|
HC MR BREAST UNI WO W CON
|
Facility
|
IP
|
$1,569.37
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000057
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$690.52 |
| Max. Negotiated Rate |
$1,412.43 |
| Rate for Payer: Aetna American Axle |
$1,020.09
|
| Rate for Payer: Aetna American Axle |
$1,530.13
|
| Rate for Payer: Aetna Commercial |
$1,333.96
|
| Rate for Payer: Aetna Commercial |
$2,000.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,020.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,530.13
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Cash Price |
$1,883.24
|
| Rate for Payer: Cofinity Commercial |
$2,024.48
|
| Rate for Payer: Cofinity Commercial |
$1,647.84
|
| Rate for Payer: Cofinity Commercial |
$1,098.56
|
| Rate for Payer: Cofinity Commercial |
$1,349.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,098.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,647.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,883.24
|
| Rate for Payer: Healthscope Commercial |
$1,412.43
|
| Rate for Payer: Healthscope Commercial |
$2,118.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,098.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,647.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,177.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,765.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,000.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,333.96
|
| Rate for Payer: PHP Commercial |
$2,000.94
|
| Rate for Payer: PHP Commercial |
$1,333.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,020.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,530.13
|
| Rate for Payer: Priority Health SBD |
$988.70
|
| Rate for Payer: Priority Health SBD |
$1,483.05
|
| Rate for Payer: UMR Bronson Commercial |
$690.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,035.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,177.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,765.54
|
|
|
HC MR BREAST W CON
|
Facility
|
OP
|
$2,354.05
|
|
|
Service Code
|
HCPCS 77048
|
| Hospital Charge Code |
61000055
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$871.00 |
| Max. Negotiated Rate |
$2,118.64 |
| Rate for Payer: Aetna American Axle |
$1,530.13
|
| Rate for Payer: Aetna American Axle |
$1,020.09
|
| Rate for Payer: Aetna Commercial |
$2,000.94
|
| Rate for Payer: Aetna Commercial |
$1,333.96
|
| Rate for Payer: Aetna Medicare |
$1,177.03
|
| Rate for Payer: Aetna Medicare |
$784.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,530.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,020.09
|
| Rate for Payer: BCBS Complete |
$627.75
|
| Rate for Payer: BCBS Complete |
$941.62
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Cash Price |
$1,883.24
|
| Rate for Payer: Cash Price |
$1,883.24
|
| Rate for Payer: Cofinity Commercial |
$1,098.56
|
| Rate for Payer: Cofinity Commercial |
$2,024.48
|
| Rate for Payer: Cofinity Commercial |
$1,647.84
|
| Rate for Payer: Cofinity Commercial |
$1,349.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,098.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,647.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,883.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.50
|
| Rate for Payer: Healthscope Commercial |
$2,118.64
|
| Rate for Payer: Healthscope Commercial |
$1,412.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,647.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,098.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,177.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,765.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,000.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,333.96
|
| Rate for Payer: PHP Commercial |
$1,333.96
|
| Rate for Payer: PHP Commercial |
$2,000.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,530.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,020.09
|
| Rate for Payer: Priority Health SBD |
$1,483.05
|
| Rate for Payer: Priority Health SBD |
$988.70
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UMR Bronson Commercial |
$580.67
|
| Rate for Payer: UMR Bronson Commercial |
$871.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,177.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,765.54
|
|
|
HC MR BREAST W CON
|
Facility
|
IP
|
$1,569.37
|
|
|
Service Code
|
HCPCS 77048
|
| Hospital Charge Code |
61000055
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$690.52 |
| Max. Negotiated Rate |
$1,412.43 |
| Rate for Payer: Aetna American Axle |
$1,020.09
|
| Rate for Payer: Aetna American Axle |
$1,530.13
|
| Rate for Payer: Aetna Commercial |
$1,333.96
|
| Rate for Payer: Aetna Commercial |
$2,000.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,020.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,530.13
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Cash Price |
$1,883.24
|
| Rate for Payer: Cofinity Commercial |
$2,024.48
|
| Rate for Payer: Cofinity Commercial |
$1,647.84
|
| Rate for Payer: Cofinity Commercial |
$1,098.56
|
| Rate for Payer: Cofinity Commercial |
$1,349.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,098.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,647.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,883.24
|
| Rate for Payer: Healthscope Commercial |
$1,412.43
|
| Rate for Payer: Healthscope Commercial |
$2,118.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,098.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,647.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,177.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,765.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,000.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,333.96
|
| Rate for Payer: PHP Commercial |
$2,000.94
|
| Rate for Payer: PHP Commercial |
$1,333.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,020.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,530.13
|
| Rate for Payer: Priority Health SBD |
$988.70
|
| Rate for Payer: Priority Health SBD |
$1,483.05
|
| Rate for Payer: UMR Bronson Commercial |
$690.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,035.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,177.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,765.54
|
|
|
HC MR BREAST WO CON BIL
|
Facility
|
IP
|
$2,132.92
|
|
|
Service Code
|
CPT 77047
|
| Hospital Charge Code |
61000091
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$938.48 |
| Max. Negotiated Rate |
$1,919.63 |
| Rate for Payer: Aetna American Axle |
$1,386.40
|
| Rate for Payer: Aetna Commercial |
$1,812.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,386.40
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cofinity Commercial |
$1,493.04
|
| Rate for Payer: Cofinity Commercial |
$1,834.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,493.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,706.34
|
| Rate for Payer: Healthscope Commercial |
$1,919.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,493.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,599.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,812.98
|
| Rate for Payer: PHP Commercial |
$1,812.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,386.40
|
| Rate for Payer: Priority Health SBD |
$1,343.74
|
| Rate for Payer: UMR Bronson Commercial |
$938.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,599.69
|
|
|
HC MR BREAST WO CON BIL
|
Facility
|
OP
|
$2,132.92
|
|
|
Service Code
|
CPT 77047
|
| Hospital Charge Code |
61000091
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$1,386.40
|
| Rate for Payer: Aetna Commercial |
$1,812.98
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,386.40
|
| 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 |
$1,706.34
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cofinity Commercial |
$1,834.31
|
| Rate for Payer: Cofinity Commercial |
$1,493.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,493.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,706.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,919.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,493.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,599.69
|
| 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 |
$1,812.98
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,812.98
|
| 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 |
$1,386.40
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,343.74
|
| 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 |
$789.18
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,599.69
|
|
|
HC MR BREAST WO CON UNI
|
Facility
|
OP
|
$1,568.76
|
|
|
Service Code
|
CPT 77046
|
| Hospital Charge Code |
61000090
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$1,019.69
|
| Rate for Payer: Aetna Commercial |
$1,333.45
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,019.69
|
| 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 |
$1,255.01
|
| Rate for Payer: Cash Price |
$1,255.01
|
| Rate for Payer: Cofinity Commercial |
$1,349.13
|
| Rate for Payer: Cofinity Commercial |
$1,098.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,098.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,411.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,098.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,176.57
|
| 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 |
$1,333.45
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,333.45
|
| 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 |
$1,019.69
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$988.32
|
| 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 |
$580.44
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,176.57
|
|
|
HC MR BREAST WO CON UNI
|
Facility
|
IP
|
$1,568.76
|
|
|
Service Code
|
CPT 77046
|
| Hospital Charge Code |
61000090
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$690.25 |
| Max. Negotiated Rate |
$1,411.88 |
| Rate for Payer: Aetna American Axle |
$1,019.69
|
| Rate for Payer: Aetna Commercial |
$1,333.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,019.69
|
| Rate for Payer: Cash Price |
$1,255.01
|
| Rate for Payer: Cofinity Commercial |
$1,098.13
|
| Rate for Payer: Cofinity Commercial |
$1,349.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,098.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.01
|
| Rate for Payer: Healthscope Commercial |
$1,411.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,098.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,176.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,333.45
|
| Rate for Payer: PHP Commercial |
$1,333.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,019.69
|
| Rate for Payer: Priority Health SBD |
$988.32
|
| Rate for Payer: UMR Bronson Commercial |
$690.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,176.57
|
|
|
HC MR CARDIAC FOR MORPHOLOGY WO CON
|
Facility
|
IP
|
$2,153.63
|
|
|
Service Code
|
CPT 75557
|
| Hospital Charge Code |
61000046
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$947.60 |
| Max. Negotiated Rate |
$1,938.27 |
| Rate for Payer: Aetna American Axle |
$1,399.86
|
| Rate for Payer: Aetna Commercial |
$1,830.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,399.86
|
| Rate for Payer: Cash Price |
$1,722.90
|
| Rate for Payer: Cofinity Commercial |
$1,507.54
|
| Rate for Payer: Cofinity Commercial |
$1,852.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,507.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,722.90
|
| Rate for Payer: Healthscope Commercial |
$1,938.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,507.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,615.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,830.59
|
| Rate for Payer: PHP Commercial |
$1,830.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,399.86
|
| Rate for Payer: Priority Health SBD |
$1,356.79
|
| Rate for Payer: UMR Bronson Commercial |
$947.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,615.22
|
|
|
HC MR CARDIAC FOR MORPHOLOGY WO CON
|
Facility
|
OP
|
$2,153.63
|
|
|
Service Code
|
CPT 75557
|
| Hospital Charge Code |
61000046
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$1,399.86
|
| Rate for Payer: Aetna Commercial |
$1,830.59
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,399.86
|
| 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 |
$1,722.90
|
| Rate for Payer: Cash Price |
$1,722.90
|
| Rate for Payer: Cofinity Commercial |
$1,852.12
|
| Rate for Payer: Cofinity Commercial |
$1,507.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,507.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,722.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,938.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,507.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,615.22
|
| 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 |
$1,830.59
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,830.59
|
| 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 |
$1,399.86
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,356.79
|
| 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 |
$796.84
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,615.22
|
|
|
HC MR CARDIAC MORP AND FUNC WO W CON
|
Facility
|
OP
|
$990.98
|
|
|
Service Code
|
CPT 75561
|
| Hospital Charge Code |
61000047
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$644.14
|
| Rate for Payer: Aetna Commercial |
$842.33
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$644.14
|
| 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 |
$792.78
|
| Rate for Payer: Cash Price |
$792.78
|
| Rate for Payer: Cofinity Commercial |
$852.24
|
| Rate for Payer: Cofinity Commercial |
$693.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$693.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$792.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$891.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$693.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.24
|
| 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 |
$842.33
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$842.33
|
| 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 |
$644.14
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$624.32
|
| 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 |
$366.66
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.24
|
|
|
HC MR CARDIAC MORP AND FUNC WO W CON
|
Facility
|
IP
|
$990.98
|
|
|
Service Code
|
CPT 75561
|
| Hospital Charge Code |
61000047
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$436.03 |
| Max. Negotiated Rate |
$891.88 |
| Rate for Payer: Aetna American Axle |
$644.14
|
| Rate for Payer: Aetna Commercial |
$842.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$644.14
|
| Rate for Payer: Cash Price |
$792.78
|
| Rate for Payer: Cofinity Commercial |
$693.69
|
| Rate for Payer: Cofinity Commercial |
$852.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$693.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$792.78
|
| Rate for Payer: Healthscope Commercial |
$891.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$693.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$842.33
|
| Rate for Payer: PHP Commercial |
$842.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$644.14
|
| Rate for Payer: Priority Health SBD |
$624.32
|
| Rate for Payer: UMR Bronson Commercial |
$436.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.24
|
|
|
HC MR CARDIAC VELOCITY MAPPING
|
Facility
|
IP
|
$1,239.30
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
61000048
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$545.29 |
| Max. Negotiated Rate |
$1,115.37 |
| Rate for Payer: Aetna American Axle |
$805.54
|
| Rate for Payer: Aetna Commercial |
$1,053.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$805.54
|
| Rate for Payer: Cash Price |
$991.44
|
| Rate for Payer: Cofinity Commercial |
$1,065.80
|
| Rate for Payer: Cofinity Commercial |
$867.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$867.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$991.44
|
| Rate for Payer: Healthscope Commercial |
$1,115.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$867.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$929.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,053.40
|
| Rate for Payer: PHP Commercial |
$1,053.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$805.54
|
| Rate for Payer: Priority Health SBD |
$780.76
|
| Rate for Payer: UMR Bronson Commercial |
$545.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$929.48
|
|
|
HC MR CARDIAC VELOCITY MAPPING
|
Facility
|
OP
|
$1,239.30
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
61000048
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$458.54 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$805.54
|
| Rate for Payer: Aetna Commercial |
$1,053.40
|
| Rate for Payer: Aetna Medicare |
$619.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$805.54
|
| Rate for Payer: BCBS Complete |
$495.72
|
| Rate for Payer: Cash Price |
$991.44
|
| Rate for Payer: Cash Price |
$991.44
|
| Rate for Payer: Cofinity Commercial |
$867.51
|
| Rate for Payer: Cofinity Commercial |
$1,065.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$867.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$991.44
|
| Rate for Payer: Healthscope Commercial |
$1,115.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$867.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$929.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,053.40
|
| Rate for Payer: PHP Commercial |
$1,053.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$805.54
|
| Rate for Payer: Priority Health SBD |
$780.76
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UMR Bronson Commercial |
$458.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$929.48
|
|
|
HC MR CHEST W CON
|
Facility
|
OP
|
$2,333.00
|
|
|
Service Code
|
CPT 71551
|
| Hospital Charge Code |
61000011
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$413.00 |
| Max. Negotiated Rate |
$2,168.96 |
| Rate for Payer: Aetna American Axle |
$1,516.45
|
| Rate for Payer: Aetna Commercial |
$1,983.05
|
| Rate for Payer: Aetna Medicare |
$801.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,516.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$963.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$963.16
|
| Rate for Payer: BCBS Complete |
$433.65
|
| Rate for Payer: BCBS MAPPO |
$770.53
|
| Rate for Payer: BCN Medicare Advantage |
$770.53
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cofinity Commercial |
$2,006.38
|
| Rate for Payer: Cofinity Commercial |
$1,633.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,633.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,866.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$770.53
|
| Rate for Payer: Healthscope Commercial |
$2,099.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,633.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,749.75
|
| Rate for Payer: Mclaren Medicaid |
$413.00
|
| Rate for Payer: Mclaren Medicare |
$770.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.06
|
| Rate for Payer: Meridian Medicaid |
$433.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$886.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,983.05
|
| Rate for Payer: PACE Medicare |
$732.00
|
| Rate for Payer: PACE SWMI |
$770.53
|
| Rate for Payer: PHP Commercial |
$1,983.05
|
| Rate for Payer: PHP Medicare Advantage |
$770.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,516.45
|
| Rate for Payer: Priority Health Medicare |
$770.53
|
| Rate for Payer: Priority Health SBD |
$1,469.79
|
| Rate for Payer: Railroad Medicare Medicare |
$770.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,168.96
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$770.53
|
| Rate for Payer: UHC Exchange |
$1,472.56
|
| Rate for Payer: UHC Medicare Advantage |
$770.53
|
| Rate for Payer: UHCCP Medicaid |
$413.00
|
| Rate for Payer: UMR Bronson Commercial |
$863.21
|
| Rate for Payer: VA VA |
$770.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,749.75
|
|
|
HC MR CHEST W CON
|
Facility
|
IP
|
$2,333.00
|
|
|
Service Code
|
CPT 71551
|
| Hospital Charge Code |
61000011
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,026.52 |
| Max. Negotiated Rate |
$2,099.70 |
| Rate for Payer: Aetna American Axle |
$1,516.45
|
| Rate for Payer: Aetna Commercial |
$1,983.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,516.45
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cofinity Commercial |
$1,633.10
|
| Rate for Payer: Cofinity Commercial |
$2,006.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,633.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,866.40
|
| Rate for Payer: Healthscope Commercial |
$2,099.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,633.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,749.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,983.05
|
| Rate for Payer: PHP Commercial |
$1,983.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,516.45
|
| Rate for Payer: Priority Health SBD |
$1,469.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,026.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,749.75
|
|
|
HC MR CHEST WO CON
|
Facility
|
OP
|
$2,032.25
|
|
|
Service Code
|
CPT 71550
|
| Hospital Charge Code |
61000010
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$1,320.96
|
| Rate for Payer: Aetna Commercial |
$1,727.41
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,320.96
|
| 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 |
$1,625.80
|
| Rate for Payer: Cash Price |
$1,625.80
|
| Rate for Payer: Cofinity Commercial |
$1,747.73
|
| Rate for Payer: Cofinity Commercial |
$1,422.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,422.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,625.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,829.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,422.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,524.19
|
| 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 |
$1,727.41
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,727.41
|
| 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 |
$1,320.96
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,280.32
|
| 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 |
$751.93
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,524.19
|
|
|
HC MR CHEST WO CON
|
Facility
|
IP
|
$2,032.25
|
|
|
Service Code
|
CPT 71550
|
| Hospital Charge Code |
61000010
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$894.19 |
| Max. Negotiated Rate |
$1,829.03 |
| Rate for Payer: Aetna American Axle |
$1,320.96
|
| Rate for Payer: Aetna Commercial |
$1,727.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,320.96
|
| Rate for Payer: Cash Price |
$1,625.80
|
| Rate for Payer: Cofinity Commercial |
$1,422.58
|
| Rate for Payer: Cofinity Commercial |
$1,747.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,422.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,625.80
|
| Rate for Payer: Healthscope Commercial |
$1,829.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,422.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,524.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,727.41
|
| Rate for Payer: PHP Commercial |
$1,727.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,320.96
|
| Rate for Payer: Priority Health SBD |
$1,280.32
|
| Rate for Payer: UMR Bronson Commercial |
$894.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,524.19
|
|
|
HC MR CHEST WO W CON
|
Facility
|
OP
|
$3,052.80
|
|
|
Service Code
|
CPT 71552
|
| Hospital Charge Code |
61000012
|
|
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 MR CHEST WO W CON
|
Facility
|
IP
|
$3,052.80
|
|
|
Service Code
|
CPT 71552
|
| Hospital Charge Code |
61000012
|
|
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 ELASTOGRAPHY
|
Facility
|
IP
|
$359.98
|
|
|
Service Code
|
CPT 76391
|
| Hospital Charge Code |
61000089
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$158.39 |
| Max. Negotiated Rate |
$323.98 |
| Rate for Payer: Aetna American Axle |
$233.99
|
| Rate for Payer: Aetna Commercial |
$305.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.99
|
| Rate for Payer: Cash Price |
$287.98
|
| Rate for Payer: Cofinity Commercial |
$251.99
|
| Rate for Payer: Cofinity Commercial |
$309.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$251.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.98
|
| Rate for Payer: Healthscope Commercial |
$323.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$251.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.98
|
| Rate for Payer: PHP Commercial |
$305.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.99
|
| Rate for Payer: Priority Health SBD |
$226.79
|
| Rate for Payer: UMR Bronson Commercial |
$158.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.99
|
|
|
HC MR ELASTOGRAPHY
|
Facility
|
OP
|
$359.98
|
|
|
Service Code
|
CPT 76391
|
| Hospital Charge Code |
61000089
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$233.99
|
| Rate for Payer: Aetna Commercial |
$305.98
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.99
|
| 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 |
$287.98
|
| Rate for Payer: Cash Price |
$287.98
|
| Rate for Payer: Cofinity Commercial |
$309.58
|
| Rate for Payer: Cofinity Commercial |
$251.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$251.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$323.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$251.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.99
|
| 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 |
$305.98
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$305.98
|
| 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 |
$233.99
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$226.79
|
| 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 |
$133.19
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.99
|
|
|
HC MR GUIDANCE FOR NEEDLE PLACEMENT
|
Facility
|
IP
|
$1,045.60
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100004
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$460.06 |
| Max. Negotiated Rate |
$941.04 |
| Rate for Payer: Aetna American Axle |
$679.64
|
| Rate for Payer: Aetna Commercial |
$888.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$679.64
|
| Rate for Payer: Cash Price |
$836.48
|
| Rate for Payer: Cofinity Commercial |
$731.92
|
| Rate for Payer: Cofinity Commercial |
$899.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$731.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$836.48
|
| Rate for Payer: Healthscope Commercial |
$941.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$731.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$784.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$888.76
|
| Rate for Payer: PHP Commercial |
$888.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$679.64
|
| Rate for Payer: Priority Health SBD |
$658.73
|
| Rate for Payer: UMR Bronson Commercial |
$460.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$784.20
|
|
|
HC MR GUIDANCE FOR NEEDLE PLACEMENT
|
Facility
|
OP
|
$1,045.60
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100004
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$386.87 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$679.64
|
| Rate for Payer: Aetna Commercial |
$888.76
|
| Rate for Payer: Aetna Medicare |
$522.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$679.64
|
| Rate for Payer: BCBS Complete |
$418.24
|
| Rate for Payer: Cash Price |
$836.48
|
| Rate for Payer: Cash Price |
$836.48
|
| Rate for Payer: Cofinity Commercial |
$899.22
|
| Rate for Payer: Cofinity Commercial |
$731.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$731.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$836.48
|
| Rate for Payer: Healthscope Commercial |
$941.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$731.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$784.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$888.76
|
| Rate for Payer: PHP Commercial |
$888.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$679.64
|
| Rate for Payer: Priority Health SBD |
$658.73
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UMR Bronson Commercial |
$386.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$784.20
|
|
|
HC MR LOWER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
IP
|
$3,014.98
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000040
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,326.59 |
| Max. Negotiated Rate |
$2,713.48 |
| Rate for Payer: Aetna American Axle |
$1,959.74
|
| Rate for Payer: Aetna Commercial |
$2,562.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,959.74
|
| Rate for Payer: Cash Price |
$2,411.98
|
| Rate for Payer: Cofinity Commercial |
$2,110.49
|
| Rate for Payer: Cofinity Commercial |
$2,592.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,110.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,411.98
|
| Rate for Payer: Healthscope Commercial |
$2,713.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,110.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,261.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,562.73
|
| Rate for Payer: PHP Commercial |
$2,562.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,959.74
|
| Rate for Payer: Priority Health SBD |
$1,899.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,326.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,261.24
|
|
|
HC MR LOWER EXTREM ANY JOINT BIL WO W CON
|
Facility
|
OP
|
$3,014.98
|
|
|
Service Code
|
CPT 73723
|
| Hospital Charge Code |
61000040
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,713.48 |
| Rate for Payer: Aetna American Axle |
$1,959.74
|
| Rate for Payer: Aetna Commercial |
$2,562.73
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,959.74
|
| 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 |
$2,411.98
|
| Rate for Payer: Cash Price |
$2,411.98
|
| Rate for Payer: Cofinity Commercial |
$2,592.88
|
| Rate for Payer: Cofinity Commercial |
$2,110.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,110.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,411.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,713.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,110.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,261.24
|
| 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 |
$2,562.73
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$2,562.73
|
| 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 |
$1,959.74
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$1,899.44
|
| 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 |
$1,115.54
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,261.24
|
|
