|
HC NM TUMOR SCAN SPECT
|
Facility
|
OP
|
$1,975.72
|
|
|
Service Code
|
CPT 78803
|
| Hospital Charge Code |
34100056
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$314.86 |
| Max. Negotiated Rate |
$4,020.13 |
| Rate for Payer: Aetna American Axle |
$1,284.22
|
| Rate for Payer: Aetna Commercial |
$1,679.36
|
| Rate for Payer: Aetna Medicare |
$1,330.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,284.22
|
| 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 |
$611.65
|
| Rate for Payer: BCN Commercial |
$611.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,279.08
|
| Rate for Payer: Cash Price |
$1,580.58
|
| Rate for Payer: Cash Price |
$1,580.58
|
| Rate for Payer: Cofinity Commercial |
$1,699.12
|
| Rate for Payer: Cofinity Commercial |
$1,383.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,383.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,580.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,279.08
|
| Rate for Payer: Healthscope Commercial |
$1,778.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,383.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,481.79
|
| 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 |
$1,679.36
|
| 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 |
$1,679.36
|
| 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 |
$1,284.22
|
| 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 |
$1,244.70
|
| Rate for Payer: Railroad Medicare Medicare |
$1,279.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$346.35
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,279.08
|
| Rate for Payer: UHC Exchange |
$314.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,279.08
|
| Rate for Payer: UHCCP Medicaid |
$685.59
|
| Rate for Payer: UMR Bronson Commercial |
$731.02
|
| Rate for Payer: VA VA |
$1,279.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,481.79
|
|
|
HC NM TUMOR SCAN SPECT
|
Facility
|
IP
|
$1,975.72
|
|
|
Service Code
|
CPT 78803
|
| Hospital Charge Code |
34100056
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$869.32 |
| Max. Negotiated Rate |
$1,778.15 |
| Rate for Payer: Aetna American Axle |
$1,284.22
|
| Rate for Payer: Aetna Commercial |
$1,679.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,284.22
|
| Rate for Payer: Cash Price |
$1,580.58
|
| Rate for Payer: Cofinity Commercial |
$1,383.00
|
| Rate for Payer: Cofinity Commercial |
$1,699.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,383.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,580.58
|
| Rate for Payer: Healthscope Commercial |
$1,778.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,383.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,481.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,679.36
|
| Rate for Payer: PHP Commercial |
$1,679.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,284.22
|
| Rate for Payer: Priority Health SBD |
$1,244.70
|
| Rate for Payer: UMR Bronson Commercial |
$869.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,481.79
|
|
|
HC NM UNLISTED PROC ENDOCRINE S
|
Facility
|
OP
|
$1,757.18
|
|
|
Service Code
|
CPT 60699
|
| Hospital Charge Code |
36100267
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$650.16 |
| Max. Negotiated Rate |
$17,966.53 |
| Rate for Payer: Aetna American Axle |
$1,142.17
|
| Rate for Payer: Aetna Commercial |
$1,493.60
|
| Rate for Payer: Aetna Medicare |
$5,945.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,142.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,145.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,145.49
|
| Rate for Payer: BCBS Complete |
$3,217.18
|
| Rate for Payer: BCBS MAPPO |
$5,716.39
|
| Rate for Payer: BCBS Trust/PPO |
$3,921.92
|
| Rate for Payer: BCN Commercial |
$3,921.92
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$1,405.74
|
| Rate for Payer: Cash Price |
$1,405.74
|
| Rate for Payer: Cash Price |
$1,405.74
|
| Rate for Payer: Cofinity Commercial |
$1,511.17
|
| Rate for Payer: Cofinity Commercial |
$1,230.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,230.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,405.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Healthscope Commercial |
$1,581.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,230.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,317.88
|
| Rate for Payer: Mclaren Medicaid |
$3,063.99
|
| Rate for Payer: Mclaren Medicare |
$5,716.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,002.21
|
| Rate for Payer: Meridian Medicaid |
$3,217.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,573.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,493.60
|
| Rate for Payer: Nomi Health Commercial |
$12,004.42
|
| Rate for Payer: PACE Medicare |
$5,430.57
|
| Rate for Payer: PACE SWMI |
$5,716.39
|
| Rate for Payer: PHP Commercial |
$1,493.60
|
| Rate for Payer: PHP Medicare Advantage |
$5,716.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,063.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,142.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,966.53
|
| Rate for Payer: Priority Health Medicare |
$5,716.39
|
| Rate for Payer: Priority Health Narrow Network |
$14,373.22
|
| Rate for Payer: Priority Health SBD |
$1,107.02
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,091.07
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,716.39
|
| Rate for Payer: UHC Exchange |
$10,924.59
|
| Rate for Payer: UHC Medicare Advantage |
$5,716.39
|
| Rate for Payer: UHCCP Medicaid |
$3,063.99
|
| Rate for Payer: UMR Bronson Commercial |
$650.16
|
| Rate for Payer: VA VA |
$5,716.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,317.88
|
|
|
HC NM UNLISTED PROC ENDOCRINE S
|
Facility
|
IP
|
$1,757.18
|
|
|
Service Code
|
CPT 60699
|
| Hospital Charge Code |
36100267
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$773.16 |
| Max. Negotiated Rate |
$1,581.46 |
| Rate for Payer: Aetna American Axle |
$1,142.17
|
| Rate for Payer: Aetna Commercial |
$1,493.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,142.17
|
| Rate for Payer: Cash Price |
$1,405.74
|
| Rate for Payer: Cofinity Commercial |
$1,230.03
|
| Rate for Payer: Cofinity Commercial |
$1,511.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,230.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,405.74
|
| Rate for Payer: Healthscope Commercial |
$1,581.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,230.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,317.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,493.60
|
| Rate for Payer: PHP Commercial |
$1,493.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,142.17
|
| Rate for Payer: Priority Health SBD |
$1,107.02
|
| Rate for Payer: UMR Bronson Commercial |
$773.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,317.88
|
|
|
HC NM VENT AEROSOL/GAS AND PERFUS
|
Facility
|
OP
|
$1,666.35
|
|
|
Service Code
|
CPT 78582
|
| Hospital Charge Code |
34100068
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$275.43 |
| Max. Negotiated Rate |
$1,657.56 |
| Rate for Payer: Aetna American Axle |
$1,083.13
|
| Rate for Payer: Aetna Commercial |
$1,416.40
|
| Rate for Payer: Aetna Medicare |
$548.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,083.13
|
| 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 |
$522.02
|
| Rate for Payer: BCN Commercial |
$522.02
|
| Rate for Payer: BCN Medicare Advantage |
$527.39
|
| Rate for Payer: Cash Price |
$1,333.08
|
| Rate for Payer: Cash Price |
$1,333.08
|
| Rate for Payer: Cofinity Commercial |
$1,433.06
|
| Rate for Payer: Cofinity Commercial |
$1,166.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,166.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,333.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.39
|
| Rate for Payer: Healthscope Commercial |
$1,499.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,166.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,249.76
|
| 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 |
$1,416.40
|
| 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 |
$1,416.40
|
| 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 |
$1,083.13
|
| 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 |
$1,049.80
|
| Rate for Payer: Railroad Medicare Medicare |
$527.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.97
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.39
|
| Rate for Payer: UHC Exchange |
$275.43
|
| Rate for Payer: UHC Medicare Advantage |
$527.39
|
| Rate for Payer: UHCCP Medicaid |
$282.68
|
| Rate for Payer: UMR Bronson Commercial |
$616.55
|
| Rate for Payer: VA VA |
$527.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,249.76
|
|
|
HC NM VENT AEROSOL/GAS AND PERFUS
|
Facility
|
IP
|
$1,666.35
|
|
|
Service Code
|
CPT 78582
|
| Hospital Charge Code |
34100068
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$733.19 |
| Max. Negotiated Rate |
$1,499.72 |
| Rate for Payer: Aetna American Axle |
$1,083.13
|
| Rate for Payer: Aetna Commercial |
$1,416.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,083.13
|
| Rate for Payer: Cash Price |
$1,333.08
|
| Rate for Payer: Cofinity Commercial |
$1,166.44
|
| Rate for Payer: Cofinity Commercial |
$1,433.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,166.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,333.08
|
| Rate for Payer: Healthscope Commercial |
$1,499.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,166.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,249.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,416.40
|
| Rate for Payer: PHP Commercial |
$1,416.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,083.13
|
| Rate for Payer: Priority Health SBD |
$1,049.80
|
| Rate for Payer: UMR Bronson Commercial |
$733.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,249.76
|
|
|
HC NM VENTILATION AEROSOL OR GAS
|
Facility
|
IP
|
$1,219.18
|
|
|
Service Code
|
CPT 78579
|
| Hospital Charge Code |
34100071
|
|
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 VENTILATION AEROSOL OR GAS
|
Facility
|
OP
|
$1,219.18
|
|
|
Service Code
|
CPT 78579
|
| Hospital Charge Code |
34100071
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$156.08 |
| Max. Negotiated Rate |
$1,237.41 |
| Rate for Payer: Aetna American Axle |
$792.47
|
| Rate for Payer: Aetna Commercial |
$1,036.30
|
| Rate for Payer: Aetna Medicare |
$409.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$792.47
|
| 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 |
$307.88
|
| Rate for Payer: BCN Commercial |
$307.88
|
| Rate for Payer: BCN Medicare Advantage |
$393.70
|
| 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 |
$393.70
|
| 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 |
$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 |
$1,036.30
|
| 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 |
$1,036.30
|
| 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 |
$792.47
|
| 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 |
$768.08
|
| Rate for Payer: Railroad Medicare Medicare |
$393.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.69
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.70
|
| Rate for Payer: UHC Exchange |
$156.08
|
| Rate for Payer: UHC Medicare Advantage |
$393.70
|
| Rate for Payer: UHCCP Medicaid |
$211.02
|
| Rate for Payer: UMR Bronson Commercial |
$451.10
|
| Rate for Payer: VA VA |
$393.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$914.38
|
|
|
HC NM VENTILATION PERFUS QUANT DIFF
|
Facility
|
OP
|
$1,666.35
|
|
|
Service Code
|
CPT 78598
|
| Hospital Charge Code |
34100070
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$249.56 |
| Max. Negotiated Rate |
$1,657.56 |
| Rate for Payer: Aetna American Axle |
$1,083.13
|
| Rate for Payer: Aetna Commercial |
$1,416.40
|
| Rate for Payer: Aetna Medicare |
$548.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,083.13
|
| 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 |
$487.13
|
| Rate for Payer: BCN Commercial |
$487.13
|
| Rate for Payer: BCN Medicare Advantage |
$527.39
|
| Rate for Payer: Cash Price |
$1,333.08
|
| Rate for Payer: Cash Price |
$1,333.08
|
| Rate for Payer: Cofinity Commercial |
$1,433.06
|
| Rate for Payer: Cofinity Commercial |
$1,166.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,166.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,333.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.39
|
| Rate for Payer: Healthscope Commercial |
$1,499.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,166.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,249.76
|
| 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 |
$1,416.40
|
| 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 |
$1,416.40
|
| 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 |
$1,083.13
|
| 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 |
$1,049.80
|
| Rate for Payer: Railroad Medicare Medicare |
$527.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$274.52
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.39
|
| Rate for Payer: UHC Exchange |
$249.56
|
| Rate for Payer: UHC Medicare Advantage |
$527.39
|
| Rate for Payer: UHCCP Medicaid |
$282.68
|
| Rate for Payer: UMR Bronson Commercial |
$616.55
|
| Rate for Payer: VA VA |
$527.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,249.76
|
|
|
HC NM VENTILATION PERFUS QUANT DIFF
|
Facility
|
IP
|
$1,666.35
|
|
|
Service Code
|
CPT 78598
|
| Hospital Charge Code |
34100070
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$733.19 |
| Max. Negotiated Rate |
$1,499.72 |
| Rate for Payer: Aetna American Axle |
$1,083.13
|
| Rate for Payer: Aetna Commercial |
$1,416.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,083.13
|
| Rate for Payer: Cash Price |
$1,333.08
|
| Rate for Payer: Cofinity Commercial |
$1,166.44
|
| Rate for Payer: Cofinity Commercial |
$1,433.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,166.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,333.08
|
| Rate for Payer: Healthscope Commercial |
$1,499.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,166.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,249.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,416.40
|
| Rate for Payer: PHP Commercial |
$1,416.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,083.13
|
| Rate for Payer: Priority Health SBD |
$1,049.80
|
| Rate for Payer: UMR Bronson Commercial |
$733.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,249.76
|
|
|
HC NM VOID CYSTO
|
Facility
|
IP
|
$1,069.28
|
|
|
Service Code
|
CPT 78740
|
| Hospital Charge Code |
34100049
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$470.48 |
| Max. Negotiated Rate |
$962.35 |
| Rate for Payer: Aetna American Axle |
$695.03
|
| Rate for Payer: Aetna Commercial |
$908.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$695.03
|
| Rate for Payer: Cash Price |
$855.42
|
| Rate for Payer: Cofinity Commercial |
$748.50
|
| Rate for Payer: Cofinity Commercial |
$919.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$748.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.42
|
| Rate for Payer: Healthscope Commercial |
$962.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$748.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$801.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.89
|
| Rate for Payer: PHP Commercial |
$908.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.03
|
| Rate for Payer: Priority Health SBD |
$673.65
|
| Rate for Payer: UMR Bronson Commercial |
$470.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$801.96
|
|
|
HC NM VOID CYSTO
|
Facility
|
OP
|
$1,069.28
|
|
|
Service Code
|
CPT 78740
|
| Hospital Charge Code |
34100049
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$190.40 |
| Max. Negotiated Rate |
$1,237.41 |
| Rate for Payer: Aetna American Axle |
$695.03
|
| Rate for Payer: Aetna Commercial |
$908.89
|
| Rate for Payer: Aetna Medicare |
$409.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$695.03
|
| 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 |
$378.35
|
| Rate for Payer: BCN Commercial |
$378.35
|
| Rate for Payer: BCN Medicare Advantage |
$393.70
|
| Rate for Payer: Cash Price |
$855.42
|
| Rate for Payer: Cash Price |
$855.42
|
| Rate for Payer: Cofinity Commercial |
$919.58
|
| Rate for Payer: Cofinity Commercial |
$748.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$748.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.70
|
| Rate for Payer: Healthscope Commercial |
$962.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$748.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$801.96
|
| 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 |
$908.89
|
| 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 |
$908.89
|
| 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 |
$695.03
|
| 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 |
$673.65
|
| Rate for Payer: Railroad Medicare Medicare |
$393.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.44
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.70
|
| Rate for Payer: UHC Exchange |
$190.40
|
| Rate for Payer: UHC Medicare Advantage |
$393.70
|
| Rate for Payer: UHCCP Medicaid |
$211.02
|
| Rate for Payer: UMR Bronson Commercial |
$395.63
|
| Rate for Payer: VA VA |
$393.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$801.96
|
|
|
HC NM ZEVALIN Y-90 THERAPY
|
Facility
|
OP
|
$1,939.87
|
|
|
Service Code
|
CPT 79403
|
| Hospital Charge Code |
34100065
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$117.71 |
| Max. Negotiated Rate |
$1,745.88 |
| Rate for Payer: Aetna American Axle |
$1,260.92
|
| Rate for Payer: Aetna Commercial |
$1,648.89
|
| Rate for Payer: Aetna Medicare |
$228.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,260.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.50
|
| Rate for Payer: BCBS Complete |
$123.59
|
| Rate for Payer: BCBS MAPPO |
$219.60
|
| Rate for Payer: BCBS Trust/PPO |
$207.31
|
| Rate for Payer: BCN Commercial |
$207.31
|
| Rate for Payer: BCN Medicare Advantage |
$219.60
|
| Rate for Payer: Cash Price |
$1,551.90
|
| Rate for Payer: Cash Price |
$1,551.90
|
| Rate for Payer: Cofinity Commercial |
$1,668.29
|
| Rate for Payer: Cofinity Commercial |
$1,357.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,357.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,551.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.60
|
| Rate for Payer: Healthscope Commercial |
$1,745.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,357.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,454.90
|
| Rate for Payer: Mclaren Medicaid |
$117.71
|
| Rate for Payer: Mclaren Medicare |
$219.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$230.58
|
| Rate for Payer: Meridian Medicaid |
$123.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,648.89
|
| Rate for Payer: Nomi Health Commercial |
$658.80
|
| Rate for Payer: PACE Medicare |
$208.62
|
| Rate for Payer: PACE SWMI |
$219.60
|
| Rate for Payer: PHP Commercial |
$1,648.89
|
| Rate for Payer: PHP Medicare Advantage |
$219.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,260.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$690.18
|
| Rate for Payer: Priority Health Medicare |
$219.60
|
| Rate for Payer: Priority Health Narrow Network |
$552.14
|
| Rate for Payer: Priority Health SBD |
$1,222.12
|
| Rate for Payer: Railroad Medicare Medicare |
$219.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.08
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.60
|
| Rate for Payer: UHC Exchange |
$194.62
|
| Rate for Payer: UHC Medicare Advantage |
$219.60
|
| Rate for Payer: UHCCP Medicaid |
$117.71
|
| Rate for Payer: UMR Bronson Commercial |
$717.75
|
| Rate for Payer: VA VA |
$219.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,454.90
|
|
|
HC NM ZEVALIN Y-90 THERAPY
|
Facility
|
IP
|
$1,939.87
|
|
|
Service Code
|
CPT 79403
|
| Hospital Charge Code |
34100065
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$853.54 |
| Max. Negotiated Rate |
$1,745.88 |
| Rate for Payer: Aetna American Axle |
$1,260.92
|
| Rate for Payer: Aetna Commercial |
$1,648.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,260.92
|
| Rate for Payer: Cash Price |
$1,551.90
|
| Rate for Payer: Cofinity Commercial |
$1,357.91
|
| Rate for Payer: Cofinity Commercial |
$1,668.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,357.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,551.90
|
| Rate for Payer: Healthscope Commercial |
$1,745.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,357.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,454.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,648.89
|
| Rate for Payer: PHP Commercial |
$1,648.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,260.92
|
| Rate for Payer: Priority Health SBD |
$1,222.12
|
| Rate for Payer: UMR Bronson Commercial |
$853.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,454.90
|
|
|
HC NO IMPLANT/INSERT DEVICE W/DEVICE-INTENS PROC
|
Facility
|
IP
|
$1.02
|
|
|
Service Code
|
HCPCS C1890
|
| Hospital Charge Code |
27800125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$0.92 |
| Rate for Payer: Aetna American Axle |
$0.66
|
| Rate for Payer: Aetna Commercial |
$0.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.66
|
| Rate for Payer: Cash Price |
$0.82
|
| Rate for Payer: Cofinity Commercial |
$0.71
|
| Rate for Payer: Cofinity Commercial |
$0.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.82
|
| Rate for Payer: Healthscope Commercial |
$0.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.87
|
| Rate for Payer: PHP Commercial |
$0.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.66
|
| Rate for Payer: Priority Health SBD |
$0.64
|
| Rate for Payer: UMR Bronson Commercial |
$0.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.77
|
|
|
HC NO IMPLANT/INSERT DEVICE W/DEVICE-INTENS PROC
|
Facility
|
OP
|
$1.02
|
|
|
Service Code
|
HCPCS C1890
|
| Hospital Charge Code |
27800125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$0.92 |
| Rate for Payer: Aetna American Axle |
$0.66
|
| Rate for Payer: Aetna Commercial |
$0.87
|
| Rate for Payer: Aetna Medicare |
$0.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.66
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: Cash Price |
$0.82
|
| Rate for Payer: Cofinity Commercial |
$0.71
|
| Rate for Payer: Cofinity Commercial |
$0.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.82
|
| Rate for Payer: Healthscope Commercial |
$0.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.87
|
| Rate for Payer: PHP Commercial |
$0.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.66
|
| Rate for Payer: Priority Health SBD |
$0.64
|
| Rate for Payer: UMR Bronson Commercial |
$0.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.77
|
|
|
HC NONCONC SLIDES W/INTERP
|
Facility
|
OP
|
$87.30
|
|
|
Service Code
|
CPT 88104
|
| Hospital Charge Code |
31100001
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$20.61 |
| Max. Negotiated Rate |
$120.87 |
| Rate for Payer: Aetna American Axle |
$56.74
|
| Rate for Payer: Aetna Commercial |
$74.20
|
| Rate for Payer: Aetna Medicare |
$40.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.08
|
| Rate for Payer: BCBS Complete |
$21.65
|
| Rate for Payer: BCBS MAPPO |
$38.46
|
| Rate for Payer: BCBS Trust/PPO |
$75.43
|
| Rate for Payer: BCN Commercial |
$75.43
|
| Rate for Payer: BCN Medicare Advantage |
$38.46
|
| Rate for Payer: Cash Price |
$69.84
|
| Rate for Payer: Cash Price |
$69.84
|
| Rate for Payer: Cofinity Commercial |
$75.08
|
| Rate for Payer: Cofinity Commercial |
$61.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$61.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.46
|
| Rate for Payer: Healthscope Commercial |
$78.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.48
|
| Rate for Payer: Mclaren Medicaid |
$20.61
|
| Rate for Payer: Mclaren Medicare |
$38.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.38
|
| Rate for Payer: Meridian Medicaid |
$21.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.20
|
| Rate for Payer: Nomi Health Commercial |
$115.38
|
| Rate for Payer: PACE Medicare |
$36.54
|
| Rate for Payer: PACE SWMI |
$38.46
|
| Rate for Payer: PHP Commercial |
$74.20
|
| Rate for Payer: PHP Medicare Advantage |
$38.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$120.87
|
| Rate for Payer: Priority Health Medicare |
$38.46
|
| Rate for Payer: Priority Health Narrow Network |
$96.70
|
| Rate for Payer: Priority Health SBD |
$55.00
|
| Rate for Payer: Railroad Medicare Medicare |
$38.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.46
|
| Rate for Payer: UHC Exchange |
$69.60
|
| Rate for Payer: UHC Medicare Advantage |
$38.46
|
| Rate for Payer: UHCCP Medicaid |
$20.61
|
| Rate for Payer: UMR Bronson Commercial |
$32.30
|
| Rate for Payer: VA VA |
$38.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.48
|
|
|
HC NONCONC SLIDES W/INTERP
|
Facility
|
IP
|
$87.30
|
|
|
Service Code
|
CPT 88104
|
| Hospital Charge Code |
31100001
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$38.41 |
| Max. Negotiated Rate |
$78.57 |
| Rate for Payer: Aetna American Axle |
$56.74
|
| Rate for Payer: Aetna Commercial |
$74.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.74
|
| Rate for Payer: Cash Price |
$69.84
|
| Rate for Payer: Cofinity Commercial |
$61.11
|
| Rate for Payer: Cofinity Commercial |
$75.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$61.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.84
|
| Rate for Payer: Healthscope Commercial |
$78.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.20
|
| Rate for Payer: PHP Commercial |
$74.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.74
|
| Rate for Payer: Priority Health SBD |
$55.00
|
| Rate for Payer: UMR Bronson Commercial |
$38.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.48
|
|
|
HC NONINVASIVE PROGRAM STIM
|
Facility
|
IP
|
$2,469.74
|
|
|
Service Code
|
CPT 93642
|
| Hospital Charge Code |
48100043
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,086.69 |
| Max. Negotiated Rate |
$2,222.77 |
| Rate for Payer: Aetna American Axle |
$1,605.33
|
| Rate for Payer: Aetna Commercial |
$2,099.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,605.33
|
| Rate for Payer: Cash Price |
$1,975.79
|
| Rate for Payer: Cofinity Commercial |
$1,728.82
|
| Rate for Payer: Cofinity Commercial |
$2,123.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,728.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,975.79
|
| Rate for Payer: Healthscope Commercial |
$2,222.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,728.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,852.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,099.28
|
| Rate for Payer: PHP Commercial |
$2,099.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,605.33
|
| Rate for Payer: Priority Health SBD |
$1,555.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,086.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,852.30
|
|
|
HC NONINVASIVE PROGRAM STIM
|
Facility
|
OP
|
$2,469.74
|
|
|
Service Code
|
CPT 93642
|
| Hospital Charge Code |
48100043
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$312.82 |
| Max. Negotiated Rate |
$3,738.41 |
| Rate for Payer: Aetna American Axle |
$1,605.33
|
| Rate for Payer: Aetna Commercial |
$2,099.28
|
| Rate for Payer: Aetna Medicare |
$1,237.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,605.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,486.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,486.80
|
| Rate for Payer: BCBS Complete |
$669.42
|
| Rate for Payer: BCBS MAPPO |
$1,189.44
|
| Rate for Payer: BCBS Trust/PPO |
$345.33
|
| Rate for Payer: BCN Commercial |
$345.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,189.44
|
| Rate for Payer: Cash Price |
$1,975.79
|
| Rate for Payer: Cash Price |
$1,975.79
|
| Rate for Payer: Cash Price |
$1,975.79
|
| Rate for Payer: Cofinity Commercial |
$2,123.98
|
| Rate for Payer: Cofinity Commercial |
$1,728.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,728.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,975.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,189.44
|
| Rate for Payer: Healthscope Commercial |
$2,222.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,728.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,852.30
|
| Rate for Payer: Mclaren Medicaid |
$637.54
|
| Rate for Payer: Mclaren Medicare |
$1,189.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,248.91
|
| Rate for Payer: Meridian Medicaid |
$669.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,367.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,099.28
|
| Rate for Payer: Nomi Health Commercial |
$2,497.82
|
| Rate for Payer: PACE Medicare |
$1,129.97
|
| Rate for Payer: PACE SWMI |
$1,189.44
|
| Rate for Payer: PHP Commercial |
$2,099.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,189.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$637.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,605.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,738.41
|
| Rate for Payer: Priority Health Medicare |
$1,189.44
|
| Rate for Payer: Priority Health Narrow Network |
$2,990.73
|
| Rate for Payer: Priority Health SBD |
$1,555.94
|
| Rate for Payer: Railroad Medicare Medicare |
$1,189.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$344.10
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,189.44
|
| Rate for Payer: UHC Exchange |
$312.82
|
| Rate for Payer: UHC Medicare Advantage |
$1,189.44
|
| Rate for Payer: UHCCP Medicaid |
$637.54
|
| Rate for Payer: UMR Bronson Commercial |
$913.80
|
| Rate for Payer: VA VA |
$1,189.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,852.30
|
|
|
HC NON OPEN HEART PLATELET MAPPING
|
Facility
|
OP
|
$1,132.67
|
|
| Hospital Charge Code |
27000389
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$419.09 |
| Max. Negotiated Rate |
$1,019.40 |
| Rate for Payer: Aetna American Axle |
$736.24
|
| Rate for Payer: Aetna Commercial |
$962.77
|
| Rate for Payer: Aetna Medicare |
$566.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$736.24
|
| Rate for Payer: BCBS Complete |
$453.07
|
| Rate for Payer: Cash Price |
$906.14
|
| Rate for Payer: Cofinity Commercial |
$792.87
|
| Rate for Payer: Cofinity Commercial |
$974.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$792.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$906.14
|
| Rate for Payer: Healthscope Commercial |
$1,019.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$792.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$849.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$962.77
|
| Rate for Payer: PHP Commercial |
$962.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$736.24
|
| Rate for Payer: Priority Health SBD |
$713.58
|
| Rate for Payer: UMR Bronson Commercial |
$419.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$849.50
|
|
|
HC NON OPEN HEART PLATELET MAPPING
|
Facility
|
IP
|
$1,132.67
|
|
| Hospital Charge Code |
27000389
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$498.37 |
| Max. Negotiated Rate |
$1,019.40 |
| Rate for Payer: Aetna American Axle |
$736.24
|
| Rate for Payer: Aetna Commercial |
$962.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$736.24
|
| Rate for Payer: Cash Price |
$906.14
|
| Rate for Payer: Cofinity Commercial |
$792.87
|
| Rate for Payer: Cofinity Commercial |
$974.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$792.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$906.14
|
| Rate for Payer: Healthscope Commercial |
$1,019.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$792.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$849.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$962.77
|
| Rate for Payer: PHP Commercial |
$962.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$736.24
|
| Rate for Payer: Priority Health SBD |
$713.58
|
| Rate for Payer: UMR Bronson Commercial |
$498.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$849.50
|
|
|
HC NON OPEN HEART TEG
|
Facility
|
IP
|
$924.31
|
|
| Hospital Charge Code |
27000197
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$406.70 |
| Max. Negotiated Rate |
$831.88 |
| Rate for Payer: Aetna American Axle |
$600.80
|
| Rate for Payer: Aetna Commercial |
$785.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$600.80
|
| Rate for Payer: Cash Price |
$739.45
|
| Rate for Payer: Cofinity Commercial |
$647.02
|
| Rate for Payer: Cofinity Commercial |
$794.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$647.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.45
|
| Rate for Payer: Healthscope Commercial |
$831.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$647.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$693.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.66
|
| Rate for Payer: PHP Commercial |
$785.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.80
|
| Rate for Payer: Priority Health SBD |
$582.32
|
| Rate for Payer: UMR Bronson Commercial |
$406.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$693.23
|
|
|
HC NON OPEN HEART TEG
|
Facility
|
OP
|
$924.31
|
|
| Hospital Charge Code |
27000197
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$341.99 |
| Max. Negotiated Rate |
$831.88 |
| Rate for Payer: Aetna American Axle |
$600.80
|
| Rate for Payer: Aetna Commercial |
$785.66
|
| Rate for Payer: Aetna Medicare |
$462.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$600.80
|
| Rate for Payer: BCBS Complete |
$369.72
|
| Rate for Payer: Cash Price |
$739.45
|
| Rate for Payer: Cofinity Commercial |
$647.02
|
| Rate for Payer: Cofinity Commercial |
$794.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$647.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.45
|
| Rate for Payer: Healthscope Commercial |
$831.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$647.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$693.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.66
|
| Rate for Payer: PHP Commercial |
$785.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.80
|
| Rate for Payer: Priority Health SBD |
$582.32
|
| Rate for Payer: UMR Bronson Commercial |
$341.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$693.23
|
|
|
HC NON-SELECTIVE DEBRIDEMENT
|
Facility
|
OP
|
$358.94
|
|
|
Service Code
|
CPT 97602
|
| Hospital Charge Code |
42000037
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$74.03 |
| Max. Negotiated Rate |
$611.90 |
| Rate for Payer: Aetna American Axle |
$233.31
|
| Rate for Payer: Aetna Commercial |
$305.10
|
| Rate for Payer: Aetna Medicare |
$202.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.35
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$194.68
|
| Rate for Payer: BCBS Trust/PPO |
$74.03
|
| Rate for Payer: BCN Commercial |
$74.03
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Cash Price |
$287.15
|
| Rate for Payer: Cash Price |
$287.15
|
| Rate for Payer: Cofinity Commercial |
$308.69
|
| Rate for Payer: Cofinity Commercial |
$251.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$251.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Healthscope Commercial |
$323.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$251.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.20
|
| Rate for Payer: Mclaren Medicaid |
$104.35
|
| Rate for Payer: Mclaren Medicare |
$194.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.41
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.10
|
| Rate for Payer: Nomi Health Commercial |
$584.04
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Commercial |
$305.10
|
| Rate for Payer: PHP Medicare Advantage |
$194.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$611.90
|
| Rate for Payer: Priority Health Medicare |
$194.68
|
| Rate for Payer: Priority Health Narrow Network |
$489.52
|
| Rate for Payer: Priority Health SBD |
$226.13
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$548.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.68
|
| Rate for Payer: UHC Exchange |
$372.05
|
| Rate for Payer: UHC Medicare Advantage |
$194.68
|
| Rate for Payer: UHCCP Medicaid |
$104.35
|
| Rate for Payer: UMR Bronson Commercial |
$132.81
|
| Rate for Payer: VA VA |
$194.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.20
|
|
