|
HC RO IMRT DEL COMPLEX
|
Facility
|
OP
|
$3,288.00
|
|
|
Service Code
|
CPT 77386
|
| Hospital Charge Code |
33300051
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$302.40 |
| Max. Negotiated Rate |
$2,959.20 |
| Rate for Payer: Aetna American Axle |
$2,137.20
|
| Rate for Payer: Aetna Commercial |
$2,794.80
|
| Rate for Payer: Aetna Medicare |
$586.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,137.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$705.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$705.21
|
| Rate for Payer: BCBS Complete |
$317.51
|
| Rate for Payer: BCBS MAPPO |
$564.17
|
| Rate for Payer: BCN Medicare Advantage |
$564.17
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cofinity Commercial |
$2,301.60
|
| Rate for Payer: Cofinity Commercial |
$2,827.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,301.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,630.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$564.17
|
| Rate for Payer: Healthscope Commercial |
$2,959.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,301.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,466.00
|
| Rate for Payer: Mclaren Medicaid |
$302.40
|
| Rate for Payer: Mclaren Medicare |
$564.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$592.38
|
| Rate for Payer: Meridian Medicaid |
$317.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$648.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.80
|
| Rate for Payer: PACE Medicare |
$535.96
|
| Rate for Payer: PACE SWMI |
$564.17
|
| Rate for Payer: PHP Commercial |
$2,794.80
|
| Rate for Payer: PHP Medicare Advantage |
$564.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$302.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,137.20
|
| Rate for Payer: Priority Health Medicare |
$564.17
|
| Rate for Payer: Priority Health SBD |
$2,071.44
|
| Rate for Payer: Railroad Medicare Medicare |
$564.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,588.08
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$564.17
|
| Rate for Payer: UHC Exchange |
$1,078.19
|
| Rate for Payer: UHC Medicare Advantage |
$564.17
|
| Rate for Payer: UHCCP Medicaid |
$302.40
|
| Rate for Payer: UMR Bronson Commercial |
$1,216.56
|
| Rate for Payer: VA VA |
$564.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,466.00
|
|
|
HC RO IMRT DEL COMPLEX
|
Facility
|
IP
|
$3,288.00
|
|
|
Service Code
|
CPT 77386
|
| Hospital Charge Code |
33300051
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,446.72 |
| Max. Negotiated Rate |
$2,959.20 |
| Rate for Payer: Aetna American Axle |
$2,137.20
|
| Rate for Payer: Aetna Commercial |
$2,794.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,137.20
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cofinity Commercial |
$2,301.60
|
| Rate for Payer: Cofinity Commercial |
$2,827.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,301.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,630.40
|
| Rate for Payer: Healthscope Commercial |
$2,959.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,301.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,466.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.80
|
| Rate for Payer: PHP Commercial |
$2,794.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,137.20
|
| Rate for Payer: Priority Health SBD |
$2,071.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,446.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,466.00
|
|
|
HC RO IMRT DEL SIMPLE
|
Facility
|
OP
|
$3,288.00
|
|
|
Service Code
|
CPT 77385
|
| Hospital Charge Code |
33300050
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$302.40 |
| Max. Negotiated Rate |
$2,959.20 |
| Rate for Payer: Aetna American Axle |
$2,137.20
|
| Rate for Payer: Aetna Commercial |
$2,794.80
|
| Rate for Payer: Aetna Medicare |
$586.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,137.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$705.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$705.21
|
| Rate for Payer: BCBS Complete |
$317.51
|
| Rate for Payer: BCBS MAPPO |
$564.17
|
| Rate for Payer: BCN Medicare Advantage |
$564.17
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cofinity Commercial |
$2,301.60
|
| Rate for Payer: Cofinity Commercial |
$2,827.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,301.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,630.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$564.17
|
| Rate for Payer: Healthscope Commercial |
$2,959.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,301.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,466.00
|
| Rate for Payer: Mclaren Medicaid |
$302.40
|
| Rate for Payer: Mclaren Medicare |
$564.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$592.38
|
| Rate for Payer: Meridian Medicaid |
$317.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$648.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.80
|
| Rate for Payer: PACE Medicare |
$535.96
|
| Rate for Payer: PACE SWMI |
$564.17
|
| Rate for Payer: PHP Commercial |
$2,794.80
|
| Rate for Payer: PHP Medicare Advantage |
$564.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$302.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,137.20
|
| Rate for Payer: Priority Health Medicare |
$564.17
|
| Rate for Payer: Priority Health SBD |
$2,071.44
|
| Rate for Payer: Railroad Medicare Medicare |
$564.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,588.08
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$564.17
|
| Rate for Payer: UHC Exchange |
$1,078.19
|
| Rate for Payer: UHC Medicare Advantage |
$564.17
|
| Rate for Payer: UHCCP Medicaid |
$302.40
|
| Rate for Payer: UMR Bronson Commercial |
$1,216.56
|
| Rate for Payer: VA VA |
$564.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,466.00
|
|
|
HC RO IMRT DEL SIMPLE
|
Facility
|
IP
|
$3,288.00
|
|
|
Service Code
|
CPT 77385
|
| Hospital Charge Code |
33300050
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,446.72 |
| Max. Negotiated Rate |
$2,959.20 |
| Rate for Payer: Aetna American Axle |
$2,137.20
|
| Rate for Payer: Aetna Commercial |
$2,794.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,137.20
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cofinity Commercial |
$2,301.60
|
| Rate for Payer: Cofinity Commercial |
$2,827.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,301.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,630.40
|
| Rate for Payer: Healthscope Commercial |
$2,959.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,301.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,466.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.80
|
| Rate for Payer: PHP Commercial |
$2,794.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,137.20
|
| Rate for Payer: Priority Health SBD |
$2,071.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,446.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,466.00
|
|
|
HC RO INFUS RADIOACTIVE MATERIAL
|
Facility
|
OP
|
$331.89
|
|
|
Service Code
|
CPT 77750
|
| Hospital Charge Code |
33300042
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$122.80 |
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$215.73
|
| Rate for Payer: Aetna Commercial |
$282.11
|
| Rate for Payer: Aetna Medicare |
$266.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$320.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$320.60
|
| Rate for Payer: BCBS Complete |
$144.35
|
| Rate for Payer: BCBS MAPPO |
$256.48
|
| Rate for Payer: BCN Medicare Advantage |
$256.48
|
| Rate for Payer: Cash Price |
$265.51
|
| Rate for Payer: Cash Price |
$265.51
|
| Rate for Payer: Cash Price |
$265.51
|
| Rate for Payer: Cofinity Commercial |
$232.32
|
| Rate for Payer: Cofinity Commercial |
$285.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$232.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$256.48
|
| Rate for Payer: Healthscope Commercial |
$298.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$232.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.92
|
| Rate for Payer: Mclaren Medicaid |
$137.47
|
| Rate for Payer: Mclaren Medicare |
$256.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$269.30
|
| Rate for Payer: Meridian Medicaid |
$144.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$294.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.11
|
| Rate for Payer: PACE Medicare |
$243.66
|
| Rate for Payer: PACE SWMI |
$256.48
|
| Rate for Payer: PHP Commercial |
$282.11
|
| Rate for Payer: PHP Medicare Advantage |
$256.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$137.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.73
|
| Rate for Payer: Priority Health Medicare |
$256.48
|
| Rate for Payer: Priority Health SBD |
$209.09
|
| Rate for Payer: Railroad Medicare Medicare |
$256.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$721.97
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$256.48
|
| Rate for Payer: UHC Exchange |
$490.16
|
| Rate for Payer: UHC Medicare Advantage |
$256.48
|
| Rate for Payer: UHCCP Medicaid |
$137.47
|
| Rate for Payer: UMR Bronson Commercial |
$122.80
|
| Rate for Payer: VA VA |
$256.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.92
|
|
|
HC RO INFUS RADIOACTIVE MATERIAL
|
Facility
|
IP
|
$331.89
|
|
|
Service Code
|
CPT 77750
|
| Hospital Charge Code |
33300042
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$146.03 |
| Max. Negotiated Rate |
$298.70 |
| Rate for Payer: Aetna American Axle |
$215.73
|
| Rate for Payer: Aetna Commercial |
$282.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.73
|
| Rate for Payer: Cash Price |
$265.51
|
| Rate for Payer: Cofinity Commercial |
$232.32
|
| Rate for Payer: Cofinity Commercial |
$285.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$232.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.51
|
| Rate for Payer: Healthscope Commercial |
$298.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$232.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.11
|
| Rate for Payer: PHP Commercial |
$282.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.73
|
| Rate for Payer: Priority Health SBD |
$209.09
|
| Rate for Payer: UMR Bronson Commercial |
$146.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.92
|
|
|
HC RO INS VAG BRACHTHER DEVICE
|
Facility
|
OP
|
$550.40
|
|
|
Service Code
|
CPT 57156
|
| Hospital Charge Code |
36100444
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$159.02 |
| Max. Negotiated Rate |
$835.10 |
| Rate for Payer: Aetna American Axle |
$357.76
|
| Rate for Payer: Aetna Commercial |
$467.84
|
| Rate for Payer: Aetna Medicare |
$308.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$357.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$370.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$370.84
|
| Rate for Payer: BCBS Complete |
$166.97
|
| Rate for Payer: BCBS MAPPO |
$296.67
|
| Rate for Payer: BCN Medicare Advantage |
$296.67
|
| Rate for Payer: Cash Price |
$440.32
|
| Rate for Payer: Cash Price |
$440.32
|
| Rate for Payer: Cofinity Commercial |
$473.34
|
| Rate for Payer: Cofinity Commercial |
$385.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$385.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$440.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$296.67
|
| Rate for Payer: Healthscope Commercial |
$495.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$385.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$412.80
|
| Rate for Payer: Mclaren Medicaid |
$159.02
|
| Rate for Payer: Mclaren Medicare |
$296.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$311.50
|
| Rate for Payer: Meridian Medicaid |
$166.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$341.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$467.84
|
| Rate for Payer: PACE Medicare |
$281.84
|
| Rate for Payer: PACE SWMI |
$296.67
|
| Rate for Payer: PHP Commercial |
$467.84
|
| Rate for Payer: PHP Medicare Advantage |
$296.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.76
|
| Rate for Payer: Priority Health Medicare |
$296.67
|
| Rate for Payer: Priority Health SBD |
$346.75
|
| Rate for Payer: Railroad Medicare Medicare |
$296.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$835.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$296.67
|
| Rate for Payer: UHC Exchange |
$566.97
|
| Rate for Payer: UHC Medicare Advantage |
$296.67
|
| Rate for Payer: UHCCP Medicaid |
$159.02
|
| Rate for Payer: UMR Bronson Commercial |
$203.65
|
| Rate for Payer: VA VA |
$296.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$412.80
|
|
|
HC RO INS VAG BRACHTHER DEVICE
|
Facility
|
IP
|
$550.40
|
|
|
Service Code
|
CPT 57156
|
| Hospital Charge Code |
36100444
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$242.18 |
| Max. Negotiated Rate |
$495.36 |
| Rate for Payer: Aetna American Axle |
$357.76
|
| Rate for Payer: Aetna Commercial |
$467.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$357.76
|
| Rate for Payer: Cash Price |
$440.32
|
| Rate for Payer: Cofinity Commercial |
$385.28
|
| Rate for Payer: Cofinity Commercial |
$473.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$385.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$440.32
|
| Rate for Payer: Healthscope Commercial |
$495.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$385.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$412.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$467.84
|
| Rate for Payer: PHP Commercial |
$467.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.76
|
| Rate for Payer: Priority Health SBD |
$346.75
|
| Rate for Payer: UMR Bronson Commercial |
$242.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$412.80
|
|
|
HC RO INTRSTI RADELEMENT APPL CMPLX
|
Facility
|
IP
|
$2,837.17
|
|
|
Service Code
|
CPT 77778
|
| Hospital Charge Code |
33300035
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,248.35 |
| Max. Negotiated Rate |
$2,553.45 |
| Rate for Payer: Aetna American Axle |
$1,844.16
|
| Rate for Payer: Aetna Commercial |
$2,411.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,844.16
|
| Rate for Payer: Cash Price |
$2,269.74
|
| Rate for Payer: Cofinity Commercial |
$1,986.02
|
| Rate for Payer: Cofinity Commercial |
$2,439.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,986.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,269.74
|
| Rate for Payer: Healthscope Commercial |
$2,553.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,986.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,127.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,411.59
|
| Rate for Payer: PHP Commercial |
$2,411.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,844.16
|
| Rate for Payer: Priority Health SBD |
$1,787.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,248.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,127.88
|
|
|
HC RO INTRSTI RADELEMENT APPL CMPLX
|
Facility
|
OP
|
$2,837.17
|
|
|
Service Code
|
CPT 77778
|
| Hospital Charge Code |
33300035
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$362.69 |
| Max. Negotiated Rate |
$2,553.45 |
| Rate for Payer: Aetna American Axle |
$1,844.16
|
| Rate for Payer: Aetna Commercial |
$2,411.59
|
| Rate for Payer: Aetna Medicare |
$703.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,844.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$845.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$845.83
|
| Rate for Payer: BCBS Complete |
$380.82
|
| Rate for Payer: BCBS MAPPO |
$676.66
|
| Rate for Payer: BCN Medicare Advantage |
$676.66
|
| Rate for Payer: Cash Price |
$2,269.74
|
| Rate for Payer: Cash Price |
$2,269.74
|
| Rate for Payer: Cash Price |
$2,269.74
|
| Rate for Payer: Cofinity Commercial |
$1,986.02
|
| Rate for Payer: Cofinity Commercial |
$2,439.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,986.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,269.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$676.66
|
| Rate for Payer: Healthscope Commercial |
$2,553.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,986.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,127.88
|
| Rate for Payer: Mclaren Medicaid |
$362.69
|
| Rate for Payer: Mclaren Medicare |
$676.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$710.49
|
| Rate for Payer: Meridian Medicaid |
$380.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$778.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,411.59
|
| Rate for Payer: PACE Medicare |
$642.83
|
| Rate for Payer: PACE SWMI |
$676.66
|
| Rate for Payer: PHP Commercial |
$2,411.59
|
| Rate for Payer: PHP Medicare Advantage |
$676.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,844.16
|
| Rate for Payer: Priority Health Medicare |
$676.66
|
| Rate for Payer: Priority Health SBD |
$1,787.42
|
| Rate for Payer: Railroad Medicare Medicare |
$676.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,904.73
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$676.66
|
| Rate for Payer: UHC Exchange |
$1,293.16
|
| Rate for Payer: UHC Medicare Advantage |
$676.66
|
| Rate for Payer: UHCCP Medicaid |
$362.69
|
| Rate for Payer: UMR Bronson Commercial |
$1,049.75
|
| Rate for Payer: VA VA |
$676.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,127.88
|
|
|
HC RO ISODOSE BRACH CALC SIMPLE
|
Facility
|
IP
|
$234.86
|
|
|
Service Code
|
CPT 77316
|
| Hospital Charge Code |
33300045
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$103.34 |
| Max. Negotiated Rate |
$211.37 |
| Rate for Payer: Aetna American Axle |
$152.66
|
| Rate for Payer: Aetna Commercial |
$199.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.66
|
| Rate for Payer: Cash Price |
$187.89
|
| Rate for Payer: Cofinity Commercial |
$164.40
|
| Rate for Payer: Cofinity Commercial |
$201.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$164.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.89
|
| Rate for Payer: Healthscope Commercial |
$211.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$164.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$176.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.63
|
| Rate for Payer: PHP Commercial |
$199.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.66
|
| Rate for Payer: Priority Health SBD |
$147.96
|
| Rate for Payer: UMR Bronson Commercial |
$103.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$176.15
|
|
|
HC RO ISODOSE BRACH CALC SIMPLE
|
Facility
|
OP
|
$234.86
|
|
|
Service Code
|
CPT 77316
|
| Hospital Charge Code |
33300045
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$86.90 |
| Max. Negotiated Rate |
$1,004.98 |
| Rate for Payer: Aetna American Axle |
$152.66
|
| Rate for Payer: Aetna Commercial |
$199.63
|
| Rate for Payer: Aetna Medicare |
$371.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$446.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$446.27
|
| Rate for Payer: BCBS Complete |
$200.93
|
| Rate for Payer: BCBS MAPPO |
$357.02
|
| Rate for Payer: BCN Medicare Advantage |
$357.02
|
| Rate for Payer: Cash Price |
$187.89
|
| Rate for Payer: Cash Price |
$187.89
|
| Rate for Payer: Cash Price |
$187.89
|
| Rate for Payer: Cofinity Commercial |
$164.40
|
| Rate for Payer: Cofinity Commercial |
$201.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$164.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.02
|
| Rate for Payer: Healthscope Commercial |
$211.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$164.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$176.15
|
| Rate for Payer: Mclaren Medicaid |
$191.36
|
| Rate for Payer: Mclaren Medicare |
$357.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$374.87
|
| Rate for Payer: Meridian Medicaid |
$200.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$410.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.63
|
| Rate for Payer: PACE Medicare |
$339.17
|
| Rate for Payer: PACE SWMI |
$357.02
|
| Rate for Payer: PHP Commercial |
$199.63
|
| Rate for Payer: PHP Medicare Advantage |
$357.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.66
|
| Rate for Payer: Priority Health Medicare |
$357.02
|
| Rate for Payer: Priority Health SBD |
$147.96
|
| Rate for Payer: Railroad Medicare Medicare |
$357.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,004.98
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$357.02
|
| Rate for Payer: UHC Exchange |
$682.30
|
| Rate for Payer: UHC Medicare Advantage |
$357.02
|
| Rate for Payer: UHCCP Medicaid |
$191.36
|
| Rate for Payer: UMR Bronson Commercial |
$86.90
|
| Rate for Payer: VA VA |
$357.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$176.15
|
|
|
HC RO ISODOSE BRACHY CALC COMPLEX
|
Facility
|
IP
|
$684.94
|
|
|
Service Code
|
CPT 77318
|
| Hospital Charge Code |
33300047
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$301.37 |
| Max. Negotiated Rate |
$616.45 |
| Rate for Payer: Aetna American Axle |
$445.21
|
| Rate for Payer: Aetna Commercial |
$582.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$445.21
|
| Rate for Payer: Cash Price |
$547.95
|
| Rate for Payer: Cofinity Commercial |
$479.46
|
| Rate for Payer: Cofinity Commercial |
$589.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$479.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$547.95
|
| Rate for Payer: Healthscope Commercial |
$616.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$479.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$513.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$582.20
|
| Rate for Payer: PHP Commercial |
$582.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$445.21
|
| Rate for Payer: Priority Health SBD |
$431.51
|
| Rate for Payer: UMR Bronson Commercial |
$301.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$513.71
|
|
|
HC RO ISODOSE BRACHY CALC COMPLEX
|
Facility
|
OP
|
$684.94
|
|
|
Service Code
|
CPT 77318
|
| Hospital Charge Code |
33300047
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$191.36 |
| Max. Negotiated Rate |
$1,004.98 |
| Rate for Payer: Aetna American Axle |
$445.21
|
| Rate for Payer: Aetna Commercial |
$582.20
|
| Rate for Payer: Aetna Medicare |
$371.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$445.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$446.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$446.27
|
| Rate for Payer: BCBS Complete |
$200.93
|
| Rate for Payer: BCBS MAPPO |
$357.02
|
| Rate for Payer: BCN Medicare Advantage |
$357.02
|
| Rate for Payer: Cash Price |
$547.95
|
| Rate for Payer: Cash Price |
$547.95
|
| Rate for Payer: Cash Price |
$547.95
|
| Rate for Payer: Cofinity Commercial |
$479.46
|
| Rate for Payer: Cofinity Commercial |
$589.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$479.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$547.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.02
|
| Rate for Payer: Healthscope Commercial |
$616.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$479.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$513.71
|
| Rate for Payer: Mclaren Medicaid |
$191.36
|
| Rate for Payer: Mclaren Medicare |
$357.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$374.87
|
| Rate for Payer: Meridian Medicaid |
$200.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$410.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$582.20
|
| Rate for Payer: PACE Medicare |
$339.17
|
| Rate for Payer: PACE SWMI |
$357.02
|
| Rate for Payer: PHP Commercial |
$582.20
|
| Rate for Payer: PHP Medicare Advantage |
$357.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$445.21
|
| Rate for Payer: Priority Health Medicare |
$357.02
|
| Rate for Payer: Priority Health SBD |
$431.51
|
| Rate for Payer: Railroad Medicare Medicare |
$357.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,004.98
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$357.02
|
| Rate for Payer: UHC Exchange |
$682.30
|
| Rate for Payer: UHC Medicare Advantage |
$357.02
|
| Rate for Payer: UHCCP Medicaid |
$191.36
|
| Rate for Payer: UMR Bronson Commercial |
$253.43
|
| Rate for Payer: VA VA |
$357.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$513.71
|
|
|
HC RO ISODOSE BRACHY CALC INTRM
|
Facility
|
IP
|
$622.67
|
|
|
Service Code
|
CPT 77317
|
| Hospital Charge Code |
33300046
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$273.97 |
| Max. Negotiated Rate |
$560.40 |
| Rate for Payer: Aetna American Axle |
$404.74
|
| Rate for Payer: Aetna Commercial |
$529.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.74
|
| Rate for Payer: Cash Price |
$498.14
|
| Rate for Payer: Cofinity Commercial |
$435.87
|
| Rate for Payer: Cofinity Commercial |
$535.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$435.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$498.14
|
| Rate for Payer: Healthscope Commercial |
$560.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$435.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$467.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$529.27
|
| Rate for Payer: PHP Commercial |
$529.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$404.74
|
| Rate for Payer: Priority Health SBD |
$392.28
|
| Rate for Payer: UMR Bronson Commercial |
$273.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$467.00
|
|
|
HC RO ISODOSE BRACHY CALC INTRM
|
Facility
|
OP
|
$622.67
|
|
|
Service Code
|
CPT 77317
|
| Hospital Charge Code |
33300046
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$191.36 |
| Max. Negotiated Rate |
$1,004.98 |
| Rate for Payer: Aetna American Axle |
$404.74
|
| Rate for Payer: Aetna Commercial |
$529.27
|
| Rate for Payer: Aetna Medicare |
$371.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$446.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$446.27
|
| Rate for Payer: BCBS Complete |
$200.93
|
| Rate for Payer: BCBS MAPPO |
$357.02
|
| Rate for Payer: BCN Medicare Advantage |
$357.02
|
| Rate for Payer: Cash Price |
$498.14
|
| Rate for Payer: Cash Price |
$498.14
|
| Rate for Payer: Cash Price |
$498.14
|
| Rate for Payer: Cofinity Commercial |
$435.87
|
| Rate for Payer: Cofinity Commercial |
$535.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$435.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$498.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.02
|
| Rate for Payer: Healthscope Commercial |
$560.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$435.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$467.00
|
| Rate for Payer: Mclaren Medicaid |
$191.36
|
| Rate for Payer: Mclaren Medicare |
$357.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$374.87
|
| Rate for Payer: Meridian Medicaid |
$200.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$410.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$529.27
|
| Rate for Payer: PACE Medicare |
$339.17
|
| Rate for Payer: PACE SWMI |
$357.02
|
| Rate for Payer: PHP Commercial |
$529.27
|
| Rate for Payer: PHP Medicare Advantage |
$357.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$404.74
|
| Rate for Payer: Priority Health Medicare |
$357.02
|
| Rate for Payer: Priority Health SBD |
$392.28
|
| Rate for Payer: Railroad Medicare Medicare |
$357.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,004.98
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$357.02
|
| Rate for Payer: UHC Exchange |
$682.30
|
| Rate for Payer: UHC Medicare Advantage |
$357.02
|
| Rate for Payer: UHCCP Medicaid |
$191.36
|
| Rate for Payer: UMR Bronson Commercial |
$230.39
|
| Rate for Payer: VA VA |
$357.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$467.00
|
|
|
HC RO ISODOSE TELETHRPY COMPLEX
|
Facility
|
OP
|
$1,157.97
|
|
|
Service Code
|
CPT 77307
|
| Hospital Charge Code |
33300044
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$191.36 |
| Max. Negotiated Rate |
$1,042.17 |
| Rate for Payer: Aetna American Axle |
$752.68
|
| Rate for Payer: Aetna Commercial |
$984.27
|
| Rate for Payer: Aetna Medicare |
$371.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$752.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$446.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$446.27
|
| Rate for Payer: BCBS Complete |
$200.93
|
| Rate for Payer: BCBS MAPPO |
$357.02
|
| Rate for Payer: BCN Medicare Advantage |
$357.02
|
| Rate for Payer: Cash Price |
$926.38
|
| Rate for Payer: Cash Price |
$926.38
|
| Rate for Payer: Cash Price |
$926.38
|
| Rate for Payer: Cofinity Commercial |
$810.58
|
| Rate for Payer: Cofinity Commercial |
$995.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$810.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$926.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.02
|
| Rate for Payer: Healthscope Commercial |
$1,042.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$810.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$868.48
|
| Rate for Payer: Mclaren Medicaid |
$191.36
|
| Rate for Payer: Mclaren Medicare |
$357.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$374.87
|
| Rate for Payer: Meridian Medicaid |
$200.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$410.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$984.27
|
| Rate for Payer: PACE Medicare |
$339.17
|
| Rate for Payer: PACE SWMI |
$357.02
|
| Rate for Payer: PHP Commercial |
$984.27
|
| Rate for Payer: PHP Medicare Advantage |
$357.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$752.68
|
| Rate for Payer: Priority Health Medicare |
$357.02
|
| Rate for Payer: Priority Health SBD |
$729.52
|
| Rate for Payer: Railroad Medicare Medicare |
$357.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,004.98
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$357.02
|
| Rate for Payer: UHC Exchange |
$682.30
|
| Rate for Payer: UHC Medicare Advantage |
$357.02
|
| Rate for Payer: UHCCP Medicaid |
$191.36
|
| Rate for Payer: UMR Bronson Commercial |
$428.45
|
| Rate for Payer: VA VA |
$357.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$868.48
|
|
|
HC RO ISODOSE TELETHRPY COMPLEX
|
Facility
|
IP
|
$1,157.97
|
|
|
Service Code
|
CPT 77307
|
| Hospital Charge Code |
33300044
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$509.51 |
| Max. Negotiated Rate |
$1,042.17 |
| Rate for Payer: Aetna American Axle |
$752.68
|
| Rate for Payer: Aetna Commercial |
$984.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$752.68
|
| Rate for Payer: Cash Price |
$926.38
|
| Rate for Payer: Cofinity Commercial |
$810.58
|
| Rate for Payer: Cofinity Commercial |
$995.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$810.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$926.38
|
| Rate for Payer: Healthscope Commercial |
$1,042.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$810.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$868.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$984.27
|
| Rate for Payer: PHP Commercial |
$984.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$752.68
|
| Rate for Payer: Priority Health SBD |
$729.52
|
| Rate for Payer: UMR Bronson Commercial |
$509.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$868.48
|
|
|
HC RO ISODOSE TELETHRPY SIMPLE
|
Facility
|
IP
|
$252.82
|
|
|
Service Code
|
CPT 77306
|
| Hospital Charge Code |
33300043
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$111.24 |
| Max. Negotiated Rate |
$227.54 |
| Rate for Payer: Aetna American Axle |
$164.33
|
| Rate for Payer: Aetna Commercial |
$214.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.33
|
| Rate for Payer: Cash Price |
$202.26
|
| Rate for Payer: Cofinity Commercial |
$176.97
|
| Rate for Payer: Cofinity Commercial |
$217.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$176.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.26
|
| Rate for Payer: Healthscope Commercial |
$227.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$176.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.90
|
| Rate for Payer: PHP Commercial |
$214.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.33
|
| Rate for Payer: Priority Health SBD |
$159.28
|
| Rate for Payer: UMR Bronson Commercial |
$111.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.62
|
|
|
HC RO ISODOSE TELETHRPY SIMPLE
|
Facility
|
OP
|
$252.82
|
|
|
Service Code
|
CPT 77306
|
| Hospital Charge Code |
33300043
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$93.54 |
| Max. Negotiated Rate |
$1,004.98 |
| Rate for Payer: Aetna American Axle |
$164.33
|
| Rate for Payer: Aetna Commercial |
$214.90
|
| Rate for Payer: Aetna Medicare |
$371.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$446.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$446.27
|
| Rate for Payer: BCBS Complete |
$200.93
|
| Rate for Payer: BCBS MAPPO |
$357.02
|
| Rate for Payer: BCN Medicare Advantage |
$357.02
|
| Rate for Payer: Cash Price |
$202.26
|
| Rate for Payer: Cash Price |
$202.26
|
| Rate for Payer: Cash Price |
$202.26
|
| Rate for Payer: Cofinity Commercial |
$176.97
|
| Rate for Payer: Cofinity Commercial |
$217.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$176.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.02
|
| Rate for Payer: Healthscope Commercial |
$227.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$176.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.62
|
| Rate for Payer: Mclaren Medicaid |
$191.36
|
| Rate for Payer: Mclaren Medicare |
$357.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$374.87
|
| Rate for Payer: Meridian Medicaid |
$200.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$410.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.90
|
| Rate for Payer: PACE Medicare |
$339.17
|
| Rate for Payer: PACE SWMI |
$357.02
|
| Rate for Payer: PHP Commercial |
$214.90
|
| Rate for Payer: PHP Medicare Advantage |
$357.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.33
|
| Rate for Payer: Priority Health Medicare |
$357.02
|
| Rate for Payer: Priority Health SBD |
$159.28
|
| Rate for Payer: Railroad Medicare Medicare |
$357.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,004.98
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$357.02
|
| Rate for Payer: UHC Exchange |
$682.30
|
| Rate for Payer: UHC Medicare Advantage |
$357.02
|
| Rate for Payer: UHCCP Medicaid |
$191.36
|
| Rate for Payer: UMR Bronson Commercial |
$93.54
|
| Rate for Payer: VA VA |
$357.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.62
|
|
|
HC RO LINAC SBRT PER SESSION
|
Facility
|
OP
|
$3,546.01
|
|
|
Service Code
|
CPT 77373
|
| Hospital Charge Code |
33300041
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$917.90 |
| Max. Negotiated Rate |
$4,820.52 |
| Rate for Payer: Aetna American Axle |
$2,304.91
|
| Rate for Payer: Aetna Commercial |
$3,014.11
|
| Rate for Payer: Aetna Medicare |
$1,781.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,304.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,140.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,140.62
|
| Rate for Payer: BCBS Complete |
$963.79
|
| Rate for Payer: BCBS MAPPO |
$1,712.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,712.50
|
| Rate for Payer: Cash Price |
$2,836.81
|
| Rate for Payer: Cash Price |
$2,836.81
|
| Rate for Payer: Cash Price |
$2,836.81
|
| Rate for Payer: Cofinity Commercial |
$2,482.21
|
| Rate for Payer: Cofinity Commercial |
$3,049.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,482.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,836.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,712.50
|
| Rate for Payer: Healthscope Commercial |
$3,191.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,482.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,659.51
|
| Rate for Payer: Mclaren Medicaid |
$917.90
|
| Rate for Payer: Mclaren Medicare |
$1,712.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,798.12
|
| Rate for Payer: Meridian Medicaid |
$963.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,969.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,014.11
|
| Rate for Payer: PACE Medicare |
$1,626.88
|
| Rate for Payer: PACE SWMI |
$1,712.50
|
| Rate for Payer: PHP Commercial |
$3,014.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,712.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$917.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,304.91
|
| Rate for Payer: Priority Health Medicare |
$1,712.50
|
| Rate for Payer: Priority Health SBD |
$2,233.99
|
| Rate for Payer: Railroad Medicare Medicare |
$1,712.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,820.52
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,712.50
|
| Rate for Payer: UHC Exchange |
$3,272.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,712.50
|
| Rate for Payer: UHCCP Medicaid |
$917.90
|
| Rate for Payer: UMR Bronson Commercial |
$1,312.02
|
| Rate for Payer: VA VA |
$1,712.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,659.51
|
|
|
HC RO LINAC SBRT PER SESSION
|
Facility
|
IP
|
$3,546.01
|
|
|
Service Code
|
CPT 77373
|
| Hospital Charge Code |
33300041
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,560.24 |
| Max. Negotiated Rate |
$3,191.41 |
| Rate for Payer: Aetna American Axle |
$2,304.91
|
| Rate for Payer: Aetna Commercial |
$3,014.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,304.91
|
| Rate for Payer: Cash Price |
$2,836.81
|
| Rate for Payer: Cofinity Commercial |
$2,482.21
|
| Rate for Payer: Cofinity Commercial |
$3,049.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,482.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,836.81
|
| Rate for Payer: Healthscope Commercial |
$3,191.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,482.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,659.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,014.11
|
| Rate for Payer: PHP Commercial |
$3,014.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,304.91
|
| Rate for Payer: Priority Health SBD |
$2,233.99
|
| Rate for Payer: UMR Bronson Commercial |
$1,560.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,659.51
|
|
|
HC ROMOSOZUMAB-AQQG INJ 1 MG
|
Facility
|
IP
|
$11.44
|
|
|
Service Code
|
HCPCS J3111
|
| Hospital Charge Code |
63600150
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.03 |
| Max. Negotiated Rate |
$10.30 |
| Rate for Payer: Aetna American Axle |
$7.44
|
| Rate for Payer: Aetna Commercial |
$9.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.44
|
| Rate for Payer: Cash Price |
$9.15
|
| Rate for Payer: Cofinity Commercial |
$8.01
|
| Rate for Payer: Cofinity Commercial |
$9.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.15
|
| Rate for Payer: Healthscope Commercial |
$10.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.72
|
| Rate for Payer: PHP Commercial |
$9.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.44
|
| Rate for Payer: Priority Health SBD |
$7.21
|
| Rate for Payer: UMR Bronson Commercial |
$5.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.58
|
|
|
HC ROMOSOZUMAB-AQQG INJ 1 MG
|
Facility
|
OP
|
$11.44
|
|
|
Service Code
|
HCPCS J3111
|
| Hospital Charge Code |
63600150
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$33.98 |
| Rate for Payer: Aetna American Axle |
$7.44
|
| Rate for Payer: Aetna Commercial |
$9.72
|
| Rate for Payer: Aetna Medicare |
$12.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.09
|
| Rate for Payer: BCBS Complete |
$6.79
|
| Rate for Payer: BCBS MAPPO |
$12.07
|
| Rate for Payer: BCN Medicare Advantage |
$12.07
|
| Rate for Payer: Cash Price |
$9.15
|
| Rate for Payer: Cash Price |
$9.15
|
| Rate for Payer: Cofinity Commercial |
$9.84
|
| Rate for Payer: Cofinity Commercial |
$8.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.07
|
| Rate for Payer: Healthscope Commercial |
$10.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.58
|
| Rate for Payer: Mclaren Medicaid |
$6.47
|
| Rate for Payer: Mclaren Medicare |
$12.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.67
|
| Rate for Payer: Meridian Medicaid |
$6.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.72
|
| Rate for Payer: PACE Medicare |
$11.47
|
| Rate for Payer: PACE SWMI |
$12.07
|
| Rate for Payer: PHP Commercial |
$9.72
|
| Rate for Payer: PHP Medicare Advantage |
$12.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.44
|
| Rate for Payer: Priority Health Medicare |
$12.07
|
| Rate for Payer: Priority Health SBD |
$7.21
|
| Rate for Payer: Railroad Medicare Medicare |
$12.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.07
|
| Rate for Payer: UHC Exchange |
$23.07
|
| Rate for Payer: UHC Medicare Advantage |
$12.07
|
| Rate for Payer: UHCCP Medicaid |
$6.47
|
| Rate for Payer: UMR Bronson Commercial |
$4.23
|
| Rate for Payer: VA VA |
$12.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.58
|
|
|
HC ROOM & BOARD PSYCH
|
Facility
|
IP
|
$1,810.72
|
|
| Hospital Charge Code |
12400001
|
|
Hospital Revenue Code
|
124
|
| Min. Negotiated Rate |
$796.72 |
| Max. Negotiated Rate |
$1,629.65 |
| Rate for Payer: Aetna American Axle |
$1,176.97
|
| Rate for Payer: Aetna Commercial |
$1,539.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,176.97
|
| Rate for Payer: Cash Price |
$1,448.58
|
| Rate for Payer: Cofinity Commercial |
$1,267.50
|
| Rate for Payer: Cofinity Commercial |
$1,557.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,267.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,448.58
|
| Rate for Payer: Healthscope Commercial |
$1,629.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,267.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,358.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,539.11
|
| Rate for Payer: PHP Commercial |
$1,539.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,176.97
|
| Rate for Payer: Priority Health SBD |
$1,140.75
|
| Rate for Payer: UMR Bronson Commercial |
$796.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,358.04
|
|
