|
HC SICKLE CELL TEST
|
Facility
|
IP
|
$31.31
|
|
|
Service Code
|
CPT 85660
|
| Hospital Charge Code |
30500061
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.78 |
| Max. Negotiated Rate |
$28.18 |
| Rate for Payer: Aetna American Axle |
$20.35
|
| Rate for Payer: Aetna Commercial |
$26.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.35
|
| Rate for Payer: Cash Price |
$25.05
|
| Rate for Payer: Cofinity Commercial |
$21.92
|
| Rate for Payer: Cofinity Commercial |
$26.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.05
|
| Rate for Payer: Healthscope Commercial |
$28.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.61
|
| Rate for Payer: PHP Commercial |
$26.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.35
|
| Rate for Payer: Priority Health SBD |
$19.73
|
| Rate for Payer: UMR Bronson Commercial |
$13.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.48
|
|
|
HC SIGMOIDOSCOPY FLX DX W/COLL SPEC BR/WA
|
Facility
|
IP
|
$1,162.48
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
76100186
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$511.49 |
| Max. Negotiated Rate |
$1,046.23 |
| Rate for Payer: Aetna American Axle |
$755.61
|
| Rate for Payer: Aetna Commercial |
$988.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$755.61
|
| Rate for Payer: Cash Price |
$929.98
|
| Rate for Payer: Cofinity Commercial |
$813.74
|
| Rate for Payer: Cofinity Commercial |
$999.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$813.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$929.98
|
| Rate for Payer: Healthscope Commercial |
$1,046.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$813.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$871.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$988.11
|
| Rate for Payer: PHP Commercial |
$988.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$755.61
|
| Rate for Payer: Priority Health SBD |
$732.36
|
| Rate for Payer: UMR Bronson Commercial |
$511.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$871.86
|
|
|
HC SIGMOIDOSCOPY FLX DX W/COLL SPEC BR/WA
|
Facility
|
OP
|
$1,162.48
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
76100186
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$53.89 |
| Max. Negotiated Rate |
$2,807.55 |
| Rate for Payer: Aetna American Axle |
$755.61
|
| Rate for Payer: Aetna Commercial |
$988.11
|
| Rate for Payer: Aetna Medicare |
$929.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$755.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,116.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,116.60
|
| Rate for Payer: BCBS Complete |
$502.74
|
| Rate for Payer: BCBS MAPPO |
$893.28
|
| Rate for Payer: BCBS Trust/PPO |
$932.09
|
| Rate for Payer: BCN Commercial |
$932.09
|
| Rate for Payer: BCN Medicare Advantage |
$893.28
|
| Rate for Payer: Cash Price |
$929.98
|
| Rate for Payer: Cash Price |
$929.98
|
| Rate for Payer: Cash Price |
$929.98
|
| Rate for Payer: Cofinity Commercial |
$999.73
|
| Rate for Payer: Cofinity Commercial |
$813.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$813.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$929.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$893.28
|
| Rate for Payer: Healthscope Commercial |
$1,046.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$813.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$871.86
|
| Rate for Payer: Mclaren Medicaid |
$478.80
|
| Rate for Payer: Mclaren Medicare |
$893.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$937.94
|
| Rate for Payer: Meridian Medicaid |
$502.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,027.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$988.11
|
| Rate for Payer: Nomi Health Commercial |
$1,875.89
|
| Rate for Payer: PACE Medicare |
$848.62
|
| Rate for Payer: PACE SWMI |
$893.28
|
| Rate for Payer: PHP Commercial |
$988.11
|
| Rate for Payer: PHP Medicare Advantage |
$893.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$478.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$755.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,807.55
|
| Rate for Payer: Priority Health Medicare |
$893.28
|
| Rate for Payer: Priority Health Narrow Network |
$2,246.04
|
| Rate for Payer: Priority Health SBD |
$732.36
|
| Rate for Payer: Railroad Medicare Medicare |
$893.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.28
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$893.28
|
| Rate for Payer: UHC Exchange |
$53.89
|
| Rate for Payer: UHC Medicare Advantage |
$893.28
|
| Rate for Payer: UHCCP Medicaid |
$478.80
|
| Rate for Payer: UMR Bronson Commercial |
$430.12
|
| Rate for Payer: VA VA |
$893.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$871.86
|
|
|
HC SIGMOIDOSCOPY W EUS EXAM
|
Facility
|
OP
|
$2,621.12
|
|
| Hospital Charge Code |
36000082
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$969.81 |
| Max. Negotiated Rate |
$2,359.01 |
| Rate for Payer: Aetna American Axle |
$1,703.73
|
| Rate for Payer: Aetna Commercial |
$2,227.95
|
| Rate for Payer: Aetna Medicare |
$1,310.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,703.73
|
| Rate for Payer: BCBS Complete |
$1,048.45
|
| Rate for Payer: Cash Price |
$2,096.90
|
| Rate for Payer: Cofinity Commercial |
$1,834.78
|
| Rate for Payer: Cofinity Commercial |
$2,254.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,834.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,096.90
|
| Rate for Payer: Healthscope Commercial |
$2,359.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,834.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,965.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,227.95
|
| Rate for Payer: PHP Commercial |
$2,227.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,703.73
|
| Rate for Payer: Priority Health SBD |
$1,651.31
|
| Rate for Payer: UMR Bronson Commercial |
$969.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,965.84
|
|
|
HC SIGMOIDOSCOPY W EUS EXAM
|
Facility
|
IP
|
$2,621.12
|
|
| Hospital Charge Code |
36000082
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,153.29 |
| Max. Negotiated Rate |
$2,359.01 |
| Rate for Payer: Aetna American Axle |
$1,703.73
|
| Rate for Payer: Aetna Commercial |
$2,227.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,703.73
|
| Rate for Payer: Cash Price |
$2,096.90
|
| Rate for Payer: Cofinity Commercial |
$1,834.78
|
| Rate for Payer: Cofinity Commercial |
$2,254.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,834.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,096.90
|
| Rate for Payer: Healthscope Commercial |
$2,359.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,834.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,965.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,227.95
|
| Rate for Payer: PHP Commercial |
$2,227.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,703.73
|
| Rate for Payer: Priority Health SBD |
$1,651.31
|
| Rate for Payer: UMR Bronson Commercial |
$1,153.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,965.84
|
|
|
HC SIGMOIDOSCOPY WITH BIOPSY
|
Facility
|
OP
|
$1,264.83
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
36000111
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$68.74 |
| Max. Negotiated Rate |
$2,807.55 |
| Rate for Payer: Aetna American Axle |
$822.14
|
| Rate for Payer: Aetna Commercial |
$1,075.11
|
| Rate for Payer: Aetna Medicare |
$929.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$822.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,116.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,116.60
|
| Rate for Payer: BCBS Complete |
$502.74
|
| Rate for Payer: BCBS MAPPO |
$893.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,164.06
|
| Rate for Payer: BCN Commercial |
$1,164.06
|
| Rate for Payer: BCN Medicare Advantage |
$893.28
|
| Rate for Payer: Cash Price |
$1,011.86
|
| Rate for Payer: Cash Price |
$1,011.86
|
| Rate for Payer: Cash Price |
$1,011.86
|
| Rate for Payer: Cofinity Commercial |
$885.38
|
| Rate for Payer: Cofinity Commercial |
$1,087.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$885.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,011.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$893.28
|
| Rate for Payer: Healthscope Commercial |
$1,138.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$885.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$948.62
|
| Rate for Payer: Mclaren Medicaid |
$478.80
|
| Rate for Payer: Mclaren Medicare |
$893.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$937.94
|
| Rate for Payer: Meridian Medicaid |
$502.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,027.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,075.11
|
| Rate for Payer: Nomi Health Commercial |
$1,875.89
|
| Rate for Payer: PACE Medicare |
$848.62
|
| Rate for Payer: PACE SWMI |
$893.28
|
| Rate for Payer: PHP Commercial |
$1,075.11
|
| Rate for Payer: PHP Medicare Advantage |
$893.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$478.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$822.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,807.55
|
| Rate for Payer: Priority Health Medicare |
$893.28
|
| Rate for Payer: Priority Health Narrow Network |
$2,246.04
|
| Rate for Payer: Priority Health SBD |
$796.84
|
| Rate for Payer: Railroad Medicare Medicare |
$893.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.61
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$893.28
|
| Rate for Payer: UHC Exchange |
$68.74
|
| Rate for Payer: UHC Medicare Advantage |
$893.28
|
| Rate for Payer: UHCCP Medicaid |
$478.80
|
| Rate for Payer: UMR Bronson Commercial |
$467.99
|
| Rate for Payer: VA VA |
$893.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$948.62
|
|
|
HC SIGMOIDOSCOPY WITH BIOPSY
|
Facility
|
IP
|
$1,264.83
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
36000111
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$556.53 |
| Max. Negotiated Rate |
$1,138.35 |
| Rate for Payer: Aetna American Axle |
$822.14
|
| Rate for Payer: Aetna Commercial |
$1,075.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$822.14
|
| Rate for Payer: Cash Price |
$1,011.86
|
| Rate for Payer: Cofinity Commercial |
$1,087.75
|
| Rate for Payer: Cofinity Commercial |
$885.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$885.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,011.86
|
| Rate for Payer: Healthscope Commercial |
$1,138.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$885.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$948.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,075.11
|
| Rate for Payer: PHP Commercial |
$1,075.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$822.14
|
| Rate for Payer: Priority Health SBD |
$796.84
|
| Rate for Payer: UMR Bronson Commercial |
$556.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$948.62
|
|
|
HC SIGNAL AVERAGE EKG
|
Facility
|
OP
|
$252.87
|
|
|
Service Code
|
CPT 93278
|
| Hospital Charge Code |
73100004
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$29.24 |
| Max. Negotiated Rate |
$816.00 |
| Rate for Payer: Aetna American Axle |
$164.37
|
| Rate for Payer: Aetna Commercial |
$214.94
|
| Rate for Payer: Aetna Medicare |
$60.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.75
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$81.75
|
| Rate for Payer: BCN Commercial |
$81.75
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$202.30
|
| Rate for Payer: Cash Price |
$202.30
|
| Rate for Payer: Cash Price |
$202.30
|
| Rate for Payer: Cofinity Commercial |
$177.01
|
| Rate for Payer: Cofinity Commercial |
$217.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$177.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$227.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$177.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.65
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$58.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.11
|
| Rate for Payer: Meridian Medicaid |
$32.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.94
|
| Rate for Payer: Nomi Health Commercial |
$174.60
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Commercial |
$214.94
|
| Rate for Payer: PHP Medicare Advantage |
$58.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.90
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$146.32
|
| Rate for Payer: Priority Health SBD |
$159.31
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.16
|
| Rate for Payer: UHC Core |
$816.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Exchange |
$29.24
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$31.20
|
| Rate for Payer: UMR Bronson Commercial |
$93.56
|
| Rate for Payer: VA VA |
$58.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.65
|
|
|
HC SIGNAL AVERAGE EKG
|
Facility
|
IP
|
$252.87
|
|
|
Service Code
|
CPT 93278
|
| Hospital Charge Code |
73100004
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$111.26 |
| Max. Negotiated Rate |
$227.58 |
| Rate for Payer: Aetna American Axle |
$164.37
|
| Rate for Payer: Aetna Commercial |
$214.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.37
|
| Rate for Payer: Cash Price |
$202.30
|
| Rate for Payer: Cofinity Commercial |
$177.01
|
| Rate for Payer: Cofinity Commercial |
$217.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$177.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.30
|
| Rate for Payer: Healthscope Commercial |
$227.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$177.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.94
|
| Rate for Payer: PHP Commercial |
$214.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.37
|
| Rate for Payer: Priority Health SBD |
$159.31
|
| Rate for Payer: UMR Bronson Commercial |
$111.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.65
|
|
|
HC SILICA CLOTTING TIME ASSAY
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500099
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.44 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna American Axle |
$16.91
|
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: UMR Bronson Commercial |
$11.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC SILICA CLOTTING TIME ASSAY
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500099
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.22 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna American Axle |
$16.91
|
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$6.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.51
|
| Rate for Payer: BCBS Complete |
$3.38
|
| Rate for Payer: BCBS MAPPO |
$6.01
|
| Rate for Payer: BCBS Trust/PPO |
$5.79
|
| Rate for Payer: BCN Commercial |
$5.79
|
| Rate for Payer: BCN Medicare Advantage |
$6.01
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.01
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Mclaren Medicaid |
$3.22
|
| Rate for Payer: Mclaren Medicare |
$6.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.31
|
| Rate for Payer: Meridian Medicaid |
$3.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$9.02
|
| Rate for Payer: PACE Medicare |
$5.71
|
| Rate for Payer: PACE SWMI |
$6.01
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$6.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.18
|
| Rate for Payer: Priority Health Medicare |
$6.01
|
| Rate for Payer: Priority Health Narrow Network |
$4.94
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: Railroad Medicare Medicare |
$6.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.01
|
| Rate for Payer: UHC Exchange |
$6.01
|
| Rate for Payer: UHC Medicare Advantage |
$6.01
|
| Rate for Payer: UHCCP Medicaid |
$3.22
|
| Rate for Payer: UMR Bronson Commercial |
$9.62
|
| Rate for Payer: VA VA |
$6.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC SILVADENE 400 GM
|
Facility
|
IP
|
$253.52
|
|
| Hospital Charge Code |
27100016
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$111.55 |
| Max. Negotiated Rate |
$228.17 |
| Rate for Payer: Aetna American Axle |
$164.79
|
| Rate for Payer: Aetna Commercial |
$215.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.79
|
| Rate for Payer: Cash Price |
$202.82
|
| Rate for Payer: Cofinity Commercial |
$177.46
|
| Rate for Payer: Cofinity Commercial |
$218.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$177.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.82
|
| Rate for Payer: Healthscope Commercial |
$228.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$177.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.49
|
| Rate for Payer: PHP Commercial |
$215.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.79
|
| Rate for Payer: Priority Health SBD |
$159.72
|
| Rate for Payer: UMR Bronson Commercial |
$111.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.14
|
|
|
HC SILVADENE 400 GM
|
Facility
|
OP
|
$253.52
|
|
| Hospital Charge Code |
27100016
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$93.80 |
| Max. Negotiated Rate |
$228.17 |
| Rate for Payer: Aetna American Axle |
$164.79
|
| Rate for Payer: Aetna Commercial |
$215.49
|
| Rate for Payer: Aetna Medicare |
$126.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.79
|
| Rate for Payer: BCBS Complete |
$101.41
|
| Rate for Payer: Cash Price |
$202.82
|
| Rate for Payer: Cofinity Commercial |
$177.46
|
| Rate for Payer: Cofinity Commercial |
$218.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$177.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.82
|
| Rate for Payer: Healthscope Commercial |
$228.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$177.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.49
|
| Rate for Payer: PHP Commercial |
$215.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.79
|
| Rate for Payer: Priority Health SBD |
$159.72
|
| Rate for Payer: UMR Bronson Commercial |
$93.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.14
|
|
|
HC SILVADENE 85 GM
|
Facility
|
IP
|
$104.62
|
|
| Hospital Charge Code |
27100017
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$94.16 |
| Rate for Payer: Aetna American Axle |
$68.00
|
| Rate for Payer: Aetna Commercial |
$88.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.00
|
| Rate for Payer: Cash Price |
$83.70
|
| Rate for Payer: Cofinity Commercial |
$73.23
|
| Rate for Payer: Cofinity Commercial |
$89.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$73.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.70
|
| Rate for Payer: Healthscope Commercial |
$94.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.93
|
| Rate for Payer: PHP Commercial |
$88.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.00
|
| Rate for Payer: Priority Health SBD |
$65.91
|
| Rate for Payer: UMR Bronson Commercial |
$46.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.46
|
|
|
HC SILVADENE 85 GM
|
Facility
|
OP
|
$104.62
|
|
| Hospital Charge Code |
27100017
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$38.71 |
| Max. Negotiated Rate |
$94.16 |
| Rate for Payer: Aetna American Axle |
$68.00
|
| Rate for Payer: Aetna Commercial |
$88.93
|
| Rate for Payer: Aetna Medicare |
$52.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.00
|
| Rate for Payer: BCBS Complete |
$41.85
|
| Rate for Payer: Cash Price |
$83.70
|
| Rate for Payer: Cofinity Commercial |
$73.23
|
| Rate for Payer: Cofinity Commercial |
$89.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$73.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.70
|
| Rate for Payer: Healthscope Commercial |
$94.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.93
|
| Rate for Payer: PHP Commercial |
$88.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.00
|
| Rate for Payer: Priority Health SBD |
$65.91
|
| Rate for Payer: UMR Bronson Commercial |
$38.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.46
|
|
|
HC SILVER 4X4
|
Facility
|
IP
|
$65.41
|
|
| Hospital Charge Code |
27000146
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.78 |
| Max. Negotiated Rate |
$58.87 |
| Rate for Payer: PHP Commercial |
$55.60
|
| Rate for Payer: Aetna American Axle |
$42.52
|
| Rate for Payer: Aetna Commercial |
$55.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.52
|
| Rate for Payer: Cash Price |
$52.33
|
| Rate for Payer: Cofinity Commercial |
$45.79
|
| Rate for Payer: Cofinity Commercial |
$56.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$45.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.33
|
| Rate for Payer: Healthscope Commercial |
$58.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.52
|
| Rate for Payer: Priority Health SBD |
$41.21
|
| Rate for Payer: UMR Bronson Commercial |
$28.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.06
|
|
|
HC SILVER 4X4
|
Facility
|
OP
|
$65.41
|
|
| Hospital Charge Code |
27000146
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.20 |
| Max. Negotiated Rate |
$58.87 |
| Rate for Payer: Aetna American Axle |
$42.52
|
| Rate for Payer: Aetna Commercial |
$55.60
|
| Rate for Payer: Aetna Medicare |
$32.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.52
|
| Rate for Payer: BCBS Complete |
$26.16
|
| Rate for Payer: Cash Price |
$52.33
|
| Rate for Payer: Cofinity Commercial |
$45.79
|
| Rate for Payer: Cofinity Commercial |
$56.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$45.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.33
|
| Rate for Payer: Healthscope Commercial |
$58.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.60
|
| Rate for Payer: PHP Commercial |
$55.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.52
|
| Rate for Payer: Priority Health SBD |
$41.21
|
| Rate for Payer: UMR Bronson Commercial |
$24.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.06
|
|
|
HC SILVER HAWK CATHETER
|
Facility
|
IP
|
$8,746.56
|
|
|
Service Code
|
HCPCS C1888
|
| Hospital Charge Code |
27200070
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,848.49 |
| Max. Negotiated Rate |
$7,871.90 |
| Rate for Payer: Aetna American Axle |
$5,685.26
|
| Rate for Payer: Aetna Commercial |
$7,434.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,685.26
|
| Rate for Payer: Cash Price |
$6,997.25
|
| Rate for Payer: Cofinity Commercial |
$6,122.59
|
| Rate for Payer: Cofinity Commercial |
$7,522.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,122.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,997.25
|
| Rate for Payer: Healthscope Commercial |
$7,871.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,122.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,559.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,434.58
|
| Rate for Payer: PHP Commercial |
$7,434.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,685.26
|
| Rate for Payer: Priority Health SBD |
$5,510.33
|
| Rate for Payer: UMR Bronson Commercial |
$3,848.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,559.92
|
|
|
HC SILVER HAWK CATHETER
|
Facility
|
OP
|
$8,746.56
|
|
|
Service Code
|
HCPCS C1888
|
| Hospital Charge Code |
27200070
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,236.23 |
| Max. Negotiated Rate |
$7,871.90 |
| Rate for Payer: Aetna American Axle |
$5,685.26
|
| Rate for Payer: Aetna Commercial |
$7,434.58
|
| Rate for Payer: Aetna Medicare |
$4,373.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,685.26
|
| Rate for Payer: BCBS Complete |
$3,498.62
|
| Rate for Payer: Cash Price |
$6,997.25
|
| Rate for Payer: Cofinity Commercial |
$6,122.59
|
| Rate for Payer: Cofinity Commercial |
$7,522.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,122.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,997.25
|
| Rate for Payer: Healthscope Commercial |
$7,871.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,122.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,559.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,434.58
|
| Rate for Payer: PHP Commercial |
$7,434.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,685.26
|
| Rate for Payer: Priority Health SBD |
$5,510.33
|
| Rate for Payer: UMR Bronson Commercial |
$3,236.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,559.92
|
|
|
HC SILVER ROPE
|
Facility
|
OP
|
$54.58
|
|
| Hospital Charge Code |
27000147
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.19 |
| Max. Negotiated Rate |
$49.12 |
| Rate for Payer: Aetna American Axle |
$35.48
|
| Rate for Payer: Aetna Commercial |
$46.39
|
| Rate for Payer: Aetna Medicare |
$27.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.48
|
| Rate for Payer: BCBS Complete |
$21.83
|
| Rate for Payer: Cash Price |
$43.66
|
| Rate for Payer: Cofinity Commercial |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$46.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.66
|
| Rate for Payer: Healthscope Commercial |
$49.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.39
|
| Rate for Payer: PHP Commercial |
$46.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.48
|
| Rate for Payer: Priority Health SBD |
$34.39
|
| Rate for Payer: UMR Bronson Commercial |
$20.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.94
|
|
|
HC SILVER ROPE
|
Facility
|
IP
|
$54.58
|
|
| Hospital Charge Code |
27000147
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.02 |
| Max. Negotiated Rate |
$49.12 |
| Rate for Payer: Aetna American Axle |
$35.48
|
| Rate for Payer: Aetna Commercial |
$46.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.48
|
| Rate for Payer: Cash Price |
$43.66
|
| Rate for Payer: Cofinity Commercial |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$46.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.66
|
| Rate for Payer: Healthscope Commercial |
$49.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.39
|
| Rate for Payer: PHP Commercial |
$46.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.48
|
| Rate for Payer: Priority Health SBD |
$34.39
|
| Rate for Payer: UMR Bronson Commercial |
$24.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.94
|
|
|
HC SIMIAN B AB
|
Facility
|
IP
|
$91.09
|
|
|
Service Code
|
CPT 86790
|
| Hospital Charge Code |
30200333
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.08 |
| Max. Negotiated Rate |
$81.98 |
| Rate for Payer: Aetna American Axle |
$59.21
|
| Rate for Payer: Aetna Commercial |
$77.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.21
|
| Rate for Payer: Cash Price |
$72.87
|
| Rate for Payer: Cofinity Commercial |
$63.76
|
| Rate for Payer: Cofinity Commercial |
$78.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$63.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.87
|
| Rate for Payer: Healthscope Commercial |
$81.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.43
|
| Rate for Payer: PHP Commercial |
$77.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.21
|
| Rate for Payer: Priority Health SBD |
$57.39
|
| Rate for Payer: UMR Bronson Commercial |
$40.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.32
|
|
|
HC SIMIAN B AB
|
Facility
|
OP
|
$91.09
|
|
|
Service Code
|
CPT 86790
|
| Hospital Charge Code |
30200333
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$81.98 |
| Rate for Payer: Aetna American Axle |
$59.21
|
| Rate for Payer: Aetna Commercial |
$77.43
|
| Rate for Payer: Aetna Medicare |
$13.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.10
|
| Rate for Payer: BCBS Complete |
$7.25
|
| Rate for Payer: BCBS MAPPO |
$12.88
|
| Rate for Payer: BCBS Trust/PPO |
$12.41
|
| Rate for Payer: BCN Commercial |
$12.41
|
| Rate for Payer: BCN Medicare Advantage |
$12.88
|
| Rate for Payer: Cash Price |
$72.87
|
| Rate for Payer: Cash Price |
$72.87
|
| Rate for Payer: Cofinity Commercial |
$78.34
|
| Rate for Payer: Cofinity Commercial |
$63.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$63.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.88
|
| Rate for Payer: Healthscope Commercial |
$81.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.32
|
| Rate for Payer: Mclaren Medicaid |
$6.90
|
| Rate for Payer: Mclaren Medicare |
$12.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.52
|
| Rate for Payer: Meridian Medicaid |
$7.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.43
|
| Rate for Payer: Nomi Health Commercial |
$19.32
|
| Rate for Payer: PACE Medicare |
$12.24
|
| Rate for Payer: PACE SWMI |
$12.88
|
| Rate for Payer: PHP Commercial |
$77.43
|
| Rate for Payer: PHP Medicare Advantage |
$12.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.25
|
| Rate for Payer: Priority Health Medicare |
$12.88
|
| Rate for Payer: Priority Health Narrow Network |
$10.60
|
| Rate for Payer: Priority Health SBD |
$57.39
|
| Rate for Payer: Railroad Medicare Medicare |
$12.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.88
|
| Rate for Payer: UHC Exchange |
$12.88
|
| Rate for Payer: UHC Medicare Advantage |
$12.88
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: UMR Bronson Commercial |
$33.70
|
| Rate for Payer: VA VA |
$12.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.32
|
|
|
HC SIMPLE CYSTOMETROGRAM
|
Facility
|
OP
|
$361.15
|
|
|
Service Code
|
CPT 51725
|
| Hospital Charge Code |
76100189
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.51 |
| Max. Negotiated Rate |
$748.94 |
| Rate for Payer: Aetna American Axle |
$234.75
|
| Rate for Payer: Aetna Commercial |
$306.98
|
| Rate for Payer: Aetna Medicare |
$247.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.86
|
| Rate for Payer: BCBS Complete |
$134.11
|
| Rate for Payer: BCBS MAPPO |
$238.29
|
| Rate for Payer: BCBS Trust/PPO |
$125.51
|
| Rate for Payer: BCN Commercial |
$125.51
|
| Rate for Payer: BCN Medicare Advantage |
$238.29
|
| Rate for Payer: Cash Price |
$288.92
|
| Rate for Payer: Cash Price |
$288.92
|
| Rate for Payer: Cash Price |
$288.92
|
| Rate for Payer: Cofinity Commercial |
$310.59
|
| Rate for Payer: Cofinity Commercial |
$252.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$252.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.29
|
| Rate for Payer: Healthscope Commercial |
$325.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$252.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$270.86
|
| Rate for Payer: Mclaren Medicaid |
$127.72
|
| Rate for Payer: Mclaren Medicare |
$238.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$250.20
|
| Rate for Payer: Meridian Medicaid |
$134.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306.98
|
| Rate for Payer: Nomi Health Commercial |
$500.41
|
| Rate for Payer: PACE Medicare |
$226.38
|
| Rate for Payer: PACE SWMI |
$238.29
|
| Rate for Payer: PHP Commercial |
$306.98
|
| Rate for Payer: PHP Medicare Advantage |
$238.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$748.94
|
| Rate for Payer: Priority Health Medicare |
$238.29
|
| Rate for Payer: Priority Health Narrow Network |
$599.15
|
| Rate for Payer: Priority Health SBD |
$227.52
|
| Rate for Payer: Railroad Medicare Medicare |
$238.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.65
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.29
|
| Rate for Payer: UHC Exchange |
$209.68
|
| Rate for Payer: UHC Medicare Advantage |
$238.29
|
| Rate for Payer: UHCCP Medicaid |
$127.72
|
| Rate for Payer: UMR Bronson Commercial |
$133.63
|
| Rate for Payer: VA VA |
$238.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$270.86
|
|
|
HC SIMPLE CYSTOMETROGRAM
|
Facility
|
IP
|
$361.15
|
|
|
Service Code
|
CPT 51725
|
| Hospital Charge Code |
76100189
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$158.91 |
| Max. Negotiated Rate |
$325.04 |
| Rate for Payer: Aetna American Axle |
$234.75
|
| Rate for Payer: Aetna Commercial |
$306.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.75
|
| Rate for Payer: Cash Price |
$288.92
|
| Rate for Payer: Cofinity Commercial |
$252.80
|
| Rate for Payer: Cofinity Commercial |
$310.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$252.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.92
|
| Rate for Payer: Healthscope Commercial |
$325.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$252.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$270.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306.98
|
| Rate for Payer: PHP Commercial |
$306.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.75
|
| Rate for Payer: Priority Health SBD |
$227.52
|
| Rate for Payer: UMR Bronson Commercial |
$158.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$270.86
|
|
