|
HC RADIUM RA223 DICHLORIDE XOFIGO PER MICROCURIE
|
Facility
|
IP
|
$286.19
|
|
|
Service Code
|
HCPCS A9606
|
| Hospital Charge Code |
63600051
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$125.92 |
| Max. Negotiated Rate |
$257.57 |
| Rate for Payer: Aetna American Axle |
$186.02
|
| Rate for Payer: Aetna Commercial |
$243.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.02
|
| Rate for Payer: Cash Price |
$228.95
|
| Rate for Payer: Cofinity Commercial |
$200.33
|
| Rate for Payer: Cofinity Commercial |
$246.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$200.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.95
|
| Rate for Payer: Healthscope Commercial |
$257.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$200.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.26
|
| Rate for Payer: PHP Commercial |
$243.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.02
|
| Rate for Payer: Priority Health SBD |
$180.30
|
| Rate for Payer: UMR Bronson Commercial |
$125.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.64
|
|
|
HC RADIUM RA223 DICHLORIDE XOFIGO PER MICROCURIE
|
Facility
|
OP
|
$286.19
|
|
|
Service Code
|
HCPCS A9606
|
| Hospital Charge Code |
63600051
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$90.43 |
| Max. Negotiated Rate |
$506.13 |
| Rate for Payer: Aetna American Axle |
$186.02
|
| Rate for Payer: Aetna Commercial |
$243.26
|
| Rate for Payer: Aetna Medicare |
$175.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$210.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$210.89
|
| Rate for Payer: BCBS Complete |
$94.95
|
| Rate for Payer: BCBS MAPPO |
$168.71
|
| Rate for Payer: BCBS Trust/PPO |
$200.65
|
| Rate for Payer: BCN Commercial |
$200.65
|
| Rate for Payer: BCN Medicare Advantage |
$168.71
|
| Rate for Payer: Cash Price |
$228.95
|
| Rate for Payer: Cash Price |
$228.95
|
| Rate for Payer: Cofinity Commercial |
$246.12
|
| Rate for Payer: Cofinity Commercial |
$200.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$200.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$168.71
|
| Rate for Payer: Healthscope Commercial |
$257.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$200.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.64
|
| Rate for Payer: Mclaren Medicaid |
$90.43
|
| Rate for Payer: Mclaren Medicare |
$168.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$177.15
|
| Rate for Payer: Meridian Medicaid |
$94.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$194.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.26
|
| Rate for Payer: Nomi Health Commercial |
$506.13
|
| Rate for Payer: PACE Medicare |
$160.27
|
| Rate for Payer: PACE SWMI |
$168.71
|
| Rate for Payer: PHP Commercial |
$243.26
|
| Rate for Payer: PHP Medicare Advantage |
$168.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$475.59
|
| Rate for Payer: Priority Health Medicare |
$168.71
|
| Rate for Payer: Priority Health Narrow Network |
$380.47
|
| Rate for Payer: Priority Health SBD |
$180.30
|
| Rate for Payer: Railroad Medicare Medicare |
$168.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$474.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$168.71
|
| Rate for Payer: UHC Exchange |
$322.42
|
| Rate for Payer: UHC Medicare Advantage |
$168.71
|
| Rate for Payer: UHCCP Medicaid |
$90.43
|
| Rate for Payer: UMR Bronson Commercial |
$105.89
|
| Rate for Payer: VA VA |
$168.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.64
|
|
|
HC RAD TX ANAL CA ROM 90 DAY EP
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS M1073
|
| Hospital Charge Code |
33300063
|
|
Hospital Revenue Code
|
333
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna American Axle |
$0.01
|
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.01
|
| Rate for Payer: Priority Health SBD |
$0.01
|
| Rate for Payer: UMR Bronson Commercial |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC RAD TX ANAL CA ROM 90 DAY EP
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS M1073
|
| Hospital Charge Code |
33300063
|
|
Hospital Revenue Code
|
333
|
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$0.01
|
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: BCBS Complete |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.01
|
| Rate for Payer: Priority Health SBD |
$0.01
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UMR Bronson Commercial |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC RAD TX BREAST CA ROM 90 DAY EP
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS M1081
|
| Hospital Charge Code |
33300067
|
|
Hospital Revenue Code
|
333
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna American Axle |
$0.01
|
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.01
|
| Rate for Payer: Priority Health SBD |
$0.01
|
| Rate for Payer: UMR Bronson Commercial |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC RAD TX BREAST CA ROM 90 DAY EP
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS M1081
|
| Hospital Charge Code |
33300067
|
|
Hospital Revenue Code
|
333
|
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$0.01
|
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: BCBS Complete |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.01
|
| Rate for Payer: Priority Health SBD |
$0.01
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UMR Bronson Commercial |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC RAD TX CERVIAL CA ROM 90 DAY EP
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS M1085
|
| Hospital Charge Code |
33300069
|
|
Hospital Revenue Code
|
333
|
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$0.01
|
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: BCBS Complete |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.01
|
| Rate for Payer: Priority Health SBD |
$0.01
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UMR Bronson Commercial |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC RAD TX CERVIAL CA ROM 90 DAY EP
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS M1085
|
| Hospital Charge Code |
33300069
|
|
Hospital Revenue Code
|
333
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna American Axle |
$0.01
|
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.01
|
| Rate for Payer: Priority Health SBD |
$0.01
|
| Rate for Payer: UMR Bronson Commercial |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC RAD TX CNS TUMOR ROM 90 DAY EP
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS M1083
|
| Hospital Charge Code |
33300068
|
|
Hospital Revenue Code
|
333
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna American Axle |
$0.01
|
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.01
|
| Rate for Payer: Priority Health SBD |
$0.01
|
| Rate for Payer: UMR Bronson Commercial |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC RAD TX CNS TUMOR ROM 90 DAY EP
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS M1083
|
| Hospital Charge Code |
33300068
|
|
Hospital Revenue Code
|
333
|
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$0.01
|
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: BCBS Complete |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.01
|
| Rate for Payer: Priority Health SBD |
$0.01
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UMR Bronson Commercial |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC RAD TX COLORECTAL CA ROM 90 DAY EP
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS M1087
|
| Hospital Charge Code |
33300070
|
|
Hospital Revenue Code
|
333
|
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$0.01
|
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: BCBS Complete |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.01
|
| Rate for Payer: Priority Health SBD |
$0.01
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UMR Bronson Commercial |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC RAD TX COLORECTAL CA ROM 90 DAY EP
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS M1087
|
| Hospital Charge Code |
33300070
|
|
Hospital Revenue Code
|
333
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna American Axle |
$0.01
|
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.01
|
| Rate for Payer: Priority Health SBD |
$0.01
|
| Rate for Payer: UMR Bronson Commercial |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC RAD TX HEAD & NECK CA ROM 90 DAY EP
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS M1089
|
| Hospital Charge Code |
33300071
|
|
Hospital Revenue Code
|
333
|
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$0.01
|
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: BCBS Complete |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.01
|
| Rate for Payer: Priority Health SBD |
$0.01
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UMR Bronson Commercial |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC RAD TX HEAD & NECK CA ROM 90 DAY EP
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS M1089
|
| Hospital Charge Code |
33300071
|
|
Hospital Revenue Code
|
333
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna American Axle |
$0.01
|
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.01
|
| Rate for Payer: Priority Health SBD |
$0.01
|
| Rate for Payer: UMR Bronson Commercial |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC RADXF UNL ABD PERITONEUM OMENT
|
Facility
|
IP
|
$3,921.50
|
|
|
Service Code
|
CPT 49999
|
| Hospital Charge Code |
36100481
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,725.46 |
| Max. Negotiated Rate |
$3,529.35 |
| Rate for Payer: Aetna American Axle |
$2,548.98
|
| Rate for Payer: Aetna Commercial |
$3,333.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,548.98
|
| Rate for Payer: Cash Price |
$3,137.20
|
| Rate for Payer: Cofinity Commercial |
$2,745.05
|
| Rate for Payer: Cofinity Commercial |
$3,372.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,745.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,137.20
|
| Rate for Payer: Healthscope Commercial |
$3,529.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,745.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,941.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,333.28
|
| Rate for Payer: PHP Commercial |
$3,333.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,548.98
|
| Rate for Payer: Priority Health SBD |
$2,470.54
|
| Rate for Payer: UMR Bronson Commercial |
$1,725.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,941.12
|
|
|
HC RADXF UNL ABD PERITONEUM OMENT
|
Facility
|
OP
|
$3,921.50
|
|
|
Service Code
|
CPT 49999
|
| Hospital Charge Code |
36100481
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$492.37 |
| Max. Negotiated Rate |
$3,529.35 |
| Rate for Payer: Aetna American Axle |
$2,548.98
|
| Rate for Payer: Aetna Commercial |
$3,333.28
|
| Rate for Payer: Aetna Medicare |
$955.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,548.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,148.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,148.25
|
| Rate for Payer: BCBS Complete |
$516.99
|
| Rate for Payer: BCBS MAPPO |
$918.60
|
| Rate for Payer: BCBS Trust/PPO |
$653.58
|
| Rate for Payer: BCN Commercial |
$653.58
|
| Rate for Payer: BCN Medicare Advantage |
$918.60
|
| Rate for Payer: Cash Price |
$3,137.20
|
| Rate for Payer: Cash Price |
$3,137.20
|
| Rate for Payer: Cash Price |
$3,137.20
|
| Rate for Payer: Cofinity Commercial |
$3,372.49
|
| Rate for Payer: Cofinity Commercial |
$2,745.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,745.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,137.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$918.60
|
| Rate for Payer: Healthscope Commercial |
$3,529.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,745.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,941.12
|
| Rate for Payer: Mclaren Medicaid |
$492.37
|
| Rate for Payer: Mclaren Medicare |
$918.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$964.53
|
| Rate for Payer: Meridian Medicaid |
$516.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,056.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,333.28
|
| Rate for Payer: Nomi Health Commercial |
$1,929.06
|
| Rate for Payer: PACE Medicare |
$872.67
|
| Rate for Payer: PACE SWMI |
$918.60
|
| Rate for Payer: PHP Commercial |
$3,333.28
|
| Rate for Payer: PHP Medicare Advantage |
$918.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,548.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,887.15
|
| Rate for Payer: Priority Health Medicare |
$918.60
|
| Rate for Payer: Priority Health Narrow Network |
$2,309.72
|
| Rate for Payer: Priority Health SBD |
$2,470.54
|
| Rate for Payer: Railroad Medicare Medicare |
$918.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,585.77
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$918.60
|
| Rate for Payer: UHC Exchange |
$1,755.54
|
| Rate for Payer: UHC Medicare Advantage |
$918.60
|
| Rate for Payer: UHCCP Medicaid |
$492.37
|
| Rate for Payer: UMR Bronson Commercial |
$1,450.96
|
| Rate for Payer: VA VA |
$918.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,941.12
|
|
|
HC RADXF UNL COMPUTED TOMO 76497
|
Facility
|
IP
|
$272.34
|
|
|
Service Code
|
CPT 76497
|
| Hospital Charge Code |
35000027
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$119.83 |
| Max. Negotiated Rate |
$245.11 |
| Rate for Payer: Aetna American Axle |
$177.02
|
| Rate for Payer: Aetna Commercial |
$231.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.02
|
| Rate for Payer: Cash Price |
$217.87
|
| Rate for Payer: Cofinity Commercial |
$190.64
|
| Rate for Payer: Cofinity Commercial |
$234.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$190.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.87
|
| Rate for Payer: Healthscope Commercial |
$245.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$190.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.49
|
| Rate for Payer: PHP Commercial |
$231.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.02
|
| Rate for Payer: Priority Health SBD |
$171.57
|
| Rate for Payer: UMR Bronson Commercial |
$119.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.26
|
|
|
HC RADXF UNL COMPUTED TOMO 76497
|
Facility
|
OP
|
$272.34
|
|
|
Service Code
|
CPT 76497
|
| Hospital Charge Code |
35000027
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$1,048.00 |
| Rate for Payer: Aetna American Axle |
$177.02
|
| Rate for Payer: Aetna Commercial |
$231.49
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$217.87
|
| Rate for Payer: Cash Price |
$217.87
|
| Rate for Payer: Cofinity Commercial |
$234.21
|
| Rate for Payer: Cofinity Commercial |
$190.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$190.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$245.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$190.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.26
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.49
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$231.49
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$171.57
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.84
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$164.87
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$100.77
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.26
|
|
|
HC RADXF UNL DIAGNOSTIC RAD 76499
|
Facility
|
IP
|
$89.92
|
|
|
Service Code
|
CPT 76499
|
| Hospital Charge Code |
32000242
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$39.56 |
| Max. Negotiated Rate |
$80.93 |
| Rate for Payer: Aetna American Axle |
$58.45
|
| Rate for Payer: Aetna Commercial |
$76.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.45
|
| Rate for Payer: Cash Price |
$71.94
|
| Rate for Payer: Cofinity Commercial |
$62.94
|
| Rate for Payer: Cofinity Commercial |
$77.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$62.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.94
|
| Rate for Payer: Healthscope Commercial |
$80.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.43
|
| Rate for Payer: PHP Commercial |
$76.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.45
|
| Rate for Payer: Priority Health SBD |
$56.65
|
| Rate for Payer: UMR Bronson Commercial |
$39.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.44
|
|
|
HC RADXF UNL DIAGNOSTIC RAD 76499
|
Facility
|
OP
|
$89.92
|
|
|
Service Code
|
CPT 76499
|
| Hospital Charge Code |
32000242
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$33.27 |
| Max. Negotiated Rate |
$271.13 |
| Rate for Payer: Aetna American Axle |
$58.45
|
| Rate for Payer: Aetna Commercial |
$76.43
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$71.94
|
| Rate for Payer: Cash Price |
$71.94
|
| Rate for Payer: Cofinity Commercial |
$77.33
|
| Rate for Payer: Cofinity Commercial |
$62.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$62.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$80.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.44
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.43
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$76.43
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$56.65
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.84
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$164.87
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$33.27
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.44
|
|
|
HC RADXF UNL FLUORO IR 76496
|
Facility
|
IP
|
$287.31
|
|
|
Service Code
|
CPT 76496
|
| Hospital Charge Code |
32000240
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$126.42 |
| Max. Negotiated Rate |
$258.58 |
| Rate for Payer: Aetna American Axle |
$186.75
|
| Rate for Payer: Aetna Commercial |
$244.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.75
|
| Rate for Payer: Cash Price |
$229.85
|
| Rate for Payer: Cofinity Commercial |
$201.12
|
| Rate for Payer: Cofinity Commercial |
$247.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$201.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.85
|
| Rate for Payer: Healthscope Commercial |
$258.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$201.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.21
|
| Rate for Payer: PHP Commercial |
$244.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.75
|
| Rate for Payer: Priority Health SBD |
$181.01
|
| Rate for Payer: UMR Bronson Commercial |
$126.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.48
|
|
|
HC RADXF UNL FLUORO IR 76496
|
Facility
|
OP
|
$287.31
|
|
|
Service Code
|
CPT 76496
|
| Hospital Charge Code |
32000240
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$271.13 |
| Rate for Payer: Aetna American Axle |
$186.75
|
| Rate for Payer: Aetna Commercial |
$244.21
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$229.85
|
| Rate for Payer: Cash Price |
$229.85
|
| Rate for Payer: Cofinity Commercial |
$247.09
|
| Rate for Payer: Cofinity Commercial |
$201.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$201.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$258.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$201.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.48
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.21
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$244.21
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$181.01
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.84
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$164.87
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$106.30
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.48
|
|
|
HC RADXF UNL MAG RES IMAGING 76498
|
Facility
|
OP
|
$955.94
|
|
|
Service Code
|
CPT 76498
|
| Hospital Charge Code |
61000050
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$1,943.00 |
| Rate for Payer: Aetna American Axle |
$621.36
|
| Rate for Payer: Aetna Commercial |
$812.55
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$621.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$764.75
|
| Rate for Payer: Cash Price |
$764.75
|
| Rate for Payer: Cofinity Commercial |
$822.11
|
| Rate for Payer: Cofinity Commercial |
$669.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$669.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$764.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$860.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$669.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$716.96
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$812.55
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$812.55
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$621.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$602.24
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.84
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$164.87
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$353.70
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$716.96
|
|
|
HC RADXF UNL MAG RES IMAGING 76498
|
Facility
|
IP
|
$955.94
|
|
|
Service Code
|
CPT 76498
|
| Hospital Charge Code |
61000050
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$420.61 |
| Max. Negotiated Rate |
$860.35 |
| Rate for Payer: Aetna American Axle |
$621.36
|
| Rate for Payer: Aetna Commercial |
$812.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$621.36
|
| Rate for Payer: Cash Price |
$764.75
|
| Rate for Payer: Cofinity Commercial |
$669.16
|
| Rate for Payer: Cofinity Commercial |
$822.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$669.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$764.75
|
| Rate for Payer: Healthscope Commercial |
$860.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$669.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$716.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$812.55
|
| Rate for Payer: PHP Commercial |
$812.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$621.36
|
| Rate for Payer: Priority Health SBD |
$602.24
|
| Rate for Payer: UMR Bronson Commercial |
$420.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$716.96
|
|
|
HC RADXF UNL NM CARDIOVASC 78499
|
Facility
|
IP
|
$803.52
|
|
|
Service Code
|
CPT 78499
|
| Hospital Charge Code |
34100031
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$353.55 |
| Max. Negotiated Rate |
$723.17 |
| Rate for Payer: Aetna American Axle |
$522.29
|
| Rate for Payer: Aetna Commercial |
$682.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.29
|
| Rate for Payer: Cash Price |
$642.82
|
| Rate for Payer: Cofinity Commercial |
$562.46
|
| Rate for Payer: Cofinity Commercial |
$691.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$562.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$642.82
|
| Rate for Payer: Healthscope Commercial |
$723.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$562.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$602.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$682.99
|
| Rate for Payer: PHP Commercial |
$682.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.29
|
| Rate for Payer: Priority Health SBD |
$506.22
|
| Rate for Payer: UMR Bronson Commercial |
$353.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$602.64
|
|
