|
HC NM LUNG PERFUSION EG PARTICULATE
|
Facility
|
IP
|
$1,020.78
|
|
|
Service Code
|
CPT 78580
|
| Hospital Charge Code |
34100032
|
|
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 |
$765.59
|
| 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 |
$765.59
|
|
|
HC NM LUNG PERFUSION EG PARTICULATE
|
Facility
|
OP
|
$1,020.78
|
|
|
Service Code
|
CPT 78580
|
| Hospital Charge Code |
34100032
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$210.06 |
| Max. Negotiated Rate |
$1,103.16 |
| Rate for Payer: Aetna American Axle |
$663.51
|
| Rate for Payer: Aetna Commercial |
$867.66
|
| Rate for Payer: Aetna Medicare |
$407.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$663.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.88
|
| Rate for Payer: BCBS Complete |
$220.56
|
| Rate for Payer: BCBS MAPPO |
$391.90
|
| Rate for Payer: BCN Medicare Advantage |
$391.90
|
| 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 |
$391.90
|
| 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 |
$765.59
|
| Rate for Payer: Mclaren Medicaid |
$210.06
|
| Rate for Payer: Mclaren Medicare |
$391.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.50
|
| Rate for Payer: Meridian Medicaid |
$220.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$867.66
|
| Rate for Payer: PACE Medicare |
$372.31
|
| Rate for Payer: PACE SWMI |
$391.90
|
| Rate for Payer: PHP Commercial |
$867.66
|
| Rate for Payer: PHP Medicare Advantage |
$391.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.51
|
| Rate for Payer: Priority Health Medicare |
$391.90
|
| Rate for Payer: Priority Health SBD |
$643.09
|
| Rate for Payer: Railroad Medicare Medicare |
$391.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,103.16
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.90
|
| Rate for Payer: UHC Exchange |
$748.96
|
| Rate for Payer: UHC Medicare Advantage |
$391.90
|
| Rate for Payer: UHCCP Medicaid |
$210.06
|
| Rate for Payer: UMR Bronson Commercial |
$377.69
|
| Rate for Payer: VA VA |
$391.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.59
|
|
|
HC NM LYMPHATIC SENTINAL NODE IMAGING
|
Facility
|
IP
|
$1,314.40
|
|
|
Service Code
|
CPT 78195
|
| Hospital Charge Code |
34100012
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$578.34 |
| Max. Negotiated Rate |
$1,182.96 |
| Rate for Payer: Aetna American Axle |
$854.36
|
| Rate for Payer: Aetna Commercial |
$1,117.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$854.36
|
| Rate for Payer: Cash Price |
$1,051.52
|
| Rate for Payer: Cofinity Commercial |
$1,130.38
|
| Rate for Payer: Cofinity Commercial |
$920.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$920.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,051.52
|
| Rate for Payer: Healthscope Commercial |
$1,182.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$920.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$985.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,117.24
|
| Rate for Payer: PHP Commercial |
$1,117.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$854.36
|
| Rate for Payer: Priority Health SBD |
$828.07
|
| Rate for Payer: UMR Bronson Commercial |
$578.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$985.80
|
|
|
HC NM LYMPHATIC SENTINAL NODE IMAGING
|
Facility
|
OP
|
$1,314.40
|
|
|
Service Code
|
CPT 78195
|
| Hospital Charge Code |
34100012
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$281.38 |
| Max. Negotiated Rate |
$1,477.71 |
| Rate for Payer: Aetna American Axle |
$854.36
|
| Rate for Payer: Aetna Commercial |
$1,117.24
|
| Rate for Payer: Aetna Medicare |
$545.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$854.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$656.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$656.20
|
| Rate for Payer: BCBS Complete |
$295.45
|
| Rate for Payer: BCBS MAPPO |
$524.96
|
| Rate for Payer: BCN Medicare Advantage |
$524.96
|
| Rate for Payer: Cash Price |
$1,051.52
|
| Rate for Payer: Cash Price |
$1,051.52
|
| Rate for Payer: Cofinity Commercial |
$920.08
|
| Rate for Payer: Cofinity Commercial |
$1,130.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$920.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,051.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$524.96
|
| Rate for Payer: Healthscope Commercial |
$1,182.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$920.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$985.80
|
| Rate for Payer: Mclaren Medicaid |
$281.38
|
| Rate for Payer: Mclaren Medicare |
$524.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$551.21
|
| Rate for Payer: Meridian Medicaid |
$295.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$603.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,117.24
|
| Rate for Payer: PACE Medicare |
$498.71
|
| Rate for Payer: PACE SWMI |
$524.96
|
| Rate for Payer: PHP Commercial |
$1,117.24
|
| Rate for Payer: PHP Medicare Advantage |
$524.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$854.36
|
| Rate for Payer: Priority Health Medicare |
$524.96
|
| Rate for Payer: Priority Health SBD |
$828.07
|
| Rate for Payer: Railroad Medicare Medicare |
$524.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,477.71
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$524.96
|
| Rate for Payer: UHC Exchange |
$1,003.25
|
| Rate for Payer: UHC Medicare Advantage |
$524.96
|
| Rate for Payer: UHCCP Medicaid |
$281.38
|
| Rate for Payer: UMR Bronson Commercial |
$486.33
|
| Rate for Payer: VA VA |
$524.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$985.80
|
|
|
HC NM MECKELS OR ABD
|
Facility
|
IP
|
$1,146.04
|
|
|
Service Code
|
CPT 78290
|
| Hospital Charge Code |
34100021
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$504.26 |
| Max. Negotiated Rate |
$1,031.44 |
| Rate for Payer: Aetna American Axle |
$744.93
|
| Rate for Payer: Aetna Commercial |
$974.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$744.93
|
| Rate for Payer: Cash Price |
$916.83
|
| Rate for Payer: Cofinity Commercial |
$802.23
|
| Rate for Payer: Cofinity Commercial |
$985.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$802.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.83
|
| Rate for Payer: Healthscope Commercial |
$1,031.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$802.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$859.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$974.13
|
| Rate for Payer: PHP Commercial |
$974.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.93
|
| Rate for Payer: Priority Health SBD |
$722.01
|
| Rate for Payer: UMR Bronson Commercial |
$504.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$859.53
|
|
|
HC NM MECKELS OR ABD
|
Facility
|
OP
|
$1,146.04
|
|
|
Service Code
|
CPT 78290
|
| Hospital Charge Code |
34100021
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$210.06 |
| Max. Negotiated Rate |
$1,103.16 |
| Rate for Payer: Aetna American Axle |
$744.93
|
| Rate for Payer: Aetna Commercial |
$974.13
|
| Rate for Payer: Aetna Medicare |
$407.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$744.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.88
|
| Rate for Payer: BCBS Complete |
$220.56
|
| Rate for Payer: BCBS MAPPO |
$391.90
|
| Rate for Payer: BCN Medicare Advantage |
$391.90
|
| Rate for Payer: Cash Price |
$916.83
|
| Rate for Payer: Cash Price |
$916.83
|
| Rate for Payer: Cofinity Commercial |
$985.59
|
| Rate for Payer: Cofinity Commercial |
$802.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$802.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.90
|
| Rate for Payer: Healthscope Commercial |
$1,031.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$802.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$859.53
|
| Rate for Payer: Mclaren Medicaid |
$210.06
|
| Rate for Payer: Mclaren Medicare |
$391.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.50
|
| Rate for Payer: Meridian Medicaid |
$220.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$974.13
|
| Rate for Payer: PACE Medicare |
$372.31
|
| Rate for Payer: PACE SWMI |
$391.90
|
| Rate for Payer: PHP Commercial |
$974.13
|
| Rate for Payer: PHP Medicare Advantage |
$391.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.93
|
| Rate for Payer: Priority Health Medicare |
$391.90
|
| Rate for Payer: Priority Health SBD |
$722.01
|
| Rate for Payer: Railroad Medicare Medicare |
$391.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,103.16
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.90
|
| Rate for Payer: UHC Exchange |
$748.96
|
| Rate for Payer: UHC Medicare Advantage |
$391.90
|
| Rate for Payer: UHCCP Medicaid |
$210.06
|
| Rate for Payer: UMR Bronson Commercial |
$424.03
|
| Rate for Payer: VA VA |
$391.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$859.53
|
|
|
HC NM MYOCARD PERF SPECT EF WM MU
|
Facility
|
IP
|
$5,128.21
|
|
|
Service Code
|
CPT 78452
|
| Hospital Charge Code |
34100029
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$2,256.41 |
| Max. Negotiated Rate |
$4,615.39 |
| Rate for Payer: Aetna American Axle |
$3,333.34
|
| Rate for Payer: Aetna Commercial |
$4,358.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,333.34
|
| Rate for Payer: Cash Price |
$4,102.57
|
| Rate for Payer: Cofinity Commercial |
$3,589.75
|
| Rate for Payer: Cofinity Commercial |
$4,410.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,589.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,102.57
|
| Rate for Payer: Healthscope Commercial |
$4,615.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,589.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,846.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,358.98
|
| Rate for Payer: PHP Commercial |
$4,358.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,333.34
|
| Rate for Payer: Priority Health SBD |
$3,230.77
|
| Rate for Payer: UMR Bronson Commercial |
$2,256.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,846.16
|
|
|
HC NM MYOCARD PERF SPECT EF WM MU
|
Facility
|
OP
|
$5,128.21
|
|
|
Service Code
|
CPT 78452
|
| Hospital Charge Code |
34100029
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$682.44 |
| Max. Negotiated Rate |
$4,615.39 |
| Rate for Payer: Aetna American Axle |
$3,333.34
|
| Rate for Payer: Aetna Commercial |
$4,358.98
|
| Rate for Payer: Aetna Medicare |
$1,324.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,333.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,591.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,591.51
|
| Rate for Payer: BCBS Complete |
$716.56
|
| Rate for Payer: BCBS MAPPO |
$1,273.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,273.21
|
| Rate for Payer: Cash Price |
$4,102.57
|
| Rate for Payer: Cash Price |
$4,102.57
|
| Rate for Payer: Cofinity Commercial |
$4,410.26
|
| Rate for Payer: Cofinity Commercial |
$3,589.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,589.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,102.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,273.21
|
| Rate for Payer: Healthscope Commercial |
$4,615.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,589.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,846.16
|
| Rate for Payer: Mclaren Medicaid |
$682.44
|
| Rate for Payer: Mclaren Medicare |
$1,273.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,336.87
|
| Rate for Payer: Meridian Medicaid |
$716.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,464.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,358.98
|
| Rate for Payer: PACE Medicare |
$1,209.55
|
| Rate for Payer: PACE SWMI |
$1,273.21
|
| Rate for Payer: PHP Commercial |
$4,358.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,273.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$682.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,333.34
|
| Rate for Payer: Priority Health Medicare |
$1,273.21
|
| Rate for Payer: Priority Health SBD |
$3,230.77
|
| Rate for Payer: Railroad Medicare Medicare |
$1,273.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,583.96
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,273.21
|
| Rate for Payer: UHC Exchange |
$2,433.23
|
| Rate for Payer: UHC Medicare Advantage |
$1,273.21
|
| Rate for Payer: UHCCP Medicaid |
$682.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,897.44
|
| Rate for Payer: VA VA |
$1,273.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,846.16
|
|
|
HC NM MYOCARD PERF SPECT EF WM SI
|
Facility
|
OP
|
$1,831.50
|
|
|
Service Code
|
CPT 78451
|
| Hospital Charge Code |
34100067
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$677.65 |
| Max. Negotiated Rate |
$3,583.96 |
| Rate for Payer: Aetna American Axle |
$1,190.47
|
| Rate for Payer: Aetna Commercial |
$1,556.78
|
| Rate for Payer: Aetna Medicare |
$1,324.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,190.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,591.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,591.51
|
| Rate for Payer: BCBS Complete |
$716.56
|
| Rate for Payer: BCBS MAPPO |
$1,273.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,273.21
|
| Rate for Payer: Cash Price |
$1,465.20
|
| Rate for Payer: Cash Price |
$1,465.20
|
| Rate for Payer: Cofinity Commercial |
$1,575.09
|
| Rate for Payer: Cofinity Commercial |
$1,282.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,282.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,465.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,273.21
|
| Rate for Payer: Healthscope Commercial |
$1,648.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,282.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,373.62
|
| Rate for Payer: Mclaren Medicaid |
$682.44
|
| Rate for Payer: Mclaren Medicare |
$1,273.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,336.87
|
| Rate for Payer: Meridian Medicaid |
$716.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,464.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,556.78
|
| Rate for Payer: PACE Medicare |
$1,209.55
|
| Rate for Payer: PACE SWMI |
$1,273.21
|
| Rate for Payer: PHP Commercial |
$1,556.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,273.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$682.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,190.47
|
| Rate for Payer: Priority Health Medicare |
$1,273.21
|
| Rate for Payer: Priority Health SBD |
$1,153.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,273.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,583.96
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,273.21
|
| Rate for Payer: UHC Exchange |
$2,433.23
|
| Rate for Payer: UHC Medicare Advantage |
$1,273.21
|
| Rate for Payer: UHCCP Medicaid |
$682.44
|
| Rate for Payer: UMR Bronson Commercial |
$677.65
|
| Rate for Payer: VA VA |
$1,273.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,373.62
|
|
|
HC NM MYOCARD PERF SPECT EF WM SI
|
Facility
|
IP
|
$1,831.50
|
|
|
Service Code
|
CPT 78451
|
| Hospital Charge Code |
34100067
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$805.86 |
| Max. Negotiated Rate |
$1,648.35 |
| Rate for Payer: Aetna American Axle |
$1,190.47
|
| Rate for Payer: Aetna Commercial |
$1,556.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,190.47
|
| Rate for Payer: Cash Price |
$1,465.20
|
| Rate for Payer: Cofinity Commercial |
$1,282.05
|
| Rate for Payer: Cofinity Commercial |
$1,575.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,282.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,465.20
|
| Rate for Payer: Healthscope Commercial |
$1,648.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,282.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,373.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,556.78
|
| Rate for Payer: PHP Commercial |
$1,556.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,190.47
|
| Rate for Payer: Priority Health SBD |
$1,153.85
|
| Rate for Payer: UMR Bronson Commercial |
$805.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,373.62
|
|
|
HC NMO/AQP4 FACS TITER SERUM
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200395
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna American Axle |
$66.30
|
| Rate for Payer: Aetna Commercial |
$86.70
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$87.72
|
| Rate for Payer: Cofinity Commercial |
$71.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.50
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.70
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$86.70
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$64.26
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$23.03
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: UMR Bronson Commercial |
$37.74
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.50
|
|
|
HC NMO/AQP4 FACS TITER SERUM
|
Facility
|
IP
|
$102.00
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200395
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.88 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna American Axle |
$66.30
|
| Rate for Payer: Aetna Commercial |
$86.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.30
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$71.40
|
| Rate for Payer: Cofinity Commercial |
$87.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.70
|
| Rate for Payer: PHP Commercial |
$86.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health SBD |
$64.26
|
| Rate for Payer: UMR Bronson Commercial |
$44.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.50
|
|
|
HC NMO/AQP4-IGG CBA, S
|
Facility
|
OP
|
$351.90
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200422
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$316.71 |
| Rate for Payer: Aetna American Axle |
$228.74
|
| Rate for Payer: Aetna Commercial |
$299.12
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$281.52
|
| Rate for Payer: Cash Price |
$281.52
|
| Rate for Payer: Cofinity Commercial |
$302.63
|
| Rate for Payer: Cofinity Commercial |
$246.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$246.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$316.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$246.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.93
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.12
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$299.12
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.74
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$221.70
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$23.03
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: UMR Bronson Commercial |
$130.20
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.93
|
|
|
HC NMO/AQP4-IGG CBA, S
|
Facility
|
IP
|
$351.90
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200422
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$154.84 |
| Max. Negotiated Rate |
$316.71 |
| Rate for Payer: Aetna American Axle |
$228.74
|
| Rate for Payer: Aetna Commercial |
$299.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.74
|
| Rate for Payer: Cash Price |
$281.52
|
| Rate for Payer: Cofinity Commercial |
$246.33
|
| Rate for Payer: Cofinity Commercial |
$302.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$246.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.52
|
| Rate for Payer: Healthscope Commercial |
$316.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$246.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.12
|
| Rate for Payer: PHP Commercial |
$299.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.74
|
| Rate for Payer: Priority Health SBD |
$221.70
|
| Rate for Payer: UMR Bronson Commercial |
$154.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.93
|
|
|
HC NMO/AQUAPO 4 IGG CBA
|
Facility
|
OP
|
$350.88
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200394
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$315.79 |
| Rate for Payer: Aetna American Axle |
$228.07
|
| Rate for Payer: Aetna Commercial |
$298.25
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$280.70
|
| Rate for Payer: Cash Price |
$280.70
|
| Rate for Payer: Cofinity Commercial |
$301.76
|
| Rate for Payer: Cofinity Commercial |
$245.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$245.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$315.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.16
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.25
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$298.25
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.07
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$221.05
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$23.03
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: UMR Bronson Commercial |
$129.83
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.16
|
|
|
HC NMO/AQUAPO 4 IGG CBA
|
Facility
|
IP
|
$350.88
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200394
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$154.39 |
| Max. Negotiated Rate |
$315.79 |
| Rate for Payer: Aetna American Axle |
$228.07
|
| Rate for Payer: Aetna Commercial |
$298.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.07
|
| Rate for Payer: Cash Price |
$280.70
|
| Rate for Payer: Cofinity Commercial |
$245.62
|
| Rate for Payer: Cofinity Commercial |
$301.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$245.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.70
|
| Rate for Payer: Healthscope Commercial |
$315.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.25
|
| Rate for Payer: PHP Commercial |
$298.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.07
|
| Rate for Payer: Priority Health SBD |
$221.05
|
| Rate for Payer: UMR Bronson Commercial |
$154.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.16
|
|
|
HC NM PARATHYROID SCAN
|
Facility
|
IP
|
$918.71
|
|
|
Service Code
|
CPT 78070
|
| Hospital Charge Code |
34100007
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$404.23 |
| Max. Negotiated Rate |
$826.84 |
| Rate for Payer: Aetna American Axle |
$597.16
|
| Rate for Payer: Aetna Commercial |
$780.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.16
|
| Rate for Payer: Cash Price |
$734.97
|
| Rate for Payer: Cofinity Commercial |
$643.10
|
| Rate for Payer: Cofinity Commercial |
$790.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$643.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.97
|
| Rate for Payer: Healthscope Commercial |
$826.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$643.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$780.90
|
| Rate for Payer: PHP Commercial |
$780.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.16
|
| Rate for Payer: Priority Health SBD |
$578.79
|
| Rate for Payer: UMR Bronson Commercial |
$404.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.03
|
|
|
HC NM PARATHYROID SCAN
|
Facility
|
OP
|
$918.71
|
|
|
Service Code
|
CPT 78070
|
| Hospital Charge Code |
34100007
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$210.06 |
| Max. Negotiated Rate |
$1,103.16 |
| Rate for Payer: Aetna American Axle |
$597.16
|
| Rate for Payer: Aetna Commercial |
$780.90
|
| Rate for Payer: Aetna Medicare |
$407.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.88
|
| Rate for Payer: BCBS Complete |
$220.56
|
| Rate for Payer: BCBS MAPPO |
$391.90
|
| Rate for Payer: BCN Medicare Advantage |
$391.90
|
| Rate for Payer: Cash Price |
$734.97
|
| Rate for Payer: Cash Price |
$734.97
|
| Rate for Payer: Cofinity Commercial |
$790.09
|
| Rate for Payer: Cofinity Commercial |
$643.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$643.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.90
|
| Rate for Payer: Healthscope Commercial |
$826.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$643.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.03
|
| Rate for Payer: Mclaren Medicaid |
$210.06
|
| Rate for Payer: Mclaren Medicare |
$391.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.50
|
| Rate for Payer: Meridian Medicaid |
$220.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$780.90
|
| Rate for Payer: PACE Medicare |
$372.31
|
| Rate for Payer: PACE SWMI |
$391.90
|
| Rate for Payer: PHP Commercial |
$780.90
|
| Rate for Payer: PHP Medicare Advantage |
$391.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.16
|
| Rate for Payer: Priority Health Medicare |
$391.90
|
| Rate for Payer: Priority Health SBD |
$578.79
|
| Rate for Payer: Railroad Medicare Medicare |
$391.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,103.16
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.90
|
| Rate for Payer: UHC Exchange |
$748.96
|
| Rate for Payer: UHC Medicare Advantage |
$391.90
|
| Rate for Payer: UHCCP Medicaid |
$210.06
|
| Rate for Payer: UMR Bronson Commercial |
$339.92
|
| Rate for Payer: VA VA |
$391.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.03
|
|
|
HC NM PARATHYROID SESTAMIBI INJ O
|
Facility
|
IP
|
$408.20
|
|
|
Service Code
|
CPT 78808
|
| Hospital Charge Code |
34100060
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$179.61 |
| Max. Negotiated Rate |
$367.38 |
| Rate for Payer: Aetna American Axle |
$265.33
|
| Rate for Payer: Aetna Commercial |
$346.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.33
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cofinity Commercial |
$285.74
|
| Rate for Payer: Cofinity Commercial |
$351.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$285.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.56
|
| Rate for Payer: Healthscope Commercial |
$367.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$285.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.97
|
| Rate for Payer: PHP Commercial |
$346.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.33
|
| Rate for Payer: Priority Health SBD |
$257.17
|
| Rate for Payer: UMR Bronson Commercial |
$179.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.15
|
|
|
HC NM PARATHYROID SESTAMIBI INJ O
|
Facility
|
OP
|
$408.20
|
|
|
Service Code
|
CPT 78808
|
| Hospital Charge Code |
34100060
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$151.03 |
| Max. Negotiated Rate |
$1,103.16 |
| Rate for Payer: Aetna American Axle |
$265.33
|
| Rate for Payer: Aetna Commercial |
$346.97
|
| Rate for Payer: Aetna Medicare |
$407.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.88
|
| Rate for Payer: BCBS Complete |
$220.56
|
| Rate for Payer: BCBS MAPPO |
$391.90
|
| Rate for Payer: BCN Medicare Advantage |
$391.90
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cofinity Commercial |
$351.05
|
| Rate for Payer: Cofinity Commercial |
$285.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$285.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.90
|
| Rate for Payer: Healthscope Commercial |
$367.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$285.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.15
|
| Rate for Payer: Mclaren Medicaid |
$210.06
|
| Rate for Payer: Mclaren Medicare |
$391.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.50
|
| Rate for Payer: Meridian Medicaid |
$220.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.97
|
| Rate for Payer: PACE Medicare |
$372.31
|
| Rate for Payer: PACE SWMI |
$391.90
|
| Rate for Payer: PHP Commercial |
$346.97
|
| Rate for Payer: PHP Medicare Advantage |
$391.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.33
|
| Rate for Payer: Priority Health Medicare |
$391.90
|
| Rate for Payer: Priority Health SBD |
$257.17
|
| Rate for Payer: Railroad Medicare Medicare |
$391.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,103.16
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.90
|
| Rate for Payer: UHC Exchange |
$748.96
|
| Rate for Payer: UHC Medicare Advantage |
$391.90
|
| Rate for Payer: UHCCP Medicaid |
$210.06
|
| Rate for Payer: UMR Bronson Commercial |
$151.03
|
| Rate for Payer: VA VA |
$391.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.15
|
|
|
HC NM PARATHYROID SPECT SCAN
|
Facility
|
OP
|
$1,032.12
|
|
|
Service Code
|
CPT 78071
|
| Hospital Charge Code |
34100077
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$210.06 |
| Max. Negotiated Rate |
$1,103.16 |
| Rate for Payer: Aetna American Axle |
$670.88
|
| Rate for Payer: Aetna Commercial |
$877.30
|
| Rate for Payer: Aetna Medicare |
$407.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.88
|
| Rate for Payer: BCBS Complete |
$220.56
|
| Rate for Payer: BCBS MAPPO |
$391.90
|
| Rate for Payer: BCN Medicare Advantage |
$391.90
|
| Rate for Payer: Cash Price |
$825.70
|
| Rate for Payer: Cash Price |
$825.70
|
| Rate for Payer: Cofinity Commercial |
$887.62
|
| Rate for Payer: Cofinity Commercial |
$722.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$722.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.90
|
| Rate for Payer: Healthscope Commercial |
$928.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$722.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$774.09
|
| Rate for Payer: Mclaren Medicaid |
$210.06
|
| Rate for Payer: Mclaren Medicare |
$391.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.50
|
| Rate for Payer: Meridian Medicaid |
$220.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$877.30
|
| Rate for Payer: PACE Medicare |
$372.31
|
| Rate for Payer: PACE SWMI |
$391.90
|
| Rate for Payer: PHP Commercial |
$877.30
|
| Rate for Payer: PHP Medicare Advantage |
$391.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$670.88
|
| Rate for Payer: Priority Health Medicare |
$391.90
|
| Rate for Payer: Priority Health SBD |
$650.24
|
| Rate for Payer: Railroad Medicare Medicare |
$391.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,103.16
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.90
|
| Rate for Payer: UHC Exchange |
$748.96
|
| Rate for Payer: UHC Medicare Advantage |
$391.90
|
| Rate for Payer: UHCCP Medicaid |
$210.06
|
| Rate for Payer: UMR Bronson Commercial |
$381.88
|
| Rate for Payer: VA VA |
$391.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$774.09
|
|
|
HC NM PARATHYROID SPECT SCAN
|
Facility
|
IP
|
$1,032.12
|
|
|
Service Code
|
CPT 78071
|
| Hospital Charge Code |
34100077
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$454.13 |
| Max. Negotiated Rate |
$928.91 |
| Rate for Payer: Aetna American Axle |
$670.88
|
| Rate for Payer: Aetna Commercial |
$877.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.88
|
| Rate for Payer: Cash Price |
$825.70
|
| Rate for Payer: Cofinity Commercial |
$722.48
|
| Rate for Payer: Cofinity Commercial |
$887.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$722.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.70
|
| Rate for Payer: Healthscope Commercial |
$928.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$722.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$774.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$877.30
|
| Rate for Payer: PHP Commercial |
$877.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$670.88
|
| Rate for Payer: Priority Health SBD |
$650.24
|
| Rate for Payer: UMR Bronson Commercial |
$454.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$774.09
|
|
|
HC NM PERFUSION QUANTITATIVE DIFF
|
Facility
|
OP
|
$1,219.18
|
|
|
Service Code
|
CPT 78597
|
| Hospital Charge Code |
34100069
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$210.06 |
| Max. Negotiated Rate |
$1,103.16 |
| Rate for Payer: Aetna American Axle |
$792.47
|
| Rate for Payer: Aetna Commercial |
$1,036.30
|
| Rate for Payer: Aetna Medicare |
$407.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$792.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.88
|
| Rate for Payer: BCBS Complete |
$220.56
|
| Rate for Payer: BCBS MAPPO |
$391.90
|
| Rate for Payer: BCN Medicare Advantage |
$391.90
|
| Rate for Payer: Cash Price |
$975.34
|
| Rate for Payer: Cash Price |
$975.34
|
| Rate for Payer: Cofinity Commercial |
$853.43
|
| Rate for Payer: Cofinity Commercial |
$1,048.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$853.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$975.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.90
|
| Rate for Payer: Healthscope Commercial |
$1,097.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$853.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$914.38
|
| Rate for Payer: Mclaren Medicaid |
$210.06
|
| Rate for Payer: Mclaren Medicare |
$391.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.50
|
| Rate for Payer: Meridian Medicaid |
$220.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,036.30
|
| Rate for Payer: PACE Medicare |
$372.31
|
| Rate for Payer: PACE SWMI |
$391.90
|
| Rate for Payer: PHP Commercial |
$1,036.30
|
| Rate for Payer: PHP Medicare Advantage |
$391.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$792.47
|
| Rate for Payer: Priority Health Medicare |
$391.90
|
| Rate for Payer: Priority Health SBD |
$768.08
|
| Rate for Payer: Railroad Medicare Medicare |
$391.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,103.16
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.90
|
| Rate for Payer: UHC Exchange |
$748.96
|
| Rate for Payer: UHC Medicare Advantage |
$391.90
|
| Rate for Payer: UHCCP Medicaid |
$210.06
|
| Rate for Payer: UMR Bronson Commercial |
$451.10
|
| Rate for Payer: VA VA |
$391.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$914.38
|
|
|
HC NM PERFUSION QUANTITATIVE DIFF
|
Facility
|
IP
|
$1,219.18
|
|
|
Service Code
|
CPT 78597
|
| Hospital Charge Code |
34100069
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$536.44 |
| Max. Negotiated Rate |
$1,097.26 |
| Rate for Payer: Aetna American Axle |
$792.47
|
| Rate for Payer: Aetna Commercial |
$1,036.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$792.47
|
| Rate for Payer: Cash Price |
$975.34
|
| Rate for Payer: Cofinity Commercial |
$1,048.49
|
| Rate for Payer: Cofinity Commercial |
$853.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$853.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$975.34
|
| Rate for Payer: Healthscope Commercial |
$1,097.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$853.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$914.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,036.30
|
| Rate for Payer: PHP Commercial |
$1,036.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$792.47
|
| Rate for Payer: Priority Health SBD |
$768.08
|
| Rate for Payer: UMR Bronson Commercial |
$536.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$914.38
|
|
|
HC NM RADIOPHARM INTRACAVITARY AD
|
Facility
|
IP
|
$777.71
|
|
|
Service Code
|
CPT 79200
|
| Hospital Charge Code |
34100064
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$342.19 |
| Max. Negotiated Rate |
$699.94 |
| Rate for Payer: Aetna American Axle |
$505.51
|
| Rate for Payer: Aetna Commercial |
$661.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.51
|
| Rate for Payer: Cash Price |
$622.17
|
| Rate for Payer: Cofinity Commercial |
$544.40
|
| Rate for Payer: Cofinity Commercial |
$668.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$544.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.17
|
| Rate for Payer: Healthscope Commercial |
$699.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$544.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$583.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$661.05
|
| Rate for Payer: PHP Commercial |
$661.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.51
|
| Rate for Payer: Priority Health SBD |
$489.96
|
| Rate for Payer: UMR Bronson Commercial |
$342.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$583.28
|
|
