|
HC PTCRAWSTENT VES/BRANCH
|
Facility
|
OP
|
$29,158.60
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
48100077
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,386.88 |
| Max. Negotiated Rate |
$49,296.87 |
| Rate for Payer: Aetna American Axle |
$18,953.09
|
| Rate for Payer: Aetna Commercial |
$24,784.81
|
| Rate for Payer: Aetna Medicare |
$18,213.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,953.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,891.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,891.04
|
| Rate for Payer: BCBS Complete |
$9,856.22
|
| Rate for Payer: BCBS MAPPO |
$17,512.83
|
| Rate for Payer: BCN Medicare Advantage |
$17,512.83
|
| Rate for Payer: Cash Price |
$23,326.88
|
| Rate for Payer: Cash Price |
$23,326.88
|
| Rate for Payer: Cofinity Commercial |
$25,076.40
|
| Rate for Payer: Cofinity Commercial |
$20,411.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,411.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,326.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,512.83
|
| Rate for Payer: Healthscope Commercial |
$26,242.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,411.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,868.95
|
| Rate for Payer: Mclaren Medicaid |
$9,386.88
|
| Rate for Payer: Mclaren Medicare |
$17,512.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,388.47
|
| Rate for Payer: Meridian Medicaid |
$9,856.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,139.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,784.81
|
| Rate for Payer: PACE Medicare |
$16,637.19
|
| Rate for Payer: PACE SWMI |
$17,512.83
|
| Rate for Payer: PHP Commercial |
$24,784.81
|
| Rate for Payer: PHP Medicare Advantage |
$17,512.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,386.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,953.09
|
| Rate for Payer: Priority Health Medicare |
$17,512.83
|
| Rate for Payer: Priority Health SBD |
$18,369.92
|
| Rate for Payer: Railroad Medicare Medicare |
$17,512.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49,296.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,512.83
|
| Rate for Payer: UHC Exchange |
$33,468.77
|
| Rate for Payer: UHC Medicare Advantage |
$17,512.83
|
| Rate for Payer: UHCCP Medicaid |
$9,386.88
|
| Rate for Payer: UMR Bronson Commercial |
$10,788.68
|
| Rate for Payer: VA VA |
$17,512.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,868.95
|
|
|
HC PTCRAWSTENT VES/BRANCH
|
Facility
|
IP
|
$29,158.60
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
48100077
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$12,829.78 |
| Max. Negotiated Rate |
$26,242.74 |
| Rate for Payer: Aetna American Axle |
$18,953.09
|
| Rate for Payer: Aetna Commercial |
$24,784.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,953.09
|
| Rate for Payer: Cash Price |
$23,326.88
|
| Rate for Payer: Cofinity Commercial |
$20,411.02
|
| Rate for Payer: Cofinity Commercial |
$25,076.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,411.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,326.88
|
| Rate for Payer: Healthscope Commercial |
$26,242.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,411.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,868.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,784.81
|
| Rate for Payer: PHP Commercial |
$24,784.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,953.09
|
| Rate for Payer: Priority Health SBD |
$18,369.92
|
| Rate for Payer: UMR Bronson Commercial |
$12,829.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,868.95
|
|
|
HC PT EVAL HIGH COMPLEXITY
|
Facility
|
IP
|
$314.72
|
|
|
Service Code
|
CPT 97163
|
| Hospital Charge Code |
42400008
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$138.48 |
| Max. Negotiated Rate |
$283.25 |
| Rate for Payer: Aetna American Axle |
$204.57
|
| Rate for Payer: Aetna Commercial |
$267.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.57
|
| Rate for Payer: Cash Price |
$251.78
|
| Rate for Payer: Cofinity Commercial |
$220.30
|
| Rate for Payer: Cofinity Commercial |
$270.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$220.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$251.78
|
| Rate for Payer: Healthscope Commercial |
$283.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$220.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$267.51
|
| Rate for Payer: PHP Commercial |
$267.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$204.57
|
| Rate for Payer: Priority Health SBD |
$198.27
|
| Rate for Payer: UMR Bronson Commercial |
$138.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.04
|
|
|
HC PT EVAL HIGH COMPLEXITY
|
Facility
|
OP
|
$314.72
|
|
|
Service Code
|
CPT 97163
|
| Hospital Charge Code |
42400008
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$116.45 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$204.57
|
| Rate for Payer: Aetna Commercial |
$267.51
|
| Rate for Payer: Aetna Medicare |
$157.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.57
|
| Rate for Payer: BCBS Complete |
$125.89
|
| Rate for Payer: Cash Price |
$251.78
|
| Rate for Payer: Cash Price |
$251.78
|
| Rate for Payer: Cofinity Commercial |
$270.66
|
| Rate for Payer: Cofinity Commercial |
$220.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$220.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$251.78
|
| Rate for Payer: Healthscope Commercial |
$283.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$220.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$267.51
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$267.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$204.57
|
| Rate for Payer: Priority Health SBD |
$198.27
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$116.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.04
|
|
|
HC PT EVAL LOW COMPLEXITY
|
Facility
|
OP
|
$257.50
|
|
|
Service Code
|
CPT 97161
|
| Hospital Charge Code |
42400006
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$95.28 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$167.38
|
| Rate for Payer: Aetna Commercial |
$218.88
|
| Rate for Payer: Aetna Medicare |
$128.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.38
|
| Rate for Payer: BCBS Complete |
$103.00
|
| Rate for Payer: Cash Price |
$206.00
|
| Rate for Payer: Cash Price |
$206.00
|
| Rate for Payer: Cofinity Commercial |
$221.45
|
| Rate for Payer: Cofinity Commercial |
$180.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$180.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.00
|
| Rate for Payer: Healthscope Commercial |
$231.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$180.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$218.88
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$218.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.38
|
| Rate for Payer: Priority Health SBD |
$162.22
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$95.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.12
|
|
|
HC PT EVAL LOW COMPLEXITY
|
Facility
|
IP
|
$257.50
|
|
|
Service Code
|
CPT 97161
|
| Hospital Charge Code |
42400006
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$113.30 |
| Max. Negotiated Rate |
$231.75 |
| Rate for Payer: Aetna American Axle |
$167.38
|
| Rate for Payer: Aetna Commercial |
$218.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.38
|
| Rate for Payer: Cash Price |
$206.00
|
| Rate for Payer: Cofinity Commercial |
$180.25
|
| Rate for Payer: Cofinity Commercial |
$221.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$180.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.00
|
| Rate for Payer: Healthscope Commercial |
$231.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$180.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$218.88
|
| Rate for Payer: PHP Commercial |
$218.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.38
|
| Rate for Payer: Priority Health SBD |
$162.22
|
| Rate for Payer: UMR Bronson Commercial |
$113.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.12
|
|
|
HC PT EVAL MODERATE COMPLEXITY
|
Facility
|
IP
|
$286.11
|
|
|
Service Code
|
CPT 97162
|
| Hospital Charge Code |
42400007
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$125.89 |
| Max. Negotiated Rate |
$257.50 |
| Rate for Payer: Aetna American Axle |
$185.97
|
| Rate for Payer: Aetna Commercial |
$243.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.97
|
| Rate for Payer: Cash Price |
$228.89
|
| Rate for Payer: Cofinity Commercial |
$200.28
|
| Rate for Payer: Cofinity Commercial |
$246.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$200.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.89
|
| Rate for Payer: Healthscope Commercial |
$257.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$200.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.19
|
| Rate for Payer: PHP Commercial |
$243.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.97
|
| Rate for Payer: Priority Health SBD |
$180.25
|
| Rate for Payer: UMR Bronson Commercial |
$125.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.58
|
|
|
HC PT EVAL MODERATE COMPLEXITY
|
Facility
|
OP
|
$286.11
|
|
|
Service Code
|
CPT 97162
|
| Hospital Charge Code |
42400007
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$105.86 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$185.97
|
| Rate for Payer: Aetna Commercial |
$243.19
|
| Rate for Payer: Aetna Medicare |
$143.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.97
|
| Rate for Payer: BCBS Complete |
$114.44
|
| Rate for Payer: Cash Price |
$228.89
|
| Rate for Payer: Cash Price |
$228.89
|
| Rate for Payer: Cofinity Commercial |
$246.05
|
| Rate for Payer: Cofinity Commercial |
$200.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$200.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.89
|
| Rate for Payer: Healthscope Commercial |
$257.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$200.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.19
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$243.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.97
|
| Rate for Payer: Priority Health SBD |
$180.25
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$105.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.58
|
|
|
HC PT MIX 1:1
|
Facility
|
IP
|
$70.44
|
|
|
Service Code
|
CPT 85611
|
| Hospital Charge Code |
30500107
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$30.99 |
| Max. Negotiated Rate |
$63.40 |
| Rate for Payer: Aetna American Axle |
$45.79
|
| Rate for Payer: Aetna Commercial |
$59.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.79
|
| Rate for Payer: Cash Price |
$56.35
|
| Rate for Payer: Cofinity Commercial |
$49.31
|
| Rate for Payer: Cofinity Commercial |
$60.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.35
|
| Rate for Payer: Healthscope Commercial |
$63.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.87
|
| Rate for Payer: PHP Commercial |
$59.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.79
|
| Rate for Payer: Priority Health SBD |
$44.38
|
| Rate for Payer: UMR Bronson Commercial |
$30.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.83
|
|
|
HC PT MIX 1:1
|
Facility
|
OP
|
$70.44
|
|
|
Service Code
|
CPT 85611
|
| Hospital Charge Code |
30500107
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.11 |
| Max. Negotiated Rate |
$63.40 |
| Rate for Payer: Aetna American Axle |
$45.79
|
| Rate for Payer: Aetna Commercial |
$59.87
|
| Rate for Payer: Aetna Medicare |
$4.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.79
|
| 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 |
$2.22
|
| Rate for Payer: BCBS MAPPO |
$3.94
|
| Rate for Payer: BCN Medicare Advantage |
$3.94
|
| Rate for Payer: Cash Price |
$56.35
|
| Rate for Payer: Cash Price |
$56.35
|
| Rate for Payer: Cofinity Commercial |
$60.58
|
| Rate for Payer: Cofinity Commercial |
$49.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.94
|
| Rate for Payer: Healthscope Commercial |
$63.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.83
|
| Rate for Payer: Mclaren Medicaid |
$2.11
|
| 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 |
$2.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.87
|
| Rate for Payer: PACE Medicare |
$3.74
|
| Rate for Payer: PACE SWMI |
$3.94
|
| Rate for Payer: PHP Commercial |
$59.87
|
| Rate for Payer: PHP Medicare Advantage |
$3.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.79
|
| Rate for Payer: Priority Health Medicare |
$3.94
|
| Rate for Payer: Priority Health SBD |
$44.38
|
| Rate for Payer: Railroad Medicare Medicare |
$3.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.94
|
| Rate for Payer: UHC Exchange |
$7.53
|
| Rate for Payer: UHC Medicare Advantage |
$3.94
|
| Rate for Payer: UHCCP Medicaid |
$2.11
|
| Rate for Payer: UMR Bronson Commercial |
$26.06
|
| Rate for Payer: VA VA |
$3.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.83
|
|
|
HC PT NEUROSTIM
|
Facility
|
IP
|
$97.14
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
42000007
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$42.74 |
| Max. Negotiated Rate |
$87.43 |
| Rate for Payer: Aetna American Axle |
$63.14
|
| Rate for Payer: Aetna Commercial |
$82.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.14
|
| Rate for Payer: Cash Price |
$77.71
|
| Rate for Payer: Cofinity Commercial |
$68.00
|
| Rate for Payer: Cofinity Commercial |
$83.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$68.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.71
|
| Rate for Payer: Healthscope Commercial |
$87.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.57
|
| Rate for Payer: PHP Commercial |
$82.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.14
|
| Rate for Payer: Priority Health SBD |
$61.20
|
| Rate for Payer: UMR Bronson Commercial |
$42.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.86
|
|
|
HC PT NEUROSTIM
|
Facility
|
OP
|
$97.14
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
42000007
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$35.94 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$63.14
|
| Rate for Payer: Aetna Commercial |
$82.57
|
| Rate for Payer: Aetna Medicare |
$48.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.14
|
| Rate for Payer: BCBS Complete |
$38.86
|
| Rate for Payer: Cash Price |
$77.71
|
| Rate for Payer: Cash Price |
$77.71
|
| Rate for Payer: Cofinity Commercial |
$83.54
|
| Rate for Payer: Cofinity Commercial |
$68.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$68.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.71
|
| Rate for Payer: Healthscope Commercial |
$87.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.57
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$82.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.14
|
| Rate for Payer: Priority Health SBD |
$61.20
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$35.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.86
|
|
|
HC PT RE-EVALUATION
|
Facility
|
OP
|
$128.16
|
|
|
Service Code
|
CPT 97164
|
| Hospital Charge Code |
42400009
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$47.42 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$83.30
|
| Rate for Payer: Aetna Commercial |
$108.94
|
| Rate for Payer: Aetna Medicare |
$64.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.30
|
| Rate for Payer: BCBS Complete |
$51.26
|
| Rate for Payer: Cash Price |
$102.53
|
| Rate for Payer: Cash Price |
$102.53
|
| Rate for Payer: Cofinity Commercial |
$89.71
|
| Rate for Payer: Cofinity Commercial |
$110.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$89.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.53
|
| Rate for Payer: Healthscope Commercial |
$115.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.94
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$108.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.30
|
| Rate for Payer: Priority Health SBD |
$80.74
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$47.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.12
|
|
|
HC PT RE-EVALUATION
|
Facility
|
IP
|
$128.16
|
|
|
Service Code
|
CPT 97164
|
| Hospital Charge Code |
42400009
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$56.39 |
| Max. Negotiated Rate |
$115.34 |
| Rate for Payer: Aetna American Axle |
$83.30
|
| Rate for Payer: Aetna Commercial |
$108.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.30
|
| Rate for Payer: Cash Price |
$102.53
|
| Rate for Payer: Cofinity Commercial |
$110.22
|
| Rate for Payer: Cofinity Commercial |
$89.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$89.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.53
|
| Rate for Payer: Healthscope Commercial |
$115.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.94
|
| Rate for Payer: PHP Commercial |
$108.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.30
|
| Rate for Payer: Priority Health SBD |
$80.74
|
| Rate for Payer: UMR Bronson Commercial |
$56.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.12
|
|
|
HC PULM EXER FUNCTION INDIV 15 MIN
|
Facility
|
OP
|
$87.68
|
|
|
Service Code
|
HCPCS G0238
|
| Hospital Charge Code |
41000045
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$56.99
|
| Rate for Payer: Aetna Commercial |
$74.53
|
| Rate for Payer: Aetna Medicare |
$24.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.85
|
| Rate for Payer: BCBS Complete |
$13.44
|
| Rate for Payer: BCBS MAPPO |
$23.88
|
| Rate for Payer: BCN Medicare Advantage |
$23.88
|
| Rate for Payer: Cash Price |
$70.14
|
| Rate for Payer: Cash Price |
$70.14
|
| Rate for Payer: Cash Price |
$70.14
|
| Rate for Payer: Cofinity Commercial |
$61.38
|
| Rate for Payer: Cofinity Commercial |
$75.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$61.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.88
|
| Rate for Payer: Healthscope Commercial |
$78.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.76
|
| Rate for Payer: Mclaren Medicaid |
$12.80
|
| Rate for Payer: Mclaren Medicare |
$23.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.07
|
| Rate for Payer: Meridian Medicaid |
$13.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.53
|
| Rate for Payer: PACE Medicare |
$22.69
|
| Rate for Payer: PACE SWMI |
$23.88
|
| Rate for Payer: PHP Commercial |
$74.53
|
| Rate for Payer: PHP Medicare Advantage |
$23.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.99
|
| Rate for Payer: Priority Health Medicare |
$23.88
|
| Rate for Payer: Priority Health SBD |
$55.24
|
| Rate for Payer: Railroad Medicare Medicare |
$23.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.22
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.88
|
| Rate for Payer: UHC Exchange |
$45.64
|
| Rate for Payer: UHC Medicare Advantage |
$23.88
|
| Rate for Payer: UHCCP Medicaid |
$12.80
|
| Rate for Payer: UMR Bronson Commercial |
$32.44
|
| Rate for Payer: VA VA |
$23.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.76
|
|
|
HC PULM EXER FUNCTION INDIV 15 MIN
|
Facility
|
IP
|
$87.68
|
|
|
Service Code
|
HCPCS G0238
|
| Hospital Charge Code |
41000045
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$38.58 |
| Max. Negotiated Rate |
$78.91 |
| Rate for Payer: Aetna American Axle |
$56.99
|
| Rate for Payer: Aetna Commercial |
$74.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.99
|
| Rate for Payer: Cash Price |
$70.14
|
| Rate for Payer: Cofinity Commercial |
$61.38
|
| Rate for Payer: Cofinity Commercial |
$75.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$61.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.14
|
| Rate for Payer: Healthscope Commercial |
$78.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.53
|
| Rate for Payer: PHP Commercial |
$74.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.99
|
| Rate for Payer: Priority Health SBD |
$55.24
|
| Rate for Payer: UMR Bronson Commercial |
$38.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.76
|
|
|
HC PULMONARY ARTERIOGRAM NONSELECTIVE
|
Facility
|
OP
|
$1,701.19
|
|
|
Service Code
|
CPT 75746
|
| Hospital Charge Code |
32000197
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$1,105.77
|
| Rate for Payer: Aetna Commercial |
$1,446.01
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,105.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$1,360.95
|
| Rate for Payer: Cash Price |
$1,360.95
|
| Rate for Payer: Cofinity Commercial |
$1,463.02
|
| Rate for Payer: Cofinity Commercial |
$1,190.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,190.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,360.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$1,531.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,190.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,275.89
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,446.01
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$1,446.01
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,105.77
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$1,071.75
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$5,866.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: UMR Bronson Commercial |
$629.44
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,275.89
|
|
|
HC PULMONARY ARTERIOGRAM NONSELECTIVE
|
Facility
|
IP
|
$1,701.19
|
|
|
Service Code
|
CPT 75746
|
| Hospital Charge Code |
32000197
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$748.52 |
| Max. Negotiated Rate |
$1,531.07 |
| Rate for Payer: Aetna American Axle |
$1,105.77
|
| Rate for Payer: Aetna Commercial |
$1,446.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,105.77
|
| Rate for Payer: Cash Price |
$1,360.95
|
| Rate for Payer: Cofinity Commercial |
$1,190.83
|
| Rate for Payer: Cofinity Commercial |
$1,463.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,190.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,360.95
|
| Rate for Payer: Healthscope Commercial |
$1,531.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,190.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,275.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,446.01
|
| Rate for Payer: PHP Commercial |
$1,446.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,105.77
|
| Rate for Payer: Priority Health SBD |
$1,071.75
|
| Rate for Payer: UMR Bronson Commercial |
$748.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,275.89
|
|
|
HC PULMONARY EXERCISE GROUP
|
Facility
|
IP
|
$105.20
|
|
|
Service Code
|
HCPCS G0239
|
| Hospital Charge Code |
41000044
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$46.29 |
| Max. Negotiated Rate |
$94.68 |
| Rate for Payer: Aetna American Axle |
$68.38
|
| Rate for Payer: Aetna Commercial |
$89.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.38
|
| Rate for Payer: Cash Price |
$84.16
|
| Rate for Payer: Cofinity Commercial |
$73.64
|
| Rate for Payer: Cofinity Commercial |
$90.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$73.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.16
|
| Rate for Payer: Healthscope Commercial |
$94.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.42
|
| Rate for Payer: PHP Commercial |
$89.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.38
|
| Rate for Payer: Priority Health SBD |
$66.28
|
| Rate for Payer: UMR Bronson Commercial |
$46.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.90
|
|
|
HC PULMONARY EXERCISE GROUP
|
Facility
|
OP
|
$105.20
|
|
|
Service Code
|
HCPCS G0239
|
| Hospital Charge Code |
41000044
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$20.52 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$68.38
|
| Rate for Payer: Aetna Commercial |
$89.42
|
| Rate for Payer: Aetna Medicare |
$39.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.85
|
| Rate for Payer: BCBS Complete |
$21.54
|
| Rate for Payer: BCBS MAPPO |
$38.28
|
| Rate for Payer: BCN Medicare Advantage |
$38.28
|
| Rate for Payer: Cash Price |
$84.16
|
| Rate for Payer: Cash Price |
$84.16
|
| Rate for Payer: Cash Price |
$84.16
|
| Rate for Payer: Cofinity Commercial |
$73.64
|
| Rate for Payer: Cofinity Commercial |
$90.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$73.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$94.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.90
|
| Rate for Payer: Mclaren Medicaid |
$20.52
|
| Rate for Payer: Mclaren Medicare |
$38.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.19
|
| Rate for Payer: Meridian Medicaid |
$21.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.42
|
| Rate for Payer: PACE Medicare |
$36.37
|
| Rate for Payer: PACE SWMI |
$38.28
|
| Rate for Payer: PHP Commercial |
$89.42
|
| Rate for Payer: PHP Medicare Advantage |
$38.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.38
|
| Rate for Payer: Priority Health Medicare |
$38.28
|
| Rate for Payer: Priority Health SBD |
$66.28
|
| Rate for Payer: Railroad Medicare Medicare |
$38.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.75
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.28
|
| Rate for Payer: UHC Exchange |
$73.16
|
| Rate for Payer: UHC Medicare Advantage |
$38.28
|
| Rate for Payer: UHCCP Medicaid |
$20.52
|
| Rate for Payer: UMR Bronson Commercial |
$38.92
|
| Rate for Payer: VA VA |
$38.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.90
|
|
|
HC PULMONARY STRESS TESTING (EG 6 MIN WALK)
|
Facility
|
OP
|
$371.82
|
|
|
Service Code
|
CPT 94618
|
| Hospital Charge Code |
46000030
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$353.86 |
| Rate for Payer: Aetna American Axle |
$241.68
|
| Rate for Payer: Aetna Commercial |
$316.05
|
| Rate for Payer: Aetna Medicare |
$130.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$297.46
|
| Rate for Payer: Cash Price |
$297.46
|
| Rate for Payer: Cash Price |
$297.46
|
| Rate for Payer: Cofinity Commercial |
$260.27
|
| Rate for Payer: Cofinity Commercial |
$319.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$260.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$334.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$260.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$278.87
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.05
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$316.05
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.68
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health SBD |
$234.25
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.86
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$240.24
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: UMR Bronson Commercial |
$137.57
|
| Rate for Payer: VA VA |
$125.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$278.87
|
|
|
HC PULMONARY STRESS TESTING (EG 6 MIN WALK)
|
Facility
|
IP
|
$371.82
|
|
|
Service Code
|
CPT 94618
|
| Hospital Charge Code |
46000030
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$163.60 |
| Max. Negotiated Rate |
$334.64 |
| Rate for Payer: Aetna American Axle |
$241.68
|
| Rate for Payer: Aetna Commercial |
$316.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.68
|
| Rate for Payer: Cash Price |
$297.46
|
| Rate for Payer: Cofinity Commercial |
$260.27
|
| Rate for Payer: Cofinity Commercial |
$319.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$260.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.46
|
| Rate for Payer: Healthscope Commercial |
$334.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$260.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$278.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.05
|
| Rate for Payer: PHP Commercial |
$316.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.68
|
| Rate for Payer: Priority Health SBD |
$234.25
|
| Rate for Payer: UMR Bronson Commercial |
$163.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$278.87
|
|
|
HC PULM REHAB W/ CONT OXIMTRY MNTR
|
Facility
|
IP
|
$219.58
|
|
|
Service Code
|
CPT 94626
|
| Hospital Charge Code |
94800004
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$96.62 |
| Max. Negotiated Rate |
$197.62 |
| Rate for Payer: Aetna American Axle |
$142.73
|
| Rate for Payer: Aetna Commercial |
$186.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.73
|
| Rate for Payer: Cash Price |
$175.66
|
| Rate for Payer: Cofinity Commercial |
$153.71
|
| Rate for Payer: Cofinity Commercial |
$188.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$153.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.66
|
| Rate for Payer: Healthscope Commercial |
$197.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$153.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.64
|
| Rate for Payer: PHP Commercial |
$186.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.73
|
| Rate for Payer: Priority Health SBD |
$138.34
|
| Rate for Payer: UMR Bronson Commercial |
$96.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.69
|
|
|
HC PULM REHAB W/ CONT OXIMTRY MNTR
|
Facility
|
OP
|
$219.58
|
|
|
Service Code
|
CPT 94626
|
| Hospital Charge Code |
94800004
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$197.62 |
| Rate for Payer: Aetna American Axle |
$142.73
|
| Rate for Payer: Aetna Commercial |
$186.64
|
| Rate for Payer: Aetna Medicare |
$60.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.41
|
| Rate for Payer: BCBS Complete |
$32.60
|
| Rate for Payer: BCBS MAPPO |
$57.93
|
| Rate for Payer: BCN Medicare Advantage |
$57.93
|
| Rate for Payer: Cash Price |
$175.66
|
| Rate for Payer: Cash Price |
$175.66
|
| Rate for Payer: Cofinity Commercial |
$188.84
|
| Rate for Payer: Cofinity Commercial |
$153.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$153.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.93
|
| Rate for Payer: Healthscope Commercial |
$197.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$153.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.69
|
| Rate for Payer: Mclaren Medicaid |
$31.05
|
| Rate for Payer: Mclaren Medicare |
$57.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.83
|
| Rate for Payer: Meridian Medicaid |
$32.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.64
|
| Rate for Payer: PACE Medicare |
$55.03
|
| Rate for Payer: PACE SWMI |
$57.93
|
| Rate for Payer: PHP Commercial |
$186.64
|
| Rate for Payer: PHP Medicare Advantage |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.73
|
| Rate for Payer: Priority Health Medicare |
$57.93
|
| Rate for Payer: Priority Health SBD |
$138.34
|
| Rate for Payer: Railroad Medicare Medicare |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.93
|
| Rate for Payer: UHC Exchange |
$110.71
|
| Rate for Payer: UHC Medicare Advantage |
$57.93
|
| Rate for Payer: UHCCP Medicaid |
$31.05
|
| Rate for Payer: UMR Bronson Commercial |
$81.24
|
| Rate for Payer: VA VA |
$57.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.69
|
|
|
HC PULM REHAB W/O CONT OXIMTRY MNTR
|
Facility
|
OP
|
$186.64
|
|
|
Service Code
|
CPT 94625
|
| Hospital Charge Code |
94800003
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$167.98 |
| Rate for Payer: Aetna American Axle |
$121.32
|
| Rate for Payer: Aetna Commercial |
$158.64
|
| Rate for Payer: Aetna Medicare |
$60.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.41
|
| Rate for Payer: BCBS Complete |
$32.60
|
| Rate for Payer: BCBS MAPPO |
$57.93
|
| Rate for Payer: BCN Medicare Advantage |
$57.93
|
| Rate for Payer: Cash Price |
$149.31
|
| Rate for Payer: Cash Price |
$149.31
|
| Rate for Payer: Cofinity Commercial |
$160.51
|
| Rate for Payer: Cofinity Commercial |
$130.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$130.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.93
|
| Rate for Payer: Healthscope Commercial |
$167.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$130.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.98
|
| Rate for Payer: Mclaren Medicaid |
$31.05
|
| Rate for Payer: Mclaren Medicare |
$57.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.83
|
| Rate for Payer: Meridian Medicaid |
$32.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158.64
|
| Rate for Payer: PACE Medicare |
$55.03
|
| Rate for Payer: PACE SWMI |
$57.93
|
| Rate for Payer: PHP Commercial |
$158.64
|
| Rate for Payer: PHP Medicare Advantage |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.32
|
| Rate for Payer: Priority Health Medicare |
$57.93
|
| Rate for Payer: Priority Health SBD |
$117.58
|
| Rate for Payer: Railroad Medicare Medicare |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.93
|
| Rate for Payer: UHC Exchange |
$110.71
|
| Rate for Payer: UHC Medicare Advantage |
$57.93
|
| Rate for Payer: UHCCP Medicaid |
$31.05
|
| Rate for Payer: UMR Bronson Commercial |
$69.06
|
| Rate for Payer: VA VA |
$57.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.98
|
|
