Axle |
$3,442.40
|
| Rate for Payer: Aetna Commercial |
$2,740.00
|
| Rate for Payer: Aetna Commercial |
$4,501.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,095.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,442.40
|
| Rate for Payer: Cash Price |
$4,236.80
|
| Rate for Payer: Cash Price |
$2,578.82
|
| Rate for Payer: Cofinity Commercial |
$2,772.24
|
| Rate for Payer: Cofinity Commercial |
$3,707.20
|
| Rate for Payer: Cofinity Commercial |
$4,554.56
|
| Rate for Payer: Cofinity Commercial |
$2,256.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,236.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,578.82
|
| Rate for Payer: Healthscope Commercial |
$4,766.40
|
| Rate for Payer: Healthscope Commercial |
$2,901.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,256.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,707.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,972.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,417.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,501.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,740.00
|
| Rate for Payer: PHP Commercial |
$2,740.00
|
| Rate for Payer: PHP Commercial |
$4,501.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,707.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,256.47
|
| Rate for Payer: Priority Health SBD |
$3,336.48
|
| Rate for Payer: Priority Health SBD |
$2,030.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,418.35
|
| Rate for Payer: UMR Bronson Commercial |
$2,330.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,417.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,972.00
|
|
|
HC RO IMRT DEL COMPLEX
|
Facility
|
OP
|
$5,296.00
|
|
|
Service Code
|
CPT 77386
|
| Hospital Charge Code |
33300051
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$286.22 |
| Max. Negotiated Rate |
$4,766.40 |
| Rate for Payer: Aetna American Axle |
$3,442.40
|
| Rate for Payer: Aetna American Axle |
$2,095.29
|
| Rate for Payer: Aetna Commercial |
$4,501.60
|
| Rate for Payer: Aetna Commercial |
$2,740.00
|
| Rate for Payer: Aetna Medicare |
$544.18
|
| Rate for Payer: Aetna Medicare |
$544.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,095.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,442.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$654.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$654.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$654.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$654.06
|
| Rate for Payer: BCBS Complete |
$300.55
|
| Rate for Payer: BCBS Complete |
$300.55
|
| Rate for Payer: BCBS MAPPO |
$523.25
|
| Rate for Payer: BCBS MAPPO |
$523.25
|
| Rate for Payer: BCBS Trust/PPO |
$633.74
|
| Rate for Payer: BCBS Trust/PPO |
$633.74
|
| Rate for Payer: BCN Medicare Advantage |
$523.25
|
| Rate for Payer: BCN Medicare Advantage |
$523.25
|
| Rate for Payer: Cash Price |
$2,578.82
|
| Rate for Payer: Cash Price |
$2,578.82
|
| Rate for Payer: Cash Price |
$2,578.82
|
| Rate for Payer: Cash Price |
$4,236.80
|
| Rate for Payer: Cash Price |
$4,236.80
|
| Rate for Payer: Cash Price |
$4,236.80
|
| Rate for Payer: Cofinity Commercial |
$3,707.20
|
| Rate for Payer: Cofinity Commercial |
$2,256.47
|
| Rate for Payer: Cofinity Commercial |
$2,772.24
|
| Rate for Payer: Cofinity Commercial |
$4,554.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,236.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,578.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$523.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$523.25
|
| Rate for Payer: Healthscope Commercial |
$4,766.40
|
| Rate for Payer: Healthscope Commercial |
$2,901.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,256.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,707.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,972.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,417.65
|
| Rate for Payer: Mclaren Medicaid |
$286.22
|
| Rate for Payer: Mclaren Medicaid |
$286.22
|
| Rate for Payer: Mclaren Medicare |
$523.25
|
| Rate for Payer: Mclaren Medicare |
$523.25
|
| Rate for Payer: Meridian Medicaid |
$300.55
|
| Rate for Payer: Meridian Medicaid |
$300.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$549.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$549.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$601.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$601.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,501.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,740.00
|
| Rate for Payer: PACE Medicare |
$497.09
|
| Rate for Payer: PACE Medicare |
$497.09
|
| Rate for Payer: PACE SWMI |
$523.25
|
| Rate for Payer: PACE SWMI |
$523.25
|
| Rate for Payer: PHP Commercial |
$2,740.00
|
| Rate for Payer: PHP Commercial |
$4,501.60
|
| Rate for Payer: PHP Medicare Advantage |
$523.25
|
| Rate for Payer: PHP Medicare Advantage |
$523.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,707.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,256.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,647.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,647.21
|
| Rate for Payer: Priority Health Medicare |
$523.25
|
| Rate for Payer: Priority Health Medicare |
$523.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,317.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,317.77
|
| Rate for Payer: Priority Health SBD |
$3,336.48
|
| Rate for Payer: Priority Health SBD |
$2,030.82
|
| Rate for Payer: Railroad Medicare Medicare |
$523.25
|
| Rate for Payer: Railroad Medicare Medicare |
$523.25
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$523.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$523.25
|
| Rate for Payer: UHC Medicare Advantage |
$538.95
|
| Rate for Payer: UHC Medicare Advantage |
$538.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,959.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,192.71
|
| Rate for Payer: VA VA |
$523.25
|
| Rate for Payer: VA VA |
$523.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,417.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,972.00
|
|
|
HC RO IMRT DEL SIMPLE
|
Facility
|
IP
|
$5,096.00
|
|
|
Service Code
|
CPT 77385
|
| Hospital Charge Code |
33300050
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$2,242.24 |
| Max. Negotiated Rate |
$4,586.40 |
| Rate for Payer: Aetna American Axle |
$3,312.40
|
| Rate for Payer: Aetna American Axle |
$2,095.29
|
| Rate for Payer: Aetna Commercial |
$4,331.60
|
| Rate for Payer: Aetna Commercial |
$2,740.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,095.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,312.40
|
| Rate for Payer: Cash Price |
$4,076.80
|
| Rate for Payer: Cash Price |
$2,578.82
|
| Rate for Payer: Cofinity Commercial |
$2,772.24
|
| Rate for Payer: Cofinity Commercial |
$3,567.20
|
| Rate for Payer: Cofinity Commercial |
$4,382.56
|
| Rate for Payer: Cofinity Commercial |
$2,256.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,076.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,578.82
|
| Rate for Payer: Healthscope Commercial |
$4,586.40
|
| Rate for Payer: Healthscope Commercial |
$2,901.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,256.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,567.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,822.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,417.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,331.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,740.00
|
| Rate for Payer: PHP Commercial |
$2,740.00
|
| Rate for Payer: PHP Commercial |
$4,331.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,567.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,256.47
|
| Rate for Payer: Priority Health SBD |
$3,210.48
|
| Rate for Payer: Priority Health SBD |
$2,030.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,418.35
|
| Rate for Payer: UMR Bronson Commercial |
$2,242.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,822.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,417.65
|
|
|
HC RO IMRT DEL SIMPLE
|
Facility
|
OP
|
$3,223.53
|
|
|
Service Code
|
CPT 77385
|
| Hospital Charge Code |
33300050
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$286.22 |
| Max. Negotiated Rate |
$2,901.18 |
| Rate for Payer: Aetna American Axle |
$2,095.29
|
| Rate for Payer: Aetna American Axle |
$3,312.40
|
| Rate for Payer: Aetna Commercial |
$2,740.00
|
| Rate for Payer: Aetna Commercial |
$4,331.60
|
| Rate for Payer: Aetna Medicare |
$544.18
|
| Rate for Payer: Aetna Medicare |
$544.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,095.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,312.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$654.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$654.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$654.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$654.06
|
| Rate for Payer: BCBS Complete |
$300.55
|
| Rate for Payer: BCBS Complete |
$300.55
|
| Rate for Payer: BCBS MAPPO |
$523.25
|
| Rate for Payer: BCBS MAPPO |
$523.25
|
| Rate for Payer: BCBS Trust/PPO |
$633.74
|
| Rate for Payer: BCBS Trust/PPO |
$633.74
|
| Rate for Payer: BCN Medicare Advantage |
$523.25
|
| Rate for Payer: BCN Medicare Advantage |
$523.25
|
| Rate for Payer: Cash Price |
$4,076.80
|
| Rate for Payer: Cash Price |
$2,578.82
|
| Rate for Payer: Cash Price |
$2,578.82
|
| Rate for Payer: Cash Price |
$2,578.82
|
| Rate for Payer: Cash Price |
$4,076.80
|
| Rate for Payer: Cash Price |
$4,076.80
|
| Rate for Payer: Cofinity Commercial |
$3,567.20
|
| Rate for Payer: Cofinity Commercial |
$4,382.56
|
| Rate for Payer: Cofinity Commercial |
$2,256.47
|
| Rate for Payer: Cofinity Commercial |
$2,772.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,076.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,578.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$523.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$523.25
|
| Rate for Payer: Healthscope Commercial |
$4,586.40
|
| Rate for Payer: Healthscope Commercial |
$2,901.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,256.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,567.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,417.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,822.00
|
| Rate for Payer: Mclaren Medicaid |
$286.22
|
| Rate for Payer: Mclaren Medicaid |
$286.22
|
| Rate for Payer: Mclaren Medicare |
$523.25
|
| Rate for Payer: Mclaren Medicare |
$523.25
|
| Rate for Payer: Meridian Medicaid |
$300.55
|
| Rate for Payer: Meridian Medicaid |
$300.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$549.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$549.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$601.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$601.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,331.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,740.00
|
| Rate for Payer: PACE Medicare |
$497.09
|
| Rate for Payer: PACE Medicare |
$497.09
|
| Rate for Payer: PACE SWMI |
$523.25
|
| Rate for Payer: PACE SWMI |
$523.25
|
| Rate for Payer: PHP Commercial |
$4,331.60
|
| Rate for Payer: PHP Commercial |
$2,740.00
|
| Rate for Payer: PHP Medicare Advantage |
$523.25
|
| Rate for Payer: PHP Medicare Advantage |
$523.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,567.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,256.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,647.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,647.21
|
| Rate for Payer: Priority Health Medicare |
$523.25
|
| Rate for Payer: Priority Health Medicare |
$523.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,317.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,317.77
|
| Rate for Payer: Priority Health SBD |
$3,210.48
|
| Rate for Payer: Priority Health SBD |
$2,030.82
|
| Rate for Payer: Railroad Medicare Medicare |
$523.25
|
| Rate for Payer: Railroad Medicare Medicare |
$523.25
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$523.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$523.25
|
| Rate for Payer: UHC Medicare Advantage |
$538.95
|
| Rate for Payer: UHC Medicare Advantage |
$538.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,192.71
|
| Rate for Payer: UMR Bronson Commercial |
$1,885.52
|
| Rate for Payer: VA VA |
$523.25
|
| Rate for Payer: VA VA |
$523.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,417.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,822.00
|
|
|
HC RO INFUS RADIOACTIVE MATERIAL
|
Facility
|
OP
|
$325.38
|
|
|
Service Code
|
CPT 77750
|
| Hospital Charge Code |
33300042
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$120.39 |
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$211.50
|
| Rate for Payer: Aetna Commercial |
$276.57
|
| Rate for Payer: Aetna Medicare |
$248.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$298.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$298.60
|
| Rate for Payer: BCBS Complete |
$137.21
|
| Rate for Payer: BCBS MAPPO |
$238.88
|
| Rate for Payer: BCBS Trust/PPO |
$245.79
|
| Rate for Payer: BCN Medicare Advantage |
$238.88
|
| Rate for Payer: Cash Price |
$260.30
|
| Rate for Payer: Cash Price |
$260.30
|
| Rate for Payer: Cash Price |
$260.30
|
| Rate for Payer: Cofinity Commercial |
$279.83
|
| Rate for Payer: Cofinity Commercial |
$227.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$260.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.88
|
| Rate for Payer: Healthscope Commercial |
$292.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$227.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$244.04
|
| Rate for Payer: Mclaren Medicaid |
$130.67
|
| Rate for Payer: Mclaren Medicare |
$238.88
|
| Rate for Payer: Meridian Medicaid |
$137.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$250.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$276.57
|
| Rate for Payer: PACE Medicare |
$226.94
|
| Rate for Payer: PACE SWMI |
$238.88
|
| Rate for Payer: PHP Commercial |
$276.57
|
| Rate for Payer: PHP Medicare Advantage |
$238.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$227.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$752.03
|
| Rate for Payer: Priority Health Medicare |
$238.88
|
| Rate for Payer: Priority Health Narrow Network |
$601.62
|
| Rate for Payer: Priority Health SBD |
$204.99
|
| Rate for Payer: Railroad Medicare Medicare |
$238.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$425.02
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.88
|
| Rate for Payer: UHC Exchange |
$386.38
|
| Rate for Payer: UHC Medicare Advantage |
$246.05
|
| Rate for Payer: UMR Bronson Commercial |
$120.39
|
| Rate for Payer: VA VA |
$238.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$244.04
|
|
|
HC RO INFUS RADIOACTIVE MATERIAL
|
Facility
|
IP
|
$325.38
|
|
|
Service Code
|
CPT 77750
|
| Hospital Charge Code |
33300042
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$143.17 |
| Max. Negotiated Rate |
$292.84 |
| Rate for Payer: Aetna American Axle |
$211.50
|
| Rate for Payer: Aetna Commercial |
$276.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.50
|
| Rate for Payer: Cash Price |
$260.30
|
| Rate for Payer: Cofinity Commercial |
$227.77
|
| Rate for Payer: Cofinity Commercial |
$279.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$260.30
|
| Rate for Payer: Healthscope Commercial |
$292.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$227.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$244.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$276.57
|
| Rate for Payer: PHP Commercial |
$276.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$227.77
|
| Rate for Payer: Priority Health SBD |
$204.99
|
| Rate for Payer: UMR Bronson Commercial |
$143.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$244.04
|
|
|
HC RO INS VAG BRACHTHER DEVICE
|
Facility
|
IP
|
$539.61
|
|
|
Service Code
|
CPT 57156
|
| Hospital Charge Code |
36100444
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$237.43 |
| Max. Negotiated Rate |
$485.65 |
| Rate for Payer: Aetna American Axle |
$350.75
|
| Rate for Payer: Aetna Commercial |
$458.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$350.75
|
| Rate for Payer: Cash Price |
$431.69
|
| Rate for Payer: Cofinity Commercial |
$464.06
|
| Rate for Payer: Cofinity Commercial |
$377.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$431.69
|
| Rate for Payer: Healthscope Commercial |
$485.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$377.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$404.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$458.67
|
| Rate for Payer: PHP Commercial |
$458.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$377.73
|
| Rate for Payer: Priority Health SBD |
$339.95
|
| Rate for Payer: UMR Bronson Commercial |
$237.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$404.71
|
|
|
HC RO INS VAG BRACHTHER DEVICE
|
Facility
|
OP
|
$539.61
|
|
|
Service Code
|
CPT 57156
|
| Hospital Charge Code |
36100444
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$148.00 |
| Max. Negotiated Rate |
$897.69 |
| Rate for Payer: Aetna American Axle |
$350.75
|
| Rate for Payer: Aetna Commercial |
$458.67
|
| Rate for Payer: Aetna Medicare |
$296.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$350.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$356.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$356.45
|
| Rate for Payer: BCBS Complete |
$163.80
|
| Rate for Payer: BCBS MAPPO |
$285.16
|
| Rate for Payer: BCBS Trust/PPO |
$312.22
|
| Rate for Payer: BCN Medicare Advantage |
$285.16
|
| Rate for Payer: Cash Price |
$431.69
|
| Rate for Payer: Cash Price |
$431.69
|
| Rate for Payer: Cofinity Commercial |
$377.73
|
| Rate for Payer: Cofinity Commercial |
$464.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$431.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.16
|
| Rate for Payer: Healthscope Commercial |
$485.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$377.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$404.71
|
| Rate for Payer: Mclaren Medicaid |
$155.98
|
| Rate for Payer: Mclaren Medicare |
$285.16
|
| Rate for Payer: Meridian Medicaid |
$163.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$299.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$327.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$458.67
|
| Rate for Payer: PACE Medicare |
$270.90
|
| Rate for Payer: PACE SWMI |
$285.16
|
| Rate for Payer: PHP Commercial |
$458.67
|
| Rate for Payer: PHP Medicare Advantage |
$285.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$377.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$897.69
|
| Rate for Payer: Priority Health Medicare |
$285.16
|
| Rate for Payer: Priority Health Narrow Network |
$718.15
|
| Rate for Payer: Priority Health SBD |
$339.95
|
| Rate for Payer: Railroad Medicare Medicare |
$285.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.80
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$285.16
|
| Rate for Payer: UHC Exchange |
$148.00
|
| Rate for Payer: UHC Medicare Advantage |
$293.71
|
| Rate for Payer: UMR Bronson Commercial |
$199.66
|
| Rate for Payer: VA VA |
$285.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$404.71
|
|
|
HC RO INTRSTI RADELEMENT APPL CMPLX
|
Facility
|
IP
|
$1,265.00
|
|
|
Service Code
|
CPT 77778
|
| Hospital Charge Code |
33300035
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$556.60 |
| Max. Negotiated Rate |
$1,138.50 |
| Rate for Payer: Aetna American Axle |
$822.25
|
| Rate for Payer: Aetna American Axle |
$1,808.00
|
| Rate for Payer: Aetna Commercial |
$2,364.31
|
| Rate for Payer: Aetna Commercial |
$1,075.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,808.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$822.25
|
| Rate for Payer: Cash Price |
$2,225.23
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cofinity Commercial |
$1,087.90
|
| Rate for Payer: Cofinity Commercial |
$885.50
|
| Rate for Payer: Cofinity Commercial |
$2,392.12
|
| Rate for Payer: Cofinity Commercial |
$1,947.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,225.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,012.00
|
| Rate for Payer: Healthscope Commercial |
$2,503.39
|
| Rate for Payer: Healthscope Commercial |
$1,138.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$885.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,947.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,086.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$948.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,364.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,075.25
|
| Rate for Payer: PHP Commercial |
$2,364.31
|
| Rate for Payer: PHP Commercial |
$1,075.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,947.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$885.50
|
| Rate for Payer: Priority Health SBD |
$1,752.37
|
| Rate for Payer: Priority Health SBD |
$796.95
|
| Rate for Payer: UMR Bronson Commercial |
$556.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,223.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$948.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,086.16
|
|
|
HC RO INTRSTI RADELEMENT APPL CMPLX
|
Facility
|
OP
|
$2,781.54
|
|
|
Service Code
|
CPT 77778
|
| Hospital Charge Code |
33300035
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$348.61 |
| Max. Negotiated Rate |
$2,503.39 |
| Rate for Payer: Aetna American Axle |
$1,808.00
|
| Rate for Payer: Aetna American Axle |
$822.25
|
| Rate for Payer: Aetna Commercial |
$2,364.31
|
| Rate for Payer: Aetna Commercial |
$1,075.25
|
| Rate for Payer: Aetna Medicare |
$662.80
|
| Rate for Payer: Aetna Medicare |
$662.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$822.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,808.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$796.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$796.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$796.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$796.64
|
| Rate for Payer: BCBS Complete |
$366.07
|
| Rate for Payer: BCBS Complete |
$366.07
|
| Rate for Payer: BCBS MAPPO |
$637.31
|
| Rate for Payer: BCBS MAPPO |
$637.31
|
| Rate for Payer: BCBS Trust/PPO |
$859.63
|
| Rate for Payer: BCBS Trust/PPO |
$859.63
|
| Rate for Payer: BCN Medicare Advantage |
$637.31
|
| Rate for Payer: BCN Medicare Advantage |
$637.31
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cash Price |
$2,225.23
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cash Price |
$2,225.23
|
| Rate for Payer: Cash Price |
$2,225.23
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cofinity Commercial |
$885.50
|
| Rate for Payer: Cofinity Commercial |
$1,947.08
|
| Rate for Payer: Cofinity Commercial |
$2,392.12
|
| Rate for Payer: Cofinity Commercial |
$1,087.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,225.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,012.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$637.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$637.31
|
| Rate for Payer: Healthscope Commercial |
$1,138.50
|
| Rate for Payer: Healthscope Commercial |
$2,503.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$885.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,947.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,086.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$948.75
|
| Rate for Payer: Mclaren Medicaid |
$348.61
|
| Rate for Payer: Mclaren Medicaid |
$348.61
|
| Rate for Payer: Mclaren Medicare |
$637.31
|
| Rate for Payer: Mclaren Medicare |
$637.31
|
| Rate for Payer: Meridian Medicaid |
$366.07
|
| Rate for Payer: Meridian Medicaid |
$366.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$669.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$669.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$732.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$732.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,075.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,364.31
|
| Rate for Payer: PACE Medicare |
$605.44
|
| Rate for Payer: PACE Medicare |
$605.44
|
| Rate for Payer: PACE SWMI |
$637.31
|
| Rate for Payer: PACE SWMI |
$637.31
|
| Rate for Payer: PHP Commercial |
$1,075.25
|
| Rate for Payer: PHP Commercial |
$2,364.31
|
| Rate for Payer: PHP Medicare Advantage |
$637.31
|
| Rate for Payer: PHP Medicare Advantage |
$637.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,947.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$885.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,006.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,006.26
|
| Rate for Payer: Priority Health Medicare |
$637.31
|
| Rate for Payer: Priority Health Medicare |
$637.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,605.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,605.01
|
| Rate for Payer: Priority Health SBD |
$1,752.37
|
| Rate for Payer: Priority Health SBD |
$796.95
|
| Rate for Payer: Railroad Medicare Medicare |
$637.31
|
| Rate for Payer: Railroad Medicare Medicare |
$637.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$995.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$995.19
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$637.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$637.31
|
| Rate for Payer: UHC Exchange |
$904.72
|
| Rate for Payer: UHC Exchange |
$904.72
|
| Rate for Payer: UHC Medicare Advantage |
$656.43
|
| Rate for Payer: UHC Medicare Advantage |
$656.43
|
| Rate for Payer: UMR Bronson Commercial |
$468.05
|
| Rate for Payer: UMR Bronson Commercial |
$1,029.17
|
| Rate for Payer: VA VA |
$637.31
|
| Rate for Payer: VA VA |
$637.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,086.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$948.75
|
|
|
HC RO ISODOSE BRACH CALC SIMPLE
|
Facility
|
OP
|
$996.00
|
|
|
Service Code
|
CPT 77316
|
| Hospital Charge Code |
33300045
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$179.65 |
| Max. Negotiated Rate |
$1,033.94 |
| Rate for Payer: Aetna American Axle |
$647.40
|
| Rate for Payer: Aetna American Axle |
$149.66
|
| Rate for Payer: Aetna Commercial |
$195.71
|
| Rate for Payer: Aetna Commercial |
$846.60
|
| Rate for Payer: Aetna Medicare |
$341.57
|
| Rate for Payer: Aetna Medicare |
$341.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$647.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.54
|
| Rate for Payer: BCBS Complete |
$188.65
|
| Rate for Payer: BCBS Complete |
$188.65
|
| Rate for Payer: BCBS MAPPO |
$328.43
|
| Rate for Payer: BCBS MAPPO |
$328.43
|
| Rate for Payer: BCBS Trust/PPO |
$323.71
|
| Rate for Payer: BCBS Trust/PPO |
$323.71
|
| Rate for Payer: BCN Medicare Advantage |
$328.43
|
| Rate for Payer: BCN Medicare Advantage |
$328.43
|
| Rate for Payer: Cash Price |
$796.80
|
| Rate for Payer: Cash Price |
$796.80
|
| Rate for Payer: Cash Price |
$184.20
|
| Rate for Payer: Cash Price |
$184.20
|
| Rate for Payer: Cash Price |
$184.20
|
| Rate for Payer: Cash Price |
$796.80
|
| Rate for Payer: Cofinity Commercial |
$856.56
|
| Rate for Payer: Cofinity Commercial |
$161.18
|
| Rate for Payer: Cofinity Commercial |
$198.02
|
| Rate for Payer: Cofinity Commercial |
$697.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$796.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.43
|
| Rate for Payer: Healthscope Commercial |
$896.40
|
| Rate for Payer: Healthscope Commercial |
$207.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$697.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$161.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$747.00
|
| Rate for Payer: Mclaren Medicaid |
$179.65
|
| Rate for Payer: Mclaren Medicaid |
$179.65
|
| Rate for Payer: Mclaren Medicare |
$328.43
|
| Rate for Payer: Mclaren Medicare |
$328.43
|
| Rate for Payer: Meridian Medicaid |
$188.65
|
| Rate for Payer: Meridian Medicaid |
$188.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$195.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$846.60
|
| Rate for Payer: PACE Medicare |
$312.01
|
| Rate for Payer: PACE Medicare |
$312.01
|
| Rate for Payer: PACE SWMI |
$328.43
|
| Rate for Payer: PACE SWMI |
$328.43
|
| Rate for Payer: PHP Commercial |
$846.60
|
| Rate for Payer: PHP Commercial |
$195.71
|
| Rate for Payer: PHP Medicare Advantage |
$328.43
|
| Rate for Payer: PHP Medicare Advantage |
$328.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,033.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,033.94
|
| Rate for Payer: Priority Health Medicare |
$328.43
|
| Rate for Payer: Priority Health Medicare |
$328.43
|
| Rate for Payer: Priority Health Narrow Network |
$827.15
|
| Rate for Payer: Priority Health Narrow Network |
$827.15
|
| Rate for Payer: Priority Health SBD |
$145.06
|
| Rate for Payer: Priority Health SBD |
$627.48
|
| Rate for Payer: Railroad Medicare Medicare |
$328.43
|
| Rate for Payer: Railroad Medicare Medicare |
$328.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.18
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.43
|
| Rate for Payer: UHC Exchange |
$241.98
|
| Rate for Payer: UHC Exchange |
$241.98
|
| Rate for Payer: UHC Medicare Advantage |
$338.28
|
| Rate for Payer: UHC Medicare Advantage |
$338.28
|
| Rate for Payer: UMR Bronson Commercial |
$368.52
|
| Rate for Payer: UMR Bronson Commercial |
$85.19
|
| Rate for Payer: VA VA |
$328.43
|
| Rate for Payer: VA VA |
$328.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$747.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.69
|
|
|
HC RO ISODOSE BRACH CALC SIMPLE
|
Facility
|
IP
|
$230.25
|
|
|
Service Code
|
CPT 77316
|
| Hospital Charge Code |
33300045
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$101.31 |
| Max. Negotiated Rate |
$207.22 |
| Rate for Payer: Aetna American Axle |
$149.66
|
| Rate for Payer: Aetna American Axle |
$647.40
|
| Rate for Payer: Aetna Commercial |
$846.60
|
| Rate for Payer: Aetna Commercial |
$195.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$647.40
|
| Rate for Payer: Cash Price |
$796.80
|
| Rate for Payer: Cash Price |
$184.20
|
| Rate for Payer: Cofinity Commercial |
$856.56
|
| Rate for Payer: Cofinity Commercial |
$161.18
|
| Rate for Payer: Cofinity Commercial |
$198.02
|
| Rate for Payer: Cofinity Commercial |
$697.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$796.80
|
| Rate for Payer: Healthscope Commercial |
$896.40
|
| Rate for Payer: Healthscope Commercial |
$207.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$161.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$697.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$747.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$195.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$846.60
|
| Rate for Payer: PHP Commercial |
$846.60
|
| Rate for Payer: PHP Commercial |
$195.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.20
|
| Rate for Payer: Priority Health SBD |
$627.48
|
| Rate for Payer: Priority Health SBD |
$145.06
|
| Rate for Payer: UMR Bronson Commercial |
$101.31
|
| Rate for Payer: UMR Bronson Commercial |
$438.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$747.00
|
|
|
HC RO ISODOSE BRACHY CALC COMPLEX
|
Facility
|
IP
|
$1,759.00
|
|
|
Service Code
|
CPT 77318
|
| Hospital Charge Code |
33300047
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$773.96 |
| Max. Negotiated Rate |
$1,583.10 |
| Rate for Payer: Aetna American Axle |
$1,143.35
|
| Rate for Payer: Aetna American Axle |
$436.48
|
| Rate for Payer: Aetna Commercial |
$570.78
|
| Rate for Payer: Aetna Commercial |
$1,495.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$436.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,143.35
|
| Rate for Payer: Cash Price |
$1,407.20
|
| Rate for Payer: Cash Price |
$537.21
|
| Rate for Payer: Cofinity Commercial |
$1,512.74
|
| Rate for Payer: Cofinity Commercial |
$1,231.30
|
| Rate for Payer: Cofinity Commercial |
$470.06
|
| Rate for Payer: Cofinity Commercial |
$577.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,407.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.21
|
| Rate for Payer: Healthscope Commercial |
$604.36
|
| Rate for Payer: Healthscope Commercial |
$1,583.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$470.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,231.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,319.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,495.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$570.78
|
| Rate for Payer: PHP Commercial |
$1,495.15
|
| Rate for Payer: PHP Commercial |
$570.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,231.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$470.06
|
| Rate for Payer: Priority Health SBD |
$1,108.17
|
| Rate for Payer: Priority Health SBD |
$423.05
|
| Rate for Payer: UMR Bronson Commercial |
$773.96
|
| Rate for Payer: UMR Bronson Commercial |
$295.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,319.25
|
|
|
HC RO ISODOSE BRACHY CALC COMPLEX
|
Facility
|
OP
|
$1,759.00
|
|
|
Service Code
|
CPT 77318
|
| Hospital Charge Code |
33300047
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$179.65 |
| Max. Negotiated Rate |
$1,583.10 |
| Rate for Payer: Aetna American Axle |
$1,143.35
|
| Rate for Payer: Aetna American Axle |
$436.48
|
| Rate for Payer: Aetna Commercial |
$1,495.15
|
| Rate for Payer: Aetna Commercial |
$570.78
|
| Rate for Payer: Aetna Medicare |
$341.57
|
| Rate for Payer: Aetna Medicare |
$341.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,143.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$436.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.54
|
| Rate for Payer: BCBS Complete |
$188.65
|
| Rate for Payer: BCBS Complete |
$188.65
|
| Rate for Payer: BCBS MAPPO |
$328.43
|
| Rate for Payer: BCBS MAPPO |
$328.43
|
| Rate for Payer: BCBS Trust/PPO |
$577.10
|
| Rate for Payer: BCBS Trust/PPO |
$577.10
|
| Rate for Payer: BCN Medicare Advantage |
$328.43
|
| Rate for Payer: BCN Medicare Advantage |
$328.43
|
| Rate for Payer: Cash Price |
$1,407.20
|
| Rate for Payer: Cash Price |
$1,407.20
|
| Rate for Payer: Cash Price |
$537.21
|
| Rate for Payer: Cash Price |
$537.21
|
| Rate for Payer: Cash Price |
$537.21
|
| Rate for Payer: Cash Price |
$1,407.20
|
| Rate for Payer: Cofinity Commercial |
$1,231.30
|
| Rate for Payer: Cofinity Commercial |
$577.50
|
| Rate for Payer: Cofinity Commercial |
$470.06
|
| Rate for Payer: Cofinity Commercial |
$1,512.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,407.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.43
|
| Rate for Payer: Healthscope Commercial |
$1,583.10
|
| Rate for Payer: Healthscope Commercial |
$604.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$470.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,231.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,319.25
|
| Rate for Payer: Mclaren Medicaid |
$179.65
|
| Rate for Payer: Mclaren Medicaid |
$179.65
|
| Rate for Payer: Mclaren Medicare |
$328.43
|
| Rate for Payer: Mclaren Medicare |
$328.43
|
| Rate for Payer: Meridian Medicaid |
$188.65
|
| Rate for Payer: Meridian Medicaid |
$188.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$570.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,495.15
|
| Rate for Payer: PACE Medicare |
$312.01
|
| Rate for Payer: PACE Medicare |
$312.01
|
| Rate for Payer: PACE SWMI |
$328.43
|
| Rate for Payer: PACE SWMI |
$328.43
|
| Rate for Payer: PHP Commercial |
$570.78
|
| Rate for Payer: PHP Commercial |
$1,495.15
|
| Rate for Payer: PHP Medicare Advantage |
$328.43
|
| Rate for Payer: PHP Medicare Advantage |
$328.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$470.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,231.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,033.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,033.94
|
| Rate for Payer: Priority Health Medicare |
$328.43
|
| Rate for Payer: Priority Health Medicare |
$328.43
|
| Rate for Payer: Priority Health Narrow Network |
$827.15
|
| Rate for Payer: Priority Health Narrow Network |
$827.15
|
| Rate for Payer: Priority Health SBD |
$423.05
|
| Rate for Payer: Priority Health SBD |
$1,108.17
|
| Rate for Payer: Railroad Medicare Medicare |
$328.43
|
| Rate for Payer: Railroad Medicare Medicare |
$328.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$496.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$496.34
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.43
|
| Rate for Payer: UHC Exchange |
$451.22
|
| Rate for Payer: UHC Exchange |
$451.22
|
| Rate for Payer: UHC Medicare Advantage |
$338.28
|
| Rate for Payer: UHC Medicare Advantage |
$338.28
|
| Rate for Payer: UMR Bronson Commercial |
$248.46
|
| Rate for Payer: UMR Bronson Commercial |
$650.83
|
| Rate for Payer: VA VA |
$328.43
|
| Rate for Payer: VA VA |
$328.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,319.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.63
|
|
|
HC RO ISODOSE BRACHY CALC INTRM
|
Facility
|
IP
|
$610.46
|
|
|
Service Code
|
CPT 77317
|
| Hospital Charge Code |
33300046
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$268.60 |
| Max. Negotiated Rate |
$549.41 |
| Rate for Payer: Aetna American Axle |
$396.80
|
| Rate for Payer: Aetna American Axle |
$833.95
|
| Rate for Payer: Aetna Commercial |
$518.89
|
| Rate for Payer: Aetna Commercial |
$1,090.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$833.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$396.80
|
| Rate for Payer: Cash Price |
$1,026.40
|
| Rate for Payer: Cash Price |
$488.37
|
| Rate for Payer: Cofinity Commercial |
$1,103.38
|
| Rate for Payer: Cofinity Commercial |
$898.10
|
| Rate for Payer: Cofinity Commercial |
$525.00
|
| Rate for Payer: Cofinity Commercial |
$427.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,026.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$488.37
|
| Rate for Payer: Healthscope Commercial |
$549.41
|
| Rate for Payer: Healthscope Commercial |
$1,154.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$898.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$427.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$962.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$457.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,090.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.89
|
| Rate for Payer: PHP Commercial |
$518.89
|
| Rate for Payer: PHP Commercial |
$1,090.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$898.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.32
|
| Rate for Payer: Priority Health SBD |
$384.59
|
| Rate for Payer: Priority Health SBD |
$808.29
|
| Rate for Payer: UMR Bronson Commercial |
$564.52
|
| Rate for Payer: UMR Bronson Commercial |
$268.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$962.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$457.84
|
|
|
HC RO ISODOSE BRACHY CALC INTRM
|
Facility
|
OP
|
$1,283.00
|
|
|
Service Code
|
CPT 77317
|
| Hospital Charge Code |
33300046
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$179.65 |
| Max. Negotiated Rate |
$1,154.70 |
| Rate for Payer: Aetna American Axle |
$833.95
|
| Rate for Payer: Aetna American Axle |
$396.80
|
| Rate for Payer: Aetna Commercial |
$1,090.55
|
| Rate for Payer: Aetna Commercial |
$518.89
|
| Rate for Payer: Aetna Medicare |
$341.57
|
| Rate for Payer: Aetna Medicare |
$341.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$833.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$396.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.54
|
| Rate for Payer: BCBS Complete |
$188.65
|
| Rate for Payer: BCBS Complete |
$188.65
|
| Rate for Payer: BCBS MAPPO |
$328.43
|
| Rate for Payer: BCBS MAPPO |
$328.43
|
| Rate for Payer: BCBS Trust/PPO |
$426.96
|
| Rate for Payer: BCBS Trust/PPO |
$426.96
|
| Rate for Payer: BCN Medicare Advantage |
$328.43
|
| Rate for Payer: BCN Medicare Advantage |
$328.43
|
| Rate for Payer: Cash Price |
$488.37
|
| Rate for Payer: Cash Price |
$1,026.40
|
| Rate for Payer: Cash Price |
$1,026.40
|
| Rate for Payer: Cash Price |
$1,026.40
|
| Rate for Payer: Cash Price |
$488.37
|
| Rate for Payer: Cash Price |
$488.37
|
| Rate for Payer: Cofinity Commercial |
$525.00
|
| Rate for Payer: Cofinity Commercial |
$427.32
|
| Rate for Payer: Cofinity Commercial |
$1,103.38
|
| Rate for Payer: Cofinity Commercial |
$898.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,026.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$488.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.43
|
| Rate for Payer: Healthscope Commercial |
$1,154.70
|
| Rate for Payer: Healthscope Commercial |
$549.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$427.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$898.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$457.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$962.25
|
| Rate for Payer: Mclaren Medicaid |
$179.65
|
| Rate for Payer: Mclaren Medicaid |
$179.65
|
| Rate for Payer: Mclaren Medicare |
$328.43
|
| Rate for Payer: Mclaren Medicare |
$328.43
|
| Rate for Payer: Meridian Medicaid |
$188.65
|
| Rate for Payer: Meridian Medicaid |
$188.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,090.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.89
|
| Rate for Payer: PACE Medicare |
$312.01
|
| Rate for Payer: PACE Medicare |
$312.01
|
| Rate for Payer: PACE SWMI |
$328.43
|
| Rate for Payer: PACE SWMI |
$328.43
|
| Rate for Payer: PHP Commercial |
$1,090.55
|
| Rate for Payer: PHP Commercial |
$518.89
|
| Rate for Payer: PHP Medicare Advantage |
$328.43
|
| Rate for Payer: PHP Medicare Advantage |
$328.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$898.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,033.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,033.94
|
| Rate for Payer: Priority Health Medicare |
$328.43
|
| Rate for Payer: Priority Health Medicare |
$328.43
|
| Rate for Payer: Priority Health Narrow Network |
$827.15
|
| Rate for Payer: Priority Health Narrow Network |
$827.15
|
| Rate for Payer: Priority Health SBD |
$808.29
|
| Rate for Payer: Priority Health SBD |
$384.59
|
| Rate for Payer: Railroad Medicare Medicare |
$328.43
|
| Rate for Payer: Railroad Medicare Medicare |
$328.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$350.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$350.10
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.43
|
| Rate for Payer: UHC Exchange |
$318.27
|
| Rate for Payer: UHC Exchange |
$318.27
|
| Rate for Payer: UHC Medicare Advantage |
$338.28
|
| Rate for Payer: UHC Medicare Advantage |
$338.28
|
| Rate for Payer: UMR Bronson Commercial |
$225.87
|
| Rate for Payer: UMR Bronson Commercial |
$474.71
|
| Rate for Payer: VA VA |
$328.43
|
| Rate for Payer: VA VA |
$328.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$962.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$457.84
|
|
