|
HC SPIKE BLOOD ACCESS
|
Facility
|
OP
|
$15.75
|
|
| Hospital Charge Code |
27000669
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.83 |
| Max. Negotiated Rate |
$14.18 |
| Rate for Payer: Aetna American Axle |
$10.24
|
| Rate for Payer: Aetna Commercial |
$13.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.24
|
| Rate for Payer: BCBS Complete |
$6.30
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cofinity Commercial |
$11.02
|
| Rate for Payer: Cofinity Commercial |
$13.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$14.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.39
|
| Rate for Payer: PHP Commercial |
$13.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.02
|
| Rate for Payer: Priority Health SBD |
$9.92
|
| Rate for Payer: UMR Bronson Commercial |
$5.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.81
|
|
|
HC SPINAL/EPI ADDL 15 MIN
|
Facility
|
IP
|
$156.58
|
|
| Hospital Charge Code |
37000013
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$68.90 |
| Max. Negotiated Rate |
$140.92 |
| Rate for Payer: Aetna American Axle |
$101.78
|
| Rate for Payer: Aetna Commercial |
$133.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.78
|
| Rate for Payer: Cash Price |
$125.26
|
| Rate for Payer: Cofinity Commercial |
$109.61
|
| Rate for Payer: Cofinity Commercial |
$134.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.26
|
| Rate for Payer: Healthscope Commercial |
$140.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$109.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$133.09
|
| Rate for Payer: PHP Commercial |
$133.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.61
|
| Rate for Payer: Priority Health SBD |
$98.65
|
| Rate for Payer: UMR Bronson Commercial |
$68.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.44
|
|
|
HC SPINAL/EPI ADDL 15 MIN
|
Facility
|
OP
|
$156.58
|
|
| Hospital Charge Code |
37000013
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$57.93 |
| Max. Negotiated Rate |
$140.92 |
| Rate for Payer: Aetna American Axle |
$101.78
|
| Rate for Payer: Aetna Commercial |
$133.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.78
|
| Rate for Payer: BCBS Complete |
$62.63
|
| Rate for Payer: Cash Price |
$125.26
|
| Rate for Payer: Cofinity Commercial |
$109.61
|
| Rate for Payer: Cofinity Commercial |
$134.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.26
|
| Rate for Payer: Healthscope Commercial |
$140.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$109.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$133.09
|
| Rate for Payer: PHP Commercial |
$133.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.61
|
| Rate for Payer: Priority Health SBD |
$98.65
|
| Rate for Payer: UMR Bronson Commercial |
$57.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.44
|
|
|
HC SPINAL/EPI INIT 30 MIN
|
Facility
|
IP
|
$428.17
|
|
| Hospital Charge Code |
37000014
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$188.39 |
| Max. Negotiated Rate |
$385.35 |
| Rate for Payer: Aetna American Axle |
$278.31
|
| Rate for Payer: Aetna Commercial |
$363.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.31
|
| Rate for Payer: Cash Price |
$342.54
|
| Rate for Payer: Cofinity Commercial |
$299.72
|
| Rate for Payer: Cofinity Commercial |
$368.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.54
|
| Rate for Payer: Healthscope Commercial |
$385.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$299.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$363.94
|
| Rate for Payer: PHP Commercial |
$363.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$299.72
|
| Rate for Payer: Priority Health SBD |
$269.75
|
| Rate for Payer: UMR Bronson Commercial |
$188.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.13
|
|
|
HC SPINAL/EPI INIT 30 MIN
|
Facility
|
OP
|
$428.17
|
|
| Hospital Charge Code |
37000014
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$158.42 |
| Max. Negotiated Rate |
$385.35 |
| Rate for Payer: Aetna American Axle |
$278.31
|
| Rate for Payer: Aetna Commercial |
$363.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.31
|
| Rate for Payer: BCBS Complete |
$171.27
|
| Rate for Payer: Cash Price |
$342.54
|
| Rate for Payer: Cofinity Commercial |
$299.72
|
| Rate for Payer: Cofinity Commercial |
$368.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.54
|
| Rate for Payer: Healthscope Commercial |
$385.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$299.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$363.94
|
| Rate for Payer: PHP Commercial |
$363.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$299.72
|
| Rate for Payer: Priority Health SBD |
$269.75
|
| Rate for Payer: UMR Bronson Commercial |
$158.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.13
|
|
|
HC SPINE JACK
|
Facility
|
IP
|
$14,119.00
|
|
|
Service Code
|
CPT C1062
|
| Hospital Charge Code |
27800148
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,212.36 |
| Max. Negotiated Rate |
$12,707.10 |
| Rate for Payer: Aetna American Axle |
$9,177.35
|
| Rate for Payer: Aetna Commercial |
$12,001.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,177.35
|
| Rate for Payer: Cash Price |
$11,295.20
|
| Rate for Payer: Cofinity Commercial |
$12,142.34
|
| Rate for Payer: Cofinity Commercial |
$9,883.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,295.20
|
| Rate for Payer: Healthscope Commercial |
$12,707.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,883.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,589.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12,001.15
|
| Rate for Payer: PHP Commercial |
$12,001.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,883.30
|
| Rate for Payer: Priority Health SBD |
$8,894.97
|
| Rate for Payer: UMR Bronson Commercial |
$6,212.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,589.25
|
|
|
HC SPINE JACK
|
Facility
|
OP
|
$14,119.00
|
|
|
Service Code
|
CPT C1062
|
| Hospital Charge Code |
27800148
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,969.89 |
| Max. Negotiated Rate |
$12,707.10 |
| Rate for Payer: Aetna American Axle |
$9,177.35
|
| Rate for Payer: Aetna Commercial |
$12,001.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,177.35
|
| Rate for Payer: BCBS Complete |
$5,647.60
|
| Rate for Payer: Cash Price |
$11,295.20
|
| Rate for Payer: Cofinity Commercial |
$12,142.34
|
| Rate for Payer: Cofinity Commercial |
$9,883.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,295.20
|
| Rate for Payer: Healthscope Commercial |
$12,707.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,883.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,589.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12,001.15
|
| Rate for Payer: PHP Commercial |
$12,001.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,883.30
|
| Rate for Payer: Priority Health SBD |
$8,894.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,969.89
|
| Rate for Payer: UHC Exchange |
$5,788.79
|
| Rate for Payer: UMR Bronson Commercial |
$5,224.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,589.25
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 1 VIEW
|
Facility
|
IP
|
$147.59
|
|
|
Service Code
|
CPT 72081
|
| Hospital Charge Code |
32000317
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$64.94 |
| Max. Negotiated Rate |
$132.83 |
| Rate for Payer: Aetna American Axle |
$95.93
|
| Rate for Payer: Aetna Commercial |
$125.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.93
|
| Rate for Payer: Cash Price |
$118.07
|
| Rate for Payer: Cofinity Commercial |
$103.31
|
| Rate for Payer: Cofinity Commercial |
$126.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.07
|
| Rate for Payer: Healthscope Commercial |
$132.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.45
|
| Rate for Payer: PHP Commercial |
$125.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.31
|
| Rate for Payer: Priority Health SBD |
$92.98
|
| Rate for Payer: UMR Bronson Commercial |
$64.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.69
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 1 VIEW
|
Facility
|
OP
|
$147.59
|
|
|
Service Code
|
CPT 72081
|
| Hospital Charge Code |
32000317
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$41.91 |
| Max. Negotiated Rate |
$262.00 |
| Rate for Payer: Aetna American Axle |
$95.93
|
| Rate for Payer: Aetna Commercial |
$125.45
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$57.65
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$118.07
|
| Rate for Payer: Cash Price |
$118.07
|
| Rate for Payer: Cofinity Commercial |
$126.93
|
| Rate for Payer: Cofinity Commercial |
$103.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$132.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.69
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.45
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$125.45
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.27
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$203.42
|
| Rate for Payer: Priority Health SBD |
$92.98
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.10
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Exchange |
$41.91
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$54.61
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.69
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 2 OR 3 VIEW
|
Facility
|
OP
|
$354.24
|
|
|
Service Code
|
CPT 72082
|
| Hospital Charge Code |
32000306
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$318.82 |
| Rate for Payer: Aetna American Axle |
$230.26
|
| Rate for Payer: Aetna Commercial |
$301.10
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$105.16
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$283.39
|
| Rate for Payer: Cash Price |
$283.39
|
| Rate for Payer: Cofinity Commercial |
$247.97
|
| Rate for Payer: Cofinity Commercial |
$304.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$318.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$247.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.68
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$301.10
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$301.10
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$223.17
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.00
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$69.09
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$131.07
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.68
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 2 OR 3 VIEW
|
Facility
|
IP
|
$354.24
|
|
|
Service Code
|
CPT 72082
|
| Hospital Charge Code |
32000306
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$155.87 |
| Max. Negotiated Rate |
$318.82 |
| Rate for Payer: Aetna American Axle |
$230.26
|
| Rate for Payer: Aetna Commercial |
$301.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.26
|
| Rate for Payer: Cash Price |
$283.39
|
| Rate for Payer: Cofinity Commercial |
$247.97
|
| Rate for Payer: Cofinity Commercial |
$304.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.39
|
| Rate for Payer: Healthscope Commercial |
$318.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$247.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$301.10
|
| Rate for Payer: PHP Commercial |
$301.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.97
|
| Rate for Payer: Priority Health SBD |
$223.17
|
| Rate for Payer: UMR Bronson Commercial |
$155.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.68
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 4 OR 5 VIEW
|
Facility
|
OP
|
$472.31
|
|
|
Service Code
|
CPT 72083
|
| Hospital Charge Code |
32000307
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$425.08 |
| Rate for Payer: Aetna American Axle |
$307.00
|
| Rate for Payer: Aetna Commercial |
$401.46
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$117.82
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$377.85
|
| Rate for Payer: Cash Price |
$377.85
|
| Rate for Payer: Cofinity Commercial |
$406.19
|
| Rate for Payer: Cofinity Commercial |
$330.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$377.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$425.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$330.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.23
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$401.46
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$401.46
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$297.56
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.72
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$77.93
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$174.75
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.23
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 4 OR 5 VIEW
|
Facility
|
IP
|
$472.31
|
|
|
Service Code
|
CPT 72083
|
| Hospital Charge Code |
32000307
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$207.82 |
| Max. Negotiated Rate |
$425.08 |
| Rate for Payer: Aetna American Axle |
$307.00
|
| Rate for Payer: Aetna Commercial |
$401.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.00
|
| Rate for Payer: Cash Price |
$377.85
|
| Rate for Payer: Cofinity Commercial |
$330.62
|
| Rate for Payer: Cofinity Commercial |
$406.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$377.85
|
| Rate for Payer: Healthscope Commercial |
$425.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$330.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$401.46
|
| Rate for Payer: PHP Commercial |
$401.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.62
|
| Rate for Payer: Priority Health SBD |
$297.56
|
| Rate for Payer: UMR Bronson Commercial |
$207.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.23
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL MIN 6 VIEW
|
Facility
|
OP
|
$590.39
|
|
|
Service Code
|
CPT 72084
|
| Hospital Charge Code |
32000308
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$531.35 |
| Rate for Payer: Aetna American Axle |
$383.75
|
| Rate for Payer: Aetna Commercial |
$501.83
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$383.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$150.77
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$472.31
|
| Rate for Payer: Cash Price |
$472.31
|
| Rate for Payer: Cofinity Commercial |
$413.27
|
| Rate for Payer: Cofinity Commercial |
$507.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$472.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$531.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$413.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$442.79
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$501.83
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$501.83
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$413.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$371.95
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.61
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$96.92
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$218.44
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$442.79
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL MIN 6 VIEW
|
Facility
|
IP
|
$590.39
|
|
|
Service Code
|
CPT 72084
|
| Hospital Charge Code |
32000308
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$259.77 |
| Max. Negotiated Rate |
$531.35 |
| Rate for Payer: Aetna American Axle |
$383.75
|
| Rate for Payer: Aetna Commercial |
$501.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$383.75
|
| Rate for Payer: Cash Price |
$472.31
|
| Rate for Payer: Cofinity Commercial |
$413.27
|
| Rate for Payer: Cofinity Commercial |
$507.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$472.31
|
| Rate for Payer: Healthscope Commercial |
$531.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$413.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$442.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$501.83
|
| Rate for Payer: PHP Commercial |
$501.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$413.27
|
| Rate for Payer: Priority Health SBD |
$371.95
|
| Rate for Payer: UMR Bronson Commercial |
$259.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$442.79
|
|
|
HC SPINE THORACIC W CON
|
Facility
|
OP
|
$2,199.20
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200008
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$1,979.28 |
| Rate for Payer: Aetna American Axle |
$1,429.48
|
| Rate for Payer: Aetna Commercial |
$1,869.32
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,429.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$380.73
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$1,759.36
|
| Rate for Payer: Cash Price |
$1,759.36
|
| Rate for Payer: Cofinity Commercial |
$1,539.44
|
| Rate for Payer: Cofinity Commercial |
$1,891.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,759.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$1,979.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,539.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,649.40
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,869.32
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$1,869.32
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,539.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,076.13
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$860.90
|
| Rate for Payer: Priority Health SBD |
$1,385.50
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.28
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$275.71
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$813.70
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,649.40
|
|
|
HC SPINE THORACIC W CON
|
Facility
|
IP
|
$2,199.20
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200008
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$967.65 |
| Max. Negotiated Rate |
$1,979.28 |
| Rate for Payer: Aetna American Axle |
$1,429.48
|
| Rate for Payer: Aetna Commercial |
$1,869.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,429.48
|
| Rate for Payer: Cash Price |
$1,759.36
|
| Rate for Payer: Cofinity Commercial |
$1,539.44
|
| Rate for Payer: Cofinity Commercial |
$1,891.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,759.36
|
| Rate for Payer: Healthscope Commercial |
$1,979.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,539.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,649.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,869.32
|
| Rate for Payer: PHP Commercial |
$1,869.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,539.44
|
| Rate for Payer: Priority Health SBD |
$1,385.50
|
| Rate for Payer: UMR Bronson Commercial |
$967.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,649.40
|
|
|
HC SP INJECTION TENDON SHEATH
|
Facility
|
IP
|
$314.06
|
|
|
Service Code
|
CPT 20550
|
| Hospital Charge Code |
36100320
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$138.19 |
| Max. Negotiated Rate |
$282.65 |
| Rate for Payer: Aetna American Axle |
$204.14
|
| Rate for Payer: Aetna Commercial |
$266.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.14
|
| Rate for Payer: Cash Price |
$251.25
|
| Rate for Payer: Cofinity Commercial |
$219.84
|
| Rate for Payer: Cofinity Commercial |
$270.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$251.25
|
| Rate for Payer: Healthscope Commercial |
$282.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$219.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$235.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$266.95
|
| Rate for Payer: PHP Commercial |
$266.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.84
|
| Rate for Payer: Priority Health SBD |
$197.86
|
| Rate for Payer: UMR Bronson Commercial |
$138.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$235.54
|
|
|
HC SP INJECTION TENDON SHEATH
|
Facility
|
OP
|
$314.06
|
|
|
Service Code
|
CPT 20550
|
| Hospital Charge Code |
36100320
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$37.98 |
| Max. Negotiated Rate |
$828.79 |
| Rate for Payer: Aetna American Axle |
$204.14
|
| Rate for Payer: Aetna Commercial |
$266.95
|
| Rate for Payer: Aetna Medicare |
$273.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$290.76
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$251.25
|
| Rate for Payer: Cash Price |
$251.25
|
| Rate for Payer: Cofinity Commercial |
$270.09
|
| Rate for Payer: Cofinity Commercial |
$219.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$251.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$282.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$219.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$235.54
|
| Rate for Payer: Mclaren Medicaid |
$144.01
|
| Rate for Payer: Mclaren Medicare |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$151.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$266.95
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$266.95
|
| Rate for Payer: PHP Medicare Advantage |
$263.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$828.79
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$663.03
|
| Rate for Payer: Priority Health SBD |
$197.86
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.27
|
| Rate for Payer: UHC Exchange |
$37.98
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: UMR Bronson Commercial |
$116.20
|
| Rate for Payer: VA VA |
$263.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$235.54
|
|
|
HC SP INSERTION IVC FILTER
|
Facility
|
OP
|
$7,147.16
|
|
|
Service Code
|
CPT 37191
|
| Hospital Charge Code |
36100351
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$210.22 |
| Max. Negotiated Rate |
$15,377.24 |
| Rate for Payer: Aetna American Axle |
$4,645.65
|
| Rate for Payer: Aetna Commercial |
$6,075.09
|
| Rate for Payer: Aetna Medicare |
$5,080.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,645.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,105.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,105.86
|
| Rate for Payer: BCBS Complete |
$2,805.77
|
| Rate for Payer: BCBS MAPPO |
$4,884.69
|
| Rate for Payer: BCBS Trust/PPO |
$3,925.98
|
| Rate for Payer: BCN Medicare Advantage |
$4,884.69
|
| Rate for Payer: Cash Price |
$5,717.73
|
| Rate for Payer: Cash Price |
$5,717.73
|
| Rate for Payer: Cofinity Commercial |
$5,003.01
|
| Rate for Payer: Cofinity Commercial |
$6,146.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,717.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,884.69
|
| Rate for Payer: Healthscope Commercial |
$6,432.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,003.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,360.37
|
| Rate for Payer: Mclaren Medicaid |
$2,671.93
|
| Rate for Payer: Mclaren Medicare |
$4,884.69
|
| Rate for Payer: Meridian Medicaid |
$2,805.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,128.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,617.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,075.09
|
| Rate for Payer: PACE Medicare |
$4,640.46
|
| Rate for Payer: PACE SWMI |
$4,884.69
|
| Rate for Payer: PHP Commercial |
$6,075.09
|
| Rate for Payer: PHP Medicare Advantage |
$4,884.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,671.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,003.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,377.24
|
| Rate for Payer: Priority Health Medicare |
$4,884.69
|
| Rate for Payer: Priority Health Narrow Network |
$12,301.79
|
| Rate for Payer: Priority Health SBD |
$4,502.71
|
| Rate for Payer: Railroad Medicare Medicare |
$4,884.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.24
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,884.69
|
| Rate for Payer: UHC Exchange |
$210.22
|
| Rate for Payer: UHC Medicare Advantage |
$5,031.23
|
| Rate for Payer: UMR Bronson Commercial |
$2,644.45
|
| Rate for Payer: VA VA |
$4,884.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,360.37
|
|
|
HC SP INSERTION IVC FILTER
|
Facility
|
IP
|
$7,147.16
|
|
|
Service Code
|
CPT 37191
|
| Hospital Charge Code |
36100351
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,144.75 |
| Max. Negotiated Rate |
$6,432.44 |
| Rate for Payer: Aetna American Axle |
$4,645.65
|
| Rate for Payer: Aetna Commercial |
$6,075.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,645.65
|
| Rate for Payer: Cash Price |
$5,717.73
|
| Rate for Payer: Cofinity Commercial |
$5,003.01
|
| Rate for Payer: Cofinity Commercial |
$6,146.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,717.73
|
| Rate for Payer: Healthscope Commercial |
$6,432.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,003.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,360.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,075.09
|
| Rate for Payer: PHP Commercial |
$6,075.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,003.01
|
| Rate for Payer: Priority Health SBD |
$4,502.71
|
| Rate for Payer: UMR Bronson Commercial |
$3,144.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,360.37
|
|
|
HC SPIROMETRY
|
Facility
|
OP
|
$314.79
|
|
|
Service Code
|
CPT 94010
|
| Hospital Charge Code |
46000014
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$26.85 |
| Max. Negotiated Rate |
$437.09 |
| Rate for Payer: Aetna American Axle |
$204.61
|
| Rate for Payer: Aetna Commercial |
$267.57
|
| Rate for Payer: Aetna Medicare |
$144.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.56
|
| Rate for Payer: BCBS Complete |
$79.76
|
| Rate for Payer: BCBS MAPPO |
$138.85
|
| Rate for Payer: BCBS Trust/PPO |
$93.82
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$251.83
|
| Rate for Payer: Cash Price |
$251.83
|
| Rate for Payer: Cash Price |
$251.83
|
| Rate for Payer: Cofinity Commercial |
$220.35
|
| Rate for Payer: Cofinity Commercial |
$270.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$251.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$283.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$220.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.09
|
| Rate for Payer: Mclaren Medicaid |
$75.95
|
| Rate for Payer: Mclaren Medicare |
$138.85
|
| Rate for Payer: Meridian Medicaid |
$79.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$267.57
|
| Rate for Payer: PACE Medicare |
$131.91
|
| Rate for Payer: PACE SWMI |
$138.85
|
| Rate for Payer: PHP Commercial |
$267.57
|
| Rate for Payer: PHP Medicare Advantage |
$138.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$437.09
|
| Rate for Payer: Priority Health Medicare |
$138.85
|
| Rate for Payer: Priority Health Narrow Network |
$349.67
|
| Rate for Payer: Priority Health SBD |
$198.32
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.54
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.85
|
| Rate for Payer: UHC Exchange |
$26.85
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: UMR Bronson Commercial |
$116.47
|
| Rate for Payer: VA VA |
$138.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.09
|
|
|
HC SPIROMETRY
|
Facility
|
IP
|
$314.79
|
|
|
Service Code
|
CPT 94010
|
| Hospital Charge Code |
46000014
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$138.51 |
| Max. Negotiated Rate |
$283.31 |
| Rate for Payer: Aetna American Axle |
$204.61
|
| Rate for Payer: Aetna Commercial |
$267.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.61
|
| Rate for Payer: Cash Price |
$251.83
|
| Rate for Payer: Cofinity Commercial |
$220.35
|
| Rate for Payer: Cofinity Commercial |
$270.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$251.83
|
| Rate for Payer: Healthscope Commercial |
$283.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$220.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$267.57
|
| Rate for Payer: PHP Commercial |
$267.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.35
|
| Rate for Payer: Priority Health SBD |
$198.32
|
| Rate for Payer: UMR Bronson Commercial |
$138.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.09
|
|
|
HC SPIROMETRY W/DRUG
|
Facility
|
OP
|
$555.21
|
|
|
Service Code
|
CPT 94060
|
| Hospital Charge Code |
46000002
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$38.31 |
| Max. Negotiated Rate |
$878.32 |
| Rate for Payer: Aetna American Axle |
$360.89
|
| Rate for Payer: Aetna Commercial |
$471.93
|
| Rate for Payer: Aetna Medicare |
$290.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$360.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$142.44
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$444.17
|
| Rate for Payer: Cash Price |
$444.17
|
| Rate for Payer: Cash Price |
$444.17
|
| Rate for Payer: Cofinity Commercial |
$388.65
|
| Rate for Payer: Cofinity Commercial |
$477.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$444.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$499.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$388.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$416.41
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$471.93
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$471.93
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$878.32
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$702.66
|
| Rate for Payer: Priority Health SBD |
$349.78
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.14
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.00
|
| Rate for Payer: UHC Exchange |
$38.31
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: UMR Bronson Commercial |
$205.43
|
| Rate for Payer: VA VA |
$279.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$416.41
|
|
|
HC SPIROMETRY W/DRUG
|
Facility
|
IP
|
$555.21
|
|
|
Service Code
|
CPT 94060
|
| Hospital Charge Code |
46000002
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$244.29 |
| Max. Negotiated Rate |
$499.69 |
| Rate for Payer: Aetna American Axle |
$360.89
|
| Rate for Payer: Aetna Commercial |
$471.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$360.89
|
| Rate for Payer: Cash Price |
$444.17
|
| Rate for Payer: Cofinity Commercial |
$388.65
|
| Rate for Payer: Cofinity Commercial |
$477.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$444.17
|
| Rate for Payer: Healthscope Commercial |
$499.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$388.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$416.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$471.93
|
| Rate for Payer: PHP Commercial |
$471.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.65
|
| Rate for Payer: Priority Health SBD |
$349.78
|
| Rate for Payer: UMR Bronson Commercial |
$244.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$416.41
|
|
