|
HC US CRANIAL
|
Facility
|
OP
|
$810.15
|
|
|
Service Code
|
CPT 76506
|
| Hospital Charge Code |
40200053
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$729.14 |
| Rate for Payer: Aetna American Axle |
$526.60
|
| Rate for Payer: Aetna Commercial |
$688.63
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$526.60
|
| 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 |
$159.00
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$648.12
|
| Rate for Payer: Cash Price |
$648.12
|
| Rate for Payer: Cofinity Commercial |
$567.10
|
| Rate for Payer: Cofinity Commercial |
$696.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$648.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$729.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$567.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$607.61
|
| 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 |
$688.63
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$688.63
|
| 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 |
$567.10
|
| 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 |
$510.39
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.10
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$111.00
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$299.76
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$607.61
|
|
|
HC US DUPLX DOP ABD PEL SCROT LTD
|
Facility
|
IP
|
$991.60
|
|
|
Service Code
|
CPT 93976
|
| Hospital Charge Code |
92100014
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$436.30 |
| Max. Negotiated Rate |
$892.44 |
| Rate for Payer: Aetna American Axle |
$644.54
|
| Rate for Payer: Aetna Commercial |
$842.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$644.54
|
| Rate for Payer: Cash Price |
$793.28
|
| Rate for Payer: Cofinity Commercial |
$694.12
|
| Rate for Payer: Cofinity Commercial |
$852.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$793.28
|
| Rate for Payer: Healthscope Commercial |
$892.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$694.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$842.86
|
| Rate for Payer: PHP Commercial |
$842.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$694.12
|
| Rate for Payer: Priority Health SBD |
$624.71
|
| Rate for Payer: UMR Bronson Commercial |
$436.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.70
|
|
|
HC US DUPLX DOP ABD PEL SCROT LTD
|
Facility
|
OP
|
$991.60
|
|
|
Service Code
|
CPT 93976
|
| Hospital Charge Code |
92100014
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$892.44 |
| Rate for Payer: Aetna American Axle |
$644.54
|
| Rate for Payer: Aetna Commercial |
$842.86
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$644.54
|
| 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 |
$608.24
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$793.28
|
| Rate for Payer: Cash Price |
$793.28
|
| Rate for Payer: Cash Price |
$793.28
|
| Rate for Payer: Cofinity Commercial |
$694.12
|
| Rate for Payer: Cofinity Commercial |
$852.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$793.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$892.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$694.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.70
|
| 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 |
$842.86
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$842.86
|
| 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 |
$694.12
|
| 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 |
$624.71
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.45
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$155.86
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$366.89
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.70
|
|
|
HC US DUPLX DOP ABD PELV SCROTUM
|
Facility
|
IP
|
$1,708.29
|
|
|
Service Code
|
CPT 93975
|
| Hospital Charge Code |
92100013
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$751.65 |
| Max. Negotiated Rate |
$1,537.46 |
| Rate for Payer: Aetna American Axle |
$1,110.39
|
| Rate for Payer: Aetna Commercial |
$1,452.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,110.39
|
| Rate for Payer: Cash Price |
$1,366.63
|
| Rate for Payer: Cofinity Commercial |
$1,195.80
|
| Rate for Payer: Cofinity Commercial |
$1,469.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,366.63
|
| Rate for Payer: Healthscope Commercial |
$1,537.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,195.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,281.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,452.05
|
| Rate for Payer: PHP Commercial |
$1,452.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,195.80
|
| Rate for Payer: Priority Health SBD |
$1,076.22
|
| Rate for Payer: UMR Bronson Commercial |
$751.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,281.22
|
|
|
HC US DUPLX DOP ABD PELV SCROTUM
|
Facility
|
OP
|
$1,708.29
|
|
|
Service Code
|
CPT 93975
|
| Hospital Charge Code |
92100013
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$1,537.46 |
| Rate for Payer: Aetna American Axle |
$1,110.39
|
| Rate for Payer: Aetna Commercial |
$1,452.05
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,110.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,062.33
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,366.63
|
| Rate for Payer: Cash Price |
$1,366.63
|
| Rate for Payer: Cash Price |
$1,366.63
|
| Rate for Payer: Cofinity Commercial |
$1,195.80
|
| Rate for Payer: Cofinity Commercial |
$1,469.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,366.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$1,537.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,195.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,281.22
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,452.05
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$1,452.05
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,195.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.66
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$548.53
|
| Rate for Payer: Priority Health SBD |
$1,076.22
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$285.63
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$259.66
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$632.07
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,281.22
|
|
|
HC US EACH ADDL FETUS BPP
|
Facility
|
OP
|
$476.47
|
|
|
Service Code
|
CPT 76819
|
| Hospital Charge Code |
40200026
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$428.82 |
| Rate for Payer: Aetna American Axle |
$309.71
|
| Rate for Payer: Aetna Commercial |
$405.00
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$309.71
|
| 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 |
$91.23
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$381.18
|
| Rate for Payer: Cash Price |
$381.18
|
| Rate for Payer: Cofinity Commercial |
$333.53
|
| Rate for Payer: Cofinity Commercial |
$409.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$381.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$428.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$333.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$357.35
|
| 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 |
$405.00
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$405.00
|
| 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 |
$333.53
|
| 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 |
$300.18
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.56
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$84.15
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$176.29
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$357.35
|
|
|
HC US EACH ADDL FETUS BPP
|
Facility
|
IP
|
$476.47
|
|
|
Service Code
|
CPT 76819
|
| Hospital Charge Code |
40200026
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$209.65 |
| Max. Negotiated Rate |
$428.82 |
| Rate for Payer: Aetna American Axle |
$309.71
|
| Rate for Payer: Aetna Commercial |
$405.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$309.71
|
| Rate for Payer: Cash Price |
$381.18
|
| Rate for Payer: Cofinity Commercial |
$333.53
|
| Rate for Payer: Cofinity Commercial |
$409.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$381.18
|
| Rate for Payer: Healthscope Commercial |
$428.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$333.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$357.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$405.00
|
| Rate for Payer: PHP Commercial |
$405.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.53
|
| Rate for Payer: Priority Health SBD |
$300.18
|
| Rate for Payer: UMR Bronson Commercial |
$209.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$357.35
|
|
|
HC US EACH ADDL FETUS GT 14 WKS
|
Facility
|
IP
|
$423.30
|
|
|
Service Code
|
CPT 76810
|
| Hospital Charge Code |
40200018
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$186.25 |
| Max. Negotiated Rate |
$380.97 |
| Rate for Payer: Aetna American Axle |
$275.14
|
| Rate for Payer: Aetna Commercial |
$359.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.14
|
| Rate for Payer: Cash Price |
$338.64
|
| Rate for Payer: Cofinity Commercial |
$296.31
|
| Rate for Payer: Cofinity Commercial |
$364.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.64
|
| Rate for Payer: Healthscope Commercial |
$380.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$296.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$317.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$359.80
|
| Rate for Payer: PHP Commercial |
$359.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$296.31
|
| Rate for Payer: Priority Health SBD |
$266.68
|
| Rate for Payer: UMR Bronson Commercial |
$186.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$317.48
|
|
|
HC US EACH ADDL FETUS GT 14 WKS
|
Facility
|
OP
|
$423.30
|
|
|
Service Code
|
CPT 76810
|
| Hospital Charge Code |
40200018
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$79.19 |
| Max. Negotiated Rate |
$380.97 |
| Rate for Payer: Aetna American Axle |
$275.14
|
| Rate for Payer: Aetna Commercial |
$359.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.14
|
| Rate for Payer: BCBS Complete |
$169.32
|
| Rate for Payer: BCBS Trust/PPO |
$79.19
|
| Rate for Payer: Cash Price |
$338.64
|
| Rate for Payer: Cash Price |
$338.64
|
| Rate for Payer: Cofinity Commercial |
$364.04
|
| Rate for Payer: Cofinity Commercial |
$296.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.64
|
| Rate for Payer: Healthscope Commercial |
$380.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$296.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$317.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$359.80
|
| Rate for Payer: PHP Commercial |
$359.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$296.31
|
| Rate for Payer: Priority Health SBD |
$266.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.37
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Exchange |
$85.79
|
| Rate for Payer: UMR Bronson Commercial |
$156.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$317.48
|
|
|
HC US EACH ADDL FETUS LESS THAN 14 WKS
|
Facility
|
IP
|
$348.47
|
|
|
Service Code
|
CPT 76802
|
| Hospital Charge Code |
40200016
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$153.33 |
| Max. Negotiated Rate |
$313.62 |
| Rate for Payer: Aetna American Axle |
$226.51
|
| Rate for Payer: Aetna Commercial |
$296.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$226.51
|
| Rate for Payer: Cash Price |
$278.78
|
| Rate for Payer: Cofinity Commercial |
$299.68
|
| Rate for Payer: Cofinity Commercial |
$243.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$278.78
|
| Rate for Payer: Healthscope Commercial |
$313.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$243.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$261.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$296.20
|
| Rate for Payer: PHP Commercial |
$296.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.93
|
| Rate for Payer: Priority Health SBD |
$219.54
|
| Rate for Payer: UMR Bronson Commercial |
$153.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$261.35
|
|
|
HC US EACH ADDL FETUS LESS THAN 14 WKS
|
Facility
|
OP
|
$348.47
|
|
|
Service Code
|
CPT 76802
|
| Hospital Charge Code |
40200016
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$40.54 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna American Axle |
$226.51
|
| Rate for Payer: Aetna Commercial |
$296.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$226.51
|
| Rate for Payer: BCBS Complete |
$139.39
|
| Rate for Payer: BCBS Trust/PPO |
$40.54
|
| Rate for Payer: Cash Price |
$278.78
|
| Rate for Payer: Cash Price |
$278.78
|
| Rate for Payer: Cofinity Commercial |
$299.68
|
| Rate for Payer: Cofinity Commercial |
$243.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$278.78
|
| Rate for Payer: Healthscope Commercial |
$313.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$243.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$261.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$296.20
|
| Rate for Payer: PHP Commercial |
$296.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.93
|
| Rate for Payer: Priority Health SBD |
$219.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.83
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Exchange |
$58.94
|
| Rate for Payer: UMR Bronson Commercial |
$128.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$261.35
|
|
|
HC US ELASTOGRAPHY 1ST LESION
|
Facility
|
IP
|
$204.00
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
40200075
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$89.76 |
| Max. Negotiated Rate |
$183.60 |
| Rate for Payer: Aetna American Axle |
$132.60
|
| Rate for Payer: Aetna Commercial |
$173.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.60
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$142.80
|
| Rate for Payer: Cofinity Commercial |
$175.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.20
|
| Rate for Payer: Healthscope Commercial |
$183.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$142.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$173.40
|
| Rate for Payer: PHP Commercial |
$173.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.80
|
| Rate for Payer: Priority Health SBD |
$128.52
|
| Rate for Payer: UMR Bronson Commercial |
$89.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.00
|
|
|
HC US ELASTOGRAPHY 1ST LESION
|
Facility
|
OP
|
$204.00
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
40200075
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna American Axle |
$132.60
|
| Rate for Payer: Aetna Commercial |
$173.40
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.60
|
| 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 |
$124.17
|
| Rate for Payer: BCCCP Commercial |
$95.77
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$142.80
|
| Rate for Payer: Cofinity Commercial |
$175.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$183.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$142.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.00
|
| 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 |
$173.40
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$173.40
|
| 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 |
$142.80
|
| 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 |
$128.52
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.85
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$91.68
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$75.48
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.00
|
|
|
HC US ELASTOGRAPHY EA ADDL LESION
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
40200076
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$13.46 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna American Axle |
$19.89
|
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health SBD |
$19.28
|
| Rate for Payer: UMR Bronson Commercial |
$13.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC US ELASTOGRAPHY EA ADDL LESION
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
40200076
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$11.32 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna American Axle |
$19.89
|
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: BCBS Complete |
$12.24
|
| Rate for Payer: BCBS Trust/PPO |
$69.04
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health SBD |
$19.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.64
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Exchange |
$60.58
|
| Rate for Payer: UMR Bronson Commercial |
$11.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC US ELASTOGRAPHY ORGAN
|
Facility
|
IP
|
$204.00
|
|
|
Service Code
|
CPT 76981
|
| Hospital Charge Code |
40200074
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$89.76 |
| Max. Negotiated Rate |
$183.60 |
| Rate for Payer: Aetna American Axle |
$132.60
|
| Rate for Payer: Aetna Commercial |
$173.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.60
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$142.80
|
| Rate for Payer: Cofinity Commercial |
$175.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.20
|
| Rate for Payer: Healthscope Commercial |
$183.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$142.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$173.40
|
| Rate for Payer: PHP Commercial |
$173.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.80
|
| Rate for Payer: Priority Health SBD |
$128.52
|
| Rate for Payer: UMR Bronson Commercial |
$89.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.00
|
|
|
HC US ELASTOGRAPHY ORGAN
|
Facility
|
OP
|
$204.00
|
|
|
Service Code
|
CPT 76981
|
| Hospital Charge Code |
40200074
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna American Axle |
$132.60
|
| Rate for Payer: Aetna Commercial |
$173.40
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.60
|
| 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 |
$144.43
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$175.44
|
| Rate for Payer: Cofinity Commercial |
$142.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$183.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$142.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.00
|
| 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 |
$173.40
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$173.40
|
| 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 |
$142.80
|
| 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 |
$128.52
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.74
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$102.49
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$75.48
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.00
|
|
|
HC USE OF SPEECH DEVICE SERVICE
|
Facility
|
IP
|
$463.88
|
|
|
Service Code
|
CPT 92609
|
| Hospital Charge Code |
44000003
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$204.11 |
| Max. Negotiated Rate |
$417.49 |
| Rate for Payer: Aetna American Axle |
$301.52
|
| Rate for Payer: Aetna Commercial |
$394.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.52
|
| Rate for Payer: Cash Price |
$371.10
|
| Rate for Payer: Cofinity Commercial |
$324.72
|
| Rate for Payer: Cofinity Commercial |
$398.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$371.10
|
| Rate for Payer: Healthscope Commercial |
$417.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$324.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$394.30
|
| Rate for Payer: PHP Commercial |
$394.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.72
|
| Rate for Payer: Priority Health SBD |
$292.24
|
| Rate for Payer: UMR Bronson Commercial |
$204.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.91
|
|
|
HC USE OF SPEECH DEVICE SERVICE
|
Facility
|
OP
|
$463.88
|
|
|
Service Code
|
CPT 92609
|
| Hospital Charge Code |
44000003
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$89.98 |
| Max. Negotiated Rate |
$417.49 |
| Rate for Payer: Aetna American Axle |
$301.52
|
| Rate for Payer: Aetna Commercial |
$394.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.52
|
| Rate for Payer: BCBS Complete |
$185.55
|
| Rate for Payer: Cash Price |
$371.10
|
| Rate for Payer: Cash Price |
$371.10
|
| Rate for Payer: Cash Price |
$371.10
|
| Rate for Payer: Cofinity Commercial |
$398.94
|
| Rate for Payer: Cofinity Commercial |
$324.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$371.10
|
| Rate for Payer: Healthscope Commercial |
$417.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$324.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$394.30
|
| Rate for Payer: PHP Commercial |
$394.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.48
|
| Rate for Payer: Priority Health Narrow Network |
$89.98
|
| Rate for Payer: Priority Health SBD |
$292.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.66
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$101.51
|
| Rate for Payer: UMR Bronson Commercial |
$171.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.91
|
|
|
HC US EXTREMITY NONVASC LTD
|
Facility
|
OP
|
$673.54
|
|
|
Service Code
|
CPT 76882
|
| Hospital Charge Code |
40200038
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$17.73 |
| Max. Negotiated Rate |
$606.19 |
| Rate for Payer: Aetna American Axle |
$437.80
|
| Rate for Payer: Aetna Commercial |
$572.51
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.80
|
| 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 |
$17.73
|
| Rate for Payer: BCCCP Commercial |
$43.69
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$538.83
|
| Rate for Payer: Cash Price |
$538.83
|
| Rate for Payer: Cofinity Commercial |
$471.48
|
| Rate for Payer: Cofinity Commercial |
$579.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$606.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$471.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$505.16
|
| 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 |
$572.51
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$572.51
|
| 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 |
$471.48
|
| 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 |
$424.33
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.43
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$62.21
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$249.21
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$505.16
|
|
|
HC US EXTREMITY NONVASC LTD
|
Facility
|
IP
|
$673.54
|
|
|
Service Code
|
CPT 76882
|
| Hospital Charge Code |
40200038
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$296.36 |
| Max. Negotiated Rate |
$606.19 |
| Rate for Payer: Aetna American Axle |
$437.80
|
| Rate for Payer: Aetna Commercial |
$572.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.80
|
| Rate for Payer: Cash Price |
$538.83
|
| Rate for Payer: Cofinity Commercial |
$471.48
|
| Rate for Payer: Cofinity Commercial |
$579.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.83
|
| Rate for Payer: Healthscope Commercial |
$606.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$471.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$505.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$572.51
|
| Rate for Payer: PHP Commercial |
$572.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$471.48
|
| Rate for Payer: Priority Health SBD |
$424.33
|
| Rate for Payer: UMR Bronson Commercial |
$296.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$505.16
|
|
|
HC US EXTREMITY NONVASCULAR COMP
|
Facility
|
IP
|
$673.54
|
|
|
Service Code
|
CPT 76881
|
| Hospital Charge Code |
40200037
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$296.36 |
| Max. Negotiated Rate |
$606.19 |
| Rate for Payer: Aetna American Axle |
$437.80
|
| Rate for Payer: Aetna Commercial |
$572.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.80
|
| Rate for Payer: Cash Price |
$538.83
|
| Rate for Payer: Cofinity Commercial |
$471.48
|
| Rate for Payer: Cofinity Commercial |
$579.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.83
|
| Rate for Payer: Healthscope Commercial |
$606.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$471.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$505.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$572.51
|
| Rate for Payer: PHP Commercial |
$572.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$471.48
|
| Rate for Payer: Priority Health SBD |
$424.33
|
| Rate for Payer: UMR Bronson Commercial |
$296.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$505.16
|
|
|
HC US EXTREMITY NONVASCULAR COMP
|
Facility
|
OP
|
$673.54
|
|
|
Service Code
|
CPT 76881
|
| Hospital Charge Code |
40200037
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$20.90 |
| Max. Negotiated Rate |
$606.19 |
| Rate for Payer: Aetna American Axle |
$437.80
|
| Rate for Payer: Aetna Commercial |
$572.51
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.80
|
| 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 |
$20.90
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$538.83
|
| Rate for Payer: Cash Price |
$538.83
|
| Rate for Payer: Cofinity Commercial |
$579.24
|
| Rate for Payer: Cofinity Commercial |
$471.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$606.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$471.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$505.16
|
| 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 |
$572.51
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$572.51
|
| 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 |
$471.48
|
| 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 |
$424.33
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.99
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$52.72
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$249.21
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$505.16
|
|
|
HC US EYE B MODE
|
Facility
|
OP
|
$1,188.71
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
40200004
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$33.57 |
| Max. Negotiated Rate |
$1,069.84 |
| Rate for Payer: Aetna American Axle |
$772.66
|
| Rate for Payer: Aetna Commercial |
$1,010.40
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$772.66
|
| 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 |
$33.57
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$950.97
|
| Rate for Payer: Cash Price |
$950.97
|
| Rate for Payer: Cofinity Commercial |
$1,022.29
|
| Rate for Payer: Cofinity Commercial |
$832.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$950.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$1,069.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$832.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$891.53
|
| 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 |
$1,010.40
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$1,010.40
|
| 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 |
$832.10
|
| 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 |
$748.89
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.86
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$47.15
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$439.82
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$891.53
|
|
|
HC US EYE B MODE
|
Facility
|
IP
|
$1,188.71
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
40200004
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$523.03 |
| Max. Negotiated Rate |
$1,069.84 |
| Rate for Payer: Aetna American Axle |
$772.66
|
| Rate for Payer: Aetna Commercial |
$1,010.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$772.66
|
| Rate for Payer: Cash Price |
$950.97
|
| Rate for Payer: Cofinity Commercial |
$1,022.29
|
| Rate for Payer: Cofinity Commercial |
$832.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$950.97
|
| Rate for Payer: Healthscope Commercial |
$1,069.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$832.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$891.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,010.40
|
| Rate for Payer: PHP Commercial |
$1,010.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$832.10
|
| Rate for Payer: Priority Health SBD |
$748.89
|
| Rate for Payer: UMR Bronson Commercial |
$523.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$891.53
|
|
