|
HC SP ANGIOGRAPHY RENAL BIL
|
Facility
|
IP
|
$3,849.48
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
36100348
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,693.77 |
| Max. Negotiated Rate |
$3,464.53 |
| Rate for Payer: Aetna American Axle |
$2,502.16
|
| Rate for Payer: Aetna Commercial |
$3,272.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,502.16
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cofinity Commercial |
$2,694.64
|
| Rate for Payer: Cofinity Commercial |
$3,310.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,694.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,079.58
|
| Rate for Payer: Healthscope Commercial |
$3,464.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,694.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,887.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,272.06
|
| Rate for Payer: PHP Commercial |
$3,272.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,502.16
|
| Rate for Payer: Priority Health SBD |
$2,425.17
|
| Rate for Payer: UMR Bronson Commercial |
$1,693.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,887.11
|
|
|
HC SP ANGIOGRAPHY RENAL UNI
|
Facility
|
IP
|
$3,982.07
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
36100347
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,752.11 |
| Max. Negotiated Rate |
$3,583.86 |
| Rate for Payer: Aetna American Axle |
$2,588.35
|
| Rate for Payer: Aetna Commercial |
$3,384.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,588.35
|
| Rate for Payer: Cash Price |
$3,185.66
|
| Rate for Payer: Cofinity Commercial |
$2,787.45
|
| Rate for Payer: Cofinity Commercial |
$3,424.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,787.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,185.66
|
| Rate for Payer: Healthscope Commercial |
$3,583.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,787.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,986.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,384.76
|
| Rate for Payer: PHP Commercial |
$3,384.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,588.35
|
| Rate for Payer: Priority Health SBD |
$2,508.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,752.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,986.55
|
|
|
HC SP ANGIOGRAPHY RENAL UNI
|
Facility
|
OP
|
$3,982.07
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
36100347
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$245.29 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna American Axle |
$2,588.35
|
| Rate for Payer: Aetna Commercial |
$3,384.76
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,588.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,204.75
|
| Rate for Payer: BCN Commercial |
$2,204.75
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$3,185.66
|
| Rate for Payer: Cash Price |
$3,185.66
|
| Rate for Payer: Cash Price |
$3,185.66
|
| Rate for Payer: Cofinity Commercial |
$2,787.45
|
| Rate for Payer: Cofinity Commercial |
$3,424.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,787.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,185.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$3,583.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,787.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,986.55
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,384.76
|
| Rate for Payer: Nomi Health Commercial |
$9,251.58
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,384.76
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,588.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$2,508.70
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.82
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$245.29
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,473.37
|
| Rate for Payer: VA VA |
$3,083.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,986.55
|
|
|
HC SP AORTAGRAM ABDOMEN W RUNOFF
|
Facility
|
OP
|
$3,266.13
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
32000177
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$132.72 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna American Axle |
$2,122.98
|
| Rate for Payer: Aetna Commercial |
$2,776.21
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,122.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$132.72
|
| Rate for Payer: BCN Commercial |
$132.72
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$2,612.90
|
| Rate for Payer: Cash Price |
$2,612.90
|
| Rate for Payer: Cofinity Commercial |
$2,808.87
|
| Rate for Payer: Cofinity Commercial |
$2,286.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,286.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,612.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$2,939.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,286.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,449.60
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,776.21
|
| Rate for Payer: Nomi Health Commercial |
$9,251.58
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$2,776.21
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,122.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$2,057.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.80
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$148.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,208.47
|
| Rate for Payer: VA VA |
$3,083.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,449.60
|
|
|
HC SP AORTAGRAM ABDOMEN W RUNOFF
|
Facility
|
IP
|
$3,266.13
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
32000177
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,437.10 |
| Max. Negotiated Rate |
$2,939.52 |
| Rate for Payer: Aetna American Axle |
$2,122.98
|
| Rate for Payer: Aetna Commercial |
$2,776.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,122.98
|
| Rate for Payer: Cash Price |
$2,612.90
|
| Rate for Payer: Cofinity Commercial |
$2,286.29
|
| Rate for Payer: Cofinity Commercial |
$2,808.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,286.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,612.90
|
| Rate for Payer: Healthscope Commercial |
$2,939.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,286.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,449.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,776.21
|
| Rate for Payer: PHP Commercial |
$2,776.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,122.98
|
| Rate for Payer: Priority Health SBD |
$2,057.66
|
| Rate for Payer: UMR Bronson Commercial |
$1,437.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,449.60
|
|
|
HC SPECIAL DOSIMETRY
|
Facility
|
OP
|
$153.98
|
|
|
Service Code
|
CPT 77331
|
| Hospital Charge Code |
33300013
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$39.68 |
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$100.09
|
| Rate for Payer: Aetna Commercial |
$130.88
|
| Rate for Payer: Aetna Medicare |
$135.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$162.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$162.61
|
| Rate for Payer: BCBS Complete |
$73.21
|
| Rate for Payer: BCBS MAPPO |
$130.09
|
| Rate for Payer: BCBS Trust/PPO |
$39.68
|
| Rate for Payer: BCN Commercial |
$39.68
|
| Rate for Payer: BCN Medicare Advantage |
$130.09
|
| Rate for Payer: Cash Price |
$123.18
|
| Rate for Payer: Cash Price |
$123.18
|
| Rate for Payer: Cash Price |
$123.18
|
| Rate for Payer: Cofinity Commercial |
$107.79
|
| Rate for Payer: Cofinity Commercial |
$132.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.09
|
| Rate for Payer: Healthscope Commercial |
$138.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.48
|
| Rate for Payer: Mclaren Medicaid |
$69.73
|
| Rate for Payer: Mclaren Medicare |
$130.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.59
|
| Rate for Payer: Meridian Medicaid |
$73.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$149.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.88
|
| Rate for Payer: Nomi Health Commercial |
$390.27
|
| Rate for Payer: PACE Medicare |
$123.59
|
| Rate for Payer: PACE SWMI |
$130.09
|
| Rate for Payer: PHP Commercial |
$130.88
|
| Rate for Payer: PHP Medicare Advantage |
$130.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$408.86
|
| Rate for Payer: Priority Health Medicare |
$130.09
|
| Rate for Payer: Priority Health Narrow Network |
$327.09
|
| Rate for Payer: Priority Health SBD |
$97.01
|
| Rate for Payer: Railroad Medicare Medicare |
$130.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.24
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$130.09
|
| Rate for Payer: UHC Exchange |
$61.13
|
| Rate for Payer: UHC Medicare Advantage |
$130.09
|
| Rate for Payer: UHCCP Medicaid |
$69.73
|
| Rate for Payer: UMR Bronson Commercial |
$56.97
|
| Rate for Payer: VA VA |
$130.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.48
|
|
|
HC SPECIAL DOSIMETRY
|
Facility
|
IP
|
$153.98
|
|
|
Service Code
|
CPT 77331
|
| Hospital Charge Code |
33300013
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$67.75 |
| Max. Negotiated Rate |
$138.58 |
| Rate for Payer: Aetna American Axle |
$100.09
|
| Rate for Payer: Aetna Commercial |
$130.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.09
|
| Rate for Payer: Cash Price |
$123.18
|
| Rate for Payer: Cofinity Commercial |
$107.79
|
| Rate for Payer: Cofinity Commercial |
$132.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.18
|
| Rate for Payer: Healthscope Commercial |
$138.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.88
|
| Rate for Payer: PHP Commercial |
$130.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.09
|
| Rate for Payer: Priority Health SBD |
$97.01
|
| Rate for Payer: UMR Bronson Commercial |
$67.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.48
|
|
|
HC SPECIAL STAINS
|
Facility
|
IP
|
$225.55
|
|
|
Service Code
|
CPT 88312
|
| Hospital Charge Code |
31000053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$99.24 |
| Max. Negotiated Rate |
$203.00 |
| Rate for Payer: Aetna American Axle |
$146.61
|
| Rate for Payer: Aetna Commercial |
$191.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.61
|
| Rate for Payer: Cash Price |
$180.44
|
| Rate for Payer: Cofinity Commercial |
$157.88
|
| Rate for Payer: Cofinity Commercial |
$193.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$157.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.44
|
| Rate for Payer: Healthscope Commercial |
$203.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$157.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.72
|
| Rate for Payer: PHP Commercial |
$191.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.61
|
| Rate for Payer: Priority Health SBD |
$142.10
|
| Rate for Payer: UMR Bronson Commercial |
$99.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.16
|
|
|
HC SPECIAL STAINS
|
Facility
|
OP
|
$225.55
|
|
|
Service Code
|
CPT 88312
|
| Hospital Charge Code |
31000053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$28.06 |
| Max. Negotiated Rate |
$203.00 |
| Rate for Payer: Aetna American Axle |
$146.61
|
| Rate for Payer: Aetna Commercial |
$191.72
|
| Rate for Payer: Aetna Medicare |
$54.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.44
|
| Rate for Payer: BCBS Complete |
$29.46
|
| Rate for Payer: BCBS MAPPO |
$52.35
|
| Rate for Payer: BCBS Trust/PPO |
$133.93
|
| Rate for Payer: BCN Commercial |
$133.93
|
| Rate for Payer: BCN Medicare Advantage |
$52.35
|
| Rate for Payer: Cash Price |
$180.44
|
| Rate for Payer: Cash Price |
$180.44
|
| Rate for Payer: Cofinity Commercial |
$193.97
|
| Rate for Payer: Cofinity Commercial |
$157.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$157.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.35
|
| Rate for Payer: Healthscope Commercial |
$203.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$157.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.16
|
| Rate for Payer: Mclaren Medicaid |
$28.06
|
| Rate for Payer: Mclaren Medicare |
$52.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.97
|
| Rate for Payer: Meridian Medicaid |
$29.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.72
|
| Rate for Payer: Nomi Health Commercial |
$157.05
|
| Rate for Payer: PACE Medicare |
$49.73
|
| Rate for Payer: PACE SWMI |
$52.35
|
| Rate for Payer: PHP Commercial |
$191.72
|
| Rate for Payer: PHP Medicare Advantage |
$52.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$164.53
|
| Rate for Payer: Priority Health Medicare |
$52.35
|
| Rate for Payer: Priority Health Narrow Network |
$131.62
|
| Rate for Payer: Priority Health SBD |
$142.10
|
| Rate for Payer: Railroad Medicare Medicare |
$52.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.35
|
| Rate for Payer: UHC Exchange |
$102.57
|
| Rate for Payer: UHC Medicare Advantage |
$52.35
|
| Rate for Payer: UHCCP Medicaid |
$28.06
|
| Rate for Payer: UMR Bronson Commercial |
$83.45
|
| Rate for Payer: VA VA |
$52.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.16
|
|
|
HC SPECIAL STAINS II
|
Facility
|
OP
|
$186.45
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31000054
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$396.95 |
| Rate for Payer: Aetna American Axle |
$121.19
|
| Rate for Payer: Aetna Commercial |
$158.48
|
| Rate for Payer: Aetna Medicare |
$131.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$109.82
|
| Rate for Payer: BCN Commercial |
$109.82
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$149.16
|
| Rate for Payer: Cash Price |
$149.16
|
| Rate for Payer: Cofinity Commercial |
$160.35
|
| Rate for Payer: Cofinity Commercial |
$130.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$130.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$167.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$130.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.84
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158.48
|
| Rate for Payer: Nomi Health Commercial |
$378.87
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$158.48
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.95
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$317.56
|
| Rate for Payer: Priority Health SBD |
$117.46
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$75.15
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: UMR Bronson Commercial |
$68.99
|
| Rate for Payer: VA VA |
$126.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.84
|
|
|
HC SPECIAL STAINS II
|
Facility
|
IP
|
$186.45
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31000054
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$82.04 |
| Max. Negotiated Rate |
$167.80 |
| Rate for Payer: Aetna American Axle |
$121.19
|
| Rate for Payer: Aetna Commercial |
$158.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.19
|
| Rate for Payer: Cash Price |
$149.16
|
| Rate for Payer: Cofinity Commercial |
$130.52
|
| Rate for Payer: Cofinity Commercial |
$160.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$130.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.16
|
| Rate for Payer: Healthscope Commercial |
$167.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$130.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158.48
|
| Rate for Payer: PHP Commercial |
$158.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.19
|
| Rate for Payer: Priority Health SBD |
$117.46
|
| Rate for Payer: UMR Bronson Commercial |
$82.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.84
|
|
|
HC SPECIFIC GRAVITY FLUID NOT URINE
|
Facility
|
OP
|
$12.34
|
|
|
Service Code
|
CPT 84315
|
| Hospital Charge Code |
30100426
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.76 |
| Max. Negotiated Rate |
$11.11 |
| Rate for Payer: Aetna American Axle |
$8.02
|
| Rate for Payer: Aetna Commercial |
$10.49
|
| Rate for Payer: Aetna Medicare |
$3.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.10
|
| Rate for Payer: BCBS Complete |
$1.85
|
| Rate for Payer: BCBS MAPPO |
$3.28
|
| Rate for Payer: BCBS Trust/PPO |
$3.16
|
| Rate for Payer: BCN Commercial |
$3.16
|
| Rate for Payer: BCN Medicare Advantage |
$3.28
|
| Rate for Payer: Cash Price |
$9.87
|
| Rate for Payer: Cash Price |
$9.87
|
| Rate for Payer: Cofinity Commercial |
$8.64
|
| Rate for Payer: Cofinity Commercial |
$10.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.28
|
| Rate for Payer: Healthscope Commercial |
$11.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.26
|
| Rate for Payer: Mclaren Medicaid |
$1.76
|
| Rate for Payer: Mclaren Medicare |
$3.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.44
|
| Rate for Payer: Meridian Medicaid |
$1.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.49
|
| Rate for Payer: Nomi Health Commercial |
$4.92
|
| Rate for Payer: PACE Medicare |
$3.12
|
| Rate for Payer: PACE SWMI |
$3.28
|
| Rate for Payer: PHP Commercial |
$10.49
|
| Rate for Payer: PHP Medicare Advantage |
$3.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.28
|
| Rate for Payer: Priority Health Medicare |
$3.28
|
| Rate for Payer: Priority Health Narrow Network |
$2.62
|
| Rate for Payer: Priority Health SBD |
$7.77
|
| Rate for Payer: Railroad Medicare Medicare |
$3.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.28
|
| Rate for Payer: UHC Exchange |
$3.28
|
| Rate for Payer: UHC Medicare Advantage |
$3.28
|
| Rate for Payer: UHCCP Medicaid |
$1.76
|
| Rate for Payer: UMR Bronson Commercial |
$4.57
|
| Rate for Payer: VA VA |
$3.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.26
|
|
|
HC SPECIFIC GRAVITY FLUID NOT URINE
|
Facility
|
IP
|
$12.34
|
|
|
Service Code
|
CPT 84315
|
| Hospital Charge Code |
30100426
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$11.11 |
| Rate for Payer: Aetna American Axle |
$8.02
|
| Rate for Payer: Aetna Commercial |
$10.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.02
|
| Rate for Payer: Cash Price |
$9.87
|
| Rate for Payer: Cofinity Commercial |
$10.61
|
| Rate for Payer: Cofinity Commercial |
$8.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.87
|
| Rate for Payer: Healthscope Commercial |
$11.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.49
|
| Rate for Payer: PHP Commercial |
$10.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.02
|
| Rate for Payer: Priority Health SBD |
$7.77
|
| Rate for Payer: UMR Bronson Commercial |
$5.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.26
|
|
|
HC SPECIMEN CONCENTRATION FOR INFECTIOUS AGENTS
|
Facility
|
OP
|
$44.06
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600068
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.58 |
| Max. Negotiated Rate |
$39.65 |
| Rate for Payer: Aetna American Axle |
$28.64
|
| Rate for Payer: Aetna Commercial |
$37.45
|
| Rate for Payer: Aetna Medicare |
$6.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.35
|
| Rate for Payer: BCBS Complete |
$3.76
|
| Rate for Payer: BCBS MAPPO |
$6.68
|
| Rate for Payer: BCBS Trust/PPO |
$6.44
|
| Rate for Payer: BCN Commercial |
$6.44
|
| Rate for Payer: BCN Medicare Advantage |
$6.68
|
| Rate for Payer: Cash Price |
$35.25
|
| Rate for Payer: Cash Price |
$35.25
|
| Rate for Payer: Cofinity Commercial |
$37.89
|
| Rate for Payer: Cofinity Commercial |
$30.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.68
|
| Rate for Payer: Healthscope Commercial |
$39.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.04
|
| Rate for Payer: Mclaren Medicaid |
$3.58
|
| Rate for Payer: Mclaren Medicare |
$6.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.01
|
| Rate for Payer: Meridian Medicaid |
$3.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.45
|
| Rate for Payer: Nomi Health Commercial |
$10.02
|
| Rate for Payer: PACE Medicare |
$6.35
|
| Rate for Payer: PACE SWMI |
$6.68
|
| Rate for Payer: PHP Commercial |
$37.45
|
| Rate for Payer: PHP Medicare Advantage |
$6.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.68
|
| Rate for Payer: Priority Health Medicare |
$6.68
|
| Rate for Payer: Priority Health Narrow Network |
$5.34
|
| Rate for Payer: Priority Health SBD |
$27.76
|
| Rate for Payer: Railroad Medicare Medicare |
$6.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.68
|
| Rate for Payer: UHC Exchange |
$6.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.68
|
| Rate for Payer: UHCCP Medicaid |
$3.58
|
| Rate for Payer: UMR Bronson Commercial |
$16.30
|
| Rate for Payer: VA VA |
$6.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.04
|
|
|
HC SPECIMEN CONCENTRATION FOR INFECTIOUS AGENTS
|
Facility
|
IP
|
$44.06
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600068
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.39 |
| Max. Negotiated Rate |
$39.65 |
| Rate for Payer: Aetna American Axle |
$28.64
|
| Rate for Payer: Aetna Commercial |
$37.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.64
|
| Rate for Payer: Cash Price |
$35.25
|
| Rate for Payer: Cofinity Commercial |
$30.84
|
| Rate for Payer: Cofinity Commercial |
$37.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.25
|
| Rate for Payer: Healthscope Commercial |
$39.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.45
|
| Rate for Payer: PHP Commercial |
$37.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.64
|
| Rate for Payer: Priority Health SBD |
$27.76
|
| Rate for Payer: UMR Bronson Commercial |
$19.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.04
|
|
|
HC SPEC PHYSICS CONSULT
|
Facility
|
OP
|
$556.61
|
|
|
Service Code
|
CPT 77370
|
| Hospital Charge Code |
33300017
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$69.73 |
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$361.80
|
| Rate for Payer: Aetna Commercial |
$473.12
|
| Rate for Payer: Aetna Medicare |
$135.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$361.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$162.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$162.61
|
| Rate for Payer: BCBS Complete |
$73.21
|
| Rate for Payer: BCBS MAPPO |
$130.09
|
| Rate for Payer: BCBS Trust/PPO |
$296.94
|
| Rate for Payer: BCN Commercial |
$296.94
|
| Rate for Payer: BCN Medicare Advantage |
$130.09
|
| Rate for Payer: Cash Price |
$445.29
|
| Rate for Payer: Cash Price |
$445.29
|
| Rate for Payer: Cash Price |
$445.29
|
| Rate for Payer: Cofinity Commercial |
$389.63
|
| Rate for Payer: Cofinity Commercial |
$478.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$389.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$445.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.09
|
| Rate for Payer: Healthscope Commercial |
$500.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$389.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$417.46
|
| Rate for Payer: Mclaren Medicaid |
$69.73
|
| Rate for Payer: Mclaren Medicare |
$130.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.59
|
| Rate for Payer: Meridian Medicaid |
$73.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$149.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$473.12
|
| Rate for Payer: Nomi Health Commercial |
$390.27
|
| Rate for Payer: PACE Medicare |
$123.59
|
| Rate for Payer: PACE SWMI |
$130.09
|
| Rate for Payer: PHP Commercial |
$473.12
|
| Rate for Payer: PHP Medicare Advantage |
$130.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$361.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$408.86
|
| Rate for Payer: Priority Health Medicare |
$130.09
|
| Rate for Payer: Priority Health Narrow Network |
$327.09
|
| Rate for Payer: Priority Health SBD |
$350.66
|
| Rate for Payer: Railroad Medicare Medicare |
$130.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.82
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$130.09
|
| Rate for Payer: UHC Exchange |
$130.75
|
| Rate for Payer: UHC Medicare Advantage |
$130.09
|
| Rate for Payer: UHCCP Medicaid |
$69.73
|
| Rate for Payer: UMR Bronson Commercial |
$205.95
|
| Rate for Payer: VA VA |
$130.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$417.46
|
|
|
HC SPEC PHYSICS CONSULT
|
Facility
|
IP
|
$556.61
|
|
|
Service Code
|
CPT 77370
|
| Hospital Charge Code |
33300017
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$244.91 |
| Max. Negotiated Rate |
$500.95 |
| Rate for Payer: Aetna American Axle |
$361.80
|
| Rate for Payer: Aetna Commercial |
$473.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$361.80
|
| Rate for Payer: Cash Price |
$445.29
|
| Rate for Payer: Cofinity Commercial |
$389.63
|
| Rate for Payer: Cofinity Commercial |
$478.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$389.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$445.29
|
| Rate for Payer: Healthscope Commercial |
$500.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$389.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$417.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$473.12
|
| Rate for Payer: PHP Commercial |
$473.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$361.80
|
| Rate for Payer: Priority Health SBD |
$350.66
|
| Rate for Payer: UMR Bronson Commercial |
$244.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$417.46
|
|
|
HC SPECTRAL DOPPLER
|
Facility
|
IP
|
$493.59
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
48000006
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$217.18 |
| Max. Negotiated Rate |
$444.23 |
| Rate for Payer: Aetna American Axle |
$320.83
|
| Rate for Payer: Aetna Commercial |
$419.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.83
|
| Rate for Payer: Cash Price |
$394.87
|
| Rate for Payer: Cofinity Commercial |
$345.51
|
| Rate for Payer: Cofinity Commercial |
$424.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$345.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$394.87
|
| Rate for Payer: Healthscope Commercial |
$444.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$345.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.55
|
| Rate for Payer: PHP Commercial |
$419.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$320.83
|
| Rate for Payer: Priority Health SBD |
$310.96
|
| Rate for Payer: UMR Bronson Commercial |
$217.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.19
|
|
|
HC SPECTRAL DOPPLER
|
Facility
|
OP
|
$493.59
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
48000006
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$46.62 |
| Max. Negotiated Rate |
$816.00 |
| Rate for Payer: Aetna American Axle |
$320.83
|
| Rate for Payer: Aetna Commercial |
$419.55
|
| Rate for Payer: Aetna Medicare |
$246.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.83
|
| Rate for Payer: BCBS Complete |
$197.44
|
| Rate for Payer: BCBS Trust/PPO |
$140.95
|
| Rate for Payer: BCN Commercial |
$140.95
|
| Rate for Payer: Cash Price |
$394.87
|
| Rate for Payer: Cash Price |
$394.87
|
| Rate for Payer: Cash Price |
$394.87
|
| Rate for Payer: Cofinity Commercial |
$424.49
|
| Rate for Payer: Cofinity Commercial |
$345.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$345.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$394.87
|
| Rate for Payer: Healthscope Commercial |
$444.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$345.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.55
|
| Rate for Payer: PHP Commercial |
$419.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$320.83
|
| Rate for Payer: Priority Health SBD |
$310.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.28
|
| Rate for Payer: UHC Core |
$816.00
|
| Rate for Payer: UHC Exchange |
$46.62
|
| Rate for Payer: UMR Bronson Commercial |
$182.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.19
|
|
|
HC SPEC TX PROCEDURE
|
Facility
|
IP
|
$1,587.65
|
|
|
Service Code
|
CPT 77470
|
| Hospital Charge Code |
33300026
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$698.57 |
| Max. Negotiated Rate |
$1,428.88 |
| Rate for Payer: Aetna American Axle |
$1,031.97
|
| Rate for Payer: Aetna Commercial |
$1,349.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.97
|
| Rate for Payer: Cash Price |
$1,270.12
|
| Rate for Payer: Cofinity Commercial |
$1,111.36
|
| Rate for Payer: Cofinity Commercial |
$1,365.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,111.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,270.12
|
| Rate for Payer: Healthscope Commercial |
$1,428.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,111.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,190.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,349.50
|
| Rate for Payer: PHP Commercial |
$1,349.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,031.97
|
| Rate for Payer: Priority Health SBD |
$1,000.22
|
| Rate for Payer: UMR Bronson Commercial |
$698.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,190.74
|
|
|
HC SPEC TX PROCEDURE
|
Facility
|
OP
|
$1,587.65
|
|
|
Service Code
|
CPT 77470
|
| Hospital Charge Code |
33300026
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$73.89 |
| Max. Negotiated Rate |
$1,781.38 |
| Rate for Payer: Aetna American Axle |
$1,031.97
|
| Rate for Payer: Aetna Commercial |
$1,349.50
|
| Rate for Payer: Aetna Medicare |
$589.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.97
|
| 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 |
$73.89
|
| Rate for Payer: BCN Commercial |
$73.89
|
| Rate for Payer: BCN Medicare Advantage |
$566.77
|
| Rate for Payer: Cash Price |
$1,270.12
|
| Rate for Payer: Cash Price |
$1,270.12
|
| Rate for Payer: Cash Price |
$1,270.12
|
| Rate for Payer: Cofinity Commercial |
$1,111.36
|
| Rate for Payer: Cofinity Commercial |
$1,365.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,111.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,270.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$566.77
|
| Rate for Payer: Healthscope Commercial |
$1,428.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,111.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,190.74
|
| 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 |
$1,349.50
|
| 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 |
$1,349.50
|
| 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 |
$1,031.97
|
| 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 |
$1,000.22
|
| Rate for Payer: Railroad Medicare Medicare |
$566.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.33
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$566.77
|
| Rate for Payer: UHC Exchange |
$133.94
|
| Rate for Payer: UHC Medicare Advantage |
$566.77
|
| Rate for Payer: UHCCP Medicaid |
$303.79
|
| Rate for Payer: UMR Bronson Commercial |
$587.43
|
| Rate for Payer: VA VA |
$566.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,190.74
|
|
|
HC SPEECH AUDIOMETRY COMPLETE
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 92556
|
| Hospital Charge Code |
76100502
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$24.53 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$43.10
|
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna Medicare |
$60.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.10
|
| 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 |
$188.87
|
| Rate for Payer: BCN Commercial |
$188.87
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$46.41
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| 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 |
$56.36
|
| 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 |
$56.36
|
| 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 |
$43.10
|
| 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 |
$41.77
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.40
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Exchange |
$40.36
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$31.20
|
| Rate for Payer: UMR Bronson Commercial |
$24.53
|
| Rate for Payer: VA VA |
$58.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC SPEECH AUDIOMETRY COMPLETE
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 92556
|
| Hospital Charge Code |
76100502
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$29.17 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna American Axle |
$43.10
|
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.10
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$46.41
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: Priority Health SBD |
$41.77
|
| Rate for Payer: UMR Bronson Commercial |
$29.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC SPEECH EVAL
|
Facility
|
OP
|
$599.67
|
|
|
Service Code
|
CPT 92523
|
| Hospital Charge Code |
44400009
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$539.70 |
| Rate for Payer: Aetna American Axle |
$389.79
|
| Rate for Payer: Aetna Commercial |
$509.72
|
| Rate for Payer: Aetna Medicare |
$299.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$389.79
|
| Rate for Payer: BCBS Complete |
$239.87
|
| Rate for Payer: BCBS Trust/PPO |
$275.92
|
| Rate for Payer: BCN Commercial |
$275.92
|
| Rate for Payer: Cash Price |
$479.74
|
| Rate for Payer: Cash Price |
$479.74
|
| Rate for Payer: Cash Price |
$479.74
|
| Rate for Payer: Cofinity Commercial |
$419.77
|
| Rate for Payer: Cofinity Commercial |
$515.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$419.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$479.74
|
| Rate for Payer: Healthscope Commercial |
$539.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$419.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$449.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$509.72
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$509.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$389.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$183.04
|
| Rate for Payer: Priority Health Narrow Network |
$146.43
|
| Rate for Payer: Priority Health SBD |
$377.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.70
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$216.09
|
| Rate for Payer: UMR Bronson Commercial |
$221.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$449.75
|
|
|
HC SPEECH EVAL
|
Facility
|
IP
|
$599.67
|
|
|
Service Code
|
CPT 92523
|
| Hospital Charge Code |
44400009
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$263.85 |
| Max. Negotiated Rate |
$539.70 |
| Rate for Payer: Aetna American Axle |
$389.79
|
| Rate for Payer: Aetna Commercial |
$509.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$389.79
|
| Rate for Payer: Cash Price |
$479.74
|
| Rate for Payer: Cofinity Commercial |
$419.77
|
| Rate for Payer: Cofinity Commercial |
$515.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$419.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$479.74
|
| Rate for Payer: Healthscope Commercial |
$539.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$419.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$449.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$509.72
|
| Rate for Payer: PHP Commercial |
$509.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$389.79
|
| Rate for Payer: Priority Health SBD |
$377.79
|
| Rate for Payer: UMR Bronson Commercial |
$263.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$449.75
|
|
