|
HC XR COLON HIGH DENSITY
|
Facility
|
OP
|
$1,200.85
|
|
|
Service Code
|
CPT 74280
|
| Hospital Charge Code |
32000146
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$1,080.76 |
| Rate for Payer: Aetna American Axle |
$780.55
|
| Rate for Payer: Aetna Commercial |
$1,020.72
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$780.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.15
|
| Rate for Payer: BCBS Complete |
$93.81
|
| Rate for Payer: BCBS MAPPO |
$163.32
|
| Rate for Payer: BCBS Trust/PPO |
$313.58
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$960.68
|
| Rate for Payer: Cash Price |
$960.68
|
| Rate for Payer: Cofinity Commercial |
$1,032.73
|
| Rate for Payer: Cofinity Commercial |
$840.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$960.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$1,080.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$840.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$900.64
|
| Rate for Payer: Mclaren Medicaid |
$89.34
|
| Rate for Payer: Mclaren Medicare |
$163.32
|
| Rate for Payer: Meridian Medicaid |
$93.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,020.72
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$1,020.72
|
| Rate for Payer: PHP Medicare Advantage |
$163.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$840.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$514.13
|
| Rate for Payer: Priority Health Medicare |
$163.32
|
| Rate for Payer: Priority Health Narrow Network |
$411.30
|
| Rate for Payer: Priority Health SBD |
$756.54
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.36
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$215.78
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$444.31
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$900.64
|
|
|
HC XR COLON THERAPEUTIC FOR INTUS
|
Facility
|
IP
|
$571.84
|
|
|
Service Code
|
CPT 74283
|
| Hospital Charge Code |
32000147
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$251.61 |
| Max. Negotiated Rate |
$514.66 |
| Rate for Payer: Aetna American Axle |
$371.70
|
| Rate for Payer: Aetna Commercial |
$486.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$371.70
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cofinity Commercial |
$491.78
|
| Rate for Payer: Cofinity Commercial |
$400.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.47
|
| Rate for Payer: Healthscope Commercial |
$514.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$400.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$428.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.06
|
| Rate for Payer: PHP Commercial |
$486.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.29
|
| Rate for Payer: Priority Health SBD |
$360.26
|
| Rate for Payer: UMR Bronson Commercial |
$251.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$428.88
|
|
|
HC XR COLON THERAPEUTIC FOR INTUS
|
Facility
|
OP
|
$571.84
|
|
|
Service Code
|
CPT 74283
|
| Hospital Charge Code |
32000147
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$514.66 |
| Rate for Payer: Aetna American Axle |
$371.70
|
| Rate for Payer: Aetna Commercial |
$486.06
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$371.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.15
|
| Rate for Payer: BCBS Complete |
$93.81
|
| Rate for Payer: BCBS MAPPO |
$163.32
|
| Rate for Payer: BCBS Trust/PPO |
$300.27
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cofinity Commercial |
$491.78
|
| Rate for Payer: Cofinity Commercial |
$400.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$514.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$400.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$428.88
|
| Rate for Payer: Mclaren Medicaid |
$89.34
|
| Rate for Payer: Mclaren Medicare |
$163.32
|
| Rate for Payer: Meridian Medicaid |
$93.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.06
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$486.06
|
| Rate for Payer: PHP Medicare Advantage |
$163.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$514.13
|
| Rate for Payer: Priority Health Medicare |
$163.32
|
| Rate for Payer: Priority Health Narrow Network |
$411.30
|
| Rate for Payer: Priority Health SBD |
$360.26
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$275.19
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$250.17
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$211.58
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$428.88
|
|
|
HC XR CYSTOGRAM MIN 3 VW
|
Facility
|
IP
|
$430.44
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000163
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$189.39 |
| Max. Negotiated Rate |
$387.40 |
| Rate for Payer: Aetna American Axle |
$279.79
|
| Rate for Payer: Aetna Commercial |
$365.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.79
|
| Rate for Payer: Cash Price |
$344.35
|
| Rate for Payer: Cofinity Commercial |
$301.31
|
| Rate for Payer: Cofinity Commercial |
$370.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.35
|
| Rate for Payer: Healthscope Commercial |
$387.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$301.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.87
|
| Rate for Payer: PHP Commercial |
$365.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.31
|
| Rate for Payer: Priority Health SBD |
$271.18
|
| Rate for Payer: UMR Bronson Commercial |
$189.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.83
|
|
|
HC XR CYSTOGRAM MIN 3 VW
|
Facility
|
OP
|
$430.44
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000163
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$40.60 |
| Max. Negotiated Rate |
$1,076.13 |
| Rate for Payer: Aetna American Axle |
$279.79
|
| Rate for Payer: Aetna Commercial |
$365.87
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.79
|
| 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 |
$50.05
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$344.35
|
| Rate for Payer: Cash Price |
$344.35
|
| Rate for Payer: Cofinity Commercial |
$301.31
|
| Rate for Payer: Cofinity Commercial |
$370.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$387.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$301.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.83
|
| 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 |
$365.87
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$365.87
|
| 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 |
$301.31
|
| 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 |
$271.18
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.66
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$40.60
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$159.26
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.83
|
|
|
HC XR CYSTOGRAM VOIDING
|
Facility
|
IP
|
$500.38
|
|
|
Service Code
|
CPT 74455
|
| Hospital Charge Code |
32000166
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$220.17 |
| Max. Negotiated Rate |
$450.34 |
| Rate for Payer: Aetna American Axle |
$325.25
|
| Rate for Payer: Aetna Commercial |
$425.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.25
|
| Rate for Payer: Cash Price |
$400.30
|
| Rate for Payer: Cofinity Commercial |
$430.33
|
| Rate for Payer: Cofinity Commercial |
$350.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.30
|
| Rate for Payer: Healthscope Commercial |
$450.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$350.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$425.32
|
| Rate for Payer: PHP Commercial |
$425.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.27
|
| Rate for Payer: Priority Health SBD |
$315.24
|
| Rate for Payer: UMR Bronson Commercial |
$220.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.28
|
|
|
HC XR CYSTOGRAM VOIDING
|
Facility
|
OP
|
$500.38
|
|
|
Service Code
|
CPT 74455
|
| Hospital Charge Code |
32000166
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$102.16 |
| Max. Negotiated Rate |
$685.66 |
| Rate for Payer: Aetna American Axle |
$325.25
|
| Rate for Payer: Aetna Commercial |
$425.32
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.25
|
| 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 |
$170.40
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$400.30
|
| Rate for Payer: Cash Price |
$400.30
|
| Rate for Payer: Cofinity Commercial |
$350.27
|
| Rate for Payer: Cofinity Commercial |
$430.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$450.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$350.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.28
|
| 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 |
$425.32
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$425.32
|
| 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 |
$350.27
|
| 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 |
$315.24
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.38
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$102.16
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$185.14
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.28
|
|
|
HC XR DEFECOGRAPHY 4 WAY
|
Facility
|
IP
|
$800.53
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000164
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$352.23 |
| Max. Negotiated Rate |
$720.48 |
| Rate for Payer: Aetna American Axle |
$520.34
|
| Rate for Payer: Aetna Commercial |
$680.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$520.34
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$560.37
|
| Rate for Payer: Cofinity Commercial |
$688.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Healthscope Commercial |
$720.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$560.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: PHP Commercial |
$680.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: Priority Health SBD |
$504.33
|
| Rate for Payer: UMR Bronson Commercial |
$352.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.40
|
|
|
HC XR DEFECOGRAPHY 4 WAY
|
Facility
|
OP
|
$800.53
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000164
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$40.60 |
| Max. Negotiated Rate |
$1,076.13 |
| Rate for Payer: Aetna American Axle |
$520.34
|
| Rate for Payer: Aetna Commercial |
$680.45
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$520.34
|
| 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 |
$50.05
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$560.37
|
| Rate for Payer: Cofinity Commercial |
$688.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$720.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$560.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.40
|
| 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 |
$680.45
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$680.45
|
| 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 |
$560.37
|
| 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 |
$504.33
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.66
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$40.60
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$296.20
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.40
|
|
|
HC XR ELBOW 2 BIL VW
|
Facility
|
IP
|
$381.09
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000072
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$167.68 |
| Max. Negotiated Rate |
$342.98 |
| Rate for Payer: Aetna American Axle |
$247.71
|
| Rate for Payer: Aetna Commercial |
$323.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.71
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$266.76
|
| Rate for Payer: Cofinity Commercial |
$327.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$266.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: PHP Commercial |
$323.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: Priority Health SBD |
$240.09
|
| Rate for Payer: UMR Bronson Commercial |
$167.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
|
HC XR ELBOW 2 BIL VW
|
Facility
|
OP
|
$381.09
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000072
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$28.81 |
| Max. Negotiated Rate |
$342.98 |
| Rate for Payer: Aetna American Axle |
$247.71
|
| Rate for Payer: Aetna Commercial |
$323.93
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.71
|
| 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 |
$40.54
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$327.74
|
| Rate for Payer: Cofinity Commercial |
$266.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$266.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
| 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 |
$323.93
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$323.93
|
| 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 |
$266.76
|
| 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 |
$240.09
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.69
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Exchange |
$28.81
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$141.00
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
|
HC XR ELBOW 2 VW
|
Facility
|
OP
|
$350.37
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000071
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$28.81 |
| Max. Negotiated Rate |
$315.33 |
| Rate for Payer: Aetna American Axle |
$227.74
|
| Rate for Payer: Aetna Commercial |
$297.81
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.74
|
| 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 |
$40.54
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cofinity Commercial |
$245.26
|
| Rate for Payer: Cofinity Commercial |
$301.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$315.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.78
|
| 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 |
$297.81
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$297.81
|
| 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 |
$245.26
|
| 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 |
$220.73
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.69
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Exchange |
$28.81
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$129.64
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.78
|
|
|
HC XR ELBOW 2 VW
|
Facility
|
IP
|
$350.37
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000071
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$154.16 |
| Max. Negotiated Rate |
$315.33 |
| Rate for Payer: Aetna American Axle |
$227.74
|
| Rate for Payer: Aetna Commercial |
$297.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.74
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cofinity Commercial |
$245.26
|
| Rate for Payer: Cofinity Commercial |
$301.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.30
|
| Rate for Payer: Healthscope Commercial |
$315.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.81
|
| Rate for Payer: PHP Commercial |
$297.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.26
|
| Rate for Payer: Priority Health SBD |
$220.73
|
| Rate for Payer: UMR Bronson Commercial |
$154.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.78
|
|
|
HC XR ELBOW BIL 3 VW
|
Facility
|
IP
|
$381.09
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000074
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$167.68 |
| Max. Negotiated Rate |
$342.98 |
| Rate for Payer: Aetna American Axle |
$247.71
|
| Rate for Payer: Aetna Commercial |
$323.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.71
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$266.76
|
| Rate for Payer: Cofinity Commercial |
$327.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$266.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: PHP Commercial |
$323.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: Priority Health SBD |
$240.09
|
| Rate for Payer: UMR Bronson Commercial |
$167.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
|
HC XR ELBOW BIL 3 VW
|
Facility
|
OP
|
$381.09
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000074
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.42 |
| Max. Negotiated Rate |
$342.98 |
| Rate for Payer: Aetna American Axle |
$247.71
|
| Rate for Payer: Aetna Commercial |
$323.93
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.71
|
| 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 |
$46.25
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$266.76
|
| Rate for Payer: Cofinity Commercial |
$327.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$266.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
| 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 |
$323.93
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$323.93
|
| 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 |
$266.76
|
| 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 |
$240.09
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.66
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Exchange |
$32.42
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$141.00
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
|
HC XR ELBOW MIN 3 VW
|
Facility
|
OP
|
$350.37
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000073
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.42 |
| Max. Negotiated Rate |
$315.33 |
| Rate for Payer: Aetna American Axle |
$227.74
|
| Rate for Payer: Aetna Commercial |
$297.81
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.74
|
| 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 |
$46.25
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cofinity Commercial |
$245.26
|
| Rate for Payer: Cofinity Commercial |
$301.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$315.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.78
|
| 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 |
$297.81
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$297.81
|
| 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 |
$245.26
|
| 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 |
$220.73
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.66
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Exchange |
$32.42
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$129.64
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.78
|
|
|
HC XR ELBOW MIN 3 VW
|
Facility
|
IP
|
$350.37
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000073
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$154.16 |
| Max. Negotiated Rate |
$315.33 |
| Rate for Payer: Aetna American Axle |
$227.74
|
| Rate for Payer: Aetna Commercial |
$297.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.74
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cofinity Commercial |
$245.26
|
| Rate for Payer: Cofinity Commercial |
$301.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.30
|
| Rate for Payer: Healthscope Commercial |
$315.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.81
|
| Rate for Payer: PHP Commercial |
$297.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.26
|
| Rate for Payer: Priority Health SBD |
$220.73
|
| Rate for Payer: UMR Bronson Commercial |
$154.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.78
|
|
|
HC XR ENDO RETROGRADE CHOLANGIOGR
|
Facility
|
OP
|
$544.76
|
|
|
Service Code
|
CPT 74328
|
| Hospital Charge Code |
32000154
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$150.14 |
| Max. Negotiated Rate |
$490.28 |
| Rate for Payer: Aetna American Axle |
$354.09
|
| Rate for Payer: Aetna Commercial |
$463.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$354.09
|
| Rate for Payer: BCBS Complete |
$217.90
|
| Rate for Payer: BCBS Trust/PPO |
$150.14
|
| Rate for Payer: Cash Price |
$435.81
|
| Rate for Payer: Cash Price |
$435.81
|
| Rate for Payer: Cofinity Commercial |
$381.33
|
| Rate for Payer: Cofinity Commercial |
$468.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$435.81
|
| Rate for Payer: Healthscope Commercial |
$490.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$381.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$408.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$463.05
|
| Rate for Payer: PHP Commercial |
$463.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$381.33
|
| Rate for Payer: Priority Health SBD |
$343.20
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UMR Bronson Commercial |
$201.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$408.57
|
|
|
HC XR ENDO RETROGRADE CHOLANGIOGR
|
Facility
|
IP
|
$544.76
|
|
|
Service Code
|
CPT 74328
|
| Hospital Charge Code |
32000154
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$239.69 |
| Max. Negotiated Rate |
$490.28 |
| Rate for Payer: Aetna American Axle |
$354.09
|
| Rate for Payer: Aetna Commercial |
$463.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$354.09
|
| Rate for Payer: Cash Price |
$435.81
|
| Rate for Payer: Cofinity Commercial |
$381.33
|
| Rate for Payer: Cofinity Commercial |
$468.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$435.81
|
| Rate for Payer: Healthscope Commercial |
$490.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$381.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$408.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$463.05
|
| Rate for Payer: PHP Commercial |
$463.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$381.33
|
| Rate for Payer: Priority Health SBD |
$343.20
|
| Rate for Payer: UMR Bronson Commercial |
$239.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$408.57
|
|
|
HC XR ESOPHAGEAL DILATION
|
Facility
|
OP
|
$257.89
|
|
|
Service Code
|
CPT 74360
|
| Hospital Charge Code |
32000297
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$95.42 |
| Max. Negotiated Rate |
$262.00 |
| Rate for Payer: Aetna American Axle |
$167.63
|
| Rate for Payer: Aetna Commercial |
$219.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.63
|
| Rate for Payer: BCBS Complete |
$103.16
|
| Rate for Payer: BCBS Trust/PPO |
$227.42
|
| Rate for Payer: Cash Price |
$206.31
|
| Rate for Payer: Cash Price |
$206.31
|
| Rate for Payer: Cofinity Commercial |
$180.52
|
| Rate for Payer: Cofinity Commercial |
$221.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.31
|
| Rate for Payer: Healthscope Commercial |
$232.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$180.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$219.21
|
| Rate for Payer: PHP Commercial |
$219.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.52
|
| Rate for Payer: Priority Health SBD |
$162.47
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UMR Bronson Commercial |
$95.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.42
|
|
|
HC XR ESOPHAGEAL DILATION
|
Facility
|
IP
|
$257.89
|
|
|
Service Code
|
CPT 74360
|
| Hospital Charge Code |
32000297
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$113.47 |
| Max. Negotiated Rate |
$232.10 |
| Rate for Payer: Aetna American Axle |
$167.63
|
| Rate for Payer: Aetna Commercial |
$219.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.63
|
| Rate for Payer: Cash Price |
$206.31
|
| Rate for Payer: Cofinity Commercial |
$180.52
|
| Rate for Payer: Cofinity Commercial |
$221.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.31
|
| Rate for Payer: Healthscope Commercial |
$232.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$180.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$219.21
|
| Rate for Payer: PHP Commercial |
$219.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.52
|
| Rate for Payer: Priority Health SBD |
$162.47
|
| Rate for Payer: UMR Bronson Commercial |
$113.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.42
|
|
|
HC XR ESOPHAGUS
|
Facility
|
IP
|
$630.27
|
|
|
Service Code
|
CPT 74220
|
| Hospital Charge Code |
32000136
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$277.32 |
| Max. Negotiated Rate |
$567.24 |
| Rate for Payer: Aetna American Axle |
$409.68
|
| Rate for Payer: Aetna Commercial |
$535.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$409.68
|
| Rate for Payer: Cash Price |
$504.22
|
| Rate for Payer: Cofinity Commercial |
$441.19
|
| Rate for Payer: Cofinity Commercial |
$542.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$504.22
|
| Rate for Payer: Healthscope Commercial |
$567.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$441.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$472.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$535.73
|
| Rate for Payer: PHP Commercial |
$535.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$441.19
|
| Rate for Payer: Priority Health SBD |
$397.07
|
| Rate for Payer: UMR Bronson Commercial |
$277.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$472.70
|
|
|
HC XR ESOPHAGUS
|
Facility
|
OP
|
$630.27
|
|
|
Service Code
|
CPT 74220
|
| Hospital Charge Code |
32000136
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$567.24 |
| Rate for Payer: Aetna American Axle |
$409.68
|
| Rate for Payer: Aetna Commercial |
$535.73
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$409.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.15
|
| Rate for Payer: BCBS Complete |
$93.81
|
| Rate for Payer: BCBS MAPPO |
$163.32
|
| Rate for Payer: BCBS Trust/PPO |
$134.93
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$504.22
|
| Rate for Payer: Cash Price |
$504.22
|
| Rate for Payer: Cofinity Commercial |
$441.19
|
| Rate for Payer: Cofinity Commercial |
$542.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$504.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$567.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$441.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$472.70
|
| Rate for Payer: Mclaren Medicaid |
$89.34
|
| Rate for Payer: Mclaren Medicare |
$163.32
|
| Rate for Payer: Meridian Medicaid |
$93.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$535.73
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$535.73
|
| Rate for Payer: PHP Medicare Advantage |
$163.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$441.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$514.13
|
| Rate for Payer: Priority Health Medicare |
$163.32
|
| Rate for Payer: Priority Health Narrow Network |
$411.30
|
| Rate for Payer: Priority Health SBD |
$397.07
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.17
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$95.61
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$233.20
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$472.70
|
|
|
HC XR ESOPHAGUS FB
|
Facility
|
IP
|
$481.37
|
|
|
Service Code
|
HCPCS 74235
|
| Hospital Charge Code |
32000296
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$211.80 |
| Max. Negotiated Rate |
$433.23 |
| Rate for Payer: Aetna American Axle |
$312.89
|
| Rate for Payer: Aetna Commercial |
$409.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$312.89
|
| Rate for Payer: Cash Price |
$385.10
|
| Rate for Payer: Cofinity Commercial |
$336.96
|
| Rate for Payer: Cofinity Commercial |
$413.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.10
|
| Rate for Payer: Healthscope Commercial |
$433.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$336.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$409.16
|
| Rate for Payer: PHP Commercial |
$409.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.96
|
| Rate for Payer: Priority Health SBD |
$303.26
|
| Rate for Payer: UMR Bronson Commercial |
$211.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.03
|
|
|
HC XR ESOPHAGUS FB
|
Facility
|
OP
|
$481.37
|
|
|
Service Code
|
HCPCS 74235
|
| Hospital Charge Code |
32000296
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$178.11 |
| Max. Negotiated Rate |
$433.23 |
| Rate for Payer: Aetna American Axle |
$312.89
|
| Rate for Payer: Aetna Commercial |
$409.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$312.89
|
| Rate for Payer: BCBS Complete |
$192.55
|
| Rate for Payer: BCBS Trust/PPO |
$183.08
|
| Rate for Payer: Cash Price |
$385.10
|
| Rate for Payer: Cash Price |
$385.10
|
| Rate for Payer: Cofinity Commercial |
$336.96
|
| Rate for Payer: Cofinity Commercial |
$413.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.10
|
| Rate for Payer: Healthscope Commercial |
$433.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$336.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$409.16
|
| Rate for Payer: PHP Commercial |
$409.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.96
|
| Rate for Payer: Priority Health SBD |
$303.26
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UMR Bronson Commercial |
$178.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.03
|
|
