|
HC MPCDS CELL SORTING BM CMPT
|
Facility
|
IP
|
$53.78
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100049
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$23.66 |
| Max. Negotiated Rate |
$48.40 |
| Rate for Payer: Aetna American Axle |
$34.96
|
| Rate for Payer: Aetna Commercial |
$45.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.96
|
| Rate for Payer: Cash Price |
$43.02
|
| Rate for Payer: Cofinity Commercial |
$37.65
|
| Rate for Payer: Cofinity Commercial |
$46.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.02
|
| Rate for Payer: Healthscope Commercial |
$48.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.71
|
| Rate for Payer: PHP Commercial |
$45.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.96
|
| Rate for Payer: Priority Health SBD |
$33.88
|
| Rate for Payer: UMR Bronson Commercial |
$23.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.34
|
|
|
HC MPL EXON 10 MUTATION DETECTION
|
Facility
|
IP
|
$379.75
|
|
|
Service Code
|
CPT 81339
|
| Hospital Charge Code |
31000149
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$167.09 |
| Max. Negotiated Rate |
$341.77 |
| Rate for Payer: Aetna American Axle |
$246.84
|
| Rate for Payer: Aetna Commercial |
$322.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$246.84
|
| Rate for Payer: Cash Price |
$303.80
|
| Rate for Payer: Cofinity Commercial |
$265.82
|
| Rate for Payer: Cofinity Commercial |
$326.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$265.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.80
|
| Rate for Payer: Healthscope Commercial |
$341.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$265.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.79
|
| Rate for Payer: PHP Commercial |
$322.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.84
|
| Rate for Payer: Priority Health SBD |
$239.24
|
| Rate for Payer: UMR Bronson Commercial |
$167.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.81
|
|
|
HC MPL EXON 10 MUTATION DETECTION
|
Facility
|
OP
|
$379.75
|
|
|
Service Code
|
CPT 81339
|
| Hospital Charge Code |
31000149
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$99.27 |
| Max. Negotiated Rate |
$521.32 |
| Rate for Payer: Aetna American Axle |
$246.84
|
| Rate for Payer: Aetna Commercial |
$322.79
|
| Rate for Payer: Aetna Medicare |
$192.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$246.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$231.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$231.50
|
| Rate for Payer: BCBS Complete |
$104.23
|
| Rate for Payer: BCBS MAPPO |
$185.20
|
| Rate for Payer: BCN Medicare Advantage |
$185.20
|
| Rate for Payer: Cash Price |
$303.80
|
| Rate for Payer: Cash Price |
$303.80
|
| Rate for Payer: Cofinity Commercial |
$326.58
|
| Rate for Payer: Cofinity Commercial |
$265.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$265.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.20
|
| Rate for Payer: Healthscope Commercial |
$341.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$265.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.81
|
| Rate for Payer: Mclaren Medicaid |
$99.27
|
| Rate for Payer: Mclaren Medicare |
$185.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.46
|
| Rate for Payer: Meridian Medicaid |
$104.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$212.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.79
|
| Rate for Payer: PACE Medicare |
$175.94
|
| Rate for Payer: PACE SWMI |
$185.20
|
| Rate for Payer: PHP Commercial |
$322.79
|
| Rate for Payer: PHP Medicare Advantage |
$185.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.84
|
| Rate for Payer: Priority Health Medicare |
$185.20
|
| Rate for Payer: Priority Health SBD |
$239.24
|
| Rate for Payer: Railroad Medicare Medicare |
$185.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$521.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$185.20
|
| Rate for Payer: UHC Exchange |
$353.94
|
| Rate for Payer: UHC Medicare Advantage |
$185.20
|
| Rate for Payer: UHCCP Medicaid |
$99.27
|
| Rate for Payer: UMR Bronson Commercial |
$140.51
|
| Rate for Payer: VA VA |
$185.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.81
|
|
|
HC MPL EXON10 MUTATION DETECTION
|
Facility
|
IP
|
$600.31
|
|
|
Service Code
|
CPT 81170
|
| Hospital Charge Code |
30000109
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$264.14 |
| Max. Negotiated Rate |
$540.28 |
| Rate for Payer: Aetna American Axle |
$390.20
|
| Rate for Payer: Aetna Commercial |
$510.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.20
|
| Rate for Payer: Cash Price |
$480.25
|
| Rate for Payer: Cofinity Commercial |
$420.22
|
| Rate for Payer: Cofinity Commercial |
$516.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$420.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.25
|
| Rate for Payer: Healthscope Commercial |
$540.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$420.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.26
|
| Rate for Payer: PHP Commercial |
$510.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.20
|
| Rate for Payer: Priority Health SBD |
$378.20
|
| Rate for Payer: UMR Bronson Commercial |
$264.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.23
|
|
|
HC MPL EXON10 MUTATION DETECTION
|
Facility
|
OP
|
$600.31
|
|
|
Service Code
|
CPT 81170
|
| Hospital Charge Code |
30000109
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$160.80 |
| Max. Negotiated Rate |
$844.47 |
| Rate for Payer: Aetna American Axle |
$390.20
|
| Rate for Payer: Aetna Commercial |
$510.26
|
| Rate for Payer: Aetna Medicare |
$312.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$375.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$375.00
|
| Rate for Payer: BCBS Complete |
$168.84
|
| Rate for Payer: BCBS MAPPO |
$300.00
|
| Rate for Payer: BCN Medicare Advantage |
$300.00
|
| Rate for Payer: Cash Price |
$480.25
|
| Rate for Payer: Cash Price |
$480.25
|
| Rate for Payer: Cofinity Commercial |
$516.27
|
| Rate for Payer: Cofinity Commercial |
$420.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$420.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.00
|
| Rate for Payer: Healthscope Commercial |
$540.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$420.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.23
|
| Rate for Payer: Mclaren Medicaid |
$160.80
|
| Rate for Payer: Mclaren Medicare |
$300.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$315.00
|
| Rate for Payer: Meridian Medicaid |
$168.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$345.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.26
|
| Rate for Payer: PACE Medicare |
$285.00
|
| Rate for Payer: PACE SWMI |
$300.00
|
| Rate for Payer: PHP Commercial |
$510.26
|
| Rate for Payer: PHP Medicare Advantage |
$300.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.20
|
| Rate for Payer: Priority Health Medicare |
$300.00
|
| Rate for Payer: Priority Health SBD |
$378.20
|
| Rate for Payer: Railroad Medicare Medicare |
$300.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$844.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$300.00
|
| Rate for Payer: UHC Exchange |
$573.33
|
| Rate for Payer: UHC Medicare Advantage |
$300.00
|
| Rate for Payer: UHCCP Medicaid |
$160.80
|
| Rate for Payer: UMR Bronson Commercial |
$222.11
|
| Rate for Payer: VA VA |
$300.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.23
|
|
|
HC MPN, CALR GENE MUTATION, EXON 9
|
Facility
|
OP
|
$648.17
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000110
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$65.19 |
| Max. Negotiated Rate |
$583.35 |
| Rate for Payer: Aetna American Axle |
$421.31
|
| Rate for Payer: Aetna Commercial |
$550.94
|
| Rate for Payer: Aetna Medicare |
$126.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$421.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$152.04
|
| Rate for Payer: BCBS Complete |
$68.45
|
| Rate for Payer: BCBS MAPPO |
$121.63
|
| Rate for Payer: BCN Medicare Advantage |
$121.63
|
| Rate for Payer: Cash Price |
$518.54
|
| Rate for Payer: Cash Price |
$518.54
|
| Rate for Payer: Cofinity Commercial |
$557.43
|
| Rate for Payer: Cofinity Commercial |
$453.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$453.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$518.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.63
|
| Rate for Payer: Healthscope Commercial |
$583.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$453.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$486.13
|
| Rate for Payer: Mclaren Medicaid |
$65.19
|
| Rate for Payer: Mclaren Medicare |
$121.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.71
|
| Rate for Payer: Meridian Medicaid |
$68.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$139.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$550.94
|
| Rate for Payer: PACE Medicare |
$115.55
|
| Rate for Payer: PACE SWMI |
$121.63
|
| Rate for Payer: PHP Commercial |
$550.94
|
| Rate for Payer: PHP Medicare Advantage |
$121.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$421.31
|
| Rate for Payer: Priority Health Medicare |
$121.63
|
| Rate for Payer: Priority Health SBD |
$408.35
|
| Rate for Payer: Railroad Medicare Medicare |
$121.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$121.63
|
| Rate for Payer: UHC Exchange |
$232.45
|
| Rate for Payer: UHC Medicare Advantage |
$121.63
|
| Rate for Payer: UHCCP Medicaid |
$65.19
|
| Rate for Payer: UMR Bronson Commercial |
$239.82
|
| Rate for Payer: VA VA |
$121.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$486.13
|
|
|
HC MPN, CALR GENE MUTATION, EXON 9
|
Facility
|
IP
|
$648.17
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000110
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$285.19 |
| Max. Negotiated Rate |
$583.35 |
| Rate for Payer: Aetna American Axle |
$421.31
|
| Rate for Payer: Aetna Commercial |
$550.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$421.31
|
| Rate for Payer: Cash Price |
$518.54
|
| Rate for Payer: Cofinity Commercial |
$453.72
|
| Rate for Payer: Cofinity Commercial |
$557.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$453.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$518.54
|
| Rate for Payer: Healthscope Commercial |
$583.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$453.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$486.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$550.94
|
| Rate for Payer: PHP Commercial |
$550.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$421.31
|
| Rate for Payer: Priority Health SBD |
$408.35
|
| Rate for Payer: UMR Bronson Commercial |
$285.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$486.13
|
|
|
HC MPN (JAK2, V617F, CALR, MPL) REFLEX
|
Facility
|
OP
|
$412.00
|
|
|
Service Code
|
CPT 81270
|
| Hospital Charge Code |
30000107
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$49.13 |
| Max. Negotiated Rate |
$370.80 |
| Rate for Payer: Aetna American Axle |
$267.80
|
| Rate for Payer: Aetna Commercial |
$350.20
|
| Rate for Payer: Aetna Medicare |
$95.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$267.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.58
|
| Rate for Payer: BCBS Complete |
$51.59
|
| Rate for Payer: BCBS MAPPO |
$91.66
|
| Rate for Payer: BCN Medicare Advantage |
$91.66
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cofinity Commercial |
$354.32
|
| Rate for Payer: Cofinity Commercial |
$288.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$288.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.66
|
| Rate for Payer: Healthscope Commercial |
$370.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$288.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.00
|
| Rate for Payer: Mclaren Medicaid |
$49.13
|
| Rate for Payer: Mclaren Medicare |
$91.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.24
|
| Rate for Payer: Meridian Medicaid |
$51.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$350.20
|
| Rate for Payer: PACE Medicare |
$87.08
|
| Rate for Payer: PACE SWMI |
$91.66
|
| Rate for Payer: PHP Commercial |
$350.20
|
| Rate for Payer: PHP Medicare Advantage |
$91.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.80
|
| Rate for Payer: Priority Health Medicare |
$91.66
|
| Rate for Payer: Priority Health SBD |
$259.56
|
| Rate for Payer: Railroad Medicare Medicare |
$91.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.66
|
| Rate for Payer: UHC Exchange |
$175.17
|
| Rate for Payer: UHC Medicare Advantage |
$91.66
|
| Rate for Payer: UHCCP Medicaid |
$49.13
|
| Rate for Payer: UMR Bronson Commercial |
$152.44
|
| Rate for Payer: VA VA |
$91.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.00
|
|
|
HC MPN (JAK2, V617F, CALR, MPL) REFLEX
|
Facility
|
IP
|
$412.00
|
|
|
Service Code
|
CPT 81270
|
| Hospital Charge Code |
30000107
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$181.28 |
| Max. Negotiated Rate |
$370.80 |
| Rate for Payer: Aetna American Axle |
$267.80
|
| Rate for Payer: Aetna Commercial |
$350.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$267.80
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cofinity Commercial |
$288.40
|
| Rate for Payer: Cofinity Commercial |
$354.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$288.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.60
|
| Rate for Payer: Healthscope Commercial |
$370.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$288.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$350.20
|
| Rate for Payer: PHP Commercial |
$350.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.80
|
| Rate for Payer: Priority Health SBD |
$259.56
|
| Rate for Payer: UMR Bronson Commercial |
$181.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.00
|
|
|
HC MR ABDOMEN W CON
|
Facility
|
OP
|
$2,364.72
|
|
|
Service Code
|
CPT 74182
|
| Hospital Charge Code |
61000043
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,128.25 |
| Rate for Payer: Aetna American Axle |
$1,537.07
|
| Rate for Payer: Aetna Commercial |
$2,010.01
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,537.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$1,891.78
|
| Rate for Payer: Cash Price |
$1,891.78
|
| Rate for Payer: Cofinity Commercial |
$2,033.66
|
| Rate for Payer: Cofinity Commercial |
$1,655.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,655.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,891.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,128.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,655.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,773.54
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,010.01
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$2,010.01
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.07
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,489.77
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$665.64
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: UMR Bronson Commercial |
$874.95
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,773.54
|
|
|
HC MR ABDOMEN W CON
|
Facility
|
IP
|
$2,364.72
|
|
|
Service Code
|
CPT 74182
|
| Hospital Charge Code |
61000043
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,040.48 |
| Max. Negotiated Rate |
$2,128.25 |
| Rate for Payer: Aetna American Axle |
$1,537.07
|
| Rate for Payer: Aetna Commercial |
$2,010.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,537.07
|
| Rate for Payer: Cash Price |
$1,891.78
|
| Rate for Payer: Cofinity Commercial |
$1,655.30
|
| Rate for Payer: Cofinity Commercial |
$2,033.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,655.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,891.78
|
| Rate for Payer: Healthscope Commercial |
$2,128.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,655.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,773.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,010.01
|
| Rate for Payer: PHP Commercial |
$2,010.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.07
|
| Rate for Payer: Priority Health SBD |
$1,489.77
|
| Rate for Payer: UMR Bronson Commercial |
$1,040.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,773.54
|
|
|
HC MR ABDOMEN WO CON
|
Facility
|
OP
|
$2,110.45
|
|
|
Service Code
|
CPT 74181
|
| Hospital Charge Code |
61000082
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$1,371.79
|
| Rate for Payer: Aetna Commercial |
$1,793.88
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,371.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,688.36
|
| Rate for Payer: Cash Price |
$1,688.36
|
| Rate for Payer: Cofinity Commercial |
$1,814.99
|
| Rate for Payer: Cofinity Commercial |
$1,477.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,477.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,688.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,899.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,477.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,582.84
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,793.88
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,793.88
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,371.79
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,329.58
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$450.52
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: UMR Bronson Commercial |
$780.87
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,582.84
|
|
|
HC MR ABDOMEN WO CON
|
Facility
|
IP
|
$2,110.45
|
|
|
Service Code
|
CPT 74181
|
| Hospital Charge Code |
61000082
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$928.60 |
| Max. Negotiated Rate |
$1,899.40 |
| Rate for Payer: Aetna American Axle |
$1,371.79
|
| Rate for Payer: Aetna Commercial |
$1,793.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,371.79
|
| Rate for Payer: Cash Price |
$1,688.36
|
| Rate for Payer: Cofinity Commercial |
$1,477.32
|
| Rate for Payer: Cofinity Commercial |
$1,814.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,477.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,688.36
|
| Rate for Payer: Healthscope Commercial |
$1,899.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,477.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,582.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,793.88
|
| Rate for Payer: PHP Commercial |
$1,793.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,371.79
|
| Rate for Payer: Priority Health SBD |
$1,329.58
|
| Rate for Payer: UMR Bronson Commercial |
$928.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,582.84
|
|
|
HC MR ABDOMEN WO W CON
|
Facility
|
OP
|
$3,090.30
|
|
|
Service Code
|
CPT 74183
|
| Hospital Charge Code |
61000044
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,781.27 |
| Rate for Payer: Aetna American Axle |
$2,008.69
|
| Rate for Payer: Aetna Commercial |
$2,626.76
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,008.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$2,472.24
|
| Rate for Payer: Cash Price |
$2,472.24
|
| Rate for Payer: Cofinity Commercial |
$2,657.66
|
| Rate for Payer: Cofinity Commercial |
$2,163.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,163.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,472.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,781.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,163.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,317.72
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,626.76
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$2,626.76
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,008.69
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,946.89
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$665.64
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: UMR Bronson Commercial |
$1,143.41
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,317.72
|
|
|
HC MR ABDOMEN WO W CON
|
Facility
|
IP
|
$3,090.30
|
|
|
Service Code
|
CPT 74183
|
| Hospital Charge Code |
61000044
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,359.73 |
| Max. Negotiated Rate |
$2,781.27 |
| Rate for Payer: Aetna American Axle |
$2,008.69
|
| Rate for Payer: Aetna Commercial |
$2,626.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,008.69
|
| Rate for Payer: Cash Price |
$2,472.24
|
| Rate for Payer: Cofinity Commercial |
$2,163.21
|
| Rate for Payer: Cofinity Commercial |
$2,657.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,163.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,472.24
|
| Rate for Payer: Healthscope Commercial |
$2,781.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,163.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,317.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,626.76
|
| Rate for Payer: PHP Commercial |
$2,626.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,008.69
|
| Rate for Payer: Priority Health SBD |
$1,946.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,359.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,317.72
|
|
|
HC MRA HEAD WO CON
|
Facility
|
IP
|
$1,809.20
|
|
|
Service Code
|
CPT 70544
|
| Hospital Charge Code |
61500001
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$796.05 |
| Max. Negotiated Rate |
$1,628.28 |
| Rate for Payer: Aetna American Axle |
$1,175.98
|
| Rate for Payer: Aetna Commercial |
$1,537.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,175.98
|
| Rate for Payer: Cash Price |
$1,447.36
|
| Rate for Payer: Cofinity Commercial |
$1,266.44
|
| Rate for Payer: Cofinity Commercial |
$1,555.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,266.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,447.36
|
| Rate for Payer: Healthscope Commercial |
$1,628.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,266.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,356.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,537.82
|
| Rate for Payer: PHP Commercial |
$1,537.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,175.98
|
| Rate for Payer: Priority Health SBD |
$1,139.80
|
| Rate for Payer: UMR Bronson Commercial |
$796.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,356.90
|
|
|
HC MRA HEAD WO CON
|
Facility
|
OP
|
$1,809.20
|
|
|
Service Code
|
CPT 70544
|
| Hospital Charge Code |
61500001
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$1,175.98
|
| Rate for Payer: Aetna Commercial |
$1,537.82
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,175.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,447.36
|
| Rate for Payer: Cash Price |
$1,447.36
|
| Rate for Payer: Cofinity Commercial |
$1,555.91
|
| Rate for Payer: Cofinity Commercial |
$1,266.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,266.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,447.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,628.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,266.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,356.90
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,537.82
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,537.82
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,175.98
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,139.80
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$450.52
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: UMR Bronson Commercial |
$669.40
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,356.90
|
|
|
HC MRA HEAD WO W CON
|
Facility
|
OP
|
$3,052.80
|
|
|
Service Code
|
CPT 70546
|
| Hospital Charge Code |
61000006
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,747.52 |
| Rate for Payer: Aetna American Axle |
$1,984.32
|
| Rate for Payer: Aetna Commercial |
$2,594.88
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,984.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$2,442.24
|
| Rate for Payer: Cash Price |
$2,442.24
|
| Rate for Payer: Cofinity Commercial |
$2,625.41
|
| Rate for Payer: Cofinity Commercial |
$2,136.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,136.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,442.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,747.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,136.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,289.60
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,594.88
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$2,594.88
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,984.32
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,923.26
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$665.64
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: UMR Bronson Commercial |
$1,129.54
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,289.60
|
|
|
HC MRA HEAD WO W CON
|
Facility
|
IP
|
$3,052.80
|
|
|
Service Code
|
CPT 70546
|
| Hospital Charge Code |
61000006
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,343.23 |
| Max. Negotiated Rate |
$2,747.52 |
| Rate for Payer: Aetna American Axle |
$1,984.32
|
| Rate for Payer: Aetna Commercial |
$2,594.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,984.32
|
| Rate for Payer: Cash Price |
$2,442.24
|
| Rate for Payer: Cofinity Commercial |
$2,136.96
|
| Rate for Payer: Cofinity Commercial |
$2,625.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,136.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,442.24
|
| Rate for Payer: Healthscope Commercial |
$2,747.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,136.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,289.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,594.88
|
| Rate for Payer: PHP Commercial |
$2,594.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,984.32
|
| Rate for Payer: Priority Health SBD |
$1,923.26
|
| Rate for Payer: UMR Bronson Commercial |
$1,343.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,289.60
|
|
|
HC MR BONE MARROW BLOOD SUPPLY
|
Facility
|
IP
|
$1,412.55
|
|
|
Service Code
|
CPT 77084
|
| Hospital Charge Code |
61000051
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$621.52 |
| Max. Negotiated Rate |
$1,271.30 |
| Rate for Payer: Aetna American Axle |
$918.16
|
| Rate for Payer: Aetna Commercial |
$1,200.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$918.16
|
| Rate for Payer: Cash Price |
$1,130.04
|
| Rate for Payer: Cofinity Commercial |
$1,214.79
|
| Rate for Payer: Cofinity Commercial |
$988.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$988.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.04
|
| Rate for Payer: Healthscope Commercial |
$1,271.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$988.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,059.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,200.67
|
| Rate for Payer: PHP Commercial |
$1,200.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$918.16
|
| Rate for Payer: Priority Health SBD |
$889.91
|
| Rate for Payer: UMR Bronson Commercial |
$621.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,059.41
|
|
|
HC MR BONE MARROW BLOOD SUPPLY
|
Facility
|
OP
|
$1,412.55
|
|
|
Service Code
|
CPT 77084
|
| Hospital Charge Code |
61000051
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$918.16
|
| Rate for Payer: Aetna Commercial |
$1,200.67
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$918.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,130.04
|
| Rate for Payer: Cash Price |
$1,130.04
|
| Rate for Payer: Cofinity Commercial |
$988.78
|
| Rate for Payer: Cofinity Commercial |
$1,214.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$988.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,271.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$988.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,059.41
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,200.67
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,200.67
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$918.16
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$889.91
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$450.52
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: UMR Bronson Commercial |
$522.64
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,059.41
|
|
|
HC MR BRAIN STEREO W CON REDUCED
|
Facility
|
OP
|
$1,857.93
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100006
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$687.43 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$1,207.65
|
| Rate for Payer: Aetna Commercial |
$1,579.24
|
| Rate for Payer: Aetna Medicare |
$928.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,207.65
|
| Rate for Payer: BCBS Complete |
$743.17
|
| Rate for Payer: Cash Price |
$1,486.34
|
| Rate for Payer: Cash Price |
$1,486.34
|
| Rate for Payer: Cofinity Commercial |
$1,597.82
|
| Rate for Payer: Cofinity Commercial |
$1,300.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,300.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,486.34
|
| Rate for Payer: Healthscope Commercial |
$1,672.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,300.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,393.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,579.24
|
| Rate for Payer: PHP Commercial |
$1,579.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,207.65
|
| Rate for Payer: Priority Health SBD |
$1,170.50
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UMR Bronson Commercial |
$687.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,393.45
|
|
|
HC MR BRAIN STEREO W CON REDUCED
|
Facility
|
IP
|
$1,857.93
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100006
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$817.49 |
| Max. Negotiated Rate |
$1,672.14 |
| Rate for Payer: Aetna American Axle |
$1,207.65
|
| Rate for Payer: Aetna Commercial |
$1,579.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,207.65
|
| Rate for Payer: Cash Price |
$1,486.34
|
| Rate for Payer: Cofinity Commercial |
$1,300.55
|
| Rate for Payer: Cofinity Commercial |
$1,597.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,300.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,486.34
|
| Rate for Payer: Healthscope Commercial |
$1,672.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,300.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,393.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,579.24
|
| Rate for Payer: PHP Commercial |
$1,579.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,207.65
|
| Rate for Payer: Priority Health SBD |
$1,170.50
|
| Rate for Payer: UMR Bronson Commercial |
$817.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,393.45
|
|
|
HC MR BRAIN STEREO WO CON REDUCED
|
Facility
|
OP
|
$1,548.26
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100005
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$572.86 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$1,006.37
|
| Rate for Payer: Aetna Commercial |
$1,316.02
|
| Rate for Payer: Aetna Medicare |
$774.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,006.37
|
| Rate for Payer: BCBS Complete |
$619.30
|
| Rate for Payer: Cash Price |
$1,238.61
|
| Rate for Payer: Cash Price |
$1,238.61
|
| Rate for Payer: Cofinity Commercial |
$1,331.50
|
| Rate for Payer: Cofinity Commercial |
$1,083.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,083.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,238.61
|
| Rate for Payer: Healthscope Commercial |
$1,393.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,083.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,161.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,316.02
|
| Rate for Payer: PHP Commercial |
$1,316.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.37
|
| Rate for Payer: Priority Health SBD |
$975.40
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UMR Bronson Commercial |
$572.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,161.19
|
|
|
HC MR BRAIN STEREO WO CON REDUCED
|
Facility
|
IP
|
$1,548.26
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100005
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$681.23 |
| Max. Negotiated Rate |
$1,393.43 |
| Rate for Payer: Aetna American Axle |
$1,006.37
|
| Rate for Payer: Aetna Commercial |
$1,316.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,006.37
|
| Rate for Payer: Cash Price |
$1,238.61
|
| Rate for Payer: Cofinity Commercial |
$1,083.78
|
| Rate for Payer: Cofinity Commercial |
$1,331.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,083.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,238.61
|
| Rate for Payer: Healthscope Commercial |
$1,393.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,083.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,161.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,316.02
|
| Rate for Payer: PHP Commercial |
$1,316.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.37
|
| Rate for Payer: Priority Health SBD |
$975.40
|
| Rate for Payer: UMR Bronson Commercial |
$681.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,161.19
|
|
