|
HC RNP U1 ANTIBODY
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200166
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.47 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna American Axle |
$22.86
|
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.86
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$24.62
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health SBD |
$22.16
|
| Rate for Payer: UMR Bronson Commercial |
$15.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC RNP U1 ANTIBODY
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200166
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna American Axle |
$22.86
|
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$17.28
|
| Rate for Payer: BCN Commercial |
$17.28
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Cofinity Commercial |
$24.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$26.90
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.93
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$14.34
|
| Rate for Payer: Priority Health SBD |
$22.16
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$17.93
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: UMR Bronson Commercial |
$13.01
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC RO GUIDE LOC TARGET VOL TX DEL
|
Facility
|
OP
|
$223.79
|
|
|
Service Code
|
CPT 77387
|
| Hospital Charge Code |
33300061
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$82.80 |
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$145.46
|
| Rate for Payer: Aetna Commercial |
$190.22
|
| Rate for Payer: Aetna Medicare |
$111.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.46
|
| Rate for Payer: BCBS Complete |
$89.52
|
| Rate for Payer: BCBS Trust/PPO |
$145.29
|
| Rate for Payer: BCN Commercial |
$145.29
|
| Rate for Payer: Cash Price |
$179.03
|
| Rate for Payer: Cash Price |
$179.03
|
| Rate for Payer: Cash Price |
$179.03
|
| Rate for Payer: Cofinity Commercial |
$156.65
|
| Rate for Payer: Cofinity Commercial |
$192.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$156.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.03
|
| Rate for Payer: Healthscope Commercial |
$201.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.22
|
| Rate for Payer: PHP Commercial |
$190.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.46
|
| Rate for Payer: Priority Health SBD |
$140.99
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UMR Bronson Commercial |
$82.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.84
|
|
|
HC RO GUIDE LOC TARGET VOL TX DEL
|
Facility
|
IP
|
$223.79
|
|
|
Service Code
|
CPT 77387
|
| Hospital Charge Code |
33300061
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$98.47 |
| Max. Negotiated Rate |
$201.41 |
| Rate for Payer: Aetna American Axle |
$145.46
|
| Rate for Payer: Aetna Commercial |
$190.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.46
|
| Rate for Payer: Cash Price |
$179.03
|
| Rate for Payer: Cofinity Commercial |
$156.65
|
| Rate for Payer: Cofinity Commercial |
$192.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$156.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.03
|
| Rate for Payer: Healthscope Commercial |
$201.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.22
|
| Rate for Payer: PHP Commercial |
$190.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.46
|
| Rate for Payer: Priority Health SBD |
$140.99
|
| Rate for Payer: UMR Bronson Commercial |
$98.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.84
|
|
|
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 COMPLEX
|
Facility
|
OP
|
$3,288.00
|
|
|
Service Code
|
CPT 77386
|
| Hospital Charge Code |
33300051
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$303.79 |
| 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 |
$589.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,137.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$708.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$708.46
|
| Rate for Payer: BCBS Complete |
$318.98
|
| Rate for Payer: BCBS MAPPO |
$566.77
|
| Rate for Payer: BCBS Trust/PPO |
$678.92
|
| Rate for Payer: BCN Commercial |
$678.92
|
| Rate for Payer: BCN Medicare Advantage |
$566.77
|
| 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 |
$566.77
|
| 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 |
$303.79
|
| Rate for Payer: Mclaren Medicare |
$566.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$595.11
|
| Rate for Payer: Meridian Medicaid |
$318.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$651.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.80
|
| Rate for Payer: Nomi Health Commercial |
$1,700.31
|
| Rate for Payer: PACE Medicare |
$538.43
|
| Rate for Payer: PACE SWMI |
$566.77
|
| Rate for Payer: PHP Commercial |
$2,794.80
|
| Rate for Payer: PHP Medicare Advantage |
$566.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$303.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,137.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,781.38
|
| Rate for Payer: Priority Health Medicare |
$566.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,425.10
|
| Rate for Payer: Priority Health SBD |
$2,071.44
|
| Rate for Payer: Railroad Medicare Medicare |
$566.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,595.40
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$566.77
|
| Rate for Payer: UHC Exchange |
$1,083.15
|
| Rate for Payer: UHC Medicare Advantage |
$566.77
|
| Rate for Payer: UHCCP Medicaid |
$303.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,216.56
|
| Rate for Payer: VA VA |
$566.77
|
| 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 IMRT DEL SIMPLE
|
Facility
|
OP
|
$3,288.00
|
|
|
Service Code
|
CPT 77385
|
| Hospital Charge Code |
33300050
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$303.79 |
| 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 |
$589.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,137.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$708.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$708.46
|
| Rate for Payer: BCBS Complete |
$318.98
|
| Rate for Payer: BCBS MAPPO |
$566.77
|
| Rate for Payer: BCBS Trust/PPO |
$678.92
|
| Rate for Payer: BCN Commercial |
$678.92
|
| Rate for Payer: BCN Medicare Advantage |
$566.77
|
| 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 |
$566.77
|
| 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 |
$303.79
|
| Rate for Payer: Mclaren Medicare |
$566.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$595.11
|
| Rate for Payer: Meridian Medicaid |
$318.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$651.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.80
|
| Rate for Payer: Nomi Health Commercial |
$1,700.31
|
| Rate for Payer: PACE Medicare |
$538.43
|
| Rate for Payer: PACE SWMI |
$566.77
|
| Rate for Payer: PHP Commercial |
$2,794.80
|
| Rate for Payer: PHP Medicare Advantage |
$566.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$303.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,137.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,781.38
|
| Rate for Payer: Priority Health Medicare |
$566.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,425.10
|
| Rate for Payer: Priority Health SBD |
$2,071.44
|
| Rate for Payer: Railroad Medicare Medicare |
$566.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,595.40
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$566.77
|
| Rate for Payer: UHC Exchange |
$1,083.15
|
| Rate for Payer: UHC Medicare Advantage |
$566.77
|
| Rate for Payer: UHCCP Medicaid |
$303.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,216.56
|
| Rate for Payer: VA VA |
$566.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,466.00
|
|
|
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 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 |
$267.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$322.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$322.08
|
| Rate for Payer: BCBS Complete |
$145.01
|
| Rate for Payer: BCBS MAPPO |
$257.66
|
| Rate for Payer: BCBS Trust/PPO |
$272.30
|
| Rate for Payer: BCN Commercial |
$272.30
|
| Rate for Payer: BCN Medicare Advantage |
$257.66
|
| 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 |
$257.66
|
| 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 |
$138.11
|
| Rate for Payer: Mclaren Medicare |
$257.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.54
|
| Rate for Payer: Meridian Medicaid |
$145.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$296.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.11
|
| Rate for Payer: Nomi Health Commercial |
$772.98
|
| Rate for Payer: PACE Medicare |
$244.78
|
| Rate for Payer: PACE SWMI |
$257.66
|
| Rate for Payer: PHP Commercial |
$282.11
|
| Rate for Payer: PHP Medicare Advantage |
$257.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$809.82
|
| Rate for Payer: Priority Health Medicare |
$257.66
|
| Rate for Payer: Priority Health Narrow Network |
$647.86
|
| Rate for Payer: Priority Health SBD |
$209.09
|
| Rate for Payer: Railroad Medicare Medicare |
$257.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$405.68
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.66
|
| Rate for Payer: UHC Exchange |
$368.80
|
| Rate for Payer: UHC Medicare Advantage |
$257.66
|
| Rate for Payer: UHCCP Medicaid |
$138.11
|
| Rate for Payer: UMR Bronson Commercial |
$122.80
|
| Rate for Payer: VA VA |
$257.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.92
|
|
|
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 INS VAG BRACHTHER DEVICE
|
Facility
|
OP
|
$550.40
|
|
|
Service Code
|
CPT 57156
|
| Hospital Charge Code |
36100444
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$144.56 |
| Max. Negotiated Rate |
$936.74 |
| Rate for Payer: Aetna American Axle |
$357.76
|
| Rate for Payer: Aetna Commercial |
$467.84
|
| Rate for Payer: Aetna Medicare |
$309.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$357.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$372.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$372.55
|
| Rate for Payer: BCBS Complete |
$167.74
|
| Rate for Payer: BCBS MAPPO |
$298.04
|
| Rate for Payer: BCBS Trust/PPO |
$327.46
|
| Rate for Payer: BCN Commercial |
$327.46
|
| Rate for Payer: BCN Medicare Advantage |
$298.04
|
| Rate for Payer: Cash Price |
$440.32
|
| 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 |
$298.04
|
| 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 |
$159.75
|
| Rate for Payer: Mclaren Medicare |
$298.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.94
|
| Rate for Payer: Meridian Medicaid |
$167.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$342.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$467.84
|
| Rate for Payer: Nomi Health Commercial |
$625.88
|
| Rate for Payer: PACE Medicare |
$283.14
|
| Rate for Payer: PACE SWMI |
$298.04
|
| Rate for Payer: PHP Commercial |
$467.84
|
| Rate for Payer: PHP Medicare Advantage |
$298.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$936.74
|
| Rate for Payer: Priority Health Medicare |
$298.04
|
| Rate for Payer: Priority Health Narrow Network |
$749.39
|
| Rate for Payer: Priority Health SBD |
$346.75
|
| Rate for Payer: Railroad Medicare Medicare |
$298.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.02
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.04
|
| Rate for Payer: UHC Exchange |
$144.56
|
| Rate for Payer: UHC Medicare Advantage |
$298.04
|
| Rate for Payer: UHCCP Medicaid |
$159.75
|
| Rate for Payer: UMR Bronson Commercial |
$203.65
|
| Rate for Payer: VA VA |
$298.04
|
| 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 |
$364.36 |
| 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 |
$706.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,844.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$849.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$849.72
|
| Rate for Payer: BCBS Complete |
$382.58
|
| Rate for Payer: BCBS MAPPO |
$679.78
|
| Rate for Payer: BCBS Trust/PPO |
$953.06
|
| Rate for Payer: BCN Commercial |
$953.06
|
| Rate for Payer: BCN Medicare Advantage |
$679.78
|
| 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 |
$679.78
|
| 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 |
$364.36
|
| Rate for Payer: Mclaren Medicare |
$679.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$713.77
|
| Rate for Payer: Meridian Medicaid |
$382.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$781.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,411.59
|
| Rate for Payer: Nomi Health Commercial |
$2,039.34
|
| Rate for Payer: PACE Medicare |
$645.79
|
| Rate for Payer: PACE SWMI |
$679.78
|
| Rate for Payer: PHP Commercial |
$2,411.59
|
| Rate for Payer: PHP Medicare Advantage |
$679.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,844.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,136.53
|
| Rate for Payer: Priority Health Medicare |
$679.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,709.22
|
| Rate for Payer: Priority Health SBD |
$1,787.42
|
| Rate for Payer: Railroad Medicare Medicare |
$679.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$939.77
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$679.78
|
| Rate for Payer: UHC Exchange |
$854.34
|
| Rate for Payer: UHC Medicare Advantage |
$679.78
|
| Rate for Payer: UHCCP Medicaid |
$364.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,049.75
|
| Rate for Payer: VA VA |
$679.78
|
| 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 |
$176.14
|
| 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 |
$176.14
|
|
|
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 |
$1,127.30 |
| Rate for Payer: Aetna American Axle |
$152.66
|
| Rate for Payer: Aetna Commercial |
$199.63
|
| Rate for Payer: Aetna Medicare |
$373.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$448.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$448.34
|
| Rate for Payer: BCBS Complete |
$201.86
|
| Rate for Payer: BCBS MAPPO |
$358.67
|
| Rate for Payer: BCBS Trust/PPO |
$355.77
|
| Rate for Payer: BCN Commercial |
$355.77
|
| Rate for Payer: BCN Medicare Advantage |
$358.67
|
| 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 |
$358.67
|
| 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 |
$176.14
|
| Rate for Payer: Mclaren Medicaid |
$192.25
|
| Rate for Payer: Mclaren Medicare |
$358.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$376.60
|
| Rate for Payer: Meridian Medicaid |
$201.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$412.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.63
|
| Rate for Payer: Nomi Health Commercial |
$1,076.01
|
| Rate for Payer: PACE Medicare |
$340.74
|
| Rate for Payer: PACE SWMI |
$358.67
|
| Rate for Payer: PHP Commercial |
$199.63
|
| Rate for Payer: PHP Medicare Advantage |
$358.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,127.30
|
| Rate for Payer: Priority Health Medicare |
$358.67
|
| Rate for Payer: Priority Health Narrow Network |
$901.84
|
| Rate for Payer: Priority Health SBD |
$147.96
|
| Rate for Payer: Railroad Medicare Medicare |
$358.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.02
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$358.67
|
| Rate for Payer: UHC Exchange |
$225.47
|
| Rate for Payer: UHC Medicare Advantage |
$358.67
|
| Rate for Payer: UHCCP Medicaid |
$192.25
|
| Rate for Payer: UMR Bronson Commercial |
$86.90
|
| Rate for Payer: VA VA |
$358.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$176.14
|
|
|
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 |
$513.70
|
| 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 |
$513.70
|
|
|
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 |
$192.25 |
| Max. Negotiated Rate |
$1,127.30 |
| Rate for Payer: Aetna American Axle |
$445.21
|
| Rate for Payer: Aetna Commercial |
$582.20
|
| Rate for Payer: Aetna Medicare |
$373.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$445.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$448.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$448.34
|
| Rate for Payer: BCBS Complete |
$201.86
|
| Rate for Payer: BCBS MAPPO |
$358.67
|
| Rate for Payer: BCBS Trust/PPO |
$633.55
|
| Rate for Payer: BCN Commercial |
$633.55
|
| Rate for Payer: BCN Medicare Advantage |
$358.67
|
| 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 |
$358.67
|
| 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 |
$513.70
|
| Rate for Payer: Mclaren Medicaid |
$192.25
|
| Rate for Payer: Mclaren Medicare |
$358.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$376.60
|
| Rate for Payer: Meridian Medicaid |
$201.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$412.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$582.20
|
| Rate for Payer: Nomi Health Commercial |
$1,076.01
|
| Rate for Payer: PACE Medicare |
$340.74
|
| Rate for Payer: PACE SWMI |
$358.67
|
| Rate for Payer: PHP Commercial |
$582.20
|
| Rate for Payer: PHP Medicare Advantage |
$358.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$445.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,127.30
|
| Rate for Payer: Priority Health Medicare |
$358.67
|
| Rate for Payer: Priority Health Narrow Network |
$901.84
|
| Rate for Payer: Priority Health SBD |
$431.51
|
| Rate for Payer: Railroad Medicare Medicare |
$358.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$463.44
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$358.67
|
| Rate for Payer: UHC Exchange |
$421.31
|
| Rate for Payer: UHC Medicare Advantage |
$358.67
|
| Rate for Payer: UHCCP Medicaid |
$192.25
|
| Rate for Payer: UMR Bronson Commercial |
$253.43
|
| Rate for Payer: VA VA |
$358.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$513.70
|
|
|
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 |
$192.25 |
| Max. Negotiated Rate |
$1,127.30 |
| Rate for Payer: Aetna American Axle |
$404.74
|
| Rate for Payer: Aetna Commercial |
$529.27
|
| Rate for Payer: Aetna Medicare |
$373.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$448.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$448.34
|
| Rate for Payer: BCBS Complete |
$201.86
|
| Rate for Payer: BCBS MAPPO |
$358.67
|
| Rate for Payer: BCBS Trust/PPO |
$468.66
|
| Rate for Payer: BCN Commercial |
$468.66
|
| Rate for Payer: BCN Medicare Advantage |
$358.67
|
| 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 |
$358.67
|
| 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 |
$192.25
|
| Rate for Payer: Mclaren Medicare |
$358.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$376.60
|
| Rate for Payer: Meridian Medicaid |
$201.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$412.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$529.27
|
| Rate for Payer: Nomi Health Commercial |
$1,076.01
|
| Rate for Payer: PACE Medicare |
$340.74
|
| Rate for Payer: PACE SWMI |
$358.67
|
| Rate for Payer: PHP Commercial |
$529.27
|
| Rate for Payer: PHP Medicare Advantage |
$358.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$404.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,127.30
|
| Rate for Payer: Priority Health Medicare |
$358.67
|
| Rate for Payer: Priority Health Narrow Network |
$901.84
|
| Rate for Payer: Priority Health SBD |
$392.28
|
| Rate for Payer: Railroad Medicare Medicare |
$358.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.13
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$358.67
|
| Rate for Payer: UHC Exchange |
$296.48
|
| Rate for Payer: UHC Medicare Advantage |
$358.67
|
| Rate for Payer: UHCCP Medicaid |
$192.25
|
| Rate for Payer: UMR Bronson Commercial |
$230.39
|
| Rate for Payer: VA VA |
$358.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$467.00
|
|
|
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 TELETHRPY COMPLEX
|
Facility
|
OP
|
$1,157.97
|
|
|
Service Code
|
CPT 77307
|
| Hospital Charge Code |
33300044
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$192.25 |
| Max. Negotiated Rate |
$1,127.30 |
| Rate for Payer: Aetna American Axle |
$752.68
|
| Rate for Payer: Aetna Commercial |
$984.27
|
| Rate for Payer: Aetna Medicare |
$373.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$752.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$448.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$448.34
|
| Rate for Payer: BCBS Complete |
$201.86
|
| Rate for Payer: BCBS MAPPO |
$358.67
|
| Rate for Payer: BCBS Trust/PPO |
$279.82
|
| Rate for Payer: BCN Commercial |
$279.82
|
| Rate for Payer: BCN Medicare Advantage |
$358.67
|
| 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 |
$358.67
|
| 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 |
$192.25
|
| Rate for Payer: Mclaren Medicare |
$358.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$376.60
|
| Rate for Payer: Meridian Medicaid |
$201.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$412.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$984.27
|
| Rate for Payer: Nomi Health Commercial |
$1,076.01
|
| Rate for Payer: PACE Medicare |
$340.74
|
| Rate for Payer: PACE SWMI |
$358.67
|
| Rate for Payer: PHP Commercial |
$984.27
|
| Rate for Payer: PHP Medicare Advantage |
$358.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$752.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,127.30
|
| Rate for Payer: Priority Health Medicare |
$358.67
|
| Rate for Payer: Priority Health Narrow Network |
$901.84
|
| Rate for Payer: Priority Health SBD |
$729.52
|
| Rate for Payer: Railroad Medicare Medicare |
$358.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$293.66
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$358.67
|
| Rate for Payer: UHC Exchange |
$266.96
|
| Rate for Payer: UHC Medicare Advantage |
$358.67
|
| Rate for Payer: UHCCP Medicaid |
$192.25
|
| Rate for Payer: UMR Bronson Commercial |
$428.45
|
| Rate for Payer: VA VA |
$358.67
|
| 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
|
OP
|
$252.82
|
|
|
Service Code
|
CPT 77306
|
| Hospital Charge Code |
33300043
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$93.54 |
| Max. Negotiated Rate |
$1,127.30 |
| Rate for Payer: Aetna American Axle |
$164.33
|
| Rate for Payer: Aetna Commercial |
$214.90
|
| Rate for Payer: Aetna Medicare |
$373.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$448.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$448.34
|
| Rate for Payer: BCBS Complete |
$201.86
|
| Rate for Payer: BCBS MAPPO |
$358.67
|
| Rate for Payer: BCBS Trust/PPO |
$154.63
|
| Rate for Payer: BCN Commercial |
$154.63
|
| Rate for Payer: BCN Medicare Advantage |
$358.67
|
| 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 |
$358.67
|
| 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 |
$192.25
|
| Rate for Payer: Mclaren Medicare |
$358.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$376.60
|
| Rate for Payer: Meridian Medicaid |
$201.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$412.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.90
|
| Rate for Payer: Nomi Health Commercial |
$1,076.01
|
| Rate for Payer: PACE Medicare |
$340.74
|
| Rate for Payer: PACE SWMI |
$358.67
|
| Rate for Payer: PHP Commercial |
$214.90
|
| Rate for Payer: PHP Medicare Advantage |
$358.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,127.30
|
| Rate for Payer: Priority Health Medicare |
$358.67
|
| Rate for Payer: Priority Health Narrow Network |
$901.84
|
| Rate for Payer: Priority Health SBD |
$159.28
|
| Rate for Payer: Railroad Medicare Medicare |
$358.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.26
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$358.67
|
| Rate for Payer: UHC Exchange |
$137.51
|
| Rate for Payer: UHC Medicare Advantage |
$358.67
|
| Rate for Payer: UHCCP Medicaid |
$192.25
|
| Rate for Payer: UMR Bronson Commercial |
$93.54
|
| Rate for Payer: VA VA |
$358.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.62
|
|
|
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 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
|
|
