|
HC RADXF UNL NM CARDIOVASC 78499
|
Facility
|
OP
|
$803.52
|
|
|
Service Code
|
CPT 78499
|
| Hospital Charge Code |
34100031
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$211.02 |
| Max. Negotiated Rate |
$1,237.41 |
| Rate for Payer: Aetna American Axle |
$522.29
|
| Rate for Payer: Aetna Commercial |
$682.99
|
| Rate for Payer: Aetna Medicare |
$409.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.12
|
| Rate for Payer: BCBS Complete |
$221.57
|
| Rate for Payer: BCBS MAPPO |
$393.70
|
| Rate for Payer: BCN Medicare Advantage |
$393.70
|
| Rate for Payer: Cash Price |
$642.82
|
| Rate for Payer: Cash Price |
$642.82
|
| Rate for Payer: Cofinity Commercial |
$691.03
|
| Rate for Payer: Cofinity Commercial |
$562.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$562.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$642.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.70
|
| 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: Mclaren Medicaid |
$211.02
|
| Rate for Payer: Mclaren Medicare |
$393.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.38
|
| Rate for Payer: Meridian Medicaid |
$221.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$682.99
|
| Rate for Payer: Nomi Health Commercial |
$1,181.10
|
| Rate for Payer: PACE Medicare |
$374.02
|
| Rate for Payer: PACE SWMI |
$393.70
|
| Rate for Payer: PHP Commercial |
$682.99
|
| Rate for Payer: PHP Medicare Advantage |
$393.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.41
|
| Rate for Payer: Priority Health Medicare |
$393.70
|
| Rate for Payer: Priority Health Narrow Network |
$989.93
|
| Rate for Payer: Priority Health SBD |
$506.22
|
| Rate for Payer: Railroad Medicare Medicare |
$393.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,108.23
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.70
|
| Rate for Payer: UHC Exchange |
$752.40
|
| Rate for Payer: UHC Medicare Advantage |
$393.70
|
| Rate for Payer: UHCCP Medicaid |
$211.02
|
| Rate for Payer: UMR Bronson Commercial |
$297.30
|
| Rate for Payer: VA VA |
$393.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$602.64
|
|
|
HC RADXF UNL NM CNS 78699
|
Facility
|
IP
|
$803.52
|
|
|
Service Code
|
CPT 78699
|
| Hospital Charge Code |
34100043
|
|
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
|
|
|
HC RADXF UNL NM CNS 78699
|
Facility
|
OP
|
$803.52
|
|
|
Service Code
|
CPT 78699
|
| Hospital Charge Code |
34100043
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$211.02 |
| Max. Negotiated Rate |
$1,237.41 |
| Rate for Payer: Aetna American Axle |
$522.29
|
| Rate for Payer: Aetna Commercial |
$682.99
|
| Rate for Payer: Aetna Medicare |
$409.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.12
|
| Rate for Payer: BCBS Complete |
$221.57
|
| Rate for Payer: BCBS MAPPO |
$393.70
|
| Rate for Payer: BCN Medicare Advantage |
$393.70
|
| Rate for Payer: Cash Price |
$642.82
|
| Rate for Payer: Cash Price |
$642.82
|
| Rate for Payer: Cofinity Commercial |
$691.03
|
| Rate for Payer: Cofinity Commercial |
$562.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$562.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$642.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.70
|
| 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: Mclaren Medicaid |
$211.02
|
| Rate for Payer: Mclaren Medicare |
$393.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.38
|
| Rate for Payer: Meridian Medicaid |
$221.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$682.99
|
| Rate for Payer: Nomi Health Commercial |
$1,181.10
|
| Rate for Payer: PACE Medicare |
$374.02
|
| Rate for Payer: PACE SWMI |
$393.70
|
| Rate for Payer: PHP Commercial |
$682.99
|
| Rate for Payer: PHP Medicare Advantage |
$393.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.41
|
| Rate for Payer: Priority Health Medicare |
$393.70
|
| Rate for Payer: Priority Health Narrow Network |
$989.93
|
| Rate for Payer: Priority Health SBD |
$506.22
|
| Rate for Payer: Railroad Medicare Medicare |
$393.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,108.23
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.70
|
| Rate for Payer: UHC Exchange |
$752.40
|
| Rate for Payer: UHC Medicare Advantage |
$393.70
|
| Rate for Payer: UHCCP Medicaid |
$211.02
|
| Rate for Payer: UMR Bronson Commercial |
$297.30
|
| Rate for Payer: VA VA |
$393.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$602.64
|
|
|
HC RADXF UNL NM ENDOCR 78099
|
Facility
|
OP
|
$803.52
|
|
|
Service Code
|
CPT 78099
|
| Hospital Charge Code |
34100008
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$211.02 |
| Max. Negotiated Rate |
$1,237.41 |
| Rate for Payer: Aetna American Axle |
$522.29
|
| Rate for Payer: Aetna Commercial |
$682.99
|
| Rate for Payer: Aetna Medicare |
$409.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.12
|
| Rate for Payer: BCBS Complete |
$221.57
|
| Rate for Payer: BCBS MAPPO |
$393.70
|
| Rate for Payer: BCN Medicare Advantage |
$393.70
|
| Rate for Payer: Cash Price |
$642.82
|
| Rate for Payer: Cash Price |
$642.82
|
| Rate for Payer: Cofinity Commercial |
$691.03
|
| Rate for Payer: Cofinity Commercial |
$562.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$562.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$642.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.70
|
| 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: Mclaren Medicaid |
$211.02
|
| Rate for Payer: Mclaren Medicare |
$393.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.38
|
| Rate for Payer: Meridian Medicaid |
$221.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$682.99
|
| Rate for Payer: Nomi Health Commercial |
$1,181.10
|
| Rate for Payer: PACE Medicare |
$374.02
|
| Rate for Payer: PACE SWMI |
$393.70
|
| Rate for Payer: PHP Commercial |
$682.99
|
| Rate for Payer: PHP Medicare Advantage |
$393.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.41
|
| Rate for Payer: Priority Health Medicare |
$393.70
|
| Rate for Payer: Priority Health Narrow Network |
$989.93
|
| Rate for Payer: Priority Health SBD |
$506.22
|
| Rate for Payer: Railroad Medicare Medicare |
$393.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,108.23
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.70
|
| Rate for Payer: UHC Exchange |
$752.40
|
| Rate for Payer: UHC Medicare Advantage |
$393.70
|
| Rate for Payer: UHCCP Medicaid |
$211.02
|
| Rate for Payer: UMR Bronson Commercial |
$297.30
|
| Rate for Payer: VA VA |
$393.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$602.64
|
|
|
HC RADXF UNL NM ENDOCR 78099
|
Facility
|
IP
|
$803.52
|
|
|
Service Code
|
CPT 78099
|
| Hospital Charge Code |
34100008
|
|
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
|
|
|
HC RADXF UNL NM GI PROC 78299
|
Facility
|
IP
|
$803.52
|
|
|
Service Code
|
CPT 78299
|
| Hospital Charge Code |
34100022
|
|
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
|
|
|
HC RADXF UNL NM GI PROC 78299
|
Facility
|
OP
|
$803.52
|
|
|
Service Code
|
CPT 78299
|
| Hospital Charge Code |
34100022
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$211.02 |
| Max. Negotiated Rate |
$1,237.41 |
| Rate for Payer: Aetna American Axle |
$522.29
|
| Rate for Payer: Aetna Commercial |
$682.99
|
| Rate for Payer: Aetna Medicare |
$409.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.12
|
| Rate for Payer: BCBS Complete |
$221.57
|
| Rate for Payer: BCBS MAPPO |
$393.70
|
| Rate for Payer: BCN Medicare Advantage |
$393.70
|
| Rate for Payer: Cash Price |
$642.82
|
| Rate for Payer: Cash Price |
$642.82
|
| Rate for Payer: Cofinity Commercial |
$691.03
|
| Rate for Payer: Cofinity Commercial |
$562.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$562.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$642.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.70
|
| 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: Mclaren Medicaid |
$211.02
|
| Rate for Payer: Mclaren Medicare |
$393.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.38
|
| Rate for Payer: Meridian Medicaid |
$221.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$682.99
|
| Rate for Payer: Nomi Health Commercial |
$1,181.10
|
| Rate for Payer: PACE Medicare |
$374.02
|
| Rate for Payer: PACE SWMI |
$393.70
|
| Rate for Payer: PHP Commercial |
$682.99
|
| Rate for Payer: PHP Medicare Advantage |
$393.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.41
|
| Rate for Payer: Priority Health Medicare |
$393.70
|
| Rate for Payer: Priority Health Narrow Network |
$989.93
|
| Rate for Payer: Priority Health SBD |
$506.22
|
| Rate for Payer: Railroad Medicare Medicare |
$393.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,108.23
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.70
|
| Rate for Payer: UHC Exchange |
$752.40
|
| Rate for Payer: UHC Medicare Advantage |
$393.70
|
| Rate for Payer: UHCCP Medicaid |
$211.02
|
| Rate for Payer: UMR Bronson Commercial |
$297.30
|
| Rate for Payer: VA VA |
$393.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$602.64
|
|
|
HC RADXF UNL NM GU 78799
|
Facility
|
IP
|
$803.52
|
|
|
Service Code
|
CPT 78799
|
| Hospital Charge Code |
34100051
|
|
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
|
|
|
HC RADXF UNL NM GU 78799
|
Facility
|
OP
|
$803.52
|
|
|
Service Code
|
CPT 78799
|
| Hospital Charge Code |
34100051
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$211.02 |
| Max. Negotiated Rate |
$1,237.41 |
| Rate for Payer: Aetna American Axle |
$522.29
|
| Rate for Payer: Aetna Commercial |
$682.99
|
| Rate for Payer: Aetna Medicare |
$409.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.12
|
| Rate for Payer: BCBS Complete |
$221.57
|
| Rate for Payer: BCBS MAPPO |
$393.70
|
| Rate for Payer: BCN Medicare Advantage |
$393.70
|
| Rate for Payer: Cash Price |
$642.82
|
| Rate for Payer: Cash Price |
$642.82
|
| Rate for Payer: Cofinity Commercial |
$691.03
|
| Rate for Payer: Cofinity Commercial |
$562.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$562.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$642.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.70
|
| 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: Mclaren Medicaid |
$211.02
|
| Rate for Payer: Mclaren Medicare |
$393.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.38
|
| Rate for Payer: Meridian Medicaid |
$221.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$682.99
|
| Rate for Payer: Nomi Health Commercial |
$1,181.10
|
| Rate for Payer: PACE Medicare |
$374.02
|
| Rate for Payer: PACE SWMI |
$393.70
|
| Rate for Payer: PHP Commercial |
$682.99
|
| Rate for Payer: PHP Medicare Advantage |
$393.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.41
|
| Rate for Payer: Priority Health Medicare |
$393.70
|
| Rate for Payer: Priority Health Narrow Network |
$989.93
|
| Rate for Payer: Priority Health SBD |
$506.22
|
| Rate for Payer: Railroad Medicare Medicare |
$393.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,108.23
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.70
|
| Rate for Payer: UHC Exchange |
$752.40
|
| Rate for Payer: UHC Medicare Advantage |
$393.70
|
| Rate for Payer: UHCCP Medicaid |
$211.02
|
| Rate for Payer: UMR Bronson Commercial |
$297.30
|
| Rate for Payer: VA VA |
$393.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$602.64
|
|
|
HC RADXF UNL NM H R L 78199
|
Facility
|
IP
|
$750.34
|
|
|
Service Code
|
CPT 78199
|
| Hospital Charge Code |
34100013
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$330.15 |
| Max. Negotiated Rate |
$675.31 |
| Rate for Payer: Aetna American Axle |
$487.72
|
| Rate for Payer: Aetna Commercial |
$637.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.72
|
| Rate for Payer: Cash Price |
$600.27
|
| Rate for Payer: Cofinity Commercial |
$525.24
|
| Rate for Payer: Cofinity Commercial |
$645.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$525.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.27
|
| Rate for Payer: Healthscope Commercial |
$675.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$525.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$562.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$637.79
|
| Rate for Payer: PHP Commercial |
$637.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.72
|
| Rate for Payer: Priority Health SBD |
$472.71
|
| Rate for Payer: UMR Bronson Commercial |
$330.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$562.76
|
|
|
HC RADXF UNL NM H R L 78199
|
Facility
|
OP
|
$750.34
|
|
|
Service Code
|
CPT 78199
|
| Hospital Charge Code |
34100013
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$211.02 |
| Max. Negotiated Rate |
$1,237.41 |
| Rate for Payer: Aetna American Axle |
$487.72
|
| Rate for Payer: Aetna Commercial |
$637.79
|
| Rate for Payer: Aetna Medicare |
$409.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.12
|
| Rate for Payer: BCBS Complete |
$221.57
|
| Rate for Payer: BCBS MAPPO |
$393.70
|
| Rate for Payer: BCN Medicare Advantage |
$393.70
|
| Rate for Payer: Cash Price |
$600.27
|
| Rate for Payer: Cash Price |
$600.27
|
| Rate for Payer: Cofinity Commercial |
$645.29
|
| Rate for Payer: Cofinity Commercial |
$525.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$525.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.70
|
| Rate for Payer: Healthscope Commercial |
$675.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$525.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$562.76
|
| Rate for Payer: Mclaren Medicaid |
$211.02
|
| Rate for Payer: Mclaren Medicare |
$393.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.38
|
| Rate for Payer: Meridian Medicaid |
$221.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$637.79
|
| Rate for Payer: Nomi Health Commercial |
$1,181.10
|
| Rate for Payer: PACE Medicare |
$374.02
|
| Rate for Payer: PACE SWMI |
$393.70
|
| Rate for Payer: PHP Commercial |
$637.79
|
| Rate for Payer: PHP Medicare Advantage |
$393.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.41
|
| Rate for Payer: Priority Health Medicare |
$393.70
|
| Rate for Payer: Priority Health Narrow Network |
$989.93
|
| Rate for Payer: Priority Health SBD |
$472.71
|
| Rate for Payer: Railroad Medicare Medicare |
$393.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,108.23
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.70
|
| Rate for Payer: UHC Exchange |
$752.40
|
| Rate for Payer: UHC Medicare Advantage |
$393.70
|
| Rate for Payer: UHCCP Medicaid |
$211.02
|
| Rate for Payer: UMR Bronson Commercial |
$277.63
|
| Rate for Payer: VA VA |
$393.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$562.76
|
|
|
HC RADXF UNL NM MUSCSKL 78399
|
Facility
|
OP
|
$1,923.10
|
|
|
Service Code
|
CPT 78399
|
| Hospital Charge Code |
34100028
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$211.02 |
| Max. Negotiated Rate |
$1,730.79 |
| Rate for Payer: Aetna American Axle |
$1,250.02
|
| Rate for Payer: Aetna Commercial |
$1,634.64
|
| Rate for Payer: Aetna Medicare |
$409.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,250.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.12
|
| Rate for Payer: BCBS Complete |
$221.57
|
| Rate for Payer: BCBS MAPPO |
$393.70
|
| Rate for Payer: BCN Medicare Advantage |
$393.70
|
| Rate for Payer: Cash Price |
$1,538.48
|
| Rate for Payer: Cash Price |
$1,538.48
|
| Rate for Payer: Cofinity Commercial |
$1,653.87
|
| Rate for Payer: Cofinity Commercial |
$1,346.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,346.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,538.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.70
|
| Rate for Payer: Healthscope Commercial |
$1,730.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,346.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,442.32
|
| Rate for Payer: Mclaren Medicaid |
$211.02
|
| Rate for Payer: Mclaren Medicare |
$393.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.38
|
| Rate for Payer: Meridian Medicaid |
$221.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,634.64
|
| Rate for Payer: Nomi Health Commercial |
$1,181.10
|
| Rate for Payer: PACE Medicare |
$374.02
|
| Rate for Payer: PACE SWMI |
$393.70
|
| Rate for Payer: PHP Commercial |
$1,634.64
|
| Rate for Payer: PHP Medicare Advantage |
$393.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,250.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.41
|
| Rate for Payer: Priority Health Medicare |
$393.70
|
| Rate for Payer: Priority Health Narrow Network |
$989.93
|
| Rate for Payer: Priority Health SBD |
$1,211.55
|
| Rate for Payer: Railroad Medicare Medicare |
$393.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,108.23
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.70
|
| Rate for Payer: UHC Exchange |
$752.40
|
| Rate for Payer: UHC Medicare Advantage |
$393.70
|
| Rate for Payer: UHCCP Medicaid |
$211.02
|
| Rate for Payer: UMR Bronson Commercial |
$711.55
|
| Rate for Payer: VA VA |
$393.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,442.32
|
|
|
HC RADXF UNL NM MUSCSKL 78399
|
Facility
|
IP
|
$1,923.10
|
|
|
Service Code
|
CPT 78399
|
| Hospital Charge Code |
34100028
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$846.16 |
| Max. Negotiated Rate |
$1,730.79 |
| Rate for Payer: Aetna American Axle |
$1,250.02
|
| Rate for Payer: Aetna Commercial |
$1,634.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,250.02
|
| Rate for Payer: Cash Price |
$1,538.48
|
| Rate for Payer: Cofinity Commercial |
$1,346.17
|
| Rate for Payer: Cofinity Commercial |
$1,653.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,346.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,538.48
|
| Rate for Payer: Healthscope Commercial |
$1,730.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,346.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,442.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,634.64
|
| Rate for Payer: PHP Commercial |
$1,634.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,250.02
|
| Rate for Payer: Priority Health SBD |
$1,211.55
|
| Rate for Payer: UMR Bronson Commercial |
$846.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,442.32
|
|
|
HC RADXF UNL NM PROC MISC 78999
|
Facility
|
IP
|
$803.52
|
|
|
Service Code
|
CPT 78999
|
| Hospital Charge Code |
34100061
|
|
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
|
|
|
HC RADXF UNL NM PROC MISC 78999
|
Facility
|
OP
|
$803.52
|
|
|
Service Code
|
CPT 78999
|
| Hospital Charge Code |
34100061
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$211.02 |
| Max. Negotiated Rate |
$1,237.41 |
| Rate for Payer: Aetna American Axle |
$522.29
|
| Rate for Payer: Aetna Commercial |
$682.99
|
| Rate for Payer: Aetna Medicare |
$409.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.12
|
| Rate for Payer: BCBS Complete |
$221.57
|
| Rate for Payer: BCBS MAPPO |
$393.70
|
| Rate for Payer: BCN Medicare Advantage |
$393.70
|
| Rate for Payer: Cash Price |
$642.82
|
| Rate for Payer: Cash Price |
$642.82
|
| Rate for Payer: Cofinity Commercial |
$691.03
|
| Rate for Payer: Cofinity Commercial |
$562.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$562.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$642.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.70
|
| 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: Mclaren Medicaid |
$211.02
|
| Rate for Payer: Mclaren Medicare |
$393.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.38
|
| Rate for Payer: Meridian Medicaid |
$221.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$682.99
|
| Rate for Payer: Nomi Health Commercial |
$1,181.10
|
| Rate for Payer: PACE Medicare |
$374.02
|
| Rate for Payer: PACE SWMI |
$393.70
|
| Rate for Payer: PHP Commercial |
$682.99
|
| Rate for Payer: PHP Medicare Advantage |
$393.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.41
|
| Rate for Payer: Priority Health Medicare |
$393.70
|
| Rate for Payer: Priority Health Narrow Network |
$989.93
|
| Rate for Payer: Priority Health SBD |
$506.22
|
| Rate for Payer: Railroad Medicare Medicare |
$393.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,108.23
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.70
|
| Rate for Payer: UHC Exchange |
$752.40
|
| Rate for Payer: UHC Medicare Advantage |
$393.70
|
| Rate for Payer: UHCCP Medicaid |
$211.02
|
| Rate for Payer: UMR Bronson Commercial |
$297.30
|
| Rate for Payer: VA VA |
$393.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$602.64
|
|
|
HC RADXF UNL NM RADPHARM THER 799
|
Facility
|
IP
|
$803.52
|
|
|
Service Code
|
CPT 79999
|
| Hospital Charge Code |
34100066
|
|
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
|
|
|
HC RADXF UNL NM RADPHARM THER 799
|
Facility
|
OP
|
$803.52
|
|
|
Service Code
|
CPT 79999
|
| Hospital Charge Code |
34100066
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$117.71 |
| Max. Negotiated Rate |
$832.00 |
| Rate for Payer: Aetna American Axle |
$522.29
|
| Rate for Payer: Aetna Commercial |
$682.99
|
| Rate for Payer: Aetna Medicare |
$228.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.50
|
| Rate for Payer: BCBS Complete |
$123.59
|
| Rate for Payer: BCBS MAPPO |
$219.60
|
| Rate for Payer: BCN Medicare Advantage |
$219.60
|
| Rate for Payer: Cash Price |
$642.82
|
| Rate for Payer: Cash Price |
$642.82
|
| Rate for Payer: Cofinity Commercial |
$691.03
|
| Rate for Payer: Cofinity Commercial |
$562.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$562.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$642.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.60
|
| 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: Mclaren Medicaid |
$117.71
|
| Rate for Payer: Mclaren Medicare |
$219.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$230.58
|
| Rate for Payer: Meridian Medicaid |
$123.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$682.99
|
| Rate for Payer: Nomi Health Commercial |
$658.80
|
| Rate for Payer: PACE Medicare |
$208.62
|
| Rate for Payer: PACE SWMI |
$219.60
|
| Rate for Payer: PHP Commercial |
$682.99
|
| Rate for Payer: PHP Medicare Advantage |
$219.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$690.18
|
| Rate for Payer: Priority Health Medicare |
$219.60
|
| Rate for Payer: Priority Health Narrow Network |
$552.14
|
| Rate for Payer: Priority Health SBD |
$506.22
|
| Rate for Payer: Railroad Medicare Medicare |
$219.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$618.15
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.60
|
| Rate for Payer: UHC Exchange |
$419.68
|
| Rate for Payer: UHC Medicare Advantage |
$219.60
|
| Rate for Payer: UHCCP Medicaid |
$117.71
|
| Rate for Payer: UMR Bronson Commercial |
$297.30
|
| Rate for Payer: VA VA |
$219.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$602.64
|
|
|
HC RADXF UNL NM RESP 78599
|
Facility
|
IP
|
$803.52
|
|
|
Service Code
|
CPT 78599
|
| Hospital Charge Code |
34100036
|
|
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
|
|
|
HC RADXF UNL NM RESP 78599
|
Facility
|
OP
|
$803.52
|
|
|
Service Code
|
CPT 78599
|
| Hospital Charge Code |
34100036
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$211.02 |
| Max. Negotiated Rate |
$1,237.41 |
| Rate for Payer: Aetna American Axle |
$522.29
|
| Rate for Payer: Aetna Commercial |
$682.99
|
| Rate for Payer: Aetna Medicare |
$409.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.12
|
| Rate for Payer: BCBS Complete |
$221.57
|
| Rate for Payer: BCBS MAPPO |
$393.70
|
| Rate for Payer: BCN Medicare Advantage |
$393.70
|
| Rate for Payer: Cash Price |
$642.82
|
| Rate for Payer: Cash Price |
$642.82
|
| Rate for Payer: Cofinity Commercial |
$691.03
|
| Rate for Payer: Cofinity Commercial |
$562.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$562.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$642.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.70
|
| 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: Mclaren Medicaid |
$211.02
|
| Rate for Payer: Mclaren Medicare |
$393.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.38
|
| Rate for Payer: Meridian Medicaid |
$221.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$682.99
|
| Rate for Payer: Nomi Health Commercial |
$1,181.10
|
| Rate for Payer: PACE Medicare |
$374.02
|
| Rate for Payer: PACE SWMI |
$393.70
|
| Rate for Payer: PHP Commercial |
$682.99
|
| Rate for Payer: PHP Medicare Advantage |
$393.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.41
|
| Rate for Payer: Priority Health Medicare |
$393.70
|
| Rate for Payer: Priority Health Narrow Network |
$989.93
|
| Rate for Payer: Priority Health SBD |
$506.22
|
| Rate for Payer: Railroad Medicare Medicare |
$393.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,108.23
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.70
|
| Rate for Payer: UHC Exchange |
$752.40
|
| Rate for Payer: UHC Medicare Advantage |
$393.70
|
| Rate for Payer: UHCCP Medicaid |
$211.02
|
| Rate for Payer: UMR Bronson Commercial |
$297.30
|
| Rate for Payer: VA VA |
$393.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$602.64
|
|
|
HC RADXF UNL ULTRASOUND 76999
|
Facility
|
IP
|
$217.26
|
|
|
Service Code
|
CPT 76999
|
| Hospital Charge Code |
40200051
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$95.59 |
| Max. Negotiated Rate |
$195.53 |
| Rate for Payer: Aetna American Axle |
$141.22
|
| Rate for Payer: Aetna Commercial |
$184.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.22
|
| Rate for Payer: Cash Price |
$173.81
|
| Rate for Payer: Cofinity Commercial |
$152.08
|
| Rate for Payer: Cofinity Commercial |
$186.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$152.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.81
|
| Rate for Payer: Healthscope Commercial |
$195.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.67
|
| Rate for Payer: PHP Commercial |
$184.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.22
|
| Rate for Payer: Priority Health SBD |
$136.87
|
| Rate for Payer: UMR Bronson Commercial |
$95.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.94
|
|
|
HC RADXF UNL ULTRASOUND 76999
|
Facility
|
OP
|
$217.26
|
|
|
Service Code
|
CPT 76999
|
| Hospital Charge Code |
40200051
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna American Axle |
$141.22
|
| Rate for Payer: Aetna Commercial |
$184.67
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.22
|
| 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: BCBS Trust/PPO |
$111.22
|
| Rate for Payer: BCN Commercial |
$111.22
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$173.81
|
| Rate for Payer: Cash Price |
$173.81
|
| Rate for Payer: Cofinity Commercial |
$186.84
|
| Rate for Payer: Cofinity Commercial |
$152.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$152.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$195.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.94
|
| 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 |
$184.67
|
| 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 |
$184.67
|
| 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 |
$141.22
|
| 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 |
$136.87
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.84
|
| Rate for Payer: UHC Core |
$367.00
|
| 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 |
$80.39
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.94
|
|
|
HC RAGWEED SHORT IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200056
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC RAGWEED SHORT IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200056
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.04
|
| Rate for Payer: BCN Commercial |
$5.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| 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 |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.37
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$4.30
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC RAJI CELL ASSAY
|
Facility
|
IP
|
$150.96
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
30200192
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$66.42 |
| Max. Negotiated Rate |
$135.86 |
| Rate for Payer: Aetna American Axle |
$98.12
|
| Rate for Payer: Aetna Commercial |
$128.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.12
|
| Rate for Payer: Cash Price |
$120.77
|
| Rate for Payer: Cofinity Commercial |
$105.67
|
| Rate for Payer: Cofinity Commercial |
$129.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$105.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.77
|
| Rate for Payer: Healthscope Commercial |
$135.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.32
|
| Rate for Payer: PHP Commercial |
$128.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.12
|
| Rate for Payer: Priority Health SBD |
$95.10
|
| Rate for Payer: UMR Bronson Commercial |
$66.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.22
|
|
|
HC RAJI CELL ASSAY
|
Facility
|
OP
|
$150.96
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
30200192
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.06 |
| Max. Negotiated Rate |
$135.86 |
| Rate for Payer: Aetna American Axle |
$98.12
|
| Rate for Payer: Aetna Commercial |
$128.32
|
| Rate for Payer: Aetna Medicare |
$25.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.46
|
| Rate for Payer: BCBS Complete |
$13.72
|
| Rate for Payer: BCBS MAPPO |
$24.37
|
| Rate for Payer: BCBS Trust/PPO |
$23.48
|
| Rate for Payer: BCN Commercial |
$23.48
|
| Rate for Payer: BCN Medicare Advantage |
$24.37
|
| Rate for Payer: Cash Price |
$120.77
|
| Rate for Payer: Cash Price |
$120.77
|
| Rate for Payer: Cofinity Commercial |
$129.83
|
| Rate for Payer: Cofinity Commercial |
$105.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$105.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.37
|
| Rate for Payer: Healthscope Commercial |
$135.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.22
|
| Rate for Payer: Mclaren Medicaid |
$13.06
|
| Rate for Payer: Mclaren Medicare |
$24.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.59
|
| Rate for Payer: Meridian Medicaid |
$13.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.32
|
| Rate for Payer: Nomi Health Commercial |
$36.56
|
| Rate for Payer: PACE Medicare |
$23.15
|
| Rate for Payer: PACE SWMI |
$24.37
|
| Rate for Payer: PHP Commercial |
$128.32
|
| Rate for Payer: PHP Medicare Advantage |
$24.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.37
|
| Rate for Payer: Priority Health Medicare |
$24.37
|
| Rate for Payer: Priority Health Narrow Network |
$19.50
|
| Rate for Payer: Priority Health SBD |
$95.10
|
| Rate for Payer: Railroad Medicare Medicare |
$24.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.37
|
| Rate for Payer: UHC Exchange |
$24.37
|
| Rate for Payer: UHC Medicare Advantage |
$24.37
|
| Rate for Payer: UHCCP Medicaid |
$13.06
|
| Rate for Payer: UMR Bronson Commercial |
$55.86
|
| Rate for Payer: VA VA |
$24.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.22
|
|
