|
HC US BREAST UNI, COMPLETE
|
Facility
|
OP
|
$561.59
|
|
|
Service Code
|
CPT 76641
|
| Hospital Charge Code |
40200068
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$505.43 |
| Rate for Payer: Aetna American Axle |
$365.03
|
| Rate for Payer: Aetna Commercial |
$477.35
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$449.27
|
| Rate for Payer: Cash Price |
$449.27
|
| Rate for Payer: Cofinity Commercial |
$482.97
|
| Rate for Payer: Cofinity Commercial |
$393.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$393.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$505.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$393.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.19
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.35
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$477.35
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.03
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$353.80
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$207.79
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.19
|
|
|
HC US BREAST UNI, COMPLETE
|
Facility
|
IP
|
$561.59
|
|
|
Service Code
|
CPT 76641
|
| Hospital Charge Code |
40200068
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$247.10 |
| Max. Negotiated Rate |
$505.43 |
| Rate for Payer: Aetna American Axle |
$365.03
|
| Rate for Payer: Aetna Commercial |
$477.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.03
|
| Rate for Payer: Cash Price |
$449.27
|
| Rate for Payer: Cofinity Commercial |
$393.11
|
| Rate for Payer: Cofinity Commercial |
$482.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$393.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.27
|
| Rate for Payer: Healthscope Commercial |
$505.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$393.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.35
|
| Rate for Payer: PHP Commercial |
$477.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.03
|
| Rate for Payer: Priority Health SBD |
$353.80
|
| Rate for Payer: UMR Bronson Commercial |
$247.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.19
|
|
|
HC US BREAST UNI, LIMITED
|
Facility
|
OP
|
$561.59
|
|
|
Service Code
|
CPT 76642
|
| Hospital Charge Code |
40200069
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$505.43 |
| Rate for Payer: Aetna American Axle |
$365.03
|
| Rate for Payer: Aetna Commercial |
$477.35
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$449.27
|
| Rate for Payer: Cash Price |
$449.27
|
| Rate for Payer: Cofinity Commercial |
$482.97
|
| Rate for Payer: Cofinity Commercial |
$393.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$393.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$505.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$393.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.19
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.35
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$477.35
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.03
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$353.80
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$164.11
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: UMR Bronson Commercial |
$207.79
|
| Rate for Payer: VA VA |
$85.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.19
|
|
|
HC US BREAST UNI, LIMITED
|
Facility
|
IP
|
$561.59
|
|
|
Service Code
|
CPT 76642
|
| Hospital Charge Code |
40200069
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$247.10 |
| Max. Negotiated Rate |
$505.43 |
| Rate for Payer: Aetna American Axle |
$365.03
|
| Rate for Payer: Aetna Commercial |
$477.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.03
|
| Rate for Payer: Cash Price |
$449.27
|
| Rate for Payer: Cofinity Commercial |
$393.11
|
| Rate for Payer: Cofinity Commercial |
$482.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$393.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.27
|
| Rate for Payer: Healthscope Commercial |
$505.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$393.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.35
|
| Rate for Payer: PHP Commercial |
$477.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.03
|
| Rate for Payer: Priority Health SBD |
$353.80
|
| Rate for Payer: UMR Bronson Commercial |
$247.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.19
|
|
|
HC US CHEST
|
Facility
|
IP
|
$561.59
|
|
|
Service Code
|
CPT 76604
|
| Hospital Charge Code |
40200007
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$247.10 |
| Max. Negotiated Rate |
$505.43 |
| Rate for Payer: Aetna American Axle |
$365.03
|
| Rate for Payer: Aetna Commercial |
$477.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.03
|
| Rate for Payer: Cash Price |
$449.27
|
| Rate for Payer: Cofinity Commercial |
$393.11
|
| Rate for Payer: Cofinity Commercial |
$482.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$393.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.27
|
| Rate for Payer: Healthscope Commercial |
$505.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$393.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.35
|
| Rate for Payer: PHP Commercial |
$477.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.03
|
| Rate for Payer: Priority Health SBD |
$353.80
|
| Rate for Payer: UMR Bronson Commercial |
$247.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.19
|
|
|
HC US CHEST
|
Facility
|
OP
|
$561.59
|
|
|
Service Code
|
CPT 76604
|
| Hospital Charge Code |
40200007
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$505.43 |
| Rate for Payer: Aetna American Axle |
$365.03
|
| Rate for Payer: Aetna Commercial |
$477.35
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$449.27
|
| Rate for Payer: Cash Price |
$449.27
|
| Rate for Payer: Cofinity Commercial |
$482.97
|
| Rate for Payer: Cofinity Commercial |
$393.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$393.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$505.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$393.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.19
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.35
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$477.35
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.03
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$353.80
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$207.79
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.19
|
|
|
HC US CHORIONIC VILLIS SAMPLE
|
Facility
|
IP
|
$573.60
|
|
|
Service Code
|
CPT 76945
|
| Hospital Charge Code |
40200048
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$252.38 |
| Max. Negotiated Rate |
$516.24 |
| Rate for Payer: Aetna American Axle |
$372.84
|
| Rate for Payer: Aetna Commercial |
$487.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.84
|
| Rate for Payer: Cash Price |
$458.88
|
| Rate for Payer: Cofinity Commercial |
$401.52
|
| Rate for Payer: Cofinity Commercial |
$493.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$401.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.88
|
| Rate for Payer: Healthscope Commercial |
$516.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$401.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$430.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$487.56
|
| Rate for Payer: PHP Commercial |
$487.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.84
|
| Rate for Payer: Priority Health SBD |
$361.37
|
| Rate for Payer: UMR Bronson Commercial |
$252.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$430.20
|
|
|
HC US CHORIONIC VILLIS SAMPLE
|
Facility
|
OP
|
$573.60
|
|
|
Service Code
|
CPT 76945
|
| Hospital Charge Code |
40200048
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$212.23 |
| Max. Negotiated Rate |
$516.24 |
| Rate for Payer: Aetna American Axle |
$372.84
|
| Rate for Payer: Aetna Commercial |
$487.56
|
| Rate for Payer: Aetna Medicare |
$286.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.84
|
| Rate for Payer: BCBS Complete |
$229.44
|
| Rate for Payer: Cash Price |
$458.88
|
| Rate for Payer: Cash Price |
$458.88
|
| Rate for Payer: Cofinity Commercial |
$493.30
|
| Rate for Payer: Cofinity Commercial |
$401.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$401.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.88
|
| Rate for Payer: Healthscope Commercial |
$516.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$401.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$430.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$487.56
|
| Rate for Payer: PHP Commercial |
$487.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.84
|
| Rate for Payer: Priority Health SBD |
$361.37
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UMR Bronson Commercial |
$212.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$430.20
|
|
|
HC US CRANIAL
|
Facility
|
IP
|
$826.35
|
|
|
Service Code
|
CPT 76506
|
| Hospital Charge Code |
40200053
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$363.59 |
| Max. Negotiated Rate |
$743.72 |
| Rate for Payer: Aetna American Axle |
$537.13
|
| Rate for Payer: Aetna Commercial |
$702.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$537.13
|
| Rate for Payer: Cash Price |
$661.08
|
| Rate for Payer: Cofinity Commercial |
$578.45
|
| Rate for Payer: Cofinity Commercial |
$710.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$578.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$661.08
|
| Rate for Payer: Healthscope Commercial |
$743.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$578.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$619.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$702.40
|
| Rate for Payer: PHP Commercial |
$702.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$537.13
|
| Rate for Payer: Priority Health SBD |
$520.60
|
| Rate for Payer: UMR Bronson Commercial |
$363.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$619.76
|
|
|
HC US CRANIAL
|
Facility
|
OP
|
$826.35
|
|
|
Service Code
|
CPT 76506
|
| Hospital Charge Code |
40200053
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$743.72 |
| Rate for Payer: Aetna American Axle |
$537.13
|
| Rate for Payer: Aetna Commercial |
$702.40
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$537.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$661.08
|
| Rate for Payer: Cash Price |
$661.08
|
| Rate for Payer: Cofinity Commercial |
$710.66
|
| Rate for Payer: Cofinity Commercial |
$578.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$578.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$661.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$743.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$578.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$619.76
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$702.40
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$702.40
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$537.13
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$520.60
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$305.75
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$619.76
|
|
|
HC US DUPLX DOP ABD PEL SCROT LTD
|
Facility
|
IP
|
$1,011.43
|
|
|
Service Code
|
CPT 93976
|
| Hospital Charge Code |
92100014
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$445.03 |
| Max. Negotiated Rate |
$910.29 |
| Rate for Payer: Aetna American Axle |
$657.43
|
| Rate for Payer: Aetna Commercial |
$859.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$657.43
|
| Rate for Payer: Cash Price |
$809.14
|
| Rate for Payer: Cofinity Commercial |
$708.00
|
| Rate for Payer: Cofinity Commercial |
$869.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$708.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$809.14
|
| Rate for Payer: Healthscope Commercial |
$910.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$708.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$758.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$859.72
|
| Rate for Payer: PHP Commercial |
$859.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$657.43
|
| Rate for Payer: Priority Health SBD |
$637.20
|
| Rate for Payer: UMR Bronson Commercial |
$445.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$758.57
|
|
|
HC US DUPLX DOP ABD PEL SCROT LTD
|
Facility
|
OP
|
$1,011.43
|
|
|
Service Code
|
CPT 93976
|
| Hospital Charge Code |
92100014
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$910.29 |
| Rate for Payer: Aetna American Axle |
$657.43
|
| Rate for Payer: Aetna Commercial |
$859.72
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$657.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$809.14
|
| Rate for Payer: Cash Price |
$809.14
|
| Rate for Payer: Cash Price |
$809.14
|
| Rate for Payer: Cofinity Commercial |
$708.00
|
| Rate for Payer: Cofinity Commercial |
$869.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$708.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$809.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$910.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$708.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$758.57
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$859.72
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$859.72
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$657.43
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$637.20
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$374.23
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$758.57
|
|
|
HC US DUPLX DOP ABD PELV SCROTUM
|
Facility
|
IP
|
$1,742.46
|
|
|
Service Code
|
CPT 93975
|
| Hospital Charge Code |
92100013
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$766.68 |
| Max. Negotiated Rate |
$1,568.21 |
| Rate for Payer: Aetna American Axle |
$1,132.60
|
| Rate for Payer: Aetna Commercial |
$1,481.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,132.60
|
| Rate for Payer: Cash Price |
$1,393.97
|
| Rate for Payer: Cofinity Commercial |
$1,219.72
|
| Rate for Payer: Cofinity Commercial |
$1,498.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,219.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,393.97
|
| Rate for Payer: Healthscope Commercial |
$1,568.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,219.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,306.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,481.09
|
| Rate for Payer: PHP Commercial |
$1,481.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,132.60
|
| Rate for Payer: Priority Health SBD |
$1,097.75
|
| Rate for Payer: UMR Bronson Commercial |
$766.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,306.85
|
|
|
HC US DUPLX DOP ABD PELV SCROTUM
|
Facility
|
OP
|
$1,742.46
|
|
|
Service Code
|
CPT 93975
|
| Hospital Charge Code |
92100013
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,568.21 |
| Rate for Payer: Aetna American Axle |
$1,132.60
|
| Rate for Payer: Aetna Commercial |
$1,481.09
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,132.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,393.97
|
| Rate for Payer: Cash Price |
$1,393.97
|
| Rate for Payer: Cash Price |
$1,393.97
|
| Rate for Payer: Cofinity Commercial |
$1,219.72
|
| Rate for Payer: Cofinity Commercial |
$1,498.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,219.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,393.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,568.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,219.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,306.85
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,481.09
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,481.09
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,132.60
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,097.75
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$450.52
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: UMR Bronson Commercial |
$644.71
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,306.85
|
|
|
HC US EACH ADDL FETUS BPP
|
Facility
|
IP
|
$486.00
|
|
|
Service Code
|
CPT 76819
|
| Hospital Charge Code |
40200026
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$213.84 |
| Max. Negotiated Rate |
$437.40 |
| Rate for Payer: Aetna American Axle |
$315.90
|
| Rate for Payer: Aetna Commercial |
$413.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.90
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cofinity Commercial |
$340.20
|
| Rate for Payer: Cofinity Commercial |
$417.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$340.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$388.80
|
| Rate for Payer: Healthscope Commercial |
$437.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$340.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$364.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$413.10
|
| Rate for Payer: PHP Commercial |
$413.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.90
|
| Rate for Payer: Priority Health SBD |
$306.18
|
| Rate for Payer: UMR Bronson Commercial |
$213.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$364.50
|
|
|
HC US EACH ADDL FETUS BPP
|
Facility
|
OP
|
$486.00
|
|
|
Service Code
|
CPT 76819
|
| Hospital Charge Code |
40200026
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$437.40 |
| Rate for Payer: Aetna American Axle |
$315.90
|
| Rate for Payer: Aetna Commercial |
$413.10
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cofinity Commercial |
$417.96
|
| Rate for Payer: Cofinity Commercial |
$340.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$340.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$388.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$437.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$340.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$364.50
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$413.10
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$413.10
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.90
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$306.18
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$179.82
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$364.50
|
|
|
HC US EACH ADDL FETUS GT 14 WKS
|
Facility
|
OP
|
$431.77
|
|
|
Service Code
|
CPT 76810
|
| Hospital Charge Code |
40200018
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$159.75 |
| Max. Negotiated Rate |
$388.59 |
| Rate for Payer: Aetna American Axle |
$280.65
|
| Rate for Payer: Aetna Commercial |
$367.00
|
| Rate for Payer: Aetna Medicare |
$215.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$280.65
|
| Rate for Payer: BCBS Complete |
$172.71
|
| Rate for Payer: Cash Price |
$345.42
|
| Rate for Payer: Cash Price |
$345.42
|
| Rate for Payer: Cofinity Commercial |
$371.32
|
| Rate for Payer: Cofinity Commercial |
$302.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$302.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$345.42
|
| Rate for Payer: Healthscope Commercial |
$388.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$302.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$323.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$367.00
|
| Rate for Payer: PHP Commercial |
$367.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.65
|
| Rate for Payer: Priority Health SBD |
$272.02
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UMR Bronson Commercial |
$159.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$323.83
|
|
|
HC US EACH ADDL FETUS GT 14 WKS
|
Facility
|
IP
|
$431.77
|
|
|
Service Code
|
CPT 76810
|
| Hospital Charge Code |
40200018
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$189.98 |
| Max. Negotiated Rate |
$388.59 |
| Rate for Payer: Aetna American Axle |
$280.65
|
| Rate for Payer: Aetna Commercial |
$367.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$280.65
|
| Rate for Payer: Cash Price |
$345.42
|
| Rate for Payer: Cofinity Commercial |
$302.24
|
| Rate for Payer: Cofinity Commercial |
$371.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$302.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$345.42
|
| Rate for Payer: Healthscope Commercial |
$388.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$302.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$323.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$367.00
|
| Rate for Payer: PHP Commercial |
$367.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.65
|
| Rate for Payer: Priority Health SBD |
$272.02
|
| Rate for Payer: UMR Bronson Commercial |
$189.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$323.83
|
|
|
HC US EACH ADDL FETUS LESS THAN 14 WKS
|
Facility
|
IP
|
$355.44
|
|
|
Service Code
|
CPT 76802
|
| Hospital Charge Code |
40200016
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$156.39 |
| Max. Negotiated Rate |
$319.90 |
| Rate for Payer: Aetna American Axle |
$231.04
|
| Rate for Payer: Aetna Commercial |
$302.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.04
|
| Rate for Payer: Cash Price |
$284.35
|
| Rate for Payer: Cofinity Commercial |
$248.81
|
| Rate for Payer: Cofinity Commercial |
$305.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$248.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.35
|
| Rate for Payer: Healthscope Commercial |
$319.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$248.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.12
|
| Rate for Payer: PHP Commercial |
$302.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.04
|
| Rate for Payer: Priority Health SBD |
$223.93
|
| Rate for Payer: UMR Bronson Commercial |
$156.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.58
|
|
|
HC US EACH ADDL FETUS LESS THAN 14 WKS
|
Facility
|
OP
|
$355.44
|
|
|
Service Code
|
CPT 76802
|
| Hospital Charge Code |
40200016
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$131.51 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna American Axle |
$231.04
|
| Rate for Payer: Aetna Commercial |
$302.12
|
| Rate for Payer: Aetna Medicare |
$177.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.04
|
| Rate for Payer: BCBS Complete |
$142.18
|
| Rate for Payer: Cash Price |
$284.35
|
| Rate for Payer: Cash Price |
$284.35
|
| Rate for Payer: Cofinity Commercial |
$305.68
|
| Rate for Payer: Cofinity Commercial |
$248.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$248.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.35
|
| Rate for Payer: Healthscope Commercial |
$319.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$248.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.12
|
| Rate for Payer: PHP Commercial |
$302.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.04
|
| Rate for Payer: Priority Health SBD |
$223.93
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UMR Bronson Commercial |
$131.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.58
|
|
|
HC US ELASTOGRAPHY 1ST LESION
|
Facility
|
IP
|
$208.08
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
40200075
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$91.56 |
| Max. Negotiated Rate |
$187.27 |
| Rate for Payer: Aetna American Axle |
$135.25
|
| Rate for Payer: Aetna Commercial |
$176.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.25
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cofinity Commercial |
$145.66
|
| Rate for Payer: Cofinity Commercial |
$178.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$145.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.46
|
| Rate for Payer: Healthscope Commercial |
$187.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$145.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.87
|
| Rate for Payer: PHP Commercial |
$176.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.25
|
| Rate for Payer: Priority Health SBD |
$131.09
|
| Rate for Payer: UMR Bronson Commercial |
$91.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.06
|
|
|
HC US ELASTOGRAPHY 1ST LESION
|
Facility
|
OP
|
$208.08
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
40200075
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna American Axle |
$135.25
|
| Rate for Payer: Aetna Commercial |
$176.87
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cofinity Commercial |
$178.95
|
| Rate for Payer: Cofinity Commercial |
$145.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$145.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$187.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$145.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.06
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.87
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$176.87
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.25
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$131.09
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$76.99
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.06
|
|
|
HC US ELASTOGRAPHY 1ST TARGET LESION
|
Facility
|
IP
|
$310.00
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
40200082
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$136.40 |
| Max. Negotiated Rate |
$279.00 |
| Rate for Payer: Aetna American Axle |
$201.50
|
| Rate for Payer: Aetna Commercial |
$263.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.50
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cofinity Commercial |
$217.00
|
| Rate for Payer: Cofinity Commercial |
$266.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$217.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.00
|
| Rate for Payer: Healthscope Commercial |
$279.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$217.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.50
|
| Rate for Payer: PHP Commercial |
$263.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.50
|
| Rate for Payer: Priority Health SBD |
$195.30
|
| Rate for Payer: UMR Bronson Commercial |
$136.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.50
|
|
|
HC US ELASTOGRAPHY 1ST TARGET LESION
|
Facility
|
OP
|
$310.00
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
40200082
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna American Axle |
$201.50
|
| Rate for Payer: Aetna Commercial |
$263.50
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cofinity Commercial |
$266.60
|
| Rate for Payer: Cofinity Commercial |
$217.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$217.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$279.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$217.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.50
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.50
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$263.50
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.50
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$195.30
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$114.70
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.50
|
|
|
HC US ELASTOGRAPHY EA ADDL LESION
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
40200076
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$11.55 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna American Axle |
$20.29
|
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna Medicare |
$15.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.29
|
| Rate for Payer: BCBS Complete |
$12.48
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Cofinity Commercial |
$21.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.29
|
| Rate for Payer: Priority Health SBD |
$19.66
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
