|
HC RO IMRT DEL SIMPLE
|
Facility
|
IP
|
$3,353.76
|
|
|
Service Code
|
CPT 77385
|
| Hospital Charge Code |
33300050
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,475.65 |
| Max. Negotiated Rate |
$3,018.38 |
| Rate for Payer: Aetna American Axle |
$2,179.94
|
| Rate for Payer: Aetna Commercial |
$2,850.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,179.94
|
| Rate for Payer: Cash Price |
$2,683.01
|
| Rate for Payer: Cofinity Advantage |
$2,347.63
|
| Rate for Payer: Cofinity Commercial |
$2,884.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,683.01
|
| Rate for Payer: Healthscope Commercial |
$3,018.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,347.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,515.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,850.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,515.32
|
| Rate for Payer: PHP Commercial |
$2,850.70
|
| Rate for Payer: Priority Health SBD |
$2,112.87
|
| Rate for Payer: UMR Bronson Commercial |
$1,475.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,515.32
|
|
|
HC RO IMRT DEL SIMPLE
|
Facility
|
OP
|
$3,353.76
|
|
|
Service Code
|
CPT 77385
|
| Hospital Charge Code |
33300050
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$814.59 |
| Max. Negotiated Rate |
$3,018.38 |
| Rate for Payer: Aetna American Axle |
$2,179.94
|
| Rate for Payer: Aetna Commercial |
$2,850.70
|
| Rate for Payer: Aetna Medicare |
$1,676.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,179.94
|
| Rate for Payer: BCBS Complete |
$1,341.50
|
| Rate for Payer: BCBS Trust/PPO |
$814.59
|
| Rate for Payer: BCN Commercial |
$814.59
|
| Rate for Payer: Cash Price |
$2,683.01
|
| Rate for Payer: Cash Price |
$2,683.01
|
| Rate for Payer: Cofinity Advantage |
$2,347.63
|
| Rate for Payer: Cofinity Commercial |
$2,884.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,683.01
|
| Rate for Payer: Healthscope Commercial |
$3,018.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,347.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,515.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,683.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,850.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,515.32
|
| Rate for Payer: PHP Commercial |
$2,850.70
|
| Rate for Payer: Priority Health SBD |
$2,112.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,179.94
|
| Rate for Payer: UHC Core |
$1,747.31
|
| Rate for Payer: UHC Exchange |
$1,318.03
|
| Rate for Payer: UMR Bronson Commercial |
$1,240.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,515.32
|
|
|
HC RO INFUS RADIOACTIVE MATERIAL
|
Facility
|
IP
|
$338.53
|
|
|
Service Code
|
CPT 77750
|
| Hospital Charge Code |
33300042
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$148.95 |
| Max. Negotiated Rate |
$304.68 |
| Rate for Payer: Aetna American Axle |
$220.04
|
| Rate for Payer: Aetna Commercial |
$287.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.04
|
| Rate for Payer: Cash Price |
$270.82
|
| Rate for Payer: Cofinity Advantage |
$236.97
|
| Rate for Payer: Cofinity Commercial |
$291.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.82
|
| Rate for Payer: Healthscope Commercial |
$304.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$236.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.90
|
| Rate for Payer: PHP Commercial |
$287.75
|
| Rate for Payer: Priority Health SBD |
$213.27
|
| Rate for Payer: UMR Bronson Commercial |
$148.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.90
|
|
|
HC RO INFUS RADIOACTIVE MATERIAL
|
Facility
|
OP
|
$338.53
|
|
|
Service Code
|
CPT 77750
|
| Hospital Charge Code |
33300042
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$125.26 |
| Max. Negotiated Rate |
$1,242.83 |
| Rate for Payer: Aetna American Axle |
$220.04
|
| Rate for Payer: Aetna Commercial |
$287.75
|
| Rate for Payer: Aetna Medicare |
$399.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$480.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$480.39
|
| Rate for Payer: BCBS Complete |
$211.06
|
| Rate for Payer: BCBS MAPPO |
$384.31
|
| Rate for Payer: BCBS Trust/PPO |
$330.01
|
| Rate for Payer: BCN Commercial |
$330.01
|
| Rate for Payer: BCN Medicare Advantage |
$384.31
|
| Rate for Payer: Cash Price |
$270.82
|
| Rate for Payer: Cash Price |
$270.82
|
| Rate for Payer: Cofinity Advantage |
$236.97
|
| Rate for Payer: Cofinity Commercial |
$291.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.31
|
| Rate for Payer: Healthscope Commercial |
$304.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$236.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.90
|
| Rate for Payer: Mclaren Medicaid |
$384.31
|
| Rate for Payer: Mclaren Medicare |
$384.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$403.53
|
| Rate for Payer: Meridian Medicaid |
$403.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$441.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$422.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.75
|
| Rate for Payer: Nomi Health Commercial |
$1,152.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.90
|
| Rate for Payer: PACE Medicare |
$365.09
|
| Rate for Payer: PACE SWMI |
$384.31
|
| Rate for Payer: PHP Commercial |
$287.75
|
| Rate for Payer: PHP Medicare Advantage |
$384.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,242.83
|
| Rate for Payer: Priority Health Medicare |
$384.31
|
| Rate for Payer: Priority Health SBD |
$213.27
|
| Rate for Payer: Priority Health Tiered Network |
$994.26
|
| Rate for Payer: Railroad Medicare Medicare |
$384.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$220.04
|
| Rate for Payer: UHC Core |
$176.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$384.31
|
| Rate for Payer: UHC Exchange |
$133.04
|
| Rate for Payer: UHC Medicaid |
$200.99
|
| Rate for Payer: UHCCP Medicaid |
$200.99
|
| Rate for Payer: UMR Bronson Commercial |
$125.26
|
| Rate for Payer: VA VA |
$384.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.90
|
|
|
HC RO INS VAG BRACHTHER DEVICE
|
Facility
|
OP
|
$561.41
|
|
|
Service Code
|
CPT 57156
|
| Hospital Charge Code |
36100444
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$158.80 |
| Max. Negotiated Rate |
$981.93 |
| Rate for Payer: Aetna American Axle |
$364.92
|
| Rate for Payer: Aetna Commercial |
$477.20
|
| Rate for Payer: Aetna Medicare |
$315.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$364.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.54
|
| Rate for Payer: BCBS Complete |
$166.75
|
| Rate for Payer: BCBS MAPPO |
$303.63
|
| Rate for Payer: BCBS Trust/PPO |
$395.61
|
| Rate for Payer: BCN Commercial |
$395.61
|
| Rate for Payer: BCN Medicare Advantage |
$303.63
|
| Rate for Payer: Cash Price |
$449.13
|
| Rate for Payer: Cash Price |
$449.13
|
| Rate for Payer: Cash Price |
$449.13
|
| Rate for Payer: Cofinity Advantage |
$392.99
|
| Rate for Payer: Cofinity Commercial |
$482.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.63
|
| Rate for Payer: Healthscope Commercial |
$505.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$392.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.06
|
| Rate for Payer: Mclaren Medicaid |
$303.63
|
| Rate for Payer: Mclaren Medicare |
$303.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.81
|
| Rate for Payer: Meridian Medicaid |
$318.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.20
|
| Rate for Payer: Nomi Health Commercial |
$910.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$421.06
|
| Rate for Payer: PACE Medicare |
$288.45
|
| Rate for Payer: PACE SWMI |
$303.63
|
| Rate for Payer: PHP Commercial |
$477.20
|
| Rate for Payer: PHP Medicare Advantage |
$303.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$981.93
|
| Rate for Payer: Priority Health Medicare |
$303.63
|
| Rate for Payer: Priority Health SBD |
$353.69
|
| Rate for Payer: Priority Health Tiered Network |
$785.54
|
| Rate for Payer: Railroad Medicare Medicare |
$303.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$303.63
|
| Rate for Payer: UHC Medicaid |
$158.80
|
| Rate for Payer: UHCCP Medicaid |
$158.80
|
| Rate for Payer: UMR Bronson Commercial |
$207.72
|
| Rate for Payer: VA VA |
$303.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.06
|
|
|
HC RO INS VAG BRACHTHER DEVICE
|
Facility
|
IP
|
$561.41
|
|
|
Service Code
|
CPT 57156
|
| Hospital Charge Code |
36100444
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$247.02 |
| Max. Negotiated Rate |
$505.27 |
| Rate for Payer: Aetna American Axle |
$364.92
|
| Rate for Payer: Aetna Commercial |
$477.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$364.92
|
| Rate for Payer: Cash Price |
$449.13
|
| Rate for Payer: Cofinity Advantage |
$392.99
|
| Rate for Payer: Cofinity Commercial |
$482.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.13
|
| Rate for Payer: Healthscope Commercial |
$505.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$392.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$421.06
|
| Rate for Payer: PHP Commercial |
$477.20
|
| Rate for Payer: Priority Health SBD |
$353.69
|
| Rate for Payer: UMR Bronson Commercial |
$247.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.06
|
|
|
HC RO INTRSTI RADELEMENT APPL CMPLX
|
Facility
|
OP
|
$2,893.91
|
|
|
Service Code
|
CPT 77778
|
| Hospital Charge Code |
33300035
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$362.95 |
| Max. Negotiated Rate |
$2,604.52 |
| Rate for Payer: Aetna American Axle |
$1,881.04
|
| Rate for Payer: Aetna Commercial |
$2,459.82
|
| Rate for Payer: Aetna Medicare |
$721.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,881.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$867.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$867.46
|
| Rate for Payer: BCBS Complete |
$381.13
|
| Rate for Payer: BCBS MAPPO |
$693.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,158.29
|
| Rate for Payer: BCN Commercial |
$1,158.29
|
| Rate for Payer: BCN Medicare Advantage |
$693.97
|
| Rate for Payer: Cash Price |
$2,315.13
|
| Rate for Payer: Cash Price |
$2,315.13
|
| Rate for Payer: Cofinity Advantage |
$2,025.74
|
| Rate for Payer: Cofinity Commercial |
$2,488.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,315.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$693.97
|
| Rate for Payer: Healthscope Commercial |
$2,604.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,025.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,170.43
|
| Rate for Payer: Mclaren Medicaid |
$693.97
|
| Rate for Payer: Mclaren Medicare |
$693.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$728.67
|
| Rate for Payer: Meridian Medicaid |
$728.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$798.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$763.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,459.82
|
| Rate for Payer: Nomi Health Commercial |
$2,081.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,170.43
|
| Rate for Payer: PACE Medicare |
$659.27
|
| Rate for Payer: PACE SWMI |
$693.97
|
| Rate for Payer: PHP Commercial |
$2,459.82
|
| Rate for Payer: PHP Medicare Advantage |
$693.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,244.23
|
| Rate for Payer: Priority Health Medicare |
$693.97
|
| Rate for Payer: Priority Health SBD |
$1,823.16
|
| Rate for Payer: Priority Health Tiered Network |
$1,795.38
|
| Rate for Payer: Railroad Medicare Medicare |
$693.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,881.04
|
| Rate for Payer: UHC Core |
$1,507.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$693.97
|
| Rate for Payer: UHC Exchange |
$1,137.31
|
| Rate for Payer: UHC Medicaid |
$362.95
|
| Rate for Payer: UHCCP Medicaid |
$362.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,070.75
|
| Rate for Payer: VA VA |
$693.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,170.43
|
|
|
HC RO INTRSTI RADELEMENT APPL CMPLX
|
Facility
|
IP
|
$2,893.91
|
|
|
Service Code
|
CPT 77778
|
| Hospital Charge Code |
33300035
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,273.32 |
| Max. Negotiated Rate |
$2,604.52 |
| Rate for Payer: Aetna American Axle |
$1,881.04
|
| Rate for Payer: Aetna Commercial |
$2,459.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,881.04
|
| Rate for Payer: Cash Price |
$2,315.13
|
| Rate for Payer: Cofinity Advantage |
$2,025.74
|
| Rate for Payer: Cofinity Commercial |
$2,488.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,315.13
|
| Rate for Payer: Healthscope Commercial |
$2,604.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,025.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,170.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,459.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,170.43
|
| Rate for Payer: PHP Commercial |
$2,459.82
|
| Rate for Payer: Priority Health SBD |
$1,823.16
|
| Rate for Payer: UMR Bronson Commercial |
$1,273.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,170.43
|
|
|
HC RO ISODOSE BRACH CALC SIMPLE
|
Facility
|
OP
|
$239.56
|
|
|
Service Code
|
CPT 77316
|
| Hospital Charge Code |
33300045
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$88.64 |
| Max. Negotiated Rate |
$1,206.50 |
| Rate for Payer: Aetna American Axle |
$155.71
|
| Rate for Payer: Aetna Commercial |
$203.63
|
| Rate for Payer: Aetna Medicare |
$388.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$466.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$466.35
|
| Rate for Payer: BCBS Complete |
$204.90
|
| Rate for Payer: BCBS MAPPO |
$373.08
|
| Rate for Payer: BCBS Trust/PPO |
$428.51
|
| Rate for Payer: BCN Commercial |
$428.51
|
| Rate for Payer: BCN Medicare Advantage |
$373.08
|
| Rate for Payer: Cash Price |
$191.65
|
| Rate for Payer: Cash Price |
$191.65
|
| Rate for Payer: Cofinity Advantage |
$167.69
|
| Rate for Payer: Cofinity Commercial |
$206.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.08
|
| Rate for Payer: Healthscope Commercial |
$215.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$167.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$179.67
|
| Rate for Payer: Mclaren Medicaid |
$373.08
|
| Rate for Payer: Mclaren Medicare |
$373.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.73
|
| Rate for Payer: Meridian Medicaid |
$391.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$429.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$410.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$203.63
|
| Rate for Payer: Nomi Health Commercial |
$1,119.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$179.67
|
| Rate for Payer: PACE Medicare |
$354.43
|
| Rate for Payer: PACE SWMI |
$373.08
|
| Rate for Payer: PHP Commercial |
$203.63
|
| Rate for Payer: PHP Medicare Advantage |
$373.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$195.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,206.50
|
| Rate for Payer: Priority Health Medicare |
$373.08
|
| Rate for Payer: Priority Health SBD |
$150.92
|
| Rate for Payer: Priority Health Tiered Network |
$965.20
|
| Rate for Payer: Railroad Medicare Medicare |
$373.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.71
|
| Rate for Payer: UHC Core |
$124.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$373.08
|
| Rate for Payer: UHC Exchange |
$94.15
|
| Rate for Payer: UHC Medicaid |
$195.12
|
| Rate for Payer: UHCCP Medicaid |
$195.12
|
| Rate for Payer: UMR Bronson Commercial |
$88.64
|
| Rate for Payer: VA VA |
$373.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$179.67
|
|
|
HC RO ISODOSE BRACH CALC SIMPLE
|
Facility
|
IP
|
$239.56
|
|
|
Service Code
|
CPT 77316
|
| Hospital Charge Code |
33300045
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$105.41 |
| Max. Negotiated Rate |
$215.60 |
| Rate for Payer: Aetna American Axle |
$155.71
|
| Rate for Payer: Aetna Commercial |
$203.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.71
|
| Rate for Payer: Cash Price |
$191.65
|
| Rate for Payer: Cofinity Advantage |
$167.69
|
| Rate for Payer: Cofinity Commercial |
$206.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.65
|
| Rate for Payer: Healthscope Commercial |
$215.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$167.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$179.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$203.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$179.67
|
| Rate for Payer: PHP Commercial |
$203.63
|
| Rate for Payer: Priority Health SBD |
$150.92
|
| Rate for Payer: UMR Bronson Commercial |
$105.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$179.67
|
|
|
HC RO ISODOSE BRACHY CALC COMPLEX
|
Facility
|
IP
|
$698.64
|
|
|
Service Code
|
CPT 77318
|
| Hospital Charge Code |
33300047
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$307.40 |
| Max. Negotiated Rate |
$628.78 |
| Rate for Payer: Aetna American Axle |
$454.12
|
| Rate for Payer: Aetna Commercial |
$593.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$454.12
|
| Rate for Payer: Cash Price |
$558.91
|
| Rate for Payer: Cofinity Advantage |
$489.05
|
| Rate for Payer: Cofinity Commercial |
$600.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$558.91
|
| Rate for Payer: Healthscope Commercial |
$628.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$489.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$523.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$593.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$523.98
|
| Rate for Payer: PHP Commercial |
$593.84
|
| Rate for Payer: Priority Health SBD |
$440.14
|
| Rate for Payer: UMR Bronson Commercial |
$307.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$523.98
|
|
|
HC RO ISODOSE BRACHY CALC COMPLEX
|
Facility
|
OP
|
$698.64
|
|
|
Service Code
|
CPT 77318
|
| Hospital Charge Code |
33300047
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$195.12 |
| Max. Negotiated Rate |
$1,206.50 |
| Rate for Payer: Aetna American Axle |
$454.12
|
| Rate for Payer: Aetna Commercial |
$593.84
|
| Rate for Payer: Aetna Medicare |
$388.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$454.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$466.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$466.35
|
| Rate for Payer: BCBS Complete |
$204.90
|
| Rate for Payer: BCBS MAPPO |
$373.08
|
| Rate for Payer: BCBS Trust/PPO |
$764.25
|
| Rate for Payer: BCN Commercial |
$764.25
|
| Rate for Payer: BCN Medicare Advantage |
$373.08
|
| Rate for Payer: Cash Price |
$558.91
|
| Rate for Payer: Cash Price |
$558.91
|
| Rate for Payer: Cofinity Advantage |
$489.05
|
| Rate for Payer: Cofinity Commercial |
$600.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$558.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.08
|
| Rate for Payer: Healthscope Commercial |
$628.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$489.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$523.98
|
| Rate for Payer: Mclaren Medicaid |
$373.08
|
| Rate for Payer: Mclaren Medicare |
$373.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.73
|
| Rate for Payer: Meridian Medicaid |
$391.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$429.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$410.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$593.84
|
| Rate for Payer: Nomi Health Commercial |
$1,119.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$523.98
|
| Rate for Payer: PACE Medicare |
$354.43
|
| Rate for Payer: PACE SWMI |
$373.08
|
| Rate for Payer: PHP Commercial |
$593.84
|
| Rate for Payer: PHP Medicare Advantage |
$373.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$195.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,206.50
|
| Rate for Payer: Priority Health Medicare |
$373.08
|
| Rate for Payer: Priority Health SBD |
$440.14
|
| Rate for Payer: Priority Health Tiered Network |
$965.20
|
| Rate for Payer: Railroad Medicare Medicare |
$373.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$454.12
|
| Rate for Payer: UHC Core |
$363.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$373.08
|
| Rate for Payer: UHC Exchange |
$274.57
|
| Rate for Payer: UHC Medicaid |
$195.12
|
| Rate for Payer: UHCCP Medicaid |
$195.12
|
| Rate for Payer: UMR Bronson Commercial |
$258.50
|
| Rate for Payer: VA VA |
$373.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$523.98
|
|
|
HC RO ISODOSE BRACHY CALC INTRM
|
Facility
|
OP
|
$635.12
|
|
|
Service Code
|
CPT 77317
|
| Hospital Charge Code |
33300046
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$195.12 |
| Max. Negotiated Rate |
$1,206.50 |
| Rate for Payer: Aetna American Axle |
$412.83
|
| Rate for Payer: Aetna Commercial |
$539.85
|
| Rate for Payer: Aetna Medicare |
$388.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$412.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$466.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$466.35
|
| Rate for Payer: BCBS Complete |
$204.90
|
| Rate for Payer: BCBS MAPPO |
$373.08
|
| Rate for Payer: BCBS Trust/PPO |
$564.78
|
| Rate for Payer: BCN Commercial |
$564.78
|
| Rate for Payer: BCN Medicare Advantage |
$373.08
|
| Rate for Payer: Cash Price |
$508.10
|
| Rate for Payer: Cash Price |
$508.10
|
| Rate for Payer: Cofinity Advantage |
$444.58
|
| Rate for Payer: Cofinity Commercial |
$546.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$508.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.08
|
| Rate for Payer: Healthscope Commercial |
$571.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$444.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$476.34
|
| Rate for Payer: Mclaren Medicaid |
$373.08
|
| Rate for Payer: Mclaren Medicare |
$373.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.73
|
| Rate for Payer: Meridian Medicaid |
$391.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$429.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$410.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.85
|
| Rate for Payer: Nomi Health Commercial |
$1,119.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$476.34
|
| Rate for Payer: PACE Medicare |
$354.43
|
| Rate for Payer: PACE SWMI |
$373.08
|
| Rate for Payer: PHP Commercial |
$539.85
|
| Rate for Payer: PHP Medicare Advantage |
$373.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$195.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,206.50
|
| Rate for Payer: Priority Health Medicare |
$373.08
|
| Rate for Payer: Priority Health SBD |
$400.13
|
| Rate for Payer: Priority Health Tiered Network |
$965.20
|
| Rate for Payer: Railroad Medicare Medicare |
$373.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$412.83
|
| Rate for Payer: UHC Core |
$330.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$373.08
|
| Rate for Payer: UHC Exchange |
$249.60
|
| Rate for Payer: UHC Medicaid |
$195.12
|
| Rate for Payer: UHCCP Medicaid |
$195.12
|
| Rate for Payer: UMR Bronson Commercial |
$234.99
|
| Rate for Payer: VA VA |
$373.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$476.34
|
|
|
HC RO ISODOSE BRACHY CALC INTRM
|
Facility
|
IP
|
$635.12
|
|
|
Service Code
|
CPT 77317
|
| Hospital Charge Code |
33300046
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$279.45 |
| Max. Negotiated Rate |
$571.61 |
| Rate for Payer: Aetna American Axle |
$412.83
|
| Rate for Payer: Aetna Commercial |
$539.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$412.83
|
| Rate for Payer: Cash Price |
$508.10
|
| Rate for Payer: Cofinity Advantage |
$444.58
|
| Rate for Payer: Cofinity Commercial |
$546.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$508.10
|
| Rate for Payer: Healthscope Commercial |
$571.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$444.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$476.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$476.34
|
| Rate for Payer: PHP Commercial |
$539.85
|
| Rate for Payer: Priority Health SBD |
$400.13
|
| Rate for Payer: UMR Bronson Commercial |
$279.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$476.34
|
|
|
HC RO ISODOSE TELETHRPY COMPLEX
|
Facility
|
OP
|
$1,181.13
|
|
|
Service Code
|
CPT 77307
|
| Hospital Charge Code |
33300044
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$195.12 |
| Max. Negotiated Rate |
$1,206.50 |
| Rate for Payer: Aetna American Axle |
$767.73
|
| Rate for Payer: Aetna Commercial |
$1,003.96
|
| Rate for Payer: Aetna Medicare |
$388.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$466.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$466.35
|
| Rate for Payer: BCBS Complete |
$204.90
|
| Rate for Payer: BCBS MAPPO |
$373.08
|
| Rate for Payer: BCBS Trust/PPO |
$339.86
|
| Rate for Payer: BCN Commercial |
$339.86
|
| Rate for Payer: BCN Medicare Advantage |
$373.08
|
| Rate for Payer: Cash Price |
$944.90
|
| Rate for Payer: Cash Price |
$944.90
|
| Rate for Payer: Cofinity Advantage |
$826.79
|
| Rate for Payer: Cofinity Commercial |
$1,015.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$944.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.08
|
| Rate for Payer: Healthscope Commercial |
$1,063.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$826.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$885.85
|
| Rate for Payer: Mclaren Medicaid |
$373.08
|
| Rate for Payer: Mclaren Medicare |
$373.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.73
|
| Rate for Payer: Meridian Medicaid |
$391.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$429.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$410.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,003.96
|
| Rate for Payer: Nomi Health Commercial |
$1,119.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$885.85
|
| Rate for Payer: PACE Medicare |
$354.43
|
| Rate for Payer: PACE SWMI |
$373.08
|
| Rate for Payer: PHP Commercial |
$1,003.96
|
| Rate for Payer: PHP Medicare Advantage |
$373.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$195.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,206.50
|
| Rate for Payer: Priority Health Medicare |
$373.08
|
| Rate for Payer: Priority Health SBD |
$744.11
|
| Rate for Payer: Priority Health Tiered Network |
$965.20
|
| Rate for Payer: Railroad Medicare Medicare |
$373.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$767.73
|
| Rate for Payer: UHC Core |
$615.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$373.08
|
| Rate for Payer: UHC Exchange |
$464.18
|
| Rate for Payer: UHC Medicaid |
$195.12
|
| Rate for Payer: UHCCP Medicaid |
$195.12
|
| Rate for Payer: UMR Bronson Commercial |
$437.02
|
| Rate for Payer: VA VA |
$373.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$885.85
|
|
|
HC RO ISODOSE TELETHRPY COMPLEX
|
Facility
|
IP
|
$1,181.13
|
|
|
Service Code
|
CPT 77307
|
| Hospital Charge Code |
33300044
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$519.70 |
| Max. Negotiated Rate |
$1,063.02 |
| Rate for Payer: Aetna American Axle |
$767.73
|
| Rate for Payer: Aetna Commercial |
$1,003.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.73
|
| Rate for Payer: Cash Price |
$944.90
|
| Rate for Payer: Cofinity Advantage |
$826.79
|
| Rate for Payer: Cofinity Commercial |
$1,015.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$944.90
|
| Rate for Payer: Healthscope Commercial |
$1,063.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$826.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$885.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,003.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$885.85
|
| Rate for Payer: PHP Commercial |
$1,003.96
|
| Rate for Payer: Priority Health SBD |
$744.11
|
| Rate for Payer: UMR Bronson Commercial |
$519.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$885.85
|
|
|
HC RO ISODOSE TELETHRPY SIMPLE
|
Facility
|
IP
|
$257.88
|
|
|
Service Code
|
CPT 77306
|
| Hospital Charge Code |
33300043
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$113.47 |
| Max. Negotiated Rate |
$232.09 |
| Rate for Payer: Aetna American Axle |
$167.62
|
| Rate for Payer: Aetna Commercial |
$219.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.62
|
| Rate for Payer: Cash Price |
$206.30
|
| Rate for Payer: Cofinity Advantage |
$180.52
|
| Rate for Payer: Cofinity Commercial |
$221.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.30
|
| Rate for Payer: Healthscope Commercial |
$232.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$180.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.41
|
| Rate for Payer: PHP Commercial |
$219.20
|
| Rate for Payer: Priority Health SBD |
$162.46
|
| Rate for Payer: UMR Bronson Commercial |
$113.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.41
|
|
|
HC RO ISODOSE TELETHRPY SIMPLE
|
Facility
|
OP
|
$257.88
|
|
|
Service Code
|
CPT 77306
|
| Hospital Charge Code |
33300043
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$95.42 |
| Max. Negotiated Rate |
$1,206.50 |
| Rate for Payer: Aetna American Axle |
$167.62
|
| Rate for Payer: Aetna Commercial |
$219.20
|
| Rate for Payer: Aetna Medicare |
$388.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$466.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$466.35
|
| Rate for Payer: BCBS Complete |
$204.90
|
| Rate for Payer: BCBS MAPPO |
$373.08
|
| Rate for Payer: BCBS Trust/PPO |
$187.16
|
| Rate for Payer: BCN Commercial |
$187.16
|
| Rate for Payer: BCN Medicare Advantage |
$373.08
|
| Rate for Payer: Cash Price |
$206.30
|
| Rate for Payer: Cash Price |
$206.30
|
| Rate for Payer: Cofinity Advantage |
$180.52
|
| Rate for Payer: Cofinity Commercial |
$221.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.08
|
| Rate for Payer: Healthscope Commercial |
$232.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$180.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.41
|
| Rate for Payer: Mclaren Medicaid |
$373.08
|
| Rate for Payer: Mclaren Medicare |
$373.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.73
|
| Rate for Payer: Meridian Medicaid |
$391.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$429.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$410.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.20
|
| Rate for Payer: Nomi Health Commercial |
$1,119.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.41
|
| Rate for Payer: PACE Medicare |
$354.43
|
| Rate for Payer: PACE SWMI |
$373.08
|
| Rate for Payer: PHP Commercial |
$219.20
|
| Rate for Payer: PHP Medicare Advantage |
$373.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$195.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,206.50
|
| Rate for Payer: Priority Health Medicare |
$373.08
|
| Rate for Payer: Priority Health SBD |
$162.46
|
| Rate for Payer: Priority Health Tiered Network |
$965.20
|
| Rate for Payer: Railroad Medicare Medicare |
$373.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.62
|
| Rate for Payer: UHC Core |
$134.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$373.08
|
| Rate for Payer: UHC Exchange |
$101.35
|
| Rate for Payer: UHC Medicaid |
$195.12
|
| Rate for Payer: UHCCP Medicaid |
$195.12
|
| Rate for Payer: UMR Bronson Commercial |
$95.42
|
| Rate for Payer: VA VA |
$373.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.41
|
|
|
HC RO LINAC SBRT PER SESSION
|
Facility
|
IP
|
$3,616.93
|
|
|
Service Code
|
CPT 77373
|
| Hospital Charge Code |
33300041
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,591.45 |
| Max. Negotiated Rate |
$3,255.24 |
| Rate for Payer: Aetna American Axle |
$2,351.00
|
| Rate for Payer: Aetna Commercial |
$3,074.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,351.00
|
| Rate for Payer: Cash Price |
$2,893.54
|
| Rate for Payer: Cofinity Advantage |
$2,531.85
|
| Rate for Payer: Cofinity Commercial |
$3,110.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,893.54
|
| Rate for Payer: Healthscope Commercial |
$3,255.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,531.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,712.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,074.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,712.70
|
| Rate for Payer: PHP Commercial |
$3,074.39
|
| Rate for Payer: Priority Health SBD |
$2,278.67
|
| Rate for Payer: UMR Bronson Commercial |
$1,591.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,712.70
|
|
|
HC RO LINAC SBRT PER SESSION
|
Facility
|
OP
|
$3,616.93
|
|
|
Service Code
|
CPT 77373
|
| Hospital Charge Code |
33300041
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$931.79 |
| Max. Negotiated Rate |
$5,761.61 |
| Rate for Payer: Aetna American Axle |
$2,351.00
|
| Rate for Payer: Aetna Commercial |
$3,074.39
|
| Rate for Payer: Aetna Medicare |
$1,852.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,351.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,227.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,227.03
|
| Rate for Payer: BCBS Complete |
$978.47
|
| Rate for Payer: BCBS MAPPO |
$1,781.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,409.33
|
| Rate for Payer: BCN Commercial |
$2,409.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,781.62
|
| Rate for Payer: Cash Price |
$2,893.54
|
| Rate for Payer: Cash Price |
$2,893.54
|
| Rate for Payer: Cofinity Advantage |
$2,531.85
|
| Rate for Payer: Cofinity Commercial |
$3,110.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,893.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,781.62
|
| Rate for Payer: Healthscope Commercial |
$3,255.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,531.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,712.70
|
| Rate for Payer: Mclaren Medicaid |
$1,781.62
|
| Rate for Payer: Mclaren Medicare |
$1,781.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,870.70
|
| Rate for Payer: Meridian Medicaid |
$1,870.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,048.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,959.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,074.39
|
| Rate for Payer: Nomi Health Commercial |
$5,344.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,712.70
|
| Rate for Payer: PACE Medicare |
$1,692.54
|
| Rate for Payer: PACE SWMI |
$1,781.62
|
| Rate for Payer: PHP Commercial |
$3,074.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,781.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$931.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,761.61
|
| Rate for Payer: Priority Health Medicare |
$1,781.62
|
| Rate for Payer: Priority Health SBD |
$2,278.67
|
| Rate for Payer: Priority Health Tiered Network |
$4,609.29
|
| Rate for Payer: Railroad Medicare Medicare |
$1,781.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,781.62
|
| Rate for Payer: UHC Medicaid |
$931.79
|
| Rate for Payer: UHCCP Medicaid |
$931.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,338.26
|
| Rate for Payer: VA VA |
$1,781.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,712.70
|
|
|
HC ROMOSOZUMAB-AQQG INJ 1 MG
|
Facility
|
OP
|
$11.67
|
|
|
Service Code
|
HCPCS J3111
|
| Hospital Charge Code |
63600150
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.32 |
| Max. Negotiated Rate |
$39.24 |
| Rate for Payer: Aetna American Axle |
$7.59
|
| Rate for Payer: Aetna Commercial |
$9.92
|
| Rate for Payer: Aetna Medicare |
$12.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.24
|
| Rate for Payer: BCBS Complete |
$6.69
|
| Rate for Payer: BCBS MAPPO |
$12.19
|
| Rate for Payer: BCBS Trust/PPO |
$39.24
|
| Rate for Payer: BCN Commercial |
$39.24
|
| Rate for Payer: BCN Medicare Advantage |
$12.19
|
| Rate for Payer: Cash Price |
$9.34
|
| Rate for Payer: Cash Price |
$9.34
|
| Rate for Payer: Cofinity Advantage |
$8.17
|
| Rate for Payer: Cofinity Commercial |
$10.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.19
|
| Rate for Payer: Healthscope Commercial |
$10.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.75
|
| Rate for Payer: Mclaren Medicaid |
$12.19
|
| Rate for Payer: Mclaren Medicare |
$12.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.80
|
| Rate for Payer: Meridian Medicaid |
$12.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.92
|
| Rate for Payer: Nomi Health Commercial |
$36.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.75
|
| Rate for Payer: PACE Medicare |
$11.58
|
| Rate for Payer: PACE SWMI |
$12.19
|
| Rate for Payer: PHP Commercial |
$9.92
|
| Rate for Payer: PHP Medicare Advantage |
$12.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$38.06
|
| Rate for Payer: Priority Health Medicare |
$12.19
|
| Rate for Payer: Priority Health SBD |
$7.35
|
| Rate for Payer: Priority Health Tiered Network |
$30.45
|
| Rate for Payer: Railroad Medicare Medicare |
$12.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.98
|
| Rate for Payer: UHC Core |
$19.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.19
|
| Rate for Payer: UHC Exchange |
$19.98
|
| Rate for Payer: UHC Medicaid |
$6.38
|
| Rate for Payer: UHCCP Medicaid |
$6.38
|
| Rate for Payer: UMR Bronson Commercial |
$4.32
|
| Rate for Payer: VA VA |
$12.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.75
|
|
|
HC ROMOSOZUMAB-AQQG INJ 1 MG
|
Facility
|
IP
|
$11.67
|
|
|
Service Code
|
HCPCS J3111
|
| Hospital Charge Code |
63600150
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$10.50 |
| Rate for Payer: Aetna American Axle |
$7.59
|
| Rate for Payer: Aetna Commercial |
$9.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.59
|
| Rate for Payer: Cash Price |
$9.34
|
| Rate for Payer: Cofinity Advantage |
$8.17
|
| Rate for Payer: Cofinity Commercial |
$10.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.34
|
| Rate for Payer: Healthscope Commercial |
$10.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.75
|
| Rate for Payer: PHP Commercial |
$9.92
|
| Rate for Payer: Priority Health SBD |
$7.35
|
| Rate for Payer: UMR Bronson Commercial |
$5.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.75
|
|
|
HC ROOM & BOARD PSYCH
|
Facility
|
IP
|
$1,846.93
|
|
| Hospital Charge Code |
12400001
|
|
Hospital Revenue Code
|
124
|
| Min. Negotiated Rate |
$812.65 |
| Max. Negotiated Rate |
$1,662.24 |
| Rate for Payer: Aetna American Axle |
$1,200.50
|
| Rate for Payer: Aetna Commercial |
$1,569.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,200.50
|
| Rate for Payer: Cash Price |
$1,477.54
|
| Rate for Payer: Cofinity Advantage |
$1,292.85
|
| Rate for Payer: Cofinity Commercial |
$1,588.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,477.54
|
| Rate for Payer: Healthscope Commercial |
$1,662.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,292.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,385.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,569.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,385.20
|
| Rate for Payer: PHP Commercial |
$1,569.89
|
| Rate for Payer: Priority Health SBD |
$1,163.57
|
| Rate for Payer: UMR Bronson Commercial |
$812.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,385.20
|
|
|
HC ROOM MED SURG
|
Facility
|
IP
|
$3,423.98
|
|
| Hospital Charge Code |
12100001
|
|
Hospital Revenue Code
|
121
|
| Min. Negotiated Rate |
$1,506.55 |
| Max. Negotiated Rate |
$3,081.58 |
| Rate for Payer: Aetna American Axle |
$2,225.59
|
| Rate for Payer: Aetna Commercial |
$2,910.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,225.59
|
| Rate for Payer: Cash Price |
$2,739.18
|
| Rate for Payer: Cofinity Advantage |
$2,396.79
|
| Rate for Payer: Cofinity Commercial |
$2,944.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,739.18
|
| Rate for Payer: Healthscope Commercial |
$3,081.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,396.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,567.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,910.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,567.99
|
| Rate for Payer: PHP Commercial |
$2,910.38
|
| Rate for Payer: Priority Health SBD |
$2,157.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,506.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,567.99
|
|
|
HC ROOM SCU
|
Facility
|
IP
|
$2,399.10
|
|
| Hospital Charge Code |
20000002
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$1,055.60 |
| Max. Negotiated Rate |
$2,159.19 |
| Rate for Payer: Aetna American Axle |
$1,559.41
|
| Rate for Payer: Aetna Commercial |
$2,039.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,559.41
|
| Rate for Payer: Cash Price |
$1,919.28
|
| Rate for Payer: Cofinity Advantage |
$1,679.37
|
| Rate for Payer: Cofinity Commercial |
$2,063.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,919.28
|
| Rate for Payer: Healthscope Commercial |
$2,159.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,679.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,799.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,039.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,799.33
|
| Rate for Payer: PHP Commercial |
$2,039.23
|
| Rate for Payer: Priority Health SBD |
$1,511.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,055.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,799.33
|
|
