|
HC NM PARATHYROID SCAN
|
Facility
|
OP
|
$937.08
|
|
|
Service Code
|
CPT 78070
|
| Hospital Charge Code |
34100007
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$208.33 |
| Max. Negotiated Rate |
$1,288.18 |
| Rate for Payer: Aetna American Axle |
$609.10
|
| Rate for Payer: Aetna Commercial |
$796.52
|
| Rate for Payer: Aetna Medicare |
$414.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$609.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$497.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$497.91
|
| Rate for Payer: BCBS Complete |
$218.76
|
| Rate for Payer: BCBS MAPPO |
$398.33
|
| Rate for Payer: BCBS Trust/PPO |
$559.85
|
| Rate for Payer: BCN Commercial |
$559.85
|
| Rate for Payer: BCN Medicare Advantage |
$398.33
|
| Rate for Payer: Cash Price |
$749.66
|
| Rate for Payer: Cash Price |
$749.66
|
| Rate for Payer: Cofinity Advantage |
$655.96
|
| Rate for Payer: Cofinity Commercial |
$805.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$749.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.33
|
| Rate for Payer: Healthscope Commercial |
$843.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$655.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$702.81
|
| Rate for Payer: Mclaren Medicaid |
$398.33
|
| Rate for Payer: Mclaren Medicare |
$398.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.25
|
| Rate for Payer: Meridian Medicaid |
$418.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$458.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$796.52
|
| Rate for Payer: Nomi Health Commercial |
$1,194.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$702.81
|
| Rate for Payer: PACE Medicare |
$378.41
|
| Rate for Payer: PACE SWMI |
$398.33
|
| Rate for Payer: PHP Commercial |
$796.52
|
| Rate for Payer: PHP Medicare Advantage |
$398.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,288.18
|
| Rate for Payer: Priority Health Medicare |
$398.33
|
| Rate for Payer: Priority Health SBD |
$590.36
|
| Rate for Payer: Priority Health Tiered Network |
$1,030.54
|
| Rate for Payer: Railroad Medicare Medicare |
$398.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$609.10
|
| Rate for Payer: UHC Core |
$488.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.33
|
| Rate for Payer: UHC Exchange |
$368.27
|
| Rate for Payer: UHC Medicaid |
$208.33
|
| Rate for Payer: UHCCP Medicaid |
$208.33
|
| Rate for Payer: UMR Bronson Commercial |
$346.72
|
| Rate for Payer: VA VA |
$398.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$702.81
|
|
|
HC NM PARATHYROID SCAN
|
Facility
|
IP
|
$937.08
|
|
|
Service Code
|
CPT 78070
|
| Hospital Charge Code |
34100007
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$412.32 |
| Max. Negotiated Rate |
$843.37 |
| Rate for Payer: Aetna American Axle |
$609.10
|
| Rate for Payer: Aetna Commercial |
$796.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$609.10
|
| Rate for Payer: Cash Price |
$749.66
|
| Rate for Payer: Cofinity Advantage |
$655.96
|
| Rate for Payer: Cofinity Commercial |
$805.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$749.66
|
| Rate for Payer: Healthscope Commercial |
$843.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$655.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$702.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$796.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$702.81
|
| Rate for Payer: PHP Commercial |
$796.52
|
| Rate for Payer: Priority Health SBD |
$590.36
|
| Rate for Payer: UMR Bronson Commercial |
$412.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$702.81
|
|
|
HC NM PARATHYROID SESTAMIBI INJ O
|
Facility
|
OP
|
$416.36
|
|
|
Service Code
|
CPT 78808
|
| Hospital Charge Code |
34100060
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$98.50 |
| Max. Negotiated Rate |
$1,288.18 |
| Rate for Payer: Aetna American Axle |
$270.63
|
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: Aetna Medicare |
$414.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$497.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$497.91
|
| Rate for Payer: BCBS Complete |
$218.76
|
| Rate for Payer: BCBS MAPPO |
$398.33
|
| Rate for Payer: BCBS Trust/PPO |
$98.50
|
| Rate for Payer: BCN Commercial |
$98.50
|
| Rate for Payer: BCN Medicare Advantage |
$398.33
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Advantage |
$291.45
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.33
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.27
|
| Rate for Payer: Mclaren Medicaid |
$398.33
|
| Rate for Payer: Mclaren Medicare |
$398.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.25
|
| Rate for Payer: Meridian Medicaid |
$418.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$458.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Nomi Health Commercial |
$1,194.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PACE Medicare |
$378.41
|
| Rate for Payer: PACE SWMI |
$398.33
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: PHP Medicare Advantage |
$398.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,288.18
|
| Rate for Payer: Priority Health Medicare |
$398.33
|
| Rate for Payer: Priority Health SBD |
$262.31
|
| Rate for Payer: Priority Health Tiered Network |
$1,030.54
|
| Rate for Payer: Railroad Medicare Medicare |
$398.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.63
|
| Rate for Payer: UHC Core |
$216.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.33
|
| Rate for Payer: UHC Exchange |
$163.63
|
| Rate for Payer: UHC Medicaid |
$208.33
|
| Rate for Payer: UHCCP Medicaid |
$208.33
|
| Rate for Payer: UMR Bronson Commercial |
$154.05
|
| Rate for Payer: VA VA |
$398.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.27
|
|
|
HC NM PARATHYROID SESTAMIBI INJ O
|
Facility
|
IP
|
$416.36
|
|
|
Service Code
|
CPT 78808
|
| Hospital Charge Code |
34100060
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$183.20 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna American Axle |
$270.63
|
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.63
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Advantage |
$291.45
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: Priority Health SBD |
$262.31
|
| Rate for Payer: UMR Bronson Commercial |
$183.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.27
|
|
|
HC NM PARATHYROID SPECT SCAN
|
Facility
|
OP
|
$1,052.76
|
|
|
Service Code
|
CPT 78071
|
| Hospital Charge Code |
34100077
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$208.33 |
| Max. Negotiated Rate |
$1,288.18 |
| Rate for Payer: Aetna American Axle |
$684.29
|
| Rate for Payer: Aetna Commercial |
$894.85
|
| Rate for Payer: Aetna Medicare |
$414.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$497.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$497.91
|
| Rate for Payer: BCBS Complete |
$218.76
|
| Rate for Payer: BCBS MAPPO |
$398.33
|
| Rate for Payer: BCBS Trust/PPO |
$637.84
|
| Rate for Payer: BCN Commercial |
$637.84
|
| Rate for Payer: BCN Medicare Advantage |
$398.33
|
| Rate for Payer: Cash Price |
$842.21
|
| Rate for Payer: Cash Price |
$842.21
|
| Rate for Payer: Cofinity Advantage |
$736.93
|
| Rate for Payer: Cofinity Commercial |
$905.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$842.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.33
|
| Rate for Payer: Healthscope Commercial |
$947.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$736.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.57
|
| Rate for Payer: Mclaren Medicaid |
$398.33
|
| Rate for Payer: Mclaren Medicare |
$398.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.25
|
| Rate for Payer: Meridian Medicaid |
$418.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$458.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$894.85
|
| Rate for Payer: Nomi Health Commercial |
$1,194.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$789.57
|
| Rate for Payer: PACE Medicare |
$378.41
|
| Rate for Payer: PACE SWMI |
$398.33
|
| Rate for Payer: PHP Commercial |
$894.85
|
| Rate for Payer: PHP Medicare Advantage |
$398.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,288.18
|
| Rate for Payer: Priority Health Medicare |
$398.33
|
| Rate for Payer: Priority Health SBD |
$663.24
|
| Rate for Payer: Priority Health Tiered Network |
$1,030.54
|
| Rate for Payer: Railroad Medicare Medicare |
$398.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$684.29
|
| Rate for Payer: UHC Core |
$548.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.33
|
| Rate for Payer: UHC Exchange |
$413.73
|
| Rate for Payer: UHC Medicaid |
$208.33
|
| Rate for Payer: UHCCP Medicaid |
$208.33
|
| Rate for Payer: UMR Bronson Commercial |
$389.52
|
| Rate for Payer: VA VA |
$398.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.57
|
|
|
HC NM PARATHYROID SPECT SCAN
|
Facility
|
IP
|
$1,052.76
|
|
|
Service Code
|
CPT 78071
|
| Hospital Charge Code |
34100077
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$463.21 |
| Max. Negotiated Rate |
$947.48 |
| Rate for Payer: Aetna American Axle |
$684.29
|
| Rate for Payer: Aetna Commercial |
$894.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.29
|
| Rate for Payer: Cash Price |
$842.21
|
| Rate for Payer: Cofinity Advantage |
$736.93
|
| Rate for Payer: Cofinity Commercial |
$905.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$842.21
|
| Rate for Payer: Healthscope Commercial |
$947.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$736.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$894.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$789.57
|
| Rate for Payer: PHP Commercial |
$894.85
|
| Rate for Payer: Priority Health SBD |
$663.24
|
| Rate for Payer: UMR Bronson Commercial |
$463.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.57
|
|
|
HC NM PERFUSION QUANTITATIVE DIFF
|
Facility
|
IP
|
$1,243.56
|
|
|
Service Code
|
CPT 78597
|
| Hospital Charge Code |
34100069
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$547.17 |
| Max. Negotiated Rate |
$1,119.20 |
| Rate for Payer: Aetna American Axle |
$808.31
|
| Rate for Payer: Aetna Commercial |
$1,057.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$808.31
|
| Rate for Payer: Cash Price |
$994.85
|
| Rate for Payer: Cofinity Advantage |
$870.49
|
| Rate for Payer: Cofinity Commercial |
$1,069.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$994.85
|
| Rate for Payer: Healthscope Commercial |
$1,119.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$870.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$932.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,057.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$932.67
|
| Rate for Payer: PHP Commercial |
$1,057.03
|
| Rate for Payer: Priority Health SBD |
$783.44
|
| Rate for Payer: UMR Bronson Commercial |
$547.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$932.67
|
|
|
HC NM PERFUSION QUANTITATIVE DIFF
|
Facility
|
OP
|
$1,243.56
|
|
|
Service Code
|
CPT 78597
|
| Hospital Charge Code |
34100069
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$208.33 |
| Max. Negotiated Rate |
$1,288.18 |
| Rate for Payer: Aetna American Axle |
$808.31
|
| Rate for Payer: Aetna Commercial |
$1,057.03
|
| Rate for Payer: Aetna Medicare |
$414.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$808.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$497.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$497.91
|
| Rate for Payer: BCBS Complete |
$218.76
|
| Rate for Payer: BCBS MAPPO |
$398.33
|
| Rate for Payer: BCBS Trust/PPO |
$364.47
|
| Rate for Payer: BCN Commercial |
$364.47
|
| Rate for Payer: BCN Medicare Advantage |
$398.33
|
| Rate for Payer: Cash Price |
$994.85
|
| Rate for Payer: Cash Price |
$994.85
|
| Rate for Payer: Cofinity Advantage |
$870.49
|
| Rate for Payer: Cofinity Commercial |
$1,069.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$994.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.33
|
| Rate for Payer: Healthscope Commercial |
$1,119.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$870.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$932.67
|
| Rate for Payer: Mclaren Medicaid |
$398.33
|
| Rate for Payer: Mclaren Medicare |
$398.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.25
|
| Rate for Payer: Meridian Medicaid |
$418.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$458.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,057.03
|
| Rate for Payer: Nomi Health Commercial |
$1,194.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$932.67
|
| Rate for Payer: PACE Medicare |
$378.41
|
| Rate for Payer: PACE SWMI |
$398.33
|
| Rate for Payer: PHP Commercial |
$1,057.03
|
| Rate for Payer: PHP Medicare Advantage |
$398.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,288.18
|
| Rate for Payer: Priority Health Medicare |
$398.33
|
| Rate for Payer: Priority Health SBD |
$783.44
|
| Rate for Payer: Priority Health Tiered Network |
$1,030.54
|
| Rate for Payer: Railroad Medicare Medicare |
$398.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$808.31
|
| Rate for Payer: UHC Core |
$647.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.33
|
| Rate for Payer: UHC Exchange |
$488.72
|
| Rate for Payer: UHC Medicaid |
$208.33
|
| Rate for Payer: UHCCP Medicaid |
$208.33
|
| Rate for Payer: UMR Bronson Commercial |
$460.12
|
| Rate for Payer: VA VA |
$398.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$932.67
|
|
|
HC NM RADIOPHARM INTRACAVITARY AD
|
Facility
|
IP
|
$793.26
|
|
|
Service Code
|
CPT 79200
|
| Hospital Charge Code |
34100064
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$349.03 |
| Max. Negotiated Rate |
$713.93 |
| Rate for Payer: Aetna American Axle |
$515.62
|
| Rate for Payer: Aetna Commercial |
$674.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$515.62
|
| Rate for Payer: Cash Price |
$634.61
|
| Rate for Payer: Cofinity Advantage |
$555.28
|
| Rate for Payer: Cofinity Commercial |
$682.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.61
|
| Rate for Payer: Healthscope Commercial |
$713.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$555.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$594.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$674.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$594.95
|
| Rate for Payer: PHP Commercial |
$674.27
|
| Rate for Payer: Priority Health SBD |
$499.75
|
| Rate for Payer: UMR Bronson Commercial |
$349.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$594.95
|
|
|
HC NM RADIOPHARM INTRACAVITARY AD
|
Facility
|
OP
|
$793.26
|
|
|
Service Code
|
CPT 79200
|
| Hospital Charge Code |
34100064
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$121.60 |
| Max. Negotiated Rate |
$751.88 |
| Rate for Payer: Aetna American Axle |
$515.62
|
| Rate for Payer: Aetna Commercial |
$674.27
|
| Rate for Payer: Aetna Medicare |
$241.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$515.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$290.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$290.62
|
| Rate for Payer: BCBS Complete |
$127.69
|
| Rate for Payer: BCBS MAPPO |
$232.50
|
| Rate for Payer: BCBS Trust/PPO |
$129.70
|
| Rate for Payer: BCN Commercial |
$129.70
|
| Rate for Payer: BCN Medicare Advantage |
$232.50
|
| Rate for Payer: Cash Price |
$634.61
|
| Rate for Payer: Cash Price |
$634.61
|
| Rate for Payer: Cofinity Advantage |
$555.28
|
| Rate for Payer: Cofinity Commercial |
$682.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$232.50
|
| Rate for Payer: Healthscope Commercial |
$713.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$555.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$594.95
|
| Rate for Payer: Mclaren Medicaid |
$232.50
|
| Rate for Payer: Mclaren Medicare |
$232.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$244.12
|
| Rate for Payer: Meridian Medicaid |
$244.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$267.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$255.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$674.27
|
| Rate for Payer: Nomi Health Commercial |
$697.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$594.95
|
| Rate for Payer: PACE Medicare |
$220.88
|
| Rate for Payer: PACE SWMI |
$232.50
|
| Rate for Payer: PHP Commercial |
$674.27
|
| Rate for Payer: PHP Medicare Advantage |
$232.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$751.88
|
| Rate for Payer: Priority Health Medicare |
$232.50
|
| Rate for Payer: Priority Health SBD |
$499.75
|
| Rate for Payer: Priority Health Tiered Network |
$601.50
|
| Rate for Payer: Railroad Medicare Medicare |
$232.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$515.62
|
| Rate for Payer: UHC Core |
$413.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$232.50
|
| Rate for Payer: UHC Exchange |
$311.75
|
| Rate for Payer: UHC Medicaid |
$121.60
|
| Rate for Payer: UHCCP Medicaid |
$121.60
|
| Rate for Payer: UMR Bronson Commercial |
$293.51
|
| Rate for Payer: VA VA |
$232.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$594.95
|
|
|
HC NM RADIOPHARM IV ADMIN
|
Facility
|
OP
|
$793.26
|
|
|
Service Code
|
CPT 79101
|
| Hospital Charge Code |
34100063
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$121.60 |
| Max. Negotiated Rate |
$751.88 |
| Rate for Payer: Aetna American Axle |
$515.62
|
| Rate for Payer: Aetna Commercial |
$674.27
|
| Rate for Payer: Aetna Medicare |
$241.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$515.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$290.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$290.62
|
| Rate for Payer: BCBS Complete |
$127.69
|
| Rate for Payer: BCBS MAPPO |
$232.50
|
| Rate for Payer: BCBS Trust/PPO |
$132.17
|
| Rate for Payer: BCN Commercial |
$132.17
|
| Rate for Payer: BCN Medicare Advantage |
$232.50
|
| Rate for Payer: Cash Price |
$634.61
|
| Rate for Payer: Cash Price |
$634.61
|
| Rate for Payer: Cofinity Advantage |
$555.28
|
| Rate for Payer: Cofinity Commercial |
$682.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$232.50
|
| Rate for Payer: Healthscope Commercial |
$713.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$555.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$594.95
|
| Rate for Payer: Mclaren Medicaid |
$232.50
|
| Rate for Payer: Mclaren Medicare |
$232.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$244.12
|
| Rate for Payer: Meridian Medicaid |
$244.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$267.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$255.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$674.27
|
| Rate for Payer: Nomi Health Commercial |
$697.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$594.95
|
| Rate for Payer: PACE Medicare |
$220.88
|
| Rate for Payer: PACE SWMI |
$232.50
|
| Rate for Payer: PHP Commercial |
$674.27
|
| Rate for Payer: PHP Medicare Advantage |
$232.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$751.88
|
| Rate for Payer: Priority Health Medicare |
$232.50
|
| Rate for Payer: Priority Health SBD |
$499.75
|
| Rate for Payer: Priority Health Tiered Network |
$601.50
|
| Rate for Payer: Railroad Medicare Medicare |
$232.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$515.62
|
| Rate for Payer: UHC Core |
$413.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$232.50
|
| Rate for Payer: UHC Exchange |
$311.75
|
| Rate for Payer: UHC Medicaid |
$121.60
|
| Rate for Payer: UHCCP Medicaid |
$121.60
|
| Rate for Payer: UMR Bronson Commercial |
$293.51
|
| Rate for Payer: VA VA |
$232.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$594.95
|
|
|
HC NM RADIOPHARM IV ADMIN
|
Facility
|
IP
|
$793.26
|
|
|
Service Code
|
CPT 79101
|
| Hospital Charge Code |
34100063
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$349.03 |
| Max. Negotiated Rate |
$713.93 |
| Rate for Payer: Aetna American Axle |
$515.62
|
| Rate for Payer: Aetna Commercial |
$674.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$515.62
|
| Rate for Payer: Cash Price |
$634.61
|
| Rate for Payer: Cofinity Advantage |
$555.28
|
| Rate for Payer: Cofinity Commercial |
$682.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.61
|
| Rate for Payer: Healthscope Commercial |
$713.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$555.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$594.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$674.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$594.95
|
| Rate for Payer: PHP Commercial |
$674.27
|
| Rate for Payer: Priority Health SBD |
$499.75
|
| Rate for Payer: UMR Bronson Commercial |
$349.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$594.95
|
|
|
HC NM RADIOPHARM ORAL ADMIN
|
Facility
|
OP
|
$793.26
|
|
|
Service Code
|
CPT 79005
|
| Hospital Charge Code |
34100062
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$121.60 |
| Max. Negotiated Rate |
$751.88 |
| Rate for Payer: Aetna American Axle |
$515.62
|
| Rate for Payer: Aetna Commercial |
$674.27
|
| Rate for Payer: Aetna Medicare |
$241.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$515.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$290.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$290.62
|
| Rate for Payer: BCBS Complete |
$127.69
|
| Rate for Payer: BCBS MAPPO |
$232.50
|
| Rate for Payer: BCBS Trust/PPO |
$127.23
|
| Rate for Payer: BCN Commercial |
$127.23
|
| Rate for Payer: BCN Medicare Advantage |
$232.50
|
| Rate for Payer: Cash Price |
$634.61
|
| Rate for Payer: Cash Price |
$634.61
|
| Rate for Payer: Cofinity Advantage |
$555.28
|
| Rate for Payer: Cofinity Commercial |
$682.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$232.50
|
| Rate for Payer: Healthscope Commercial |
$713.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$555.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$594.95
|
| Rate for Payer: Mclaren Medicaid |
$232.50
|
| Rate for Payer: Mclaren Medicare |
$232.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$244.12
|
| Rate for Payer: Meridian Medicaid |
$244.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$267.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$255.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$674.27
|
| Rate for Payer: Nomi Health Commercial |
$697.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$594.95
|
| Rate for Payer: PACE Medicare |
$220.88
|
| Rate for Payer: PACE SWMI |
$232.50
|
| Rate for Payer: PHP Commercial |
$674.27
|
| Rate for Payer: PHP Medicare Advantage |
$232.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$751.88
|
| Rate for Payer: Priority Health Medicare |
$232.50
|
| Rate for Payer: Priority Health SBD |
$499.75
|
| Rate for Payer: Priority Health Tiered Network |
$601.50
|
| Rate for Payer: Railroad Medicare Medicare |
$232.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$515.62
|
| Rate for Payer: UHC Core |
$413.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$232.50
|
| Rate for Payer: UHC Exchange |
$311.75
|
| Rate for Payer: UHC Medicaid |
$121.60
|
| Rate for Payer: UHCCP Medicaid |
$121.60
|
| Rate for Payer: UMR Bronson Commercial |
$293.51
|
| Rate for Payer: VA VA |
$232.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$594.95
|
|
|
HC NM RADIOPHARM ORAL ADMIN
|
Facility
|
IP
|
$793.26
|
|
|
Service Code
|
CPT 79005
|
| Hospital Charge Code |
34100062
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$349.03 |
| Max. Negotiated Rate |
$713.93 |
| Rate for Payer: Aetna American Axle |
$515.62
|
| Rate for Payer: Aetna Commercial |
$674.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$515.62
|
| Rate for Payer: Cash Price |
$634.61
|
| Rate for Payer: Cofinity Advantage |
$555.28
|
| Rate for Payer: Cofinity Commercial |
$682.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.61
|
| Rate for Payer: Healthscope Commercial |
$713.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$555.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$594.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$674.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$594.95
|
| Rate for Payer: PHP Commercial |
$674.27
|
| Rate for Payer: Priority Health SBD |
$499.75
|
| Rate for Payer: UMR Bronson Commercial |
$349.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$594.95
|
|
|
HC NM RENAL NON FLOW STUDY
|
Facility
|
OP
|
$1,388.07
|
|
|
Service Code
|
CPT 78700
|
| Hospital Charge Code |
34100044
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$208.33 |
| Max. Negotiated Rate |
$1,288.18 |
| Rate for Payer: Aetna American Axle |
$902.25
|
| Rate for Payer: Aetna Commercial |
$1,179.86
|
| Rate for Payer: Aetna Medicare |
$414.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$902.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$497.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$497.91
|
| Rate for Payer: BCBS Complete |
$218.76
|
| Rate for Payer: BCBS MAPPO |
$398.33
|
| Rate for Payer: BCBS Trust/PPO |
$334.92
|
| Rate for Payer: BCN Commercial |
$334.92
|
| Rate for Payer: BCN Medicare Advantage |
$398.33
|
| Rate for Payer: Cash Price |
$1,110.46
|
| Rate for Payer: Cash Price |
$1,110.46
|
| Rate for Payer: Cofinity Advantage |
$971.65
|
| Rate for Payer: Cofinity Commercial |
$1,193.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,110.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.33
|
| Rate for Payer: Healthscope Commercial |
$1,249.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$971.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,041.05
|
| Rate for Payer: Mclaren Medicaid |
$398.33
|
| Rate for Payer: Mclaren Medicare |
$398.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.25
|
| Rate for Payer: Meridian Medicaid |
$418.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$458.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,179.86
|
| Rate for Payer: Nomi Health Commercial |
$1,194.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,041.05
|
| Rate for Payer: PACE Medicare |
$378.41
|
| Rate for Payer: PACE SWMI |
$398.33
|
| Rate for Payer: PHP Commercial |
$1,179.86
|
| Rate for Payer: PHP Medicare Advantage |
$398.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,288.18
|
| Rate for Payer: Priority Health Medicare |
$398.33
|
| Rate for Payer: Priority Health SBD |
$874.48
|
| Rate for Payer: Priority Health Tiered Network |
$1,030.54
|
| Rate for Payer: Railroad Medicare Medicare |
$398.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$902.25
|
| Rate for Payer: UHC Core |
$723.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.33
|
| Rate for Payer: UHC Exchange |
$545.51
|
| Rate for Payer: UHC Medicaid |
$208.33
|
| Rate for Payer: UHCCP Medicaid |
$208.33
|
| Rate for Payer: UMR Bronson Commercial |
$513.59
|
| Rate for Payer: VA VA |
$398.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,041.05
|
|
|
HC NM RENAL NON FLOW STUDY
|
Facility
|
IP
|
$1,388.07
|
|
|
Service Code
|
CPT 78700
|
| Hospital Charge Code |
34100044
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$610.75 |
| Max. Negotiated Rate |
$1,249.26 |
| Rate for Payer: Aetna American Axle |
$902.25
|
| Rate for Payer: Aetna Commercial |
$1,179.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$902.25
|
| Rate for Payer: Cash Price |
$1,110.46
|
| Rate for Payer: Cofinity Advantage |
$971.65
|
| Rate for Payer: Cofinity Commercial |
$1,193.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,110.46
|
| Rate for Payer: Healthscope Commercial |
$1,249.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$971.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,041.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,179.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,041.05
|
| Rate for Payer: PHP Commercial |
$1,179.86
|
| Rate for Payer: Priority Health SBD |
$874.48
|
| Rate for Payer: UMR Bronson Commercial |
$610.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,041.05
|
|
|
HC NM RENOGRAM WITH FLOW
|
Facility
|
IP
|
$1,353.19
|
|
|
Service Code
|
CPT 78707
|
| Hospital Charge Code |
34100045
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$595.40 |
| Max. Negotiated Rate |
$1,217.87 |
| Rate for Payer: Aetna American Axle |
$879.57
|
| Rate for Payer: Aetna Commercial |
$1,150.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$879.57
|
| Rate for Payer: Cash Price |
$1,082.55
|
| Rate for Payer: Cofinity Advantage |
$947.23
|
| Rate for Payer: Cofinity Commercial |
$1,163.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,082.55
|
| Rate for Payer: Healthscope Commercial |
$1,217.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$947.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,014.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,150.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,014.89
|
| Rate for Payer: PHP Commercial |
$1,150.21
|
| Rate for Payer: Priority Health SBD |
$852.51
|
| Rate for Payer: UMR Bronson Commercial |
$595.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,014.89
|
|
|
HC NM RENOGRAM WITH FLOW
|
Facility
|
OP
|
$1,353.19
|
|
|
Service Code
|
CPT 78707
|
| Hospital Charge Code |
34100045
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$282.95 |
| Max. Negotiated Rate |
$1,749.61 |
| Rate for Payer: Aetna American Axle |
$879.57
|
| Rate for Payer: Aetna Commercial |
$1,150.21
|
| Rate for Payer: Aetna Medicare |
$562.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$879.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$676.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$676.27
|
| Rate for Payer: BCBS Complete |
$297.13
|
| Rate for Payer: BCBS MAPPO |
$541.02
|
| Rate for Payer: BCBS Trust/PPO |
$415.38
|
| Rate for Payer: BCN Commercial |
$415.38
|
| Rate for Payer: BCN Medicare Advantage |
$541.02
|
| Rate for Payer: Cash Price |
$1,082.55
|
| Rate for Payer: Cash Price |
$1,082.55
|
| Rate for Payer: Cofinity Advantage |
$947.23
|
| Rate for Payer: Cofinity Commercial |
$1,163.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,082.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$541.02
|
| Rate for Payer: Healthscope Commercial |
$1,217.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$947.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,014.89
|
| Rate for Payer: Mclaren Medicaid |
$541.02
|
| Rate for Payer: Mclaren Medicare |
$541.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$568.07
|
| Rate for Payer: Meridian Medicaid |
$568.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$622.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$595.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,150.21
|
| Rate for Payer: Nomi Health Commercial |
$1,623.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,014.89
|
| Rate for Payer: PACE Medicare |
$513.97
|
| Rate for Payer: PACE SWMI |
$541.02
|
| Rate for Payer: PHP Commercial |
$1,150.21
|
| Rate for Payer: PHP Medicare Advantage |
$541.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,749.61
|
| Rate for Payer: Priority Health Medicare |
$541.02
|
| Rate for Payer: Priority Health SBD |
$852.51
|
| Rate for Payer: Priority Health Tiered Network |
$1,399.69
|
| Rate for Payer: Railroad Medicare Medicare |
$541.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$879.57
|
| Rate for Payer: UHC Core |
$705.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$541.02
|
| Rate for Payer: UHC Exchange |
$531.80
|
| Rate for Payer: UHC Medicaid |
$282.95
|
| Rate for Payer: UHCCP Medicaid |
$282.95
|
| Rate for Payer: UMR Bronson Commercial |
$500.68
|
| Rate for Payer: VA VA |
$541.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,014.89
|
|
|
HC NM RENOGRAM WITH PHARM INTERVENTION
|
Facility
|
IP
|
$1,717.83
|
|
|
Service Code
|
CPT 78708
|
| Hospital Charge Code |
34100046
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$755.85 |
| Max. Negotiated Rate |
$1,546.05 |
| Rate for Payer: Aetna American Axle |
$1,116.59
|
| Rate for Payer: Aetna Commercial |
$1,460.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,116.59
|
| Rate for Payer: Cash Price |
$1,374.26
|
| Rate for Payer: Cofinity Advantage |
$1,202.48
|
| Rate for Payer: Cofinity Commercial |
$1,477.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,374.26
|
| Rate for Payer: Healthscope Commercial |
$1,546.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,202.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,288.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,460.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,288.37
|
| Rate for Payer: PHP Commercial |
$1,460.16
|
| Rate for Payer: Priority Health SBD |
$1,082.23
|
| Rate for Payer: UMR Bronson Commercial |
$755.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,288.37
|
|
|
HC NM RENOGRAM WITH PHARM INTERVENTION
|
Facility
|
OP
|
$1,717.83
|
|
|
Service Code
|
CPT 78708
|
| Hospital Charge Code |
34100046
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$282.95 |
| Max. Negotiated Rate |
$1,749.61 |
| Rate for Payer: Aetna American Axle |
$1,116.59
|
| Rate for Payer: Aetna Commercial |
$1,460.16
|
| Rate for Payer: Aetna Medicare |
$562.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,116.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$676.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$676.27
|
| Rate for Payer: BCBS Complete |
$297.13
|
| Rate for Payer: BCBS MAPPO |
$541.02
|
| Rate for Payer: BCBS Trust/PPO |
$296.35
|
| Rate for Payer: BCN Commercial |
$296.35
|
| Rate for Payer: BCN Medicare Advantage |
$541.02
|
| Rate for Payer: Cash Price |
$1,374.26
|
| Rate for Payer: Cash Price |
$1,374.26
|
| Rate for Payer: Cofinity Advantage |
$1,202.48
|
| Rate for Payer: Cofinity Commercial |
$1,477.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,374.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$541.02
|
| Rate for Payer: Healthscope Commercial |
$1,546.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,202.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,288.37
|
| Rate for Payer: Mclaren Medicaid |
$541.02
|
| Rate for Payer: Mclaren Medicare |
$541.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$568.07
|
| Rate for Payer: Meridian Medicaid |
$568.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$622.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$595.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,460.16
|
| Rate for Payer: Nomi Health Commercial |
$1,623.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,288.37
|
| Rate for Payer: PACE Medicare |
$513.97
|
| Rate for Payer: PACE SWMI |
$541.02
|
| Rate for Payer: PHP Commercial |
$1,460.16
|
| Rate for Payer: PHP Medicare Advantage |
$541.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,749.61
|
| Rate for Payer: Priority Health Medicare |
$541.02
|
| Rate for Payer: Priority Health SBD |
$1,082.23
|
| Rate for Payer: Priority Health Tiered Network |
$1,399.69
|
| Rate for Payer: Railroad Medicare Medicare |
$541.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,116.59
|
| Rate for Payer: UHC Core |
$894.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$541.02
|
| Rate for Payer: UHC Exchange |
$675.11
|
| Rate for Payer: UHC Medicaid |
$282.95
|
| Rate for Payer: UHCCP Medicaid |
$282.95
|
| Rate for Payer: UMR Bronson Commercial |
$635.60
|
| Rate for Payer: VA VA |
$541.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,288.37
|
|
|
HC NM SENTINEL NODE INJECTION NON IMAGE BIL
|
Facility
|
IP
|
$817.13
|
|
|
Service Code
|
CPT 38792
|
| Hospital Charge Code |
36100622
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$359.54 |
| Max. Negotiated Rate |
$735.42 |
| Rate for Payer: Aetna American Axle |
$531.13
|
| Rate for Payer: Aetna Commercial |
$694.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$531.13
|
| Rate for Payer: Cash Price |
$653.70
|
| Rate for Payer: Cofinity Advantage |
$571.99
|
| Rate for Payer: Cofinity Commercial |
$702.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.70
|
| Rate for Payer: Healthscope Commercial |
$735.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$571.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$612.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$612.85
|
| Rate for Payer: PHP Commercial |
$694.56
|
| Rate for Payer: Priority Health SBD |
$514.79
|
| Rate for Payer: UMR Bronson Commercial |
$359.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$612.85
|
|
|
HC NM SENTINEL NODE INJECTION NON IMAGE BIL
|
Facility
|
OP
|
$817.13
|
|
|
Service Code
|
CPT 38792
|
| Hospital Charge Code |
36100622
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$177.13 |
| Max. Negotiated Rate |
$1,288.18 |
| Rate for Payer: Aetna American Axle |
$531.13
|
| Rate for Payer: Aetna Commercial |
$694.56
|
| Rate for Payer: Aetna Medicare |
$414.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$531.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$497.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$497.91
|
| Rate for Payer: BCBS Complete |
$218.76
|
| Rate for Payer: BCBS MAPPO |
$398.33
|
| Rate for Payer: BCBS Trust/PPO |
$177.13
|
| Rate for Payer: BCN Commercial |
$177.13
|
| Rate for Payer: BCN Medicare Advantage |
$398.33
|
| Rate for Payer: Cash Price |
$653.70
|
| Rate for Payer: Cash Price |
$653.70
|
| Rate for Payer: Cash Price |
$653.70
|
| Rate for Payer: Cofinity Advantage |
$571.99
|
| Rate for Payer: Cofinity Commercial |
$702.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.33
|
| Rate for Payer: Healthscope Commercial |
$735.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$571.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$612.85
|
| Rate for Payer: Mclaren Medicaid |
$398.33
|
| Rate for Payer: Mclaren Medicare |
$398.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.25
|
| Rate for Payer: Meridian Medicaid |
$418.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$458.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.56
|
| Rate for Payer: Nomi Health Commercial |
$1,194.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$612.85
|
| Rate for Payer: PACE Medicare |
$378.41
|
| Rate for Payer: PACE SWMI |
$398.33
|
| Rate for Payer: PHP Commercial |
$694.56
|
| Rate for Payer: PHP Medicare Advantage |
$398.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,288.18
|
| Rate for Payer: Priority Health Medicare |
$398.33
|
| Rate for Payer: Priority Health SBD |
$514.79
|
| Rate for Payer: Priority Health Tiered Network |
$1,030.54
|
| Rate for Payer: Railroad Medicare Medicare |
$398.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.33
|
| Rate for Payer: UHC Medicaid |
$208.33
|
| Rate for Payer: UHCCP Medicaid |
$208.33
|
| Rate for Payer: UMR Bronson Commercial |
$302.34
|
| Rate for Payer: VA VA |
$398.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$612.85
|
|
|
HC NM SENTINEL NODE INJ NON-IMAGI
|
Facility
|
OP
|
$1,011.19
|
|
|
Service Code
|
CPT 38792
|
| Hospital Charge Code |
36100187
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$177.13 |
| Max. Negotiated Rate |
$1,288.18 |
| Rate for Payer: Aetna American Axle |
$657.27
|
| Rate for Payer: Aetna Commercial |
$859.51
|
| Rate for Payer: Aetna Medicare |
$414.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$657.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$497.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$497.91
|
| Rate for Payer: BCBS Complete |
$218.76
|
| Rate for Payer: BCBS MAPPO |
$398.33
|
| Rate for Payer: BCBS Trust/PPO |
$177.13
|
| Rate for Payer: BCN Commercial |
$177.13
|
| Rate for Payer: BCN Medicare Advantage |
$398.33
|
| Rate for Payer: Cash Price |
$808.95
|
| Rate for Payer: Cash Price |
$808.95
|
| Rate for Payer: Cash Price |
$808.95
|
| Rate for Payer: Cofinity Advantage |
$707.83
|
| Rate for Payer: Cofinity Commercial |
$869.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$808.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.33
|
| Rate for Payer: Healthscope Commercial |
$910.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$707.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$758.39
|
| Rate for Payer: Mclaren Medicaid |
$398.33
|
| Rate for Payer: Mclaren Medicare |
$398.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.25
|
| Rate for Payer: Meridian Medicaid |
$418.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$458.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$859.51
|
| Rate for Payer: Nomi Health Commercial |
$1,194.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$758.39
|
| Rate for Payer: PACE Medicare |
$378.41
|
| Rate for Payer: PACE SWMI |
$398.33
|
| Rate for Payer: PHP Commercial |
$859.51
|
| Rate for Payer: PHP Medicare Advantage |
$398.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,288.18
|
| Rate for Payer: Priority Health Medicare |
$398.33
|
| Rate for Payer: Priority Health SBD |
$637.05
|
| Rate for Payer: Priority Health Tiered Network |
$1,030.54
|
| Rate for Payer: Railroad Medicare Medicare |
$398.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.33
|
| Rate for Payer: UHC Medicaid |
$208.33
|
| Rate for Payer: UHCCP Medicaid |
$208.33
|
| Rate for Payer: UMR Bronson Commercial |
$374.14
|
| Rate for Payer: VA VA |
$398.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$758.39
|
|
|
HC NM SENTINEL NODE INJ NON-IMAGI
|
Facility
|
IP
|
$1,011.19
|
|
|
Service Code
|
CPT 38792
|
| Hospital Charge Code |
36100187
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$444.92 |
| Max. Negotiated Rate |
$910.07 |
| Rate for Payer: Aetna American Axle |
$657.27
|
| Rate for Payer: Aetna Commercial |
$859.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$657.27
|
| Rate for Payer: Cash Price |
$808.95
|
| Rate for Payer: Cofinity Advantage |
$707.83
|
| Rate for Payer: Cofinity Commercial |
$869.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$808.95
|
| Rate for Payer: Healthscope Commercial |
$910.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$707.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$758.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$859.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$758.39
|
| Rate for Payer: PHP Commercial |
$859.51
|
| Rate for Payer: Priority Health SBD |
$637.05
|
| Rate for Payer: UMR Bronson Commercial |
$444.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$758.39
|
|
|
HC NM TC 99M TILMANOCEPT DX PER 0.5 MCI
|
Facility
|
OP
|
$1,129.10
|
|
|
Service Code
|
HCPCS A9520
|
| Hospital Charge Code |
34300033
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$417.77 |
| Max. Negotiated Rate |
$1,016.19 |
| Rate for Payer: Aetna American Axle |
$733.91
|
| Rate for Payer: Aetna Commercial |
$959.74
|
| Rate for Payer: Aetna Medicare |
$564.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$733.91
|
| Rate for Payer: BCBS Complete |
$451.64
|
| Rate for Payer: BCBS Trust/PPO |
$766.03
|
| Rate for Payer: BCN Commercial |
$766.03
|
| Rate for Payer: Cash Price |
$903.28
|
| Rate for Payer: Cash Price |
$903.28
|
| Rate for Payer: Cofinity Advantage |
$790.37
|
| Rate for Payer: Cofinity Commercial |
$971.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$903.28
|
| Rate for Payer: Healthscope Commercial |
$1,016.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$790.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$846.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$903.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$959.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$846.83
|
| Rate for Payer: PHP Commercial |
$959.74
|
| Rate for Payer: Priority Health SBD |
$711.33
|
| Rate for Payer: UMR Bronson Commercial |
$417.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$846.83
|
|
