|
HC PTCRAWSTENT ADD.BRANCH
|
Facility
|
IP
|
$19,483.94
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
48100078
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,572.93 |
| Max. Negotiated Rate |
$17,535.55 |
| Rate for Payer: Aetna American Axle |
$12,664.56
|
| Rate for Payer: Aetna Commercial |
$16,561.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,664.56
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cofinity Advantage |
$13,638.76
|
| Rate for Payer: Cofinity Commercial |
$16,756.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,587.15
|
| Rate for Payer: Healthscope Commercial |
$17,535.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,638.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,612.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,561.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,612.95
|
| Rate for Payer: PHP Commercial |
$16,561.35
|
| Rate for Payer: Priority Health SBD |
$12,274.88
|
| Rate for Payer: UMR Bronson Commercial |
$8,572.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,612.95
|
|
|
HC PTCRAWSTENT VES/BRANCH
|
Facility
|
OP
|
$29,741.77
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
48100077
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$307.44 |
| Max. Negotiated Rate |
$59,069.70 |
| Rate for Payer: Aetna American Axle |
$19,332.15
|
| Rate for Payer: Aetna Commercial |
$25,280.50
|
| Rate for Payer: Aetna Medicare |
$18,996.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,332.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,832.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,832.15
|
| Rate for Payer: BCBS Complete |
$10,031.53
|
| Rate for Payer: BCBS MAPPO |
$18,265.72
|
| Rate for Payer: BCBS Trust/PPO |
$307.44
|
| Rate for Payer: BCN Commercial |
$307.44
|
| Rate for Payer: BCN Medicare Advantage |
$18,265.72
|
| Rate for Payer: Cash Price |
$23,793.42
|
| Rate for Payer: Cash Price |
$23,793.42
|
| Rate for Payer: Cash Price |
$23,793.42
|
| Rate for Payer: Cofinity Advantage |
$20,819.24
|
| Rate for Payer: Cofinity Commercial |
$25,577.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,793.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,265.72
|
| Rate for Payer: Healthscope Commercial |
$26,767.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,819.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,306.33
|
| Rate for Payer: Mclaren Medicaid |
$18,265.72
|
| Rate for Payer: Mclaren Medicare |
$18,265.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,179.01
|
| Rate for Payer: Meridian Medicaid |
$19,179.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,005.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,092.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,280.50
|
| Rate for Payer: Nomi Health Commercial |
$54,797.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,306.33
|
| Rate for Payer: PACE Medicare |
$17,352.43
|
| Rate for Payer: PACE SWMI |
$18,265.72
|
| Rate for Payer: PHP Commercial |
$25,280.50
|
| Rate for Payer: PHP Medicare Advantage |
$18,265.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,552.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$59,069.70
|
| Rate for Payer: Priority Health Medicare |
$18,265.72
|
| Rate for Payer: Priority Health SBD |
$18,737.32
|
| Rate for Payer: Priority Health Tiered Network |
$47,255.76
|
| Rate for Payer: Railroad Medicare Medicare |
$18,265.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,265.72
|
| Rate for Payer: UHC Medicaid |
$9,552.97
|
| Rate for Payer: UHCCP Medicaid |
$9,552.97
|
| Rate for Payer: UMR Bronson Commercial |
$11,004.45
|
| Rate for Payer: VA VA |
$18,265.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,306.33
|
|
|
HC PTCRAWSTENT VES/BRANCH
|
Facility
|
IP
|
$29,741.77
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
48100077
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$13,086.38 |
| Max. Negotiated Rate |
$26,767.59 |
| Rate for Payer: Aetna American Axle |
$19,332.15
|
| Rate for Payer: Aetna Commercial |
$25,280.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,332.15
|
| Rate for Payer: Cash Price |
$23,793.42
|
| Rate for Payer: Cofinity Advantage |
$20,819.24
|
| Rate for Payer: Cofinity Commercial |
$25,577.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,793.42
|
| Rate for Payer: Healthscope Commercial |
$26,767.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,819.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,306.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,280.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,306.33
|
| Rate for Payer: PHP Commercial |
$25,280.50
|
| Rate for Payer: Priority Health SBD |
$18,737.32
|
| Rate for Payer: UMR Bronson Commercial |
$13,086.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,306.33
|
|
|
HC PT EVAL HIGH COMPLEXITY
|
Facility
|
OP
|
$321.01
|
|
|
Service Code
|
CPT 97163
|
| Hospital Charge Code |
42400008
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$60.80 |
| Max. Negotiated Rate |
$288.91 |
| Rate for Payer: Aetna American Axle |
$208.66
|
| Rate for Payer: Aetna Commercial |
$272.86
|
| Rate for Payer: Aetna Medicare |
$160.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.66
|
| Rate for Payer: BCBS Complete |
$128.40
|
| Rate for Payer: BCBS Trust/PPO |
$79.49
|
| Rate for Payer: BCN Commercial |
$79.49
|
| Rate for Payer: Cash Price |
$256.81
|
| Rate for Payer: Cash Price |
$256.81
|
| Rate for Payer: Cash Price |
$256.81
|
| Rate for Payer: Cofinity Advantage |
$224.71
|
| Rate for Payer: Cofinity Commercial |
$276.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.81
|
| Rate for Payer: Healthscope Commercial |
$288.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$224.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$256.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.86
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.76
|
| Rate for Payer: PHP Commercial |
$272.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$76.00
|
| Rate for Payer: Priority Health SBD |
$202.24
|
| Rate for Payer: Priority Health Tiered Network |
$60.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$208.66
|
| Rate for Payer: UHC Core |
$167.25
|
| Rate for Payer: UHC Exchange |
$126.16
|
| Rate for Payer: UMR Bronson Commercial |
$118.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.76
|
|
|
HC PT EVAL HIGH COMPLEXITY
|
Facility
|
IP
|
$321.01
|
|
|
Service Code
|
CPT 97163
|
| Hospital Charge Code |
42400008
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$141.24 |
| Max. Negotiated Rate |
$288.91 |
| Rate for Payer: Aetna American Axle |
$208.66
|
| Rate for Payer: Aetna Commercial |
$272.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.66
|
| Rate for Payer: Cash Price |
$256.81
|
| Rate for Payer: Cofinity Advantage |
$224.71
|
| Rate for Payer: Cofinity Commercial |
$276.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.81
|
| Rate for Payer: Healthscope Commercial |
$288.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$224.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.76
|
| Rate for Payer: PHP Commercial |
$272.86
|
| Rate for Payer: Priority Health SBD |
$202.24
|
| Rate for Payer: UMR Bronson Commercial |
$141.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.76
|
|
|
HC PT EVAL LOW COMPLEXITY
|
Facility
|
OP
|
$262.65
|
|
|
Service Code
|
CPT 97161
|
| Hospital Charge Code |
42400006
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$60.80 |
| Max. Negotiated Rate |
$236.38 |
| Rate for Payer: Aetna American Axle |
$170.72
|
| Rate for Payer: Aetna Commercial |
$223.25
|
| Rate for Payer: Aetna Medicare |
$131.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.72
|
| Rate for Payer: BCBS Complete |
$105.06
|
| Rate for Payer: BCBS Trust/PPO |
$79.49
|
| Rate for Payer: BCN Commercial |
$79.49
|
| Rate for Payer: Cash Price |
$210.12
|
| Rate for Payer: Cash Price |
$210.12
|
| Rate for Payer: Cash Price |
$210.12
|
| Rate for Payer: Cofinity Advantage |
$183.85
|
| Rate for Payer: Cofinity Commercial |
$225.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.12
|
| Rate for Payer: Healthscope Commercial |
$236.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$183.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$210.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.25
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.99
|
| Rate for Payer: PHP Commercial |
$223.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$76.00
|
| Rate for Payer: Priority Health SBD |
$165.47
|
| Rate for Payer: Priority Health Tiered Network |
$60.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.72
|
| Rate for Payer: UHC Core |
$136.84
|
| Rate for Payer: UHC Exchange |
$103.22
|
| Rate for Payer: UMR Bronson Commercial |
$97.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.99
|
|
|
HC PT EVAL LOW COMPLEXITY
|
Facility
|
IP
|
$262.65
|
|
|
Service Code
|
CPT 97161
|
| Hospital Charge Code |
42400006
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$115.57 |
| Max. Negotiated Rate |
$236.38 |
| Rate for Payer: Aetna American Axle |
$170.72
|
| Rate for Payer: Aetna Commercial |
$223.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.72
|
| Rate for Payer: Cash Price |
$210.12
|
| Rate for Payer: Cofinity Advantage |
$183.85
|
| Rate for Payer: Cofinity Commercial |
$225.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.12
|
| Rate for Payer: Healthscope Commercial |
$236.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$183.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.99
|
| Rate for Payer: PHP Commercial |
$223.25
|
| Rate for Payer: Priority Health SBD |
$165.47
|
| Rate for Payer: UMR Bronson Commercial |
$115.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.99
|
|
|
HC PT EVAL MODERATE COMPLEXITY
|
Facility
|
OP
|
$291.83
|
|
|
Service Code
|
CPT 97162
|
| Hospital Charge Code |
42400007
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$60.80 |
| Max. Negotiated Rate |
$262.65 |
| Rate for Payer: Aetna American Axle |
$189.69
|
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: Aetna Medicare |
$145.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.69
|
| Rate for Payer: BCBS Complete |
$116.73
|
| Rate for Payer: BCBS Trust/PPO |
$79.49
|
| Rate for Payer: BCN Commercial |
$79.49
|
| Rate for Payer: Cash Price |
$233.46
|
| Rate for Payer: Cash Price |
$233.46
|
| Rate for Payer: Cash Price |
$233.46
|
| Rate for Payer: Cofinity Advantage |
$204.28
|
| Rate for Payer: Cofinity Commercial |
$250.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.46
|
| Rate for Payer: Healthscope Commercial |
$262.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$204.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$233.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.87
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$76.00
|
| Rate for Payer: Priority Health SBD |
$183.85
|
| Rate for Payer: Priority Health Tiered Network |
$60.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.69
|
| Rate for Payer: UHC Core |
$152.04
|
| Rate for Payer: UHC Exchange |
$114.69
|
| Rate for Payer: UMR Bronson Commercial |
$107.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.87
|
|
|
HC PT EVAL MODERATE COMPLEXITY
|
Facility
|
IP
|
$291.83
|
|
|
Service Code
|
CPT 97162
|
| Hospital Charge Code |
42400007
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$128.41 |
| Max. Negotiated Rate |
$262.65 |
| Rate for Payer: Aetna American Axle |
$189.69
|
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.69
|
| Rate for Payer: Cash Price |
$233.46
|
| Rate for Payer: Cofinity Advantage |
$204.28
|
| Rate for Payer: Cofinity Commercial |
$250.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.46
|
| Rate for Payer: Healthscope Commercial |
$262.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$204.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.87
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: Priority Health SBD |
$183.85
|
| Rate for Payer: UMR Bronson Commercial |
$128.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.87
|
|
|
HC PT MIX 1:1
|
Facility
|
OP
|
$71.85
|
|
|
Service Code
|
CPT 85611
|
| Hospital Charge Code |
30500107
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.06 |
| Max. Negotiated Rate |
$64.67 |
| Rate for Payer: Aetna American Axle |
$46.70
|
| Rate for Payer: Aetna Commercial |
$61.07
|
| Rate for Payer: Aetna Medicare |
$4.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.92
|
| Rate for Payer: BCBS Complete |
$2.16
|
| Rate for Payer: BCBS MAPPO |
$3.94
|
| Rate for Payer: BCBS Trust/PPO |
$4.56
|
| Rate for Payer: BCN Commercial |
$4.56
|
| Rate for Payer: BCN Medicare Advantage |
$3.94
|
| Rate for Payer: Cash Price |
$57.48
|
| Rate for Payer: Cash Price |
$57.48
|
| Rate for Payer: Cofinity Advantage |
$50.30
|
| Rate for Payer: Cofinity Commercial |
$61.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.94
|
| Rate for Payer: Healthscope Commercial |
$64.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.89
|
| Rate for Payer: Mclaren Medicaid |
$3.94
|
| Rate for Payer: Mclaren Medicare |
$3.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.14
|
| Rate for Payer: Meridian Medicaid |
$4.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.07
|
| Rate for Payer: Nomi Health Commercial |
$5.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.89
|
| Rate for Payer: PACE Medicare |
$3.74
|
| Rate for Payer: PACE SWMI |
$3.94
|
| Rate for Payer: PHP Commercial |
$61.07
|
| Rate for Payer: PHP Medicare Advantage |
$3.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3.94
|
| Rate for Payer: Priority Health Medicare |
$3.94
|
| Rate for Payer: Priority Health SBD |
$45.27
|
| Rate for Payer: Priority Health Tiered Network |
$3.15
|
| Rate for Payer: Railroad Medicare Medicare |
$3.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.91
|
| Rate for Payer: UHC Core |
$5.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.94
|
| Rate for Payer: UHC Exchange |
$5.91
|
| Rate for Payer: UHC Medicaid |
$2.06
|
| Rate for Payer: UHCCP Medicaid |
$2.06
|
| Rate for Payer: UMR Bronson Commercial |
$26.58
|
| Rate for Payer: VA VA |
$3.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.89
|
|
|
HC PT MIX 1:1
|
Facility
|
IP
|
$71.85
|
|
|
Service Code
|
CPT 85611
|
| Hospital Charge Code |
30500107
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$31.61 |
| Max. Negotiated Rate |
$64.67 |
| Rate for Payer: Aetna American Axle |
$46.70
|
| Rate for Payer: Aetna Commercial |
$61.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.70
|
| Rate for Payer: Cash Price |
$57.48
|
| Rate for Payer: Cofinity Advantage |
$50.30
|
| Rate for Payer: Cofinity Commercial |
$61.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.48
|
| Rate for Payer: Healthscope Commercial |
$64.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.89
|
| Rate for Payer: PHP Commercial |
$61.07
|
| Rate for Payer: Priority Health SBD |
$45.27
|
| Rate for Payer: UMR Bronson Commercial |
$31.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.89
|
|
|
HC PT NEUROSTIM
|
Facility
|
IP
|
$99.08
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
42000007
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$43.60 |
| Max. Negotiated Rate |
$89.17 |
| Rate for Payer: Aetna American Axle |
$64.40
|
| Rate for Payer: Aetna Commercial |
$84.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.40
|
| Rate for Payer: Cash Price |
$79.26
|
| Rate for Payer: Cofinity Advantage |
$69.36
|
| Rate for Payer: Cofinity Commercial |
$85.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.26
|
| Rate for Payer: Healthscope Commercial |
$89.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.31
|
| Rate for Payer: PHP Commercial |
$84.22
|
| Rate for Payer: Priority Health SBD |
$62.42
|
| Rate for Payer: UMR Bronson Commercial |
$43.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.31
|
|
|
HC PT NEUROSTIM
|
Facility
|
OP
|
$99.08
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
42000007
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna American Axle |
$64.40
|
| Rate for Payer: Aetna Commercial |
$84.22
|
| Rate for Payer: Aetna Medicare |
$49.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.40
|
| Rate for Payer: BCBS Complete |
$39.63
|
| Rate for Payer: BCBS Trust/PPO |
$13.30
|
| Rate for Payer: BCN Commercial |
$13.30
|
| Rate for Payer: Cash Price |
$79.26
|
| Rate for Payer: Cash Price |
$79.26
|
| Rate for Payer: Cash Price |
$79.26
|
| Rate for Payer: Cofinity Advantage |
$69.36
|
| Rate for Payer: Cofinity Commercial |
$85.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.26
|
| Rate for Payer: Healthscope Commercial |
$89.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.22
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.31
|
| Rate for Payer: PHP Commercial |
$84.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.00
|
| Rate for Payer: Priority Health SBD |
$62.42
|
| Rate for Payer: Priority Health Tiered Network |
$12.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.40
|
| Rate for Payer: UHC Core |
$51.62
|
| Rate for Payer: UHC Exchange |
$38.94
|
| Rate for Payer: UMR Bronson Commercial |
$36.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.31
|
|
|
HC PT RE-EVALUATION
|
Facility
|
OP
|
$130.72
|
|
|
Service Code
|
CPT 97164
|
| Hospital Charge Code |
42400009
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$30.40 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna American Axle |
$84.97
|
| Rate for Payer: Aetna Commercial |
$111.11
|
| Rate for Payer: Aetna Medicare |
$65.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.97
|
| Rate for Payer: BCBS Complete |
$52.29
|
| Rate for Payer: BCBS Trust/PPO |
$54.63
|
| Rate for Payer: BCN Commercial |
$54.63
|
| Rate for Payer: Cash Price |
$104.58
|
| Rate for Payer: Cash Price |
$104.58
|
| Rate for Payer: Cash Price |
$104.58
|
| Rate for Payer: Cofinity Advantage |
$91.50
|
| Rate for Payer: Cofinity Commercial |
$112.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.58
|
| Rate for Payer: Healthscope Commercial |
$117.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.11
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.04
|
| Rate for Payer: PHP Commercial |
$111.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$38.00
|
| Rate for Payer: Priority Health SBD |
$82.35
|
| Rate for Payer: Priority Health Tiered Network |
$30.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.97
|
| Rate for Payer: UHC Core |
$68.11
|
| Rate for Payer: UHC Exchange |
$51.37
|
| Rate for Payer: UMR Bronson Commercial |
$48.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.04
|
|
|
HC PT RE-EVALUATION
|
Facility
|
IP
|
$130.72
|
|
|
Service Code
|
CPT 97164
|
| Hospital Charge Code |
42400009
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$57.52 |
| Max. Negotiated Rate |
$117.65 |
| Rate for Payer: Aetna American Axle |
$84.97
|
| Rate for Payer: Aetna Commercial |
$111.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.97
|
| Rate for Payer: Cash Price |
$104.58
|
| Rate for Payer: Cofinity Advantage |
$91.50
|
| Rate for Payer: Cofinity Commercial |
$112.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.58
|
| Rate for Payer: Healthscope Commercial |
$117.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.04
|
| Rate for Payer: PHP Commercial |
$111.11
|
| Rate for Payer: Priority Health SBD |
$82.35
|
| Rate for Payer: UMR Bronson Commercial |
$57.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.04
|
|
|
HC PULM EXER FUNCTION INDIV 15 MIN
|
Facility
|
IP
|
$89.43
|
|
|
Service Code
|
HCPCS G0238
|
| Hospital Charge Code |
41000045
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$39.35 |
| Max. Negotiated Rate |
$80.49 |
| Rate for Payer: Aetna American Axle |
$58.13
|
| Rate for Payer: Aetna Commercial |
$76.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.13
|
| Rate for Payer: Cash Price |
$71.54
|
| Rate for Payer: Cofinity Advantage |
$62.60
|
| Rate for Payer: Cofinity Commercial |
$76.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.54
|
| Rate for Payer: Healthscope Commercial |
$80.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.07
|
| Rate for Payer: PHP Commercial |
$76.02
|
| Rate for Payer: Priority Health SBD |
$56.34
|
| Rate for Payer: UMR Bronson Commercial |
$39.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.07
|
|
|
HC PULM EXER FUNCTION INDIV 15 MIN
|
Facility
|
OP
|
$89.43
|
|
|
Service Code
|
HCPCS G0238
|
| Hospital Charge Code |
41000045
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$13.98 |
| Max. Negotiated Rate |
$93.19 |
| Rate for Payer: Aetna American Axle |
$58.13
|
| Rate for Payer: Aetna Commercial |
$76.02
|
| Rate for Payer: Aetna Medicare |
$29.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.02
|
| Rate for Payer: BCBS Complete |
$15.83
|
| Rate for Payer: BCBS MAPPO |
$28.82
|
| Rate for Payer: BCBS Trust/PPO |
$13.98
|
| Rate for Payer: BCN Commercial |
$13.98
|
| Rate for Payer: BCN Medicare Advantage |
$28.82
|
| Rate for Payer: Cash Price |
$71.54
|
| Rate for Payer: Cash Price |
$71.54
|
| Rate for Payer: Cofinity Advantage |
$62.60
|
| Rate for Payer: Cofinity Commercial |
$76.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.82
|
| Rate for Payer: Healthscope Commercial |
$80.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.07
|
| Rate for Payer: Mclaren Medicaid |
$28.82
|
| Rate for Payer: Mclaren Medicare |
$28.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.26
|
| Rate for Payer: Meridian Medicaid |
$30.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.02
|
| Rate for Payer: Nomi Health Commercial |
$86.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.07
|
| Rate for Payer: PACE Medicare |
$27.38
|
| Rate for Payer: PACE SWMI |
$28.82
|
| Rate for Payer: PHP Commercial |
$76.02
|
| Rate for Payer: PHP Medicare Advantage |
$28.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$93.19
|
| Rate for Payer: Priority Health Medicare |
$28.82
|
| Rate for Payer: Priority Health SBD |
$56.34
|
| Rate for Payer: Priority Health Tiered Network |
$74.55
|
| Rate for Payer: Railroad Medicare Medicare |
$28.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.13
|
| Rate for Payer: UHC Core |
$46.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.82
|
| Rate for Payer: UHC Exchange |
$35.15
|
| Rate for Payer: UHC Medicaid |
$15.07
|
| Rate for Payer: UHCCP Medicaid |
$15.07
|
| Rate for Payer: UMR Bronson Commercial |
$33.09
|
| Rate for Payer: VA VA |
$28.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.07
|
|
|
HC PULMONARY ARTERIOGRAM NONSELECTIVE
|
Facility
|
OP
|
$1,735.21
|
|
|
Service Code
|
CPT 75746
|
| Hospital Charge Code |
32000197
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$205.22 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna American Axle |
$1,127.89
|
| Rate for Payer: Aetna Commercial |
$1,474.93
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,127.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$205.22
|
| Rate for Payer: BCN Commercial |
$205.22
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$1,388.17
|
| Rate for Payer: Cash Price |
$1,388.17
|
| Rate for Payer: Cofinity Advantage |
$1,214.65
|
| Rate for Payer: Cofinity Commercial |
$1,492.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,388.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$1,561.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,214.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,301.41
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,474.93
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,301.41
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$1,474.93
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$1,093.18
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,127.89
|
| Rate for Payer: UHC Core |
$904.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$681.94
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: UMR Bronson Commercial |
$642.03
|
| Rate for Payer: VA VA |
$3,146.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,301.41
|
|
|
HC PULMONARY ARTERIOGRAM NONSELECTIVE
|
Facility
|
IP
|
$1,735.21
|
|
|
Service Code
|
CPT 75746
|
| Hospital Charge Code |
32000197
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$763.49 |
| Max. Negotiated Rate |
$1,561.69 |
| Rate for Payer: Aetna American Axle |
$1,127.89
|
| Rate for Payer: Aetna Commercial |
$1,474.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,127.89
|
| Rate for Payer: Cash Price |
$1,388.17
|
| Rate for Payer: Cofinity Advantage |
$1,214.65
|
| Rate for Payer: Cofinity Commercial |
$1,492.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,388.17
|
| Rate for Payer: Healthscope Commercial |
$1,561.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,214.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,301.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,474.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,301.41
|
| Rate for Payer: PHP Commercial |
$1,474.93
|
| Rate for Payer: Priority Health SBD |
$1,093.18
|
| Rate for Payer: UMR Bronson Commercial |
$763.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,301.41
|
|
|
HC PULMONARY EXERCISE GROUP
|
Facility
|
OP
|
$107.30
|
|
|
Service Code
|
HCPCS G0239
|
| Hospital Charge Code |
41000044
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$19.47 |
| Max. Negotiated Rate |
$120.34 |
| Rate for Payer: Aetna American Axle |
$69.75
|
| Rate for Payer: Aetna Commercial |
$91.20
|
| Rate for Payer: Aetna Medicare |
$38.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.52
|
| Rate for Payer: BCBS Complete |
$20.44
|
| Rate for Payer: BCBS MAPPO |
$37.22
|
| Rate for Payer: BCBS Trust/PPO |
$54.94
|
| Rate for Payer: BCN Commercial |
$54.94
|
| Rate for Payer: BCN Medicare Advantage |
$37.22
|
| Rate for Payer: Cash Price |
$85.84
|
| Rate for Payer: Cash Price |
$85.84
|
| Rate for Payer: Cofinity Advantage |
$75.11
|
| Rate for Payer: Cofinity Commercial |
$92.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.22
|
| Rate for Payer: Healthscope Commercial |
$96.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.47
|
| Rate for Payer: Mclaren Medicaid |
$37.22
|
| Rate for Payer: Mclaren Medicare |
$37.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.08
|
| Rate for Payer: Meridian Medicaid |
$39.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.20
|
| Rate for Payer: Nomi Health Commercial |
$111.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.47
|
| Rate for Payer: PACE Medicare |
$35.36
|
| Rate for Payer: PACE SWMI |
$37.22
|
| Rate for Payer: PHP Commercial |
$91.20
|
| Rate for Payer: PHP Medicare Advantage |
$37.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$120.34
|
| Rate for Payer: Priority Health Medicare |
$37.22
|
| Rate for Payer: Priority Health SBD |
$67.60
|
| Rate for Payer: Priority Health Tiered Network |
$96.27
|
| Rate for Payer: Railroad Medicare Medicare |
$37.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.75
|
| Rate for Payer: UHC Core |
$55.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.22
|
| Rate for Payer: UHC Exchange |
$42.17
|
| Rate for Payer: UHC Medicaid |
$19.47
|
| Rate for Payer: UHCCP Medicaid |
$19.47
|
| Rate for Payer: UMR Bronson Commercial |
$39.70
|
| Rate for Payer: VA VA |
$37.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.47
|
|
|
HC PULMONARY EXERCISE GROUP
|
Facility
|
IP
|
$107.30
|
|
|
Service Code
|
HCPCS G0239
|
| Hospital Charge Code |
41000044
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$47.21 |
| Max. Negotiated Rate |
$96.57 |
| Rate for Payer: Aetna American Axle |
$69.75
|
| Rate for Payer: Aetna Commercial |
$91.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.75
|
| Rate for Payer: Cash Price |
$85.84
|
| Rate for Payer: Cofinity Advantage |
$75.11
|
| Rate for Payer: Cofinity Commercial |
$92.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.84
|
| Rate for Payer: Healthscope Commercial |
$96.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.47
|
| Rate for Payer: PHP Commercial |
$91.20
|
| Rate for Payer: Priority Health SBD |
$67.60
|
| Rate for Payer: UMR Bronson Commercial |
$47.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.47
|
|
|
HC PULMONARY STRESS TESTING (EG 6 MIN WALK)
|
Facility
|
OP
|
$379.26
|
|
|
Service Code
|
CPT 94618
|
| Hospital Charge Code |
46000030
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$53.54 |
| Max. Negotiated Rate |
$428.73 |
| Rate for Payer: Aetna American Axle |
$246.52
|
| Rate for Payer: Aetna Commercial |
$322.37
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$246.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$53.54
|
| Rate for Payer: BCN Commercial |
$53.54
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$303.41
|
| Rate for Payer: Cash Price |
$303.41
|
| Rate for Payer: Cofinity Advantage |
$265.48
|
| Rate for Payer: Cofinity Commercial |
$326.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$341.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$265.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.44
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.37
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$284.44
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$322.37
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$238.93
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.52
|
| Rate for Payer: UHC Core |
$197.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$149.05
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: UMR Bronson Commercial |
$140.33
|
| Rate for Payer: VA VA |
$132.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.44
|
|
|
HC PULMONARY STRESS TESTING (EG 6 MIN WALK)
|
Facility
|
IP
|
$379.26
|
|
|
Service Code
|
CPT 94618
|
| Hospital Charge Code |
46000030
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$166.87 |
| Max. Negotiated Rate |
$341.33 |
| Rate for Payer: Aetna American Axle |
$246.52
|
| Rate for Payer: Aetna Commercial |
$322.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$246.52
|
| Rate for Payer: Cash Price |
$303.41
|
| Rate for Payer: Cofinity Advantage |
$265.48
|
| Rate for Payer: Cofinity Commercial |
$326.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.41
|
| Rate for Payer: Healthscope Commercial |
$341.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$265.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$284.44
|
| Rate for Payer: PHP Commercial |
$322.37
|
| Rate for Payer: Priority Health SBD |
$238.93
|
| Rate for Payer: UMR Bronson Commercial |
$166.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.44
|
|
|
HC PULM REHAB W/ CONT OXIMTRY MNTR
|
Facility
|
OP
|
$263.50
|
|
|
Service Code
|
CPT 94626
|
| Hospital Charge Code |
94800004
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$270.51 |
| Rate for Payer: Aetna American Axle |
$171.28
|
| Rate for Payer: Aetna Commercial |
$223.97
|
| Rate for Payer: Aetna Medicare |
$61.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS Trust/PPO |
$270.51
|
| Rate for Payer: BCN Commercial |
$270.51
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$210.80
|
| Rate for Payer: Cash Price |
$210.80
|
| Rate for Payer: Cofinity Advantage |
$184.45
|
| Rate for Payer: Cofinity Commercial |
$226.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$237.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.62
|
| Rate for Payer: Mclaren Medicaid |
$58.78
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$61.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.97
|
| Rate for Payer: Nomi Health Commercial |
$176.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.62
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$223.97
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$190.09
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health SBD |
$166.00
|
| Rate for Payer: Priority Health Tiered Network |
$152.07
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.28
|
| Rate for Payer: UHC Core |
$137.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$103.56
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: UMR Bronson Commercial |
$97.50
|
| Rate for Payer: VA VA |
$58.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.62
|
|
|
HC PULM REHAB W/ CONT OXIMTRY MNTR
|
Facility
|
IP
|
$263.50
|
|
|
Service Code
|
CPT 94626
|
| Hospital Charge Code |
94800004
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$115.94 |
| Max. Negotiated Rate |
$237.15 |
| Rate for Payer: Aetna American Axle |
$171.28
|
| Rate for Payer: Aetna Commercial |
$223.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.28
|
| Rate for Payer: Cash Price |
$210.80
|
| Rate for Payer: Cofinity Advantage |
$184.45
|
| Rate for Payer: Cofinity Commercial |
$226.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.80
|
| Rate for Payer: Healthscope Commercial |
$237.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.62
|
| Rate for Payer: PHP Commercial |
$223.97
|
| Rate for Payer: Priority Health SBD |
$166.00
|
| Rate for Payer: UMR Bronson Commercial |
$115.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.62
|
|
