|
HC NM BONE MARROW LIMITED AREA
|
Facility
|
OP
|
$901.67
|
|
|
Service Code
|
CPT 78102
|
| Hospital Charge Code |
34100009
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$145.60 |
| Max. Negotiated Rate |
$1,237.41 |
| Rate for Payer: Aetna American Axle |
$586.09
|
| Rate for Payer: Aetna Commercial |
$766.42
|
| Rate for Payer: Aetna Medicare |
$409.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$586.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.12
|
| Rate for Payer: BCBS Complete |
$221.57
|
| Rate for Payer: BCBS MAPPO |
$393.70
|
| Rate for Payer: BCBS Trust/PPO |
$279.14
|
| Rate for Payer: BCN Commercial |
$279.14
|
| Rate for Payer: BCN Medicare Advantage |
$393.70
|
| Rate for Payer: Cash Price |
$721.34
|
| Rate for Payer: Cash Price |
$721.34
|
| Rate for Payer: Cofinity Commercial |
$775.44
|
| Rate for Payer: Cofinity Commercial |
$631.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$631.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$721.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.70
|
| Rate for Payer: Healthscope Commercial |
$811.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$631.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$676.25
|
| Rate for Payer: Mclaren Medicaid |
$211.02
|
| Rate for Payer: Mclaren Medicare |
$393.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.38
|
| Rate for Payer: Meridian Medicaid |
$221.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$766.42
|
| Rate for Payer: Nomi Health Commercial |
$1,181.10
|
| Rate for Payer: PACE Medicare |
$374.02
|
| Rate for Payer: PACE SWMI |
$393.70
|
| Rate for Payer: PHP Commercial |
$766.42
|
| Rate for Payer: PHP Medicare Advantage |
$393.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$586.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.41
|
| Rate for Payer: Priority Health Medicare |
$393.70
|
| Rate for Payer: Priority Health Narrow Network |
$989.93
|
| Rate for Payer: Priority Health SBD |
$568.05
|
| Rate for Payer: Railroad Medicare Medicare |
$393.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.16
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.70
|
| Rate for Payer: UHC Exchange |
$145.60
|
| Rate for Payer: UHC Medicare Advantage |
$393.70
|
| Rate for Payer: UHCCP Medicaid |
$211.02
|
| Rate for Payer: UMR Bronson Commercial |
$333.62
|
| Rate for Payer: VA VA |
$393.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$676.25
|
|
|
HC NM BONE MARROW LIMITED AREA
|
Facility
|
IP
|
$901.67
|
|
|
Service Code
|
CPT 78102
|
| Hospital Charge Code |
34100009
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$396.73 |
| Max. Negotiated Rate |
$811.50 |
| Rate for Payer: Aetna American Axle |
$586.09
|
| Rate for Payer: Aetna Commercial |
$766.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$586.09
|
| Rate for Payer: Cash Price |
$721.34
|
| Rate for Payer: Cofinity Commercial |
$631.17
|
| Rate for Payer: Cofinity Commercial |
$775.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$631.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$721.34
|
| Rate for Payer: Healthscope Commercial |
$811.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$631.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$676.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$766.42
|
| Rate for Payer: PHP Commercial |
$766.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$586.09
|
| Rate for Payer: Priority Health SBD |
$568.05
|
| Rate for Payer: UMR Bronson Commercial |
$396.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$676.25
|
|
|
HC NM BONE MARROW MULTIPLE AREA
|
Facility
|
IP
|
$1,149.41
|
|
|
Service Code
|
CPT 78103
|
| Hospital Charge Code |
34100010
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$505.74 |
| Max. Negotiated Rate |
$1,034.47 |
| Rate for Payer: Aetna American Axle |
$747.12
|
| Rate for Payer: Aetna Commercial |
$977.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$747.12
|
| Rate for Payer: Cash Price |
$919.53
|
| Rate for Payer: Cofinity Commercial |
$804.59
|
| Rate for Payer: Cofinity Commercial |
$988.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$804.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$919.53
|
| Rate for Payer: Healthscope Commercial |
$1,034.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$804.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$862.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$977.00
|
| Rate for Payer: PHP Commercial |
$977.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$747.12
|
| Rate for Payer: Priority Health SBD |
$724.13
|
| Rate for Payer: UMR Bronson Commercial |
$505.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$862.06
|
|
|
HC NM BONE MARROW MULTIPLE AREA
|
Facility
|
OP
|
$1,149.41
|
|
|
Service Code
|
CPT 78103
|
| Hospital Charge Code |
34100010
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$155.64 |
| Max. Negotiated Rate |
$1,237.41 |
| Rate for Payer: Aetna American Axle |
$747.12
|
| Rate for Payer: Aetna Commercial |
$977.00
|
| Rate for Payer: Aetna Medicare |
$409.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$747.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.12
|
| Rate for Payer: BCBS Complete |
$221.57
|
| Rate for Payer: BCBS MAPPO |
$393.70
|
| Rate for Payer: BCBS Trust/PPO |
$290.78
|
| Rate for Payer: BCN Commercial |
$290.78
|
| Rate for Payer: BCN Medicare Advantage |
$393.70
|
| Rate for Payer: Cash Price |
$919.53
|
| Rate for Payer: Cash Price |
$919.53
|
| Rate for Payer: Cofinity Commercial |
$988.49
|
| Rate for Payer: Cofinity Commercial |
$804.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$804.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$919.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.70
|
| Rate for Payer: Healthscope Commercial |
$1,034.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$804.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$862.06
|
| Rate for Payer: Mclaren Medicaid |
$211.02
|
| Rate for Payer: Mclaren Medicare |
$393.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.38
|
| Rate for Payer: Meridian Medicaid |
$221.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$977.00
|
| Rate for Payer: Nomi Health Commercial |
$1,181.10
|
| Rate for Payer: PACE Medicare |
$374.02
|
| Rate for Payer: PACE SWMI |
$393.70
|
| Rate for Payer: PHP Commercial |
$977.00
|
| Rate for Payer: PHP Medicare Advantage |
$393.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$747.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.41
|
| Rate for Payer: Priority Health Medicare |
$393.70
|
| Rate for Payer: Priority Health Narrow Network |
$989.93
|
| Rate for Payer: Priority Health SBD |
$724.13
|
| Rate for Payer: Railroad Medicare Medicare |
$393.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.20
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.70
|
| Rate for Payer: UHC Exchange |
$155.64
|
| Rate for Payer: UHC Medicare Advantage |
$393.70
|
| Rate for Payer: UHCCP Medicaid |
$211.02
|
| Rate for Payer: UMR Bronson Commercial |
$425.28
|
| Rate for Payer: VA VA |
$393.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$862.06
|
|
|
HC NM BONE MARROW WHOLE BODY
|
Facility
|
OP
|
$1,066.32
|
|
|
Service Code
|
CPT 78104
|
| Hospital Charge Code |
34100011
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$208.55 |
| Max. Negotiated Rate |
$1,237.41 |
| Rate for Payer: Aetna American Axle |
$693.11
|
| Rate for Payer: Aetna Commercial |
$906.37
|
| Rate for Payer: Aetna Medicare |
$409.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$693.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.12
|
| Rate for Payer: BCBS Complete |
$221.57
|
| Rate for Payer: BCBS MAPPO |
$393.70
|
| Rate for Payer: BCBS Trust/PPO |
$397.51
|
| Rate for Payer: BCN Commercial |
$397.51
|
| Rate for Payer: BCN Medicare Advantage |
$393.70
|
| Rate for Payer: Cash Price |
$853.06
|
| Rate for Payer: Cash Price |
$853.06
|
| Rate for Payer: Cofinity Commercial |
$917.04
|
| Rate for Payer: Cofinity Commercial |
$746.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$746.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$853.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.70
|
| Rate for Payer: Healthscope Commercial |
$959.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$746.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$799.74
|
| Rate for Payer: Mclaren Medicaid |
$211.02
|
| Rate for Payer: Mclaren Medicare |
$393.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.38
|
| Rate for Payer: Meridian Medicaid |
$221.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$906.37
|
| Rate for Payer: Nomi Health Commercial |
$1,181.10
|
| Rate for Payer: PACE Medicare |
$374.02
|
| Rate for Payer: PACE SWMI |
$393.70
|
| Rate for Payer: PHP Commercial |
$906.37
|
| Rate for Payer: PHP Medicare Advantage |
$393.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$693.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.41
|
| Rate for Payer: Priority Health Medicare |
$393.70
|
| Rate for Payer: Priority Health Narrow Network |
$989.93
|
| Rate for Payer: Priority Health SBD |
$671.78
|
| Rate for Payer: Railroad Medicare Medicare |
$393.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.40
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.70
|
| Rate for Payer: UHC Exchange |
$208.55
|
| Rate for Payer: UHC Medicare Advantage |
$393.70
|
| Rate for Payer: UHCCP Medicaid |
$211.02
|
| Rate for Payer: UMR Bronson Commercial |
$394.54
|
| Rate for Payer: VA VA |
$393.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$799.74
|
|
|
HC NM BONE MARROW WHOLE BODY
|
Facility
|
IP
|
$1,066.32
|
|
|
Service Code
|
CPT 78104
|
| Hospital Charge Code |
34100011
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$469.18 |
| Max. Negotiated Rate |
$959.69 |
| Rate for Payer: Aetna American Axle |
$693.11
|
| Rate for Payer: Aetna Commercial |
$906.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$693.11
|
| Rate for Payer: Cash Price |
$853.06
|
| Rate for Payer: Cofinity Commercial |
$746.42
|
| Rate for Payer: Cofinity Commercial |
$917.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$746.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$853.06
|
| Rate for Payer: Healthscope Commercial |
$959.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$746.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$799.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$906.37
|
| Rate for Payer: PHP Commercial |
$906.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$693.11
|
| Rate for Payer: Priority Health SBD |
$671.78
|
| Rate for Payer: UMR Bronson Commercial |
$469.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$799.74
|
|
|
HC NM BONE MULTIPLE AREAS
|
Facility
|
OP
|
$1,296.09
|
|
|
Service Code
|
CPT 78305
|
| Hospital Charge Code |
34100024
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$211.02 |
| Max. Negotiated Rate |
$1,237.41 |
| Rate for Payer: Aetna American Axle |
$842.46
|
| Rate for Payer: Aetna Commercial |
$1,101.68
|
| Rate for Payer: Aetna Medicare |
$409.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$842.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.12
|
| Rate for Payer: BCBS Complete |
$221.57
|
| Rate for Payer: BCBS MAPPO |
$393.70
|
| Rate for Payer: BCBS Trust/PPO |
$433.77
|
| Rate for Payer: BCN Commercial |
$433.77
|
| Rate for Payer: BCN Medicare Advantage |
$393.70
|
| Rate for Payer: Cash Price |
$1,036.87
|
| Rate for Payer: Cash Price |
$1,036.87
|
| Rate for Payer: Cofinity Commercial |
$907.26
|
| Rate for Payer: Cofinity Commercial |
$1,114.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$907.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,036.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.70
|
| Rate for Payer: Healthscope Commercial |
$1,166.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$907.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$972.07
|
| Rate for Payer: Mclaren Medicaid |
$211.02
|
| Rate for Payer: Mclaren Medicare |
$393.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.38
|
| Rate for Payer: Meridian Medicaid |
$221.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,101.68
|
| Rate for Payer: Nomi Health Commercial |
$1,181.10
|
| Rate for Payer: PACE Medicare |
$374.02
|
| Rate for Payer: PACE SWMI |
$393.70
|
| Rate for Payer: PHP Commercial |
$1,101.68
|
| Rate for Payer: PHP Medicare Advantage |
$393.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$842.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.41
|
| Rate for Payer: Priority Health Medicare |
$393.70
|
| Rate for Payer: Priority Health Narrow Network |
$989.93
|
| Rate for Payer: Priority Health SBD |
$816.54
|
| Rate for Payer: Railroad Medicare Medicare |
$393.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.85
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.70
|
| Rate for Payer: UHC Exchange |
$226.23
|
| Rate for Payer: UHC Medicare Advantage |
$393.70
|
| Rate for Payer: UHCCP Medicaid |
$211.02
|
| Rate for Payer: UMR Bronson Commercial |
$479.55
|
| Rate for Payer: VA VA |
$393.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$972.07
|
|
|
HC NM BONE MULTIPLE AREAS
|
Facility
|
IP
|
$1,296.09
|
|
|
Service Code
|
CPT 78305
|
| Hospital Charge Code |
34100024
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$570.28 |
| Max. Negotiated Rate |
$1,166.48 |
| Rate for Payer: Aetna American Axle |
$842.46
|
| Rate for Payer: Aetna Commercial |
$1,101.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$842.46
|
| Rate for Payer: Cash Price |
$1,036.87
|
| Rate for Payer: Cofinity Commercial |
$1,114.64
|
| Rate for Payer: Cofinity Commercial |
$907.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$907.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,036.87
|
| Rate for Payer: Healthscope Commercial |
$1,166.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$907.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$972.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,101.68
|
| Rate for Payer: PHP Commercial |
$1,101.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$842.46
|
| Rate for Payer: Priority Health SBD |
$816.54
|
| Rate for Payer: UMR Bronson Commercial |
$570.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$972.07
|
|
|
HC NM BONE SINGLE AREA
|
Facility
|
IP
|
$1,204.47
|
|
|
Service Code
|
CPT 78300
|
| Hospital Charge Code |
34100023
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$529.97 |
| Max. Negotiated Rate |
$1,084.02 |
| Rate for Payer: Aetna American Axle |
$782.91
|
| Rate for Payer: Aetna Commercial |
$1,023.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$782.91
|
| Rate for Payer: Cash Price |
$963.58
|
| Rate for Payer: Cofinity Commercial |
$1,035.84
|
| Rate for Payer: Cofinity Commercial |
$843.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$843.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.58
|
| Rate for Payer: Healthscope Commercial |
$1,084.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$843.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$903.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,023.80
|
| Rate for Payer: PHP Commercial |
$1,023.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$782.91
|
| Rate for Payer: Priority Health SBD |
$758.82
|
| Rate for Payer: UMR Bronson Commercial |
$529.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$903.35
|
|
|
HC NM BONE SINGLE AREA
|
Facility
|
OP
|
$1,204.47
|
|
|
Service Code
|
CPT 78300
|
| Hospital Charge Code |
34100023
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$187.27 |
| Max. Negotiated Rate |
$1,237.41 |
| Rate for Payer: Aetna American Axle |
$782.91
|
| Rate for Payer: Aetna Commercial |
$1,023.80
|
| Rate for Payer: Aetna Medicare |
$409.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$782.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.12
|
| Rate for Payer: BCBS Complete |
$221.57
|
| Rate for Payer: BCBS MAPPO |
$393.70
|
| Rate for Payer: BCBS Trust/PPO |
$365.35
|
| Rate for Payer: BCN Commercial |
$365.35
|
| Rate for Payer: BCN Medicare Advantage |
$393.70
|
| Rate for Payer: Cash Price |
$963.58
|
| Rate for Payer: Cash Price |
$963.58
|
| Rate for Payer: Cofinity Commercial |
$843.13
|
| Rate for Payer: Cofinity Commercial |
$1,035.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$843.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.70
|
| Rate for Payer: Healthscope Commercial |
$1,084.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$843.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$903.35
|
| Rate for Payer: Mclaren Medicaid |
$211.02
|
| Rate for Payer: Mclaren Medicare |
$393.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.38
|
| Rate for Payer: Meridian Medicaid |
$221.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,023.80
|
| Rate for Payer: Nomi Health Commercial |
$1,181.10
|
| Rate for Payer: PACE Medicare |
$374.02
|
| Rate for Payer: PACE SWMI |
$393.70
|
| Rate for Payer: PHP Commercial |
$1,023.80
|
| Rate for Payer: PHP Medicare Advantage |
$393.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$782.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.41
|
| Rate for Payer: Priority Health Medicare |
$393.70
|
| Rate for Payer: Priority Health Narrow Network |
$989.93
|
| Rate for Payer: Priority Health SBD |
$758.82
|
| Rate for Payer: Railroad Medicare Medicare |
$393.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.00
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.70
|
| Rate for Payer: UHC Exchange |
$187.27
|
| Rate for Payer: UHC Medicare Advantage |
$393.70
|
| Rate for Payer: UHCCP Medicaid |
$211.02
|
| Rate for Payer: UMR Bronson Commercial |
$445.65
|
| Rate for Payer: VA VA |
$393.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$903.35
|
|
|
HC NM BONE TOTAL BODY
|
Facility
|
OP
|
$1,765.95
|
|
|
Service Code
|
CPT 78306
|
| Hospital Charge Code |
34100025
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$211.02 |
| Max. Negotiated Rate |
$1,589.36 |
| Rate for Payer: Aetna American Axle |
$1,147.87
|
| Rate for Payer: Aetna Commercial |
$1,501.06
|
| Rate for Payer: Aetna Medicare |
$409.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,147.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.12
|
| Rate for Payer: BCBS Complete |
$221.57
|
| Rate for Payer: BCBS MAPPO |
$393.70
|
| Rate for Payer: BCBS Trust/PPO |
$472.08
|
| Rate for Payer: BCN Commercial |
$472.08
|
| Rate for Payer: BCN Medicare Advantage |
$393.70
|
| Rate for Payer: Cash Price |
$1,412.76
|
| Rate for Payer: Cash Price |
$1,412.76
|
| Rate for Payer: Cofinity Commercial |
$1,518.72
|
| Rate for Payer: Cofinity Commercial |
$1,236.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,236.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,412.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.70
|
| Rate for Payer: Healthscope Commercial |
$1,589.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,236.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,324.46
|
| Rate for Payer: Mclaren Medicaid |
$211.02
|
| Rate for Payer: Mclaren Medicare |
$393.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.38
|
| Rate for Payer: Meridian Medicaid |
$221.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,501.06
|
| Rate for Payer: Nomi Health Commercial |
$1,181.10
|
| Rate for Payer: PACE Medicare |
$374.02
|
| Rate for Payer: PACE SWMI |
$393.70
|
| Rate for Payer: PHP Commercial |
$1,501.06
|
| Rate for Payer: PHP Medicare Advantage |
$393.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,147.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.41
|
| Rate for Payer: Priority Health Medicare |
$393.70
|
| Rate for Payer: Priority Health Narrow Network |
$989.93
|
| Rate for Payer: Priority Health SBD |
$1,112.55
|
| Rate for Payer: Railroad Medicare Medicare |
$393.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.64
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.70
|
| Rate for Payer: UHC Exchange |
$244.22
|
| Rate for Payer: UHC Medicare Advantage |
$393.70
|
| Rate for Payer: UHCCP Medicaid |
$211.02
|
| Rate for Payer: UMR Bronson Commercial |
$653.40
|
| Rate for Payer: VA VA |
$393.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,324.46
|
|
|
HC NM BONE TOTAL BODY
|
Facility
|
IP
|
$1,765.95
|
|
|
Service Code
|
CPT 78306
|
| Hospital Charge Code |
34100025
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$777.02 |
| Max. Negotiated Rate |
$1,589.36 |
| Rate for Payer: Cofinity Commercial |
$1,518.72
|
| Rate for Payer: Aetna American Axle |
$1,147.87
|
| Rate for Payer: Aetna Commercial |
$1,501.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,147.87
|
| Rate for Payer: Cash Price |
$1,412.76
|
| Rate for Payer: Cofinity Commercial |
$1,236.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,236.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,412.76
|
| Rate for Payer: Healthscope Commercial |
$1,589.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,236.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,324.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,501.06
|
| Rate for Payer: PHP Commercial |
$1,501.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,147.87
|
| Rate for Payer: Priority Health SBD |
$1,112.55
|
| Rate for Payer: UMR Bronson Commercial |
$777.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,324.46
|
|
|
HC NM BONE W BLOOD FLOW 3 PHASE
|
Facility
|
OP
|
$1,735.24
|
|
|
Service Code
|
CPT 78315
|
| Hospital Charge Code |
34100026
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$211.02 |
| Max. Negotiated Rate |
$1,561.72 |
| Rate for Payer: Aetna American Axle |
$1,127.91
|
| Rate for Payer: Aetna Commercial |
$1,474.95
|
| Rate for Payer: Aetna Medicare |
$409.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,127.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.12
|
| Rate for Payer: BCBS Complete |
$221.57
|
| Rate for Payer: BCBS MAPPO |
$393.70
|
| Rate for Payer: BCBS Trust/PPO |
$553.50
|
| Rate for Payer: BCN Commercial |
$553.50
|
| Rate for Payer: BCN Medicare Advantage |
$393.70
|
| Rate for Payer: Cash Price |
$1,388.19
|
| Rate for Payer: Cash Price |
$1,388.19
|
| Rate for Payer: Cofinity Commercial |
$1,492.31
|
| Rate for Payer: Cofinity Commercial |
$1,214.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,214.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,388.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.70
|
| Rate for Payer: Healthscope Commercial |
$1,561.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,214.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,301.43
|
| Rate for Payer: Mclaren Medicaid |
$211.02
|
| Rate for Payer: Mclaren Medicare |
$393.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.38
|
| Rate for Payer: Meridian Medicaid |
$221.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,474.95
|
| Rate for Payer: Nomi Health Commercial |
$1,181.10
|
| Rate for Payer: PACE Medicare |
$374.02
|
| Rate for Payer: PACE SWMI |
$393.70
|
| Rate for Payer: PHP Commercial |
$1,474.95
|
| Rate for Payer: PHP Medicare Advantage |
$393.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.41
|
| Rate for Payer: Priority Health Medicare |
$393.70
|
| Rate for Payer: Priority Health Narrow Network |
$989.93
|
| Rate for Payer: Priority Health SBD |
$1,093.20
|
| Rate for Payer: Railroad Medicare Medicare |
$393.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.03
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.70
|
| Rate for Payer: UHC Exchange |
$287.30
|
| Rate for Payer: UHC Medicare Advantage |
$393.70
|
| Rate for Payer: UHCCP Medicaid |
$211.02
|
| Rate for Payer: UMR Bronson Commercial |
$642.04
|
| Rate for Payer: VA VA |
$393.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,301.43
|
|
|
HC NM BONE W BLOOD FLOW 3 PHASE
|
Facility
|
IP
|
$1,735.24
|
|
|
Service Code
|
CPT 78315
|
| Hospital Charge Code |
34100026
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$763.51 |
| Max. Negotiated Rate |
$1,561.72 |
| Rate for Payer: Aetna American Axle |
$1,127.91
|
| Rate for Payer: Aetna Commercial |
$1,474.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,127.91
|
| Rate for Payer: Cash Price |
$1,388.19
|
| Rate for Payer: Cofinity Commercial |
$1,214.67
|
| Rate for Payer: Cofinity Commercial |
$1,492.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,214.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,388.19
|
| Rate for Payer: Healthscope Commercial |
$1,561.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,214.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,301.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,474.95
|
| Rate for Payer: PHP Commercial |
$1,474.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.91
|
| Rate for Payer: Priority Health SBD |
$1,093.20
|
| Rate for Payer: UMR Bronson Commercial |
$763.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,301.43
|
|
|
HC NM BRAIN <4 STATC VIEW W VAS F
|
Facility
|
IP
|
$1,296.09
|
|
|
Service Code
|
CPT 78601
|
| Hospital Charge Code |
34100038
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$570.28 |
| Max. Negotiated Rate |
$1,166.48 |
| Rate for Payer: Aetna American Axle |
$842.46
|
| Rate for Payer: Aetna Commercial |
$1,101.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$842.46
|
| Rate for Payer: Cash Price |
$1,036.87
|
| Rate for Payer: Cofinity Commercial |
$1,114.64
|
| Rate for Payer: Cofinity Commercial |
$907.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$907.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,036.87
|
| Rate for Payer: Healthscope Commercial |
$1,166.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$907.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$972.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,101.68
|
| Rate for Payer: PHP Commercial |
$1,101.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$842.46
|
| Rate for Payer: Priority Health SBD |
$816.54
|
| Rate for Payer: UMR Bronson Commercial |
$570.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$972.07
|
|
|
HC NM BRAIN <4 STATC VIEW W VAS F
|
Facility
|
OP
|
$1,296.09
|
|
|
Service Code
|
CPT 78601
|
| Hospital Charge Code |
34100038
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$181.28 |
| Max. Negotiated Rate |
$1,237.41 |
| Rate for Payer: Aetna American Axle |
$842.46
|
| Rate for Payer: Aetna Commercial |
$1,101.68
|
| Rate for Payer: Aetna Medicare |
$409.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$842.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.12
|
| Rate for Payer: BCBS Complete |
$221.57
|
| Rate for Payer: BCBS MAPPO |
$393.70
|
| Rate for Payer: BCBS Trust/PPO |
$363.30
|
| Rate for Payer: BCN Commercial |
$363.30
|
| Rate for Payer: BCN Medicare Advantage |
$393.70
|
| Rate for Payer: Cash Price |
$1,036.87
|
| Rate for Payer: Cash Price |
$1,036.87
|
| Rate for Payer: Cofinity Commercial |
$907.26
|
| Rate for Payer: Cofinity Commercial |
$1,114.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$907.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,036.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.70
|
| Rate for Payer: Healthscope Commercial |
$1,166.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$907.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$972.07
|
| Rate for Payer: Mclaren Medicaid |
$211.02
|
| Rate for Payer: Mclaren Medicare |
$393.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.38
|
| Rate for Payer: Meridian Medicaid |
$221.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,101.68
|
| Rate for Payer: Nomi Health Commercial |
$1,181.10
|
| Rate for Payer: PACE Medicare |
$374.02
|
| Rate for Payer: PACE SWMI |
$393.70
|
| Rate for Payer: PHP Commercial |
$1,101.68
|
| Rate for Payer: PHP Medicare Advantage |
$393.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$842.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.41
|
| Rate for Payer: Priority Health Medicare |
$393.70
|
| Rate for Payer: Priority Health Narrow Network |
$989.93
|
| Rate for Payer: Priority Health SBD |
$816.54
|
| Rate for Payer: Railroad Medicare Medicare |
$393.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.41
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.70
|
| Rate for Payer: UHC Exchange |
$181.28
|
| Rate for Payer: UHC Medicare Advantage |
$393.70
|
| Rate for Payer: UHCCP Medicaid |
$211.02
|
| Rate for Payer: UMR Bronson Commercial |
$479.55
|
| Rate for Payer: VA VA |
$393.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$972.07
|
|
|
HC NM BREAST IMAGING BILAT
|
Facility
|
IP
|
$1,183.46
|
|
|
Service Code
|
CPT 78800
|
| Hospital Charge Code |
34100053
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$520.72 |
| Max. Negotiated Rate |
$1,065.11 |
| Rate for Payer: Aetna American Axle |
$769.25
|
| Rate for Payer: Aetna Commercial |
$1,005.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$769.25
|
| Rate for Payer: Cash Price |
$946.77
|
| Rate for Payer: Cofinity Commercial |
$1,017.78
|
| Rate for Payer: Cofinity Commercial |
$828.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$828.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$946.77
|
| Rate for Payer: Healthscope Commercial |
$1,065.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$828.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$887.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,005.94
|
| Rate for Payer: PHP Commercial |
$1,005.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$769.25
|
| Rate for Payer: Priority Health SBD |
$745.58
|
| Rate for Payer: UMR Bronson Commercial |
$520.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$887.60
|
|
|
HC NM BREAST IMAGING BILAT
|
Facility
|
OP
|
$1,183.46
|
|
|
Service Code
|
CPT 78800
|
| Hospital Charge Code |
34100053
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$210.64 |
| Max. Negotiated Rate |
$1,237.41 |
| Rate for Payer: Aetna American Axle |
$769.25
|
| Rate for Payer: Aetna Commercial |
$1,005.94
|
| Rate for Payer: Aetna Medicare |
$409.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$769.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.12
|
| Rate for Payer: BCBS Complete |
$221.57
|
| Rate for Payer: BCBS MAPPO |
$393.70
|
| Rate for Payer: BCBS Trust/PPO |
$414.62
|
| Rate for Payer: BCN Commercial |
$414.62
|
| Rate for Payer: BCN Medicare Advantage |
$393.70
|
| Rate for Payer: Cash Price |
$946.77
|
| Rate for Payer: Cash Price |
$946.77
|
| Rate for Payer: Cofinity Commercial |
$828.42
|
| Rate for Payer: Cofinity Commercial |
$1,017.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$828.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$946.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.70
|
| Rate for Payer: Healthscope Commercial |
$1,065.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$828.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$887.60
|
| Rate for Payer: Mclaren Medicaid |
$211.02
|
| Rate for Payer: Mclaren Medicare |
$393.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.38
|
| Rate for Payer: Meridian Medicaid |
$221.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,005.94
|
| Rate for Payer: Nomi Health Commercial |
$1,181.10
|
| Rate for Payer: PACE Medicare |
$374.02
|
| Rate for Payer: PACE SWMI |
$393.70
|
| Rate for Payer: PHP Commercial |
$1,005.94
|
| Rate for Payer: PHP Medicare Advantage |
$393.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$769.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.41
|
| Rate for Payer: Priority Health Medicare |
$393.70
|
| Rate for Payer: Priority Health Narrow Network |
$989.93
|
| Rate for Payer: Priority Health SBD |
$745.58
|
| Rate for Payer: Railroad Medicare Medicare |
$393.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.70
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.70
|
| Rate for Payer: UHC Exchange |
$210.64
|
| Rate for Payer: UHC Medicare Advantage |
$393.70
|
| Rate for Payer: UHCCP Medicaid |
$211.02
|
| Rate for Payer: UMR Bronson Commercial |
$437.88
|
| Rate for Payer: VA VA |
$393.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$887.60
|
|
|
HC NM CARDIAC GATED WALL MUGA
|
Facility
|
IP
|
$1,326.80
|
|
|
Service Code
|
CPT 78472
|
| Hospital Charge Code |
34100030
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$583.79 |
| Max. Negotiated Rate |
$1,194.12 |
| Rate for Payer: Aetna American Axle |
$862.42
|
| Rate for Payer: Aetna Commercial |
$1,127.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$862.42
|
| Rate for Payer: Cash Price |
$1,061.44
|
| Rate for Payer: Cofinity Commercial |
$1,141.05
|
| Rate for Payer: Cofinity Commercial |
$928.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$928.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,061.44
|
| Rate for Payer: Healthscope Commercial |
$1,194.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$928.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$995.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,127.78
|
| Rate for Payer: PHP Commercial |
$1,127.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$862.42
|
| Rate for Payer: Priority Health SBD |
$835.88
|
| Rate for Payer: UMR Bronson Commercial |
$583.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$995.10
|
|
|
HC NM CARDIAC GATED WALL MUGA
|
Facility
|
OP
|
$1,326.80
|
|
|
Service Code
|
CPT 78472
|
| Hospital Charge Code |
34100030
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$191.77 |
| Max. Negotiated Rate |
$1,237.41 |
| Rate for Payer: Aetna American Axle |
$862.42
|
| Rate for Payer: Aetna Commercial |
$1,127.78
|
| Rate for Payer: Aetna Medicare |
$409.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$862.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.12
|
| Rate for Payer: BCBS Complete |
$221.57
|
| Rate for Payer: BCBS MAPPO |
$393.70
|
| Rate for Payer: BCBS Trust/PPO |
$339.35
|
| Rate for Payer: BCN Commercial |
$339.35
|
| Rate for Payer: BCN Medicare Advantage |
$393.70
|
| Rate for Payer: Cash Price |
$1,061.44
|
| Rate for Payer: Cash Price |
$1,061.44
|
| Rate for Payer: Cofinity Commercial |
$928.76
|
| Rate for Payer: Cofinity Commercial |
$1,141.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$928.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,061.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.70
|
| Rate for Payer: Healthscope Commercial |
$1,194.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$928.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$995.10
|
| Rate for Payer: Mclaren Medicaid |
$211.02
|
| Rate for Payer: Mclaren Medicare |
$393.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.38
|
| Rate for Payer: Meridian Medicaid |
$221.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,127.78
|
| Rate for Payer: Nomi Health Commercial |
$1,181.10
|
| Rate for Payer: PACE Medicare |
$374.02
|
| Rate for Payer: PACE SWMI |
$393.70
|
| Rate for Payer: PHP Commercial |
$1,127.78
|
| Rate for Payer: PHP Medicare Advantage |
$393.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$862.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.41
|
| Rate for Payer: Priority Health Medicare |
$393.70
|
| Rate for Payer: Priority Health Narrow Network |
$989.93
|
| Rate for Payer: Priority Health SBD |
$835.88
|
| Rate for Payer: Railroad Medicare Medicare |
$393.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.95
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.70
|
| Rate for Payer: UHC Exchange |
$191.77
|
| Rate for Payer: UHC Medicare Advantage |
$393.70
|
| Rate for Payer: UHCCP Medicaid |
$211.02
|
| Rate for Payer: UMR Bronson Commercial |
$490.92
|
| Rate for Payer: VA VA |
$393.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$995.10
|
|
|
HC NM CEREBRAL SHUNT EVAL
|
Facility
|
OP
|
$874.85
|
|
|
Service Code
|
CPT 78645
|
| Hospital Charge Code |
34100041
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$266.73 |
| Max. Negotiated Rate |
$1,657.56 |
| Rate for Payer: Aetna American Axle |
$568.65
|
| Rate for Payer: Aetna Commercial |
$743.62
|
| Rate for Payer: Aetna Medicare |
$548.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$568.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$659.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$659.24
|
| Rate for Payer: BCBS Complete |
$296.82
|
| Rate for Payer: BCBS MAPPO |
$527.39
|
| Rate for Payer: BCBS Trust/PPO |
$552.81
|
| Rate for Payer: BCN Commercial |
$552.81
|
| Rate for Payer: BCN Medicare Advantage |
$527.39
|
| Rate for Payer: Cash Price |
$699.88
|
| Rate for Payer: Cash Price |
$699.88
|
| Rate for Payer: Cofinity Commercial |
$752.37
|
| Rate for Payer: Cofinity Commercial |
$612.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$612.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$699.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.39
|
| Rate for Payer: Healthscope Commercial |
$787.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$612.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$656.14
|
| Rate for Payer: Mclaren Medicaid |
$282.68
|
| Rate for Payer: Mclaren Medicare |
$527.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$553.76
|
| Rate for Payer: Meridian Medicaid |
$296.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$606.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$743.62
|
| Rate for Payer: Nomi Health Commercial |
$1,582.17
|
| Rate for Payer: PACE Medicare |
$501.02
|
| Rate for Payer: PACE SWMI |
$527.39
|
| Rate for Payer: PHP Commercial |
$743.62
|
| Rate for Payer: PHP Medicare Advantage |
$527.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$568.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,657.56
|
| Rate for Payer: Priority Health Medicare |
$527.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,326.05
|
| Rate for Payer: Priority Health SBD |
$551.16
|
| Rate for Payer: Railroad Medicare Medicare |
$527.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$293.40
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.39
|
| Rate for Payer: UHC Exchange |
$266.73
|
| Rate for Payer: UHC Medicare Advantage |
$527.39
|
| Rate for Payer: UHCCP Medicaid |
$282.68
|
| Rate for Payer: UMR Bronson Commercial |
$323.69
|
| Rate for Payer: VA VA |
$527.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$656.14
|
|
|
HC NM CEREBRAL SHUNT EVAL
|
Facility
|
IP
|
$874.85
|
|
|
Service Code
|
CPT 78645
|
| Hospital Charge Code |
34100041
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$384.93 |
| Max. Negotiated Rate |
$787.36 |
| Rate for Payer: Aetna American Axle |
$568.65
|
| Rate for Payer: Aetna Commercial |
$743.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$568.65
|
| Rate for Payer: Cash Price |
$699.88
|
| Rate for Payer: Cofinity Commercial |
$612.40
|
| Rate for Payer: Cofinity Commercial |
$752.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$612.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$699.88
|
| Rate for Payer: Healthscope Commercial |
$787.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$612.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$656.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$743.62
|
| Rate for Payer: PHP Commercial |
$743.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$568.65
|
| Rate for Payer: Priority Health SBD |
$551.16
|
| Rate for Payer: UMR Bronson Commercial |
$384.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$656.14
|
|
|
HC NM CISTERNOGRAM
|
Facility
|
OP
|
$1,020.78
|
|
|
Service Code
|
CPT 78630
|
| Hospital Charge Code |
34100040
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$278.08 |
| Max. Negotiated Rate |
$1,657.56 |
| Rate for Payer: Cash Price |
$816.62
|
| Rate for Payer: Aetna American Axle |
$663.51
|
| Rate for Payer: Aetna Commercial |
$867.66
|
| Rate for Payer: Aetna Medicare |
$548.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$663.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$659.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$659.24
|
| Rate for Payer: BCBS Complete |
$296.82
|
| Rate for Payer: BCBS MAPPO |
$527.39
|
| Rate for Payer: BCBS Trust/PPO |
$567.87
|
| Rate for Payer: BCN Commercial |
$567.87
|
| Rate for Payer: BCN Medicare Advantage |
$527.39
|
| Rate for Payer: Cash Price |
$816.62
|
| Rate for Payer: Cofinity Commercial |
$877.87
|
| Rate for Payer: Cofinity Commercial |
$714.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$714.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.39
|
| Rate for Payer: Healthscope Commercial |
$918.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$714.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.58
|
| Rate for Payer: Mclaren Medicaid |
$282.68
|
| Rate for Payer: Mclaren Medicare |
$527.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$553.76
|
| Rate for Payer: Meridian Medicaid |
$296.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$606.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$867.66
|
| Rate for Payer: Nomi Health Commercial |
$1,582.17
|
| Rate for Payer: PACE Medicare |
$501.02
|
| Rate for Payer: PACE SWMI |
$527.39
|
| Rate for Payer: PHP Commercial |
$867.66
|
| Rate for Payer: PHP Medicare Advantage |
$527.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,657.56
|
| Rate for Payer: Priority Health Medicare |
$527.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,326.05
|
| Rate for Payer: Priority Health SBD |
$643.09
|
| Rate for Payer: Railroad Medicare Medicare |
$527.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$305.89
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.39
|
| Rate for Payer: UHC Exchange |
$278.08
|
| Rate for Payer: UHC Medicare Advantage |
$527.39
|
| Rate for Payer: UHCCP Medicaid |
$282.68
|
| Rate for Payer: UMR Bronson Commercial |
$377.69
|
| Rate for Payer: VA VA |
$527.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.58
|
|
|
HC NM CISTERNOGRAM
|
Facility
|
IP
|
$1,020.78
|
|
|
Service Code
|
CPT 78630
|
| Hospital Charge Code |
34100040
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$449.14 |
| Max. Negotiated Rate |
$918.70 |
| Rate for Payer: Aetna American Axle |
$663.51
|
| Rate for Payer: Aetna Commercial |
$867.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$663.51
|
| Rate for Payer: Cash Price |
$816.62
|
| Rate for Payer: Cofinity Commercial |
$714.55
|
| Rate for Payer: Cofinity Commercial |
$877.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$714.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.62
|
| Rate for Payer: Healthscope Commercial |
$918.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$714.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$867.66
|
| Rate for Payer: PHP Commercial |
$867.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.51
|
| Rate for Payer: Priority Health SBD |
$643.09
|
| Rate for Payer: UMR Bronson Commercial |
$449.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.58
|
|
|
HC NM CSF LEAK
|
Facility
|
OP
|
$1,020.78
|
|
|
Service Code
|
CPT 78650
|
| Hospital Charge Code |
34100042
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$224.01 |
| Max. Negotiated Rate |
$4,020.13 |
| Rate for Payer: Aetna American Axle |
$663.51
|
| Rate for Payer: Aetna Commercial |
$867.66
|
| Rate for Payer: Aetna Medicare |
$1,330.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$663.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,598.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,598.85
|
| Rate for Payer: BCBS Complete |
$719.87
|
| Rate for Payer: BCBS MAPPO |
$1,279.08
|
| Rate for Payer: BCBS Trust/PPO |
$459.08
|
| Rate for Payer: BCN Commercial |
$459.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,279.08
|
| Rate for Payer: Cash Price |
$816.62
|
| Rate for Payer: Cash Price |
$816.62
|
| Rate for Payer: Cofinity Commercial |
$877.87
|
| Rate for Payer: Cofinity Commercial |
$714.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$714.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,279.08
|
| Rate for Payer: Healthscope Commercial |
$918.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$714.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.58
|
| Rate for Payer: Mclaren Medicaid |
$685.59
|
| Rate for Payer: Mclaren Medicare |
$1,279.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,343.03
|
| Rate for Payer: Meridian Medicaid |
$719.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,470.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$867.66
|
| Rate for Payer: Nomi Health Commercial |
$3,837.24
|
| Rate for Payer: PACE Medicare |
$1,215.13
|
| Rate for Payer: PACE SWMI |
$1,279.08
|
| Rate for Payer: PHP Commercial |
$867.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,279.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$685.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,020.13
|
| Rate for Payer: Priority Health Medicare |
$1,279.08
|
| Rate for Payer: Priority Health Narrow Network |
$3,216.10
|
| Rate for Payer: Priority Health SBD |
$643.09
|
| Rate for Payer: Railroad Medicare Medicare |
$1,279.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.41
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,279.08
|
| Rate for Payer: UHC Exchange |
$224.01
|
| Rate for Payer: UHC Medicare Advantage |
$1,279.08
|
| Rate for Payer: UHCCP Medicaid |
$685.59
|
| Rate for Payer: UMR Bronson Commercial |
$377.69
|
| Rate for Payer: VA VA |
$1,279.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.58
|
|
