|
HC US EACH ADDL FETUS GT 14 WKS
|
Facility
|
IP
|
$440.41
|
|
|
Service Code
|
CPT 76810
|
| Hospital Charge Code |
40200018
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$193.78 |
| Max. Negotiated Rate |
$396.37 |
| Rate for Payer: Aetna American Axle |
$286.27
|
| Rate for Payer: Aetna Commercial |
$374.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.27
|
| Rate for Payer: Cash Price |
$352.33
|
| Rate for Payer: Cofinity Advantage |
$308.29
|
| Rate for Payer: Cofinity Commercial |
$378.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.33
|
| Rate for Payer: Healthscope Commercial |
$396.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$308.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$330.31
|
| Rate for Payer: PHP Commercial |
$374.35
|
| Rate for Payer: Priority Health SBD |
$277.46
|
| Rate for Payer: UMR Bronson Commercial |
$193.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.31
|
|
|
HC US EACH ADDL FETUS LESS THAN 14 WKS
|
Facility
|
IP
|
$362.55
|
|
|
Service Code
|
CPT 76802
|
| Hospital Charge Code |
40200016
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$159.52 |
| Max. Negotiated Rate |
$326.30 |
| Rate for Payer: Aetna American Axle |
$235.66
|
| Rate for Payer: Aetna Commercial |
$308.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.66
|
| Rate for Payer: Cash Price |
$290.04
|
| Rate for Payer: Cofinity Advantage |
$253.78
|
| Rate for Payer: Cofinity Commercial |
$311.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.04
|
| Rate for Payer: Healthscope Commercial |
$326.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$253.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$271.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$308.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$271.91
|
| Rate for Payer: PHP Commercial |
$308.17
|
| Rate for Payer: Priority Health SBD |
$228.41
|
| Rate for Payer: UMR Bronson Commercial |
$159.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$271.91
|
|
|
HC US EACH ADDL FETUS LESS THAN 14 WKS
|
Facility
|
OP
|
$362.55
|
|
|
Service Code
|
CPT 76802
|
| Hospital Charge Code |
40200016
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$50.89 |
| Max. Negotiated Rate |
$326.30 |
| Rate for Payer: Aetna American Axle |
$235.66
|
| Rate for Payer: Aetna Commercial |
$308.17
|
| Rate for Payer: Aetna Medicare |
$181.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.66
|
| Rate for Payer: BCBS Complete |
$145.02
|
| Rate for Payer: BCBS Trust/PPO |
$50.89
|
| Rate for Payer: BCN Commercial |
$50.89
|
| Rate for Payer: Cash Price |
$290.04
|
| Rate for Payer: Cash Price |
$290.04
|
| Rate for Payer: Cofinity Advantage |
$253.78
|
| Rate for Payer: Cofinity Commercial |
$311.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.04
|
| Rate for Payer: Healthscope Commercial |
$326.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$253.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$271.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$290.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$308.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$271.91
|
| Rate for Payer: PHP Commercial |
$308.17
|
| Rate for Payer: Priority Health SBD |
$228.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$235.66
|
| Rate for Payer: UHC Core |
$188.89
|
| Rate for Payer: UHC Exchange |
$142.48
|
| Rate for Payer: UMR Bronson Commercial |
$134.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$271.91
|
|
|
HC US ELASTOGRAPHY 1ST LESION
|
Facility
|
OP
|
$212.24
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
40200075
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$336.87 |
| Rate for Payer: Aetna American Axle |
$137.96
|
| Rate for Payer: Aetna Commercial |
$180.40
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$158.43
|
| Rate for Payer: BCCCP Commercial |
$86.41
|
| Rate for Payer: BCN Commercial |
$158.43
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$169.79
|
| Rate for Payer: Cash Price |
$169.79
|
| Rate for Payer: Cofinity Advantage |
$148.57
|
| Rate for Payer: Cofinity Commercial |
$182.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$191.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$148.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.18
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.40
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.18
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$180.40
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$133.71
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.96
|
| Rate for Payer: UHC Core |
$110.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$83.41
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$78.53
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.18
|
|
|
HC US ELASTOGRAPHY 1ST LESION
|
Facility
|
IP
|
$212.24
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
40200075
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$93.39 |
| Max. Negotiated Rate |
$191.02 |
| Rate for Payer: Aetna American Axle |
$137.96
|
| Rate for Payer: Aetna Commercial |
$180.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.96
|
| Rate for Payer: Cash Price |
$169.79
|
| Rate for Payer: Cofinity Advantage |
$148.57
|
| Rate for Payer: Cofinity Commercial |
$182.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.79
|
| Rate for Payer: Healthscope Commercial |
$191.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$148.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.18
|
| Rate for Payer: PHP Commercial |
$180.40
|
| Rate for Payer: Priority Health SBD |
$133.71
|
| Rate for Payer: UMR Bronson Commercial |
$93.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.18
|
|
|
HC US ELASTOGRAPHY 1ST TARGET LESION
|
Facility
|
OP
|
$316.20
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
40200082
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$336.87 |
| Rate for Payer: Aetna American Axle |
$205.53
|
| Rate for Payer: Aetna Commercial |
$268.77
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$158.43
|
| Rate for Payer: BCCCP Commercial |
$86.41
|
| Rate for Payer: BCN Commercial |
$158.43
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$252.96
|
| Rate for Payer: Cash Price |
$252.96
|
| Rate for Payer: Cofinity Advantage |
$221.34
|
| Rate for Payer: Cofinity Commercial |
$271.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$284.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$221.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$237.15
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.77
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.15
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$268.77
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$199.21
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.53
|
| Rate for Payer: UHC Core |
$164.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$124.27
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$116.99
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$237.15
|
|
|
HC US ELASTOGRAPHY 1ST TARGET LESION
|
Facility
|
IP
|
$316.20
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
40200082
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$139.13 |
| Max. Negotiated Rate |
$284.58 |
| Rate for Payer: Aetna American Axle |
$205.53
|
| Rate for Payer: Aetna Commercial |
$268.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.53
|
| Rate for Payer: Cash Price |
$252.96
|
| Rate for Payer: Cofinity Advantage |
$221.34
|
| Rate for Payer: Cofinity Commercial |
$271.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.96
|
| Rate for Payer: Healthscope Commercial |
$284.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$221.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$237.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.15
|
| Rate for Payer: PHP Commercial |
$268.77
|
| Rate for Payer: Priority Health SBD |
$199.21
|
| Rate for Payer: UMR Bronson Commercial |
$139.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$237.15
|
|
|
HC US ELASTOGRAPHY EA ADDL LESION
|
Facility
|
IP
|
$31.83
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
40200076
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$14.01 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna American Axle |
$20.69
|
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.69
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Advantage |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: Priority Health SBD |
$20.05
|
| Rate for Payer: UMR Bronson Commercial |
$14.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC US ELASTOGRAPHY EA ADDL LESION
|
Facility
|
OP
|
$31.83
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
40200076
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$11.78 |
| Max. Negotiated Rate |
$89.47 |
| Rate for Payer: Aetna American Axle |
$20.69
|
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.69
|
| Rate for Payer: BCBS Complete |
$12.73
|
| Rate for Payer: BCBS Trust/PPO |
$89.47
|
| Rate for Payer: BCN Commercial |
$89.47
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Advantage |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: Priority Health SBD |
$20.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.69
|
| Rate for Payer: UHC Core |
$16.58
|
| Rate for Payer: UHC Exchange |
$12.51
|
| Rate for Payer: UMR Bronson Commercial |
$11.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC US ELASTOGRAPHY EA ADDL TARGET LESION
|
Facility
|
IP
|
$214.20
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
40200083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$94.25 |
| Max. Negotiated Rate |
$192.78 |
| Rate for Payer: Aetna American Axle |
$139.23
|
| Rate for Payer: Aetna Commercial |
$182.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.23
|
| Rate for Payer: Cash Price |
$171.36
|
| Rate for Payer: Cofinity Advantage |
$149.94
|
| Rate for Payer: Cofinity Commercial |
$184.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.36
|
| Rate for Payer: Healthscope Commercial |
$192.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$149.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.65
|
| Rate for Payer: PHP Commercial |
$182.07
|
| Rate for Payer: Priority Health SBD |
$134.95
|
| Rate for Payer: UMR Bronson Commercial |
$94.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.65
|
|
|
HC US ELASTOGRAPHY EA ADDL TARGET LESION
|
Facility
|
OP
|
$214.20
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
40200083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$79.25 |
| Max. Negotiated Rate |
$192.78 |
| Rate for Payer: Aetna American Axle |
$139.23
|
| Rate for Payer: Aetna Commercial |
$182.07
|
| Rate for Payer: Aetna Medicare |
$107.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.23
|
| Rate for Payer: BCBS Complete |
$85.68
|
| Rate for Payer: BCBS Trust/PPO |
$89.47
|
| Rate for Payer: BCN Commercial |
$89.47
|
| Rate for Payer: Cash Price |
$171.36
|
| Rate for Payer: Cash Price |
$171.36
|
| Rate for Payer: Cofinity Advantage |
$149.94
|
| Rate for Payer: Cofinity Commercial |
$184.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.36
|
| Rate for Payer: Healthscope Commercial |
$192.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$149.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$171.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.65
|
| Rate for Payer: PHP Commercial |
$182.07
|
| Rate for Payer: Priority Health SBD |
$134.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.23
|
| Rate for Payer: UHC Core |
$111.60
|
| Rate for Payer: UHC Exchange |
$84.18
|
| Rate for Payer: UMR Bronson Commercial |
$79.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.65
|
|
|
HC US ELASTOGRAPHY ORGAN
|
Facility
|
IP
|
$293.76
|
|
|
Service Code
|
CPT 76981
|
| Hospital Charge Code |
40200074
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$129.25 |
| Max. Negotiated Rate |
$264.38 |
| Rate for Payer: Aetna American Axle |
$190.94
|
| Rate for Payer: Aetna Commercial |
$249.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.94
|
| Rate for Payer: Cash Price |
$235.01
|
| Rate for Payer: Cofinity Advantage |
$205.63
|
| Rate for Payer: Cofinity Commercial |
$252.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$235.01
|
| Rate for Payer: Healthscope Commercial |
$264.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$205.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$220.32
|
| Rate for Payer: PHP Commercial |
$249.70
|
| Rate for Payer: Priority Health SBD |
$185.07
|
| Rate for Payer: UMR Bronson Commercial |
$129.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.32
|
|
|
HC US ELASTOGRAPHY ORGAN
|
Facility
|
OP
|
$293.76
|
|
|
Service Code
|
CPT 76981
|
| Hospital Charge Code |
40200074
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$336.87 |
| Rate for Payer: Aetna American Axle |
$190.94
|
| Rate for Payer: Aetna Commercial |
$249.70
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$190.44
|
| Rate for Payer: BCN Commercial |
$190.44
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$235.01
|
| Rate for Payer: Cash Price |
$235.01
|
| Rate for Payer: Cofinity Advantage |
$205.63
|
| Rate for Payer: Cofinity Commercial |
$252.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$235.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$264.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$205.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.32
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.70
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$220.32
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$249.70
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$185.07
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.94
|
| Rate for Payer: UHC Core |
$153.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$115.45
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$108.69
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.32
|
|
|
HC USE OF SPEECH DEVICE SERVICE
|
Facility
|
IP
|
$482.62
|
|
|
Service Code
|
CPT 92609
|
| Hospital Charge Code |
44000003
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$212.35 |
| Max. Negotiated Rate |
$434.36 |
| Rate for Payer: Aetna American Axle |
$313.70
|
| Rate for Payer: Aetna Commercial |
$410.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$313.70
|
| Rate for Payer: Cash Price |
$386.10
|
| Rate for Payer: Cofinity Advantage |
$337.83
|
| Rate for Payer: Cofinity Commercial |
$415.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$386.10
|
| Rate for Payer: Healthscope Commercial |
$434.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$337.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$410.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$361.96
|
| Rate for Payer: PHP Commercial |
$410.23
|
| Rate for Payer: Priority Health SBD |
$304.05
|
| Rate for Payer: UMR Bronson Commercial |
$212.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.96
|
|
|
HC USE OF SPEECH DEVICE SERVICE
|
Facility
|
OP
|
$482.62
|
|
|
Service Code
|
CPT 92609
|
| Hospital Charge Code |
44000003
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$89.98 |
| Max. Negotiated Rate |
$439.57 |
| Rate for Payer: Aetna American Axle |
$313.70
|
| Rate for Payer: Aetna Commercial |
$410.23
|
| Rate for Payer: Aetna Medicare |
$241.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$313.70
|
| Rate for Payer: BCBS Complete |
$193.05
|
| Rate for Payer: BCBS Trust/PPO |
$439.57
|
| Rate for Payer: BCN Commercial |
$439.57
|
| Rate for Payer: Cash Price |
$386.10
|
| Rate for Payer: Cash Price |
$386.10
|
| Rate for Payer: Cash Price |
$386.10
|
| Rate for Payer: Cofinity Advantage |
$337.83
|
| Rate for Payer: Cofinity Commercial |
$415.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$386.10
|
| Rate for Payer: Healthscope Commercial |
$434.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$337.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$386.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$410.23
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$361.96
|
| Rate for Payer: PHP Commercial |
$410.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$112.48
|
| Rate for Payer: Priority Health SBD |
$304.05
|
| Rate for Payer: Priority Health Tiered Network |
$89.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.70
|
| Rate for Payer: UHC Core |
$251.45
|
| Rate for Payer: UHC Exchange |
$189.67
|
| Rate for Payer: UMR Bronson Commercial |
$178.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.96
|
|
|
HC US EXTREMITY NONVASC LTD
|
Facility
|
IP
|
$700.75
|
|
|
Service Code
|
CPT 76882
|
| Hospital Charge Code |
40200038
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$308.33 |
| Max. Negotiated Rate |
$630.67 |
| Rate for Payer: Aetna American Axle |
$455.49
|
| Rate for Payer: Aetna Commercial |
$595.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.49
|
| Rate for Payer: Cash Price |
$560.60
|
| Rate for Payer: Cofinity Advantage |
$490.52
|
| Rate for Payer: Cofinity Commercial |
$602.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$560.60
|
| Rate for Payer: Healthscope Commercial |
$630.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$490.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$525.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$595.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$525.56
|
| Rate for Payer: PHP Commercial |
$595.64
|
| Rate for Payer: Priority Health SBD |
$441.47
|
| Rate for Payer: UMR Bronson Commercial |
$308.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$525.56
|
|
|
HC US EXTREMITY NONVASC LTD
|
Facility
|
OP
|
$700.75
|
|
|
Service Code
|
CPT 76882
|
| Hospital Charge Code |
40200038
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$630.67 |
| Rate for Payer: Aetna American Axle |
$455.49
|
| Rate for Payer: Aetna Commercial |
$595.64
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$77.99
|
| Rate for Payer: BCCCP Commercial |
$60.92
|
| Rate for Payer: BCN Commercial |
$77.99
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$560.60
|
| Rate for Payer: Cash Price |
$560.60
|
| Rate for Payer: Cofinity Advantage |
$490.52
|
| Rate for Payer: Cofinity Commercial |
$602.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$560.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$630.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$490.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$525.56
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$595.64
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$525.56
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$595.64
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$441.47
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$455.49
|
| Rate for Payer: UHC Core |
$365.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$275.39
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$259.28
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$525.56
|
|
|
HC US EXTREMITY NONVASCULAR COMP
|
Facility
|
OP
|
$700.75
|
|
|
Service Code
|
CPT 76881
|
| Hospital Charge Code |
40200037
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$26.26 |
| Max. Negotiated Rate |
$630.67 |
| Rate for Payer: Aetna American Axle |
$455.49
|
| Rate for Payer: Aetna Commercial |
$595.64
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$26.26
|
| Rate for Payer: BCN Commercial |
$26.26
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$560.60
|
| Rate for Payer: Cash Price |
$560.60
|
| Rate for Payer: Cofinity Advantage |
$490.52
|
| Rate for Payer: Cofinity Commercial |
$602.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$560.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$630.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$490.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$525.56
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$595.64
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$525.56
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$595.64
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$441.47
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$455.49
|
| Rate for Payer: UHC Core |
$365.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$275.39
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$259.28
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$525.56
|
|
|
HC US EXTREMITY NONVASCULAR COMP
|
Facility
|
IP
|
$700.75
|
|
|
Service Code
|
CPT 76881
|
| Hospital Charge Code |
40200037
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$308.33 |
| Max. Negotiated Rate |
$630.67 |
| Rate for Payer: Aetna American Axle |
$455.49
|
| Rate for Payer: Aetna Commercial |
$595.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.49
|
| Rate for Payer: Cash Price |
$560.60
|
| Rate for Payer: Cofinity Advantage |
$490.52
|
| Rate for Payer: Cofinity Commercial |
$602.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$560.60
|
| Rate for Payer: Healthscope Commercial |
$630.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$490.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$525.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$595.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$525.56
|
| Rate for Payer: PHP Commercial |
$595.64
|
| Rate for Payer: Priority Health SBD |
$441.47
|
| Rate for Payer: UMR Bronson Commercial |
$308.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$525.56
|
|
|
HC US EYE B MODE
|
Facility
|
IP
|
$1,236.73
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
40200004
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$544.16 |
| Max. Negotiated Rate |
$1,113.06 |
| Rate for Payer: Aetna American Axle |
$803.87
|
| Rate for Payer: Aetna Commercial |
$1,051.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$803.87
|
| Rate for Payer: Cash Price |
$989.38
|
| Rate for Payer: Cofinity Advantage |
$865.71
|
| Rate for Payer: Cofinity Commercial |
$1,063.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$989.38
|
| Rate for Payer: Healthscope Commercial |
$1,113.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$865.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$927.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,051.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$927.55
|
| Rate for Payer: PHP Commercial |
$1,051.22
|
| Rate for Payer: Priority Health SBD |
$779.14
|
| Rate for Payer: UMR Bronson Commercial |
$544.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$927.55
|
|
|
HC US EYE B MODE
|
Facility
|
OP
|
$1,236.73
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
40200004
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$43.51 |
| Max. Negotiated Rate |
$1,113.06 |
| Rate for Payer: Aetna American Axle |
$803.87
|
| Rate for Payer: Aetna Commercial |
$1,051.22
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$803.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$43.51
|
| Rate for Payer: BCN Commercial |
$43.51
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$989.38
|
| Rate for Payer: Cash Price |
$989.38
|
| Rate for Payer: Cofinity Advantage |
$865.71
|
| Rate for Payer: Cofinity Commercial |
$1,063.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$989.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$1,113.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$865.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$927.55
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,051.22
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$927.55
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$1,051.22
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$779.14
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$803.87
|
| Rate for Payer: UHC Core |
$644.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$486.03
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$457.59
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$927.55
|
|
|
HC US EYE B MODE BILAT
|
Facility
|
IP
|
$2,473.59
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
40200005
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$1,088.38 |
| Max. Negotiated Rate |
$2,226.23 |
| Rate for Payer: Aetna American Axle |
$1,607.83
|
| Rate for Payer: Aetna Commercial |
$2,102.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,607.83
|
| Rate for Payer: Cash Price |
$1,978.87
|
| Rate for Payer: Cofinity Advantage |
$1,731.51
|
| Rate for Payer: Cofinity Commercial |
$2,127.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,978.87
|
| Rate for Payer: Healthscope Commercial |
$2,226.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,731.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,855.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,102.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,855.19
|
| Rate for Payer: PHP Commercial |
$2,102.55
|
| Rate for Payer: Priority Health SBD |
$1,558.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,088.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,855.19
|
|
|
HC US EYE B MODE BILAT
|
Facility
|
OP
|
$2,473.59
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
40200005
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$43.51 |
| Max. Negotiated Rate |
$2,226.23 |
| Rate for Payer: Aetna American Axle |
$1,607.83
|
| Rate for Payer: Aetna Commercial |
$2,102.55
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,607.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$43.51
|
| Rate for Payer: BCN Commercial |
$43.51
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$1,978.87
|
| Rate for Payer: Cash Price |
$1,978.87
|
| Rate for Payer: Cofinity Advantage |
$1,731.51
|
| Rate for Payer: Cofinity Commercial |
$2,127.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,978.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$2,226.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,731.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,855.19
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,102.55
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,855.19
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$2,102.55
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$1,558.36
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,607.83
|
| Rate for Payer: UHC Core |
$1,288.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$972.12
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$915.23
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,855.19
|
|
|
HC US FETAL FLUID DRAIN INCL GUID
|
Facility
|
IP
|
$879.73
|
|
|
Service Code
|
CPT 59074
|
| Hospital Charge Code |
36100088
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$387.08 |
| Max. Negotiated Rate |
$791.76 |
| Rate for Payer: Aetna American Axle |
$571.82
|
| Rate for Payer: Aetna Commercial |
$747.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$571.82
|
| Rate for Payer: Cash Price |
$703.78
|
| Rate for Payer: Cofinity Advantage |
$615.81
|
| Rate for Payer: Cofinity Commercial |
$756.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$703.78
|
| Rate for Payer: Healthscope Commercial |
$791.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$615.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$659.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$747.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$659.80
|
| Rate for Payer: PHP Commercial |
$747.77
|
| Rate for Payer: Priority Health SBD |
$554.23
|
| Rate for Payer: UMR Bronson Commercial |
$387.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$659.80
|
|
|
HC US FETAL FLUID DRAIN INCL GUID
|
Facility
|
OP
|
$879.73
|
|
|
Service Code
|
CPT 59074
|
| Hospital Charge Code |
36100088
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$158.80 |
| Max. Negotiated Rate |
$981.93 |
| Rate for Payer: Aetna American Axle |
$571.82
|
| Rate for Payer: Aetna Commercial |
$747.77
|
| Rate for Payer: Aetna Medicare |
$315.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$571.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.54
|
| Rate for Payer: BCBS Complete |
$166.75
|
| Rate for Payer: BCBS MAPPO |
$303.63
|
| Rate for Payer: BCBS Trust/PPO |
$338.80
|
| Rate for Payer: BCN Commercial |
$338.80
|
| Rate for Payer: BCN Medicare Advantage |
$303.63
|
| Rate for Payer: Cash Price |
$703.78
|
| Rate for Payer: Cash Price |
$703.78
|
| Rate for Payer: Cash Price |
$703.78
|
| Rate for Payer: Cofinity Advantage |
$615.81
|
| Rate for Payer: Cofinity Commercial |
$756.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$703.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.63
|
| Rate for Payer: Healthscope Commercial |
$791.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$615.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$659.80
|
| Rate for Payer: Mclaren Medicaid |
$303.63
|
| Rate for Payer: Mclaren Medicare |
$303.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.81
|
| Rate for Payer: Meridian Medicaid |
$318.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$747.77
|
| Rate for Payer: Nomi Health Commercial |
$910.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$659.80
|
| Rate for Payer: PACE Medicare |
$288.45
|
| Rate for Payer: PACE SWMI |
$303.63
|
| Rate for Payer: PHP Commercial |
$747.77
|
| Rate for Payer: PHP Medicare Advantage |
$303.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$981.93
|
| Rate for Payer: Priority Health Medicare |
$303.63
|
| Rate for Payer: Priority Health SBD |
$554.23
|
| Rate for Payer: Priority Health Tiered Network |
$785.54
|
| Rate for Payer: Railroad Medicare Medicare |
$303.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$303.63
|
| Rate for Payer: UHC Medicaid |
$158.80
|
| Rate for Payer: UHCCP Medicaid |
$158.80
|
| Rate for Payer: UMR Bronson Commercial |
$325.50
|
| Rate for Payer: VA VA |
$303.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$659.80
|
|
