|
HC SCALLOP IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200060
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC SCALLOP IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200060
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC SCALP ELECTRODE
|
Facility
|
IP
|
$136.45
|
|
| Hospital Charge Code |
72000005
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$60.04 |
| Max. Negotiated Rate |
$122.81 |
| Rate for Payer: Aetna American Axle |
$88.69
|
| Rate for Payer: Aetna Commercial |
$115.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.69
|
| Rate for Payer: Cash Price |
$109.16
|
| Rate for Payer: Cofinity Advantage |
$95.52
|
| Rate for Payer: Cofinity Commercial |
$117.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.16
|
| Rate for Payer: Healthscope Commercial |
$122.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.34
|
| Rate for Payer: PHP Commercial |
$115.98
|
| Rate for Payer: Priority Health SBD |
$85.96
|
| Rate for Payer: UMR Bronson Commercial |
$60.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.34
|
|
|
HC SCALP ELECTRODE
|
Facility
|
OP
|
$136.45
|
|
| Hospital Charge Code |
72000005
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$50.49 |
| Max. Negotiated Rate |
$122.81 |
| Rate for Payer: Aetna American Axle |
$88.69
|
| Rate for Payer: Aetna Commercial |
$115.98
|
| Rate for Payer: Aetna Medicare |
$68.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.69
|
| Rate for Payer: BCBS Complete |
$54.58
|
| Rate for Payer: Cash Price |
$109.16
|
| Rate for Payer: Cofinity Advantage |
$95.52
|
| Rate for Payer: Cofinity Commercial |
$117.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.16
|
| Rate for Payer: Healthscope Commercial |
$122.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.34
|
| Rate for Payer: PHP Commercial |
$115.98
|
| Rate for Payer: Priority Health SBD |
$85.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.69
|
| Rate for Payer: UHC Core |
$71.09
|
| Rate for Payer: UHC Exchange |
$53.62
|
| Rate for Payer: UMR Bronson Commercial |
$50.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.34
|
|
|
HC SCHISTOSOMA SPECIES ANTIBODY, IGG, SERUM
|
Facility
|
IP
|
$101.76
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
30200489
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.77 |
| Max. Negotiated Rate |
$91.58 |
| Rate for Payer: Aetna American Axle |
$66.14
|
| Rate for Payer: Aetna Commercial |
$86.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.14
|
| Rate for Payer: Cash Price |
$81.41
|
| Rate for Payer: Cofinity Advantage |
$71.23
|
| Rate for Payer: Cofinity Commercial |
$87.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.41
|
| Rate for Payer: Healthscope Commercial |
$91.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.32
|
| Rate for Payer: PHP Commercial |
$86.50
|
| Rate for Payer: Priority Health SBD |
$64.11
|
| Rate for Payer: UMR Bronson Commercial |
$44.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.32
|
|
|
HC SCHISTOSOMA SPECIES ANTIBODY, IGG, SERUM
|
Facility
|
OP
|
$101.76
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
30200489
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$91.58 |
| Rate for Payer: Aetna American Axle |
$66.14
|
| Rate for Payer: Aetna Commercial |
$86.50
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$7.15
|
| Rate for Payer: BCBS MAPPO |
$13.01
|
| Rate for Payer: BCBS Trust/PPO |
$15.04
|
| Rate for Payer: BCN Commercial |
$15.04
|
| Rate for Payer: BCN Medicare Advantage |
$13.01
|
| Rate for Payer: Cash Price |
$81.41
|
| Rate for Payer: Cash Price |
$81.41
|
| Rate for Payer: Cofinity Advantage |
$71.23
|
| Rate for Payer: Cofinity Commercial |
$87.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$91.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.32
|
| Rate for Payer: Mclaren Medicaid |
$13.01
|
| Rate for Payer: Mclaren Medicare |
$13.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$13.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.50
|
| Rate for Payer: Nomi Health Commercial |
$19.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.32
|
| Rate for Payer: PACE Medicare |
$12.36
|
| Rate for Payer: PACE SWMI |
$13.01
|
| Rate for Payer: PHP Commercial |
$86.50
|
| Rate for Payer: PHP Medicare Advantage |
$13.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.01
|
| Rate for Payer: Priority Health Medicare |
$13.01
|
| Rate for Payer: Priority Health SBD |
$64.11
|
| Rate for Payer: Priority Health Tiered Network |
$10.41
|
| Rate for Payer: Railroad Medicare Medicare |
$13.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.52
|
| Rate for Payer: UHC Core |
$19.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.01
|
| Rate for Payer: UHC Exchange |
$19.52
|
| Rate for Payer: UHC Medicaid |
$6.80
|
| Rate for Payer: UHCCP Medicaid |
$6.80
|
| Rate for Payer: UMR Bronson Commercial |
$37.65
|
| Rate for Payer: VA VA |
$13.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.32
|
|
|
HC SCISSORS
|
Facility
|
OP
|
$18.02
|
|
| Hospital Charge Code |
27000143
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.67 |
| Max. Negotiated Rate |
$16.22 |
| Rate for Payer: Aetna American Axle |
$11.71
|
| Rate for Payer: Aetna Commercial |
$15.32
|
| Rate for Payer: Aetna Medicare |
$9.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.71
|
| Rate for Payer: BCBS Complete |
$7.21
|
| Rate for Payer: Cash Price |
$14.42
|
| Rate for Payer: Cofinity Advantage |
$12.61
|
| Rate for Payer: Cofinity Commercial |
$15.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.42
|
| Rate for Payer: Healthscope Commercial |
$16.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.52
|
| Rate for Payer: PHP Commercial |
$15.32
|
| Rate for Payer: Priority Health SBD |
$11.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.71
|
| Rate for Payer: UHC Core |
$9.39
|
| Rate for Payer: UHC Exchange |
$7.08
|
| Rate for Payer: UMR Bronson Commercial |
$6.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.52
|
|
|
HC SCISSORS
|
Facility
|
IP
|
$18.02
|
|
| Hospital Charge Code |
27000143
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.93 |
| Max. Negotiated Rate |
$16.22 |
| Rate for Payer: Aetna American Axle |
$11.71
|
| Rate for Payer: Aetna Commercial |
$15.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.71
|
| Rate for Payer: Cash Price |
$14.42
|
| Rate for Payer: Cofinity Advantage |
$12.61
|
| Rate for Payer: Cofinity Commercial |
$15.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.42
|
| Rate for Payer: Healthscope Commercial |
$16.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.52
|
| Rate for Payer: PHP Commercial |
$15.32
|
| Rate for Payer: Priority Health SBD |
$11.35
|
| Rate for Payer: UMR Bronson Commercial |
$7.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.52
|
|
|
HC SCL70 SCLERODERMA AB
|
Facility
|
IP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200161
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.78 |
| Max. Negotiated Rate |
$32.28 |
| Rate for Payer: Aetna American Axle |
$23.32
|
| Rate for Payer: Aetna Commercial |
$30.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.32
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Advantage |
$25.11
|
| Rate for Payer: Cofinity Commercial |
$30.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Healthscope Commercial |
$32.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PHP Commercial |
$30.49
|
| Rate for Payer: Priority Health SBD |
$22.60
|
| Rate for Payer: UMR Bronson Commercial |
$15.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.90
|
|
|
HC SCL70 SCLERODERMA AB
|
Facility
|
OP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200161
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$32.28 |
| Rate for Payer: Aetna American Axle |
$23.32
|
| Rate for Payer: Aetna Commercial |
$30.49
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$9.85
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$20.73
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Advantage |
$25.11
|
| Rate for Payer: Cofinity Commercial |
$30.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$32.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.90
|
| Rate for Payer: Mclaren Medicaid |
$17.93
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$18.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$26.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$30.49
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.93
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health SBD |
$22.60
|
| Rate for Payer: Priority Health Tiered Network |
$14.34
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.90
|
| Rate for Payer: UHC Core |
$26.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.93
|
| Rate for Payer: UHC Exchange |
$26.90
|
| Rate for Payer: UHC Medicaid |
$9.38
|
| Rate for Payer: UHCCP Medicaid |
$9.38
|
| Rate for Payer: UMR Bronson Commercial |
$13.27
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.90
|
|
|
HC SCLEROTHERAPY OF FLUID COLLECTION
|
Facility
|
OP
|
$2,678.00
|
|
|
Service Code
|
CPT 49185
|
| Hospital Charge Code |
36100501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna American Axle |
$1,740.70
|
| Rate for Payer: Aetna Commercial |
$2,276.30
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,740.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,592.38
|
| Rate for Payer: BCN Commercial |
$1,592.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$2,142.40
|
| Rate for Payer: Cash Price |
$2,142.40
|
| Rate for Payer: Cash Price |
$2,142.40
|
| Rate for Payer: Cofinity Advantage |
$1,874.60
|
| Rate for Payer: Cofinity Commercial |
$2,303.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,142.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$2,410.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,874.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,008.50
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,276.30
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,008.50
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$2,276.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,687.14
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: UMR Bronson Commercial |
$990.86
|
| Rate for Payer: VA VA |
$1,645.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,008.50
|
|
|
HC SCLEROTHERAPY OF FLUID COLLECTION
|
Facility
|
IP
|
$2,678.00
|
|
|
Service Code
|
CPT 49185
|
| Hospital Charge Code |
36100501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,178.32 |
| Max. Negotiated Rate |
$2,410.20 |
| Rate for Payer: Aetna American Axle |
$1,740.70
|
| Rate for Payer: Aetna Commercial |
$2,276.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,740.70
|
| Rate for Payer: Cash Price |
$2,142.40
|
| Rate for Payer: Cofinity Advantage |
$1,874.60
|
| Rate for Payer: Cofinity Commercial |
$2,303.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,142.40
|
| Rate for Payer: Healthscope Commercial |
$2,410.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,874.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,008.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,276.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,008.50
|
| Rate for Payer: PHP Commercial |
$2,276.30
|
| Rate for Payer: Priority Health SBD |
$1,687.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,178.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,008.50
|
|
|
HC SCREENING PAP SMEAR, OBTAIN PREP TO LAB
|
Facility
|
IP
|
$80.16
|
|
|
Service Code
|
CPT Q0091
|
| Hospital Charge Code |
31100043
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$35.27 |
| Max. Negotiated Rate |
$72.14 |
| Rate for Payer: Aetna American Axle |
$52.10
|
| Rate for Payer: Aetna Commercial |
$68.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.10
|
| Rate for Payer: Cash Price |
$64.13
|
| Rate for Payer: Cofinity Advantage |
$56.11
|
| Rate for Payer: Cofinity Commercial |
$68.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.13
|
| Rate for Payer: Healthscope Commercial |
$72.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.12
|
| Rate for Payer: PHP Commercial |
$68.14
|
| Rate for Payer: Priority Health SBD |
$50.50
|
| Rate for Payer: UMR Bronson Commercial |
$35.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.12
|
|
|
HC SCREENING PAP SMEAR, OBTAIN PREP TO LAB
|
Facility
|
OP
|
$80.16
|
|
|
Service Code
|
CPT Q0091
|
| Hospital Charge Code |
31100043
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$15.07 |
| Max. Negotiated Rate |
$93.19 |
| Rate for Payer: Aetna American Axle |
$52.10
|
| Rate for Payer: Aetna Commercial |
$68.14
|
| Rate for Payer: Aetna Medicare |
$29.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.10
|
| 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 |
$65.06
|
| Rate for Payer: BCCCP Commercial |
$17.38
|
| Rate for Payer: BCN Commercial |
$65.06
|
| Rate for Payer: BCN Medicare Advantage |
$28.82
|
| Rate for Payer: Cash Price |
$64.13
|
| Rate for Payer: Cash Price |
$64.13
|
| Rate for Payer: Cofinity Advantage |
$56.11
|
| Rate for Payer: Cofinity Commercial |
$68.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.82
|
| Rate for Payer: Healthscope Commercial |
$72.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.12
|
| 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 |
$68.14
|
| Rate for Payer: Nomi Health Commercial |
$86.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.12
|
| Rate for Payer: PACE Medicare |
$27.38
|
| Rate for Payer: PACE SWMI |
$28.82
|
| Rate for Payer: PHP Commercial |
$68.14
|
| 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 |
$50.50
|
| 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) |
$36.74
|
| Rate for Payer: UHC Core |
$36.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.82
|
| Rate for Payer: UHC Exchange |
$36.74
|
| Rate for Payer: UHC Medicaid |
$15.07
|
| Rate for Payer: UHCCP Medicaid |
$15.07
|
| Rate for Payer: UMR Bronson Commercial |
$29.66
|
| Rate for Payer: VA VA |
$28.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.12
|
|
|
HC SCREENING TOMOSYNTHESIS
|
Facility
|
IP
|
$105.27
|
|
|
Service Code
|
CPT 77063
|
| Hospital Charge Code |
32000301
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$46.32 |
| Max. Negotiated Rate |
$94.74 |
| Rate for Payer: Aetna American Axle |
$68.43
|
| Rate for Payer: Aetna Commercial |
$89.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.43
|
| Rate for Payer: Cash Price |
$84.22
|
| Rate for Payer: Cofinity Advantage |
$73.69
|
| Rate for Payer: Cofinity Commercial |
$90.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.22
|
| Rate for Payer: Healthscope Commercial |
$94.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.95
|
| Rate for Payer: PHP Commercial |
$89.48
|
| Rate for Payer: Priority Health SBD |
$66.32
|
| Rate for Payer: UMR Bronson Commercial |
$46.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.95
|
|
|
HC SCREENING TOMOSYNTHESIS
|
Facility
|
OP
|
$105.27
|
|
|
Service Code
|
CPT 77063
|
| Hospital Charge Code |
32000301
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$20.38 |
| Max. Negotiated Rate |
$94.74 |
| Rate for Payer: Aetna American Axle |
$68.43
|
| Rate for Payer: Aetna Commercial |
$89.48
|
| Rate for Payer: Aetna Medicare |
$52.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.43
|
| Rate for Payer: BCBS Complete |
$42.11
|
| Rate for Payer: BCBS Trust/PPO |
$59.11
|
| Rate for Payer: BCCCP Commercial |
$49.44
|
| Rate for Payer: BCN Commercial |
$59.11
|
| Rate for Payer: Cash Price |
$84.22
|
| Rate for Payer: Cash Price |
$84.22
|
| Rate for Payer: Cofinity Advantage |
$73.69
|
| Rate for Payer: Cofinity Commercial |
$90.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.22
|
| Rate for Payer: Healthscope Commercial |
$94.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.95
|
| Rate for Payer: PHP Commercial |
$89.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25.48
|
| Rate for Payer: Priority Health SBD |
$66.32
|
| Rate for Payer: Priority Health Tiered Network |
$20.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.43
|
| Rate for Payer: UHC Core |
$54.85
|
| Rate for Payer: UHC Exchange |
$41.37
|
| Rate for Payer: UMR Bronson Commercial |
$38.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.95
|
|
|
HC SDL MSLT/MWT
|
Facility
|
IP
|
$2,623.63
|
|
|
Service Code
|
CPT 95805
|
| Hospital Charge Code |
92000005
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$1,154.40 |
| Max. Negotiated Rate |
$2,361.27 |
| Rate for Payer: Aetna American Axle |
$1,705.36
|
| Rate for Payer: Aetna Commercial |
$2,230.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,705.36
|
| Rate for Payer: Cash Price |
$2,098.90
|
| Rate for Payer: Cofinity Advantage |
$1,836.54
|
| Rate for Payer: Cofinity Commercial |
$2,256.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,098.90
|
| Rate for Payer: Healthscope Commercial |
$2,361.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,836.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,967.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,230.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,967.72
|
| Rate for Payer: PHP Commercial |
$2,230.09
|
| Rate for Payer: Priority Health SBD |
$1,652.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,154.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,967.72
|
|
|
HC SDL MSLT/MWT
|
Facility
|
OP
|
$2,623.63
|
|
|
Service Code
|
CPT 95805
|
| Hospital Charge Code |
92000005
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$447.50 |
| Max. Negotiated Rate |
$2,767.09 |
| Rate for Payer: Aetna American Axle |
$1,705.36
|
| Rate for Payer: Aetna Commercial |
$2,230.09
|
| Rate for Payer: Aetna Medicare |
$889.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,705.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,069.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,069.56
|
| Rate for Payer: BCBS Complete |
$469.92
|
| Rate for Payer: BCBS MAPPO |
$855.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,617.39
|
| Rate for Payer: BCN Commercial |
$1,617.39
|
| Rate for Payer: BCN Medicare Advantage |
$855.65
|
| Rate for Payer: Cash Price |
$2,098.90
|
| Rate for Payer: Cash Price |
$2,098.90
|
| Rate for Payer: Cofinity Advantage |
$1,836.54
|
| Rate for Payer: Cofinity Commercial |
$2,256.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,098.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$855.65
|
| Rate for Payer: Healthscope Commercial |
$2,361.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,836.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,967.72
|
| Rate for Payer: Mclaren Medicaid |
$855.65
|
| Rate for Payer: Mclaren Medicare |
$855.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$898.43
|
| Rate for Payer: Meridian Medicaid |
$898.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$984.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$941.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,230.09
|
| Rate for Payer: Nomi Health Commercial |
$2,566.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,967.72
|
| Rate for Payer: PACE Medicare |
$812.87
|
| Rate for Payer: PACE SWMI |
$855.65
|
| Rate for Payer: PHP Commercial |
$2,230.09
|
| Rate for Payer: PHP Medicare Advantage |
$855.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,767.09
|
| Rate for Payer: Priority Health Medicare |
$855.65
|
| Rate for Payer: Priority Health SBD |
$1,652.89
|
| Rate for Payer: Priority Health Tiered Network |
$2,213.67
|
| Rate for Payer: Railroad Medicare Medicare |
$855.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,705.36
|
| Rate for Payer: UHC Core |
$1,366.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$855.65
|
| Rate for Payer: UHC Exchange |
$1,031.09
|
| Rate for Payer: UHC Medicaid |
$447.50
|
| Rate for Payer: UHCCP Medicaid |
$447.50
|
| Rate for Payer: UMR Bronson Commercial |
$970.74
|
| Rate for Payer: VA VA |
$855.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,967.72
|
|
|
HC SDL POLYSOMNOGRAPHY
|
Facility
|
IP
|
$3,631.60
|
|
|
Service Code
|
CPT 95810
|
| Hospital Charge Code |
74000001
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,597.90 |
| Max. Negotiated Rate |
$3,268.44 |
| Rate for Payer: Aetna American Axle |
$2,360.54
|
| Rate for Payer: Aetna Commercial |
$3,086.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,360.54
|
| Rate for Payer: Cash Price |
$2,905.28
|
| Rate for Payer: Cofinity Advantage |
$2,542.12
|
| Rate for Payer: Cofinity Commercial |
$3,123.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,905.28
|
| Rate for Payer: Healthscope Commercial |
$3,268.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,542.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,723.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,086.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,723.70
|
| Rate for Payer: PHP Commercial |
$3,086.86
|
| Rate for Payer: Priority Health SBD |
$2,287.91
|
| Rate for Payer: UMR Bronson Commercial |
$1,597.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,723.70
|
|
|
HC SDL POLYSOMNOGRAPHY
|
Facility
|
OP
|
$3,631.60
|
|
|
Service Code
|
CPT 95810
|
| Hospital Charge Code |
74000001
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$447.50 |
| Max. Negotiated Rate |
$3,268.44 |
| Rate for Payer: Aetna American Axle |
$2,360.54
|
| Rate for Payer: Aetna Commercial |
$3,086.86
|
| Rate for Payer: Aetna Medicare |
$889.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,360.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,069.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,069.56
|
| Rate for Payer: BCBS Complete |
$469.92
|
| Rate for Payer: BCBS MAPPO |
$855.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,704.31
|
| Rate for Payer: BCN Commercial |
$1,704.31
|
| Rate for Payer: BCN Medicare Advantage |
$855.65
|
| Rate for Payer: Cash Price |
$2,905.28
|
| Rate for Payer: Cash Price |
$2,905.28
|
| Rate for Payer: Cofinity Advantage |
$2,542.12
|
| Rate for Payer: Cofinity Commercial |
$3,123.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,905.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$855.65
|
| Rate for Payer: Healthscope Commercial |
$3,268.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,542.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,723.70
|
| Rate for Payer: Mclaren Medicaid |
$855.65
|
| Rate for Payer: Mclaren Medicare |
$855.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$898.43
|
| Rate for Payer: Meridian Medicaid |
$898.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$984.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$941.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,086.86
|
| Rate for Payer: Nomi Health Commercial |
$2,566.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,723.70
|
| Rate for Payer: PACE Medicare |
$812.87
|
| Rate for Payer: PACE SWMI |
$855.65
|
| Rate for Payer: PHP Commercial |
$3,086.86
|
| Rate for Payer: PHP Medicare Advantage |
$855.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,767.09
|
| Rate for Payer: Priority Health Medicare |
$855.65
|
| Rate for Payer: Priority Health SBD |
$2,287.91
|
| Rate for Payer: Priority Health Tiered Network |
$2,213.67
|
| Rate for Payer: Railroad Medicare Medicare |
$855.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,360.54
|
| Rate for Payer: UHC Core |
$1,892.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$855.65
|
| Rate for Payer: UHC Exchange |
$1,427.22
|
| Rate for Payer: UHC Medicaid |
$447.50
|
| Rate for Payer: UHCCP Medicaid |
$447.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,343.69
|
| Rate for Payer: VA VA |
$855.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,723.70
|
|
|
HC SDL PSG WITH CPAP/BIPAP
|
Facility
|
IP
|
$4,014.94
|
|
|
Service Code
|
CPT 95811
|
| Hospital Charge Code |
74000002
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,766.57 |
| Max. Negotiated Rate |
$3,613.45 |
| Rate for Payer: Aetna American Axle |
$2,609.71
|
| Rate for Payer: Aetna Commercial |
$3,412.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,609.71
|
| Rate for Payer: Cash Price |
$3,211.95
|
| Rate for Payer: Cofinity Advantage |
$2,810.46
|
| Rate for Payer: Cofinity Commercial |
$3,452.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,211.95
|
| Rate for Payer: Healthscope Commercial |
$3,613.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,810.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,011.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,412.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,011.20
|
| Rate for Payer: PHP Commercial |
$3,412.70
|
| Rate for Payer: Priority Health SBD |
$2,529.41
|
| Rate for Payer: UMR Bronson Commercial |
$1,766.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,011.20
|
|
|
HC SDL PSG WITH CPAP/BIPAP
|
Facility
|
OP
|
$4,014.94
|
|
|
Service Code
|
CPT 95811
|
| Hospital Charge Code |
74000002
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$447.50 |
| Max. Negotiated Rate |
$3,613.45 |
| Rate for Payer: Aetna American Axle |
$2,609.71
|
| Rate for Payer: Aetna Commercial |
$3,412.70
|
| Rate for Payer: Aetna Medicare |
$889.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,609.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,069.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,069.56
|
| Rate for Payer: BCBS Complete |
$469.92
|
| Rate for Payer: BCBS MAPPO |
$855.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,786.53
|
| Rate for Payer: BCN Commercial |
$1,786.53
|
| Rate for Payer: BCN Medicare Advantage |
$855.65
|
| Rate for Payer: Cash Price |
$3,211.95
|
| Rate for Payer: Cash Price |
$3,211.95
|
| Rate for Payer: Cofinity Advantage |
$2,810.46
|
| Rate for Payer: Cofinity Commercial |
$3,452.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,211.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$855.65
|
| Rate for Payer: Healthscope Commercial |
$3,613.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,810.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,011.20
|
| Rate for Payer: Mclaren Medicaid |
$855.65
|
| Rate for Payer: Mclaren Medicare |
$855.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$898.43
|
| Rate for Payer: Meridian Medicaid |
$898.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$984.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$941.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,412.70
|
| Rate for Payer: Nomi Health Commercial |
$2,566.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,011.20
|
| Rate for Payer: PACE Medicare |
$812.87
|
| Rate for Payer: PACE SWMI |
$855.65
|
| Rate for Payer: PHP Commercial |
$3,412.70
|
| Rate for Payer: PHP Medicare Advantage |
$855.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,767.09
|
| Rate for Payer: Priority Health Medicare |
$855.65
|
| Rate for Payer: Priority Health SBD |
$2,529.41
|
| Rate for Payer: Priority Health Tiered Network |
$2,213.67
|
| Rate for Payer: Railroad Medicare Medicare |
$855.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,609.71
|
| Rate for Payer: UHC Core |
$2,091.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$855.65
|
| Rate for Payer: UHC Exchange |
$1,577.87
|
| Rate for Payer: UHC Medicaid |
$447.50
|
| Rate for Payer: UHCCP Medicaid |
$447.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,485.53
|
| Rate for Payer: VA VA |
$855.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,011.20
|
|
|
HC SEDATION IV / IM OR INHALANT
|
Facility
|
OP
|
$749.58
|
|
| Hospital Charge Code |
37000005
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$277.34 |
| Max. Negotiated Rate |
$674.62 |
| Rate for Payer: Aetna American Axle |
$487.23
|
| Rate for Payer: Aetna Commercial |
$637.14
|
| Rate for Payer: Aetna Medicare |
$374.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.23
|
| Rate for Payer: BCBS Complete |
$299.83
|
| Rate for Payer: Cash Price |
$599.66
|
| Rate for Payer: Cofinity Advantage |
$524.71
|
| Rate for Payer: Cofinity Commercial |
$644.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$599.66
|
| Rate for Payer: Healthscope Commercial |
$674.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$524.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$562.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$599.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$637.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$562.18
|
| Rate for Payer: PHP Commercial |
$637.14
|
| Rate for Payer: Priority Health SBD |
$472.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$487.23
|
| Rate for Payer: UHC Core |
$390.53
|
| Rate for Payer: UHC Exchange |
$294.58
|
| Rate for Payer: UMR Bronson Commercial |
$277.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$562.18
|
|
|
HC SEDATION IV / IM OR INHALANT
|
Facility
|
IP
|
$749.58
|
|
| Hospital Charge Code |
37000005
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$329.82 |
| Max. Negotiated Rate |
$674.62 |
| Rate for Payer: Aetna American Axle |
$487.23
|
| Rate for Payer: Aetna Commercial |
$637.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.23
|
| Rate for Payer: Cash Price |
$599.66
|
| Rate for Payer: Cofinity Advantage |
$524.71
|
| Rate for Payer: Cofinity Commercial |
$644.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$599.66
|
| Rate for Payer: Healthscope Commercial |
$674.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$524.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$562.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$637.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$562.18
|
| Rate for Payer: PHP Commercial |
$637.14
|
| Rate for Payer: Priority Health SBD |
$472.24
|
| Rate for Payer: UMR Bronson Commercial |
$329.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$562.18
|
|
|
HC SED RATE WESTERGREN
|
Facility
|
IP
|
$15.92
|
|
|
Service Code
|
CPT 85652
|
| Hospital Charge Code |
30500060
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna American Axle |
$10.35
|
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.35
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Advantage |
$11.14
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: Priority Health SBD |
$10.03
|
| Rate for Payer: UMR Bronson Commercial |
$7.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
