|
HC US HYSTEROSONOGRAM
|
Facility
|
OP
|
$357.38
|
|
|
Service Code
|
CPT 76831
|
| Hospital Charge Code |
40200032
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$663.58 |
| Rate for Payer: Aetna American Axle |
$232.30
|
| Rate for Payer: Aetna Commercial |
$303.77
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.30
|
| 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 |
$285.90
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$307.35
|
| Rate for Payer: Cofinity Commercial |
$250.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$250.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$321.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$250.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.04
|
| 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 |
$303.77
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$303.77
|
| 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 |
$232.30
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$225.15
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$367.00
|
| 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 |
$132.23
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
|
HC US HYSTEROSONOGRAM
|
Facility
|
IP
|
$357.38
|
|
|
Service Code
|
CPT 76831
|
| Hospital Charge Code |
40200032
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$157.25 |
| Max. Negotiated Rate |
$321.64 |
| Rate for Payer: Aetna American Axle |
$232.30
|
| Rate for Payer: Aetna Commercial |
$303.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.30
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$250.17
|
| Rate for Payer: Cofinity Commercial |
$307.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$250.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Healthscope Commercial |
$321.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$250.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: PHP Commercial |
$303.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health SBD |
$225.15
|
| Rate for Payer: UMR Bronson Commercial |
$157.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
|
HC US INFANT HIPS W MANIPULATION
|
Facility
|
IP
|
$388.71
|
|
|
Service Code
|
CPT 76885
|
| Hospital Charge Code |
40200040
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$171.03 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna American Axle |
$252.66
|
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.66
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$272.10
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$272.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$272.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health SBD |
$244.89
|
| Rate for Payer: UMR Bronson Commercial |
$171.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC US INFANT HIPS W MANIPULATION
|
Facility
|
OP
|
$388.71
|
|
|
Service Code
|
CPT 76885
|
| Hospital Charge Code |
40200040
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna American Axle |
$252.66
|
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.66
|
| 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 |
$310.97
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Cofinity Commercial |
$272.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$272.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$272.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| 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 |
$330.40
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$330.40
|
| 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 |
$252.66
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$244.89
|
| 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 |
$143.82
|
| Rate for Payer: VA VA |
$85.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC US INFANT HIPS WO MANIPULATION
|
Facility
|
OP
|
$324.21
|
|
|
Service Code
|
CPT 76886
|
| Hospital Charge Code |
40200041
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna American Axle |
$210.74
|
| Rate for Payer: Aetna Commercial |
$275.58
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.74
|
| 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 |
$259.37
|
| Rate for Payer: Cash Price |
$259.37
|
| Rate for Payer: Cofinity Commercial |
$278.82
|
| Rate for Payer: Cofinity Commercial |
$226.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$226.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$259.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$291.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$226.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$243.16
|
| 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 |
$275.58
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$275.58
|
| 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 |
$210.74
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$204.25
|
| 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 |
$119.96
|
| Rate for Payer: VA VA |
$85.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$243.16
|
|
|
HC US INFANT HIPS WO MANIPULATION
|
Facility
|
IP
|
$324.21
|
|
|
Service Code
|
CPT 76886
|
| Hospital Charge Code |
40200041
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$142.65 |
| Max. Negotiated Rate |
$291.79 |
| Rate for Payer: Aetna American Axle |
$210.74
|
| Rate for Payer: Aetna Commercial |
$275.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.74
|
| Rate for Payer: Cash Price |
$259.37
|
| Rate for Payer: Cofinity Commercial |
$226.95
|
| Rate for Payer: Cofinity Commercial |
$278.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$226.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$259.37
|
| Rate for Payer: Healthscope Commercial |
$291.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$226.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$243.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$275.58
|
| Rate for Payer: PHP Commercial |
$275.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.74
|
| Rate for Payer: Priority Health SBD |
$204.25
|
| Rate for Payer: UMR Bronson Commercial |
$142.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$243.16
|
|
|
HC US MFM AMNIOCENTESIS W GUIDANCE
|
Facility
|
OP
|
$592.16
|
|
|
Service Code
|
CPT 76946
|
| Hospital Charge Code |
40200049
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$219.10 |
| Max. Negotiated Rate |
$532.94 |
| Rate for Payer: Aetna American Axle |
$384.90
|
| Rate for Payer: Aetna Commercial |
$503.34
|
| Rate for Payer: Aetna Medicare |
$296.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$384.90
|
| Rate for Payer: BCBS Complete |
$236.86
|
| Rate for Payer: Cash Price |
$473.73
|
| Rate for Payer: Cash Price |
$473.73
|
| Rate for Payer: Cofinity Commercial |
$509.26
|
| Rate for Payer: Cofinity Commercial |
$414.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$414.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$473.73
|
| Rate for Payer: Healthscope Commercial |
$532.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$414.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$444.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$503.34
|
| Rate for Payer: PHP Commercial |
$503.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.90
|
| Rate for Payer: Priority Health SBD |
$373.06
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UMR Bronson Commercial |
$219.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$444.12
|
|
|
HC US MFM AMNIOCENTESIS W GUIDANCE
|
Facility
|
IP
|
$592.16
|
|
|
Service Code
|
CPT 76946
|
| Hospital Charge Code |
40200049
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$260.55 |
| Max. Negotiated Rate |
$532.94 |
| Rate for Payer: Aetna American Axle |
$384.90
|
| Rate for Payer: Aetna Commercial |
$503.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$384.90
|
| Rate for Payer: Cash Price |
$473.73
|
| Rate for Payer: Cofinity Commercial |
$414.51
|
| Rate for Payer: Cofinity Commercial |
$509.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$414.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$473.73
|
| Rate for Payer: Healthscope Commercial |
$532.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$414.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$444.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$503.34
|
| Rate for Payer: PHP Commercial |
$503.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.90
|
| Rate for Payer: Priority Health SBD |
$373.06
|
| Rate for Payer: UMR Bronson Commercial |
$260.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$444.12
|
|
|
HC US MFM CORDOCENTESIS GUIDE
|
Facility
|
OP
|
$583.28
|
|
|
Service Code
|
CPT 76941
|
| Hospital Charge Code |
40200044
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$215.81 |
| Max. Negotiated Rate |
$524.95 |
| Rate for Payer: Aetna American Axle |
$379.13
|
| Rate for Payer: Aetna Commercial |
$495.79
|
| Rate for Payer: Aetna Medicare |
$291.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.13
|
| Rate for Payer: BCBS Complete |
$233.31
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$501.62
|
| Rate for Payer: Cofinity Commercial |
$408.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$408.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Healthscope Commercial |
$524.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$408.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: PHP Commercial |
$495.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health SBD |
$367.47
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UMR Bronson Commercial |
$215.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.46
|
|
|
HC US MFM CORDOCENTESIS GUIDE
|
Facility
|
IP
|
$583.28
|
|
|
Service Code
|
CPT 76941
|
| Hospital Charge Code |
40200044
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$256.64 |
| Max. Negotiated Rate |
$524.95 |
| Rate for Payer: Aetna American Axle |
$379.13
|
| Rate for Payer: Aetna Commercial |
$495.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.13
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$408.30
|
| Rate for Payer: Cofinity Commercial |
$501.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$408.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Healthscope Commercial |
$524.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$408.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: PHP Commercial |
$495.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health SBD |
$367.47
|
| Rate for Payer: UMR Bronson Commercial |
$256.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.46
|
|
|
HC US OB BPP WO NON STRESS
|
Facility
|
IP
|
$642.88
|
|
|
Service Code
|
CPT 76819
|
| Hospital Charge Code |
40200027
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$282.87 |
| Max. Negotiated Rate |
$578.59 |
| Rate for Payer: Aetna American Axle |
$417.87
|
| Rate for Payer: Aetna Commercial |
$546.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$417.87
|
| Rate for Payer: Cash Price |
$514.30
|
| Rate for Payer: Cofinity Commercial |
$450.02
|
| Rate for Payer: Cofinity Commercial |
$552.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$450.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$514.30
|
| Rate for Payer: Healthscope Commercial |
$578.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$450.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$482.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$546.45
|
| Rate for Payer: PHP Commercial |
$546.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$417.87
|
| Rate for Payer: Priority Health SBD |
$405.01
|
| Rate for Payer: UMR Bronson Commercial |
$282.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$482.16
|
|
|
HC US OB BPP WO NON STRESS
|
Facility
|
OP
|
$642.88
|
|
|
Service Code
|
CPT 76819
|
| Hospital Charge Code |
40200027
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$578.59 |
| Rate for Payer: Aetna American Axle |
$417.87
|
| Rate for Payer: Aetna Commercial |
$546.45
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$417.87
|
| 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 |
$514.30
|
| Rate for Payer: Cash Price |
$514.30
|
| Rate for Payer: Cofinity Commercial |
$552.88
|
| Rate for Payer: Cofinity Commercial |
$450.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$450.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$514.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$578.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$450.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$482.16
|
| 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 |
$546.45
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$546.45
|
| 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 |
$417.87
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$405.01
|
| 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 |
$237.87
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$482.16
|
|
|
HC US OB DETAILED
|
Facility
|
OP
|
$583.28
|
|
|
Service Code
|
CPT 76811
|
| Hospital Charge Code |
40200019
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$663.58 |
| Rate for Payer: Aetna American Axle |
$379.13
|
| Rate for Payer: Aetna Commercial |
$495.79
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.13
|
| 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 |
$466.62
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$501.62
|
| Rate for Payer: Cofinity Commercial |
$408.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$408.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$524.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$408.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.46
|
| 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 |
$495.79
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$495.79
|
| 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 |
$379.13
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$367.47
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$367.00
|
| 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 |
$215.81
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.46
|
|
|
HC US OB DETAILED
|
Facility
|
IP
|
$583.28
|
|
|
Service Code
|
CPT 76811
|
| Hospital Charge Code |
40200019
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$256.64 |
| Max. Negotiated Rate |
$524.95 |
| Rate for Payer: Aetna American Axle |
$379.13
|
| Rate for Payer: Aetna Commercial |
$495.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.13
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$408.30
|
| Rate for Payer: Cofinity Commercial |
$501.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$408.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Healthscope Commercial |
$524.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$408.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: PHP Commercial |
$495.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health SBD |
$367.47
|
| Rate for Payer: UMR Bronson Commercial |
$256.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.46
|
|
|
HC US OB DETAILED EACH ADDTL FETUS
|
Facility
|
OP
|
$388.71
|
|
|
Service Code
|
CPT 76812
|
| Hospital Charge Code |
40200020
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$143.82 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna American Axle |
$252.66
|
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: Aetna Medicare |
$194.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.66
|
| Rate for Payer: BCBS Complete |
$155.48
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Cofinity Commercial |
$272.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$272.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$272.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health SBD |
$244.89
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UMR Bronson Commercial |
$143.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC US OB DETAILED EACH ADDTL FETUS
|
Facility
|
IP
|
$388.71
|
|
|
Service Code
|
CPT 76812
|
| Hospital Charge Code |
40200020
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$171.03 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna American Axle |
$252.66
|
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.66
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$272.10
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$272.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$272.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health SBD |
$244.89
|
| Rate for Payer: UMR Bronson Commercial |
$171.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC US OB FETAL CARDIOVASCULAR FU
|
Facility
|
IP
|
$691.91
|
|
|
Service Code
|
CPT 76826
|
| Hospital Charge Code |
40200055
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$304.44 |
| Max. Negotiated Rate |
$622.72 |
| Rate for Payer: Aetna American Axle |
$449.74
|
| Rate for Payer: Aetna Commercial |
$588.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.74
|
| Rate for Payer: Cash Price |
$553.53
|
| Rate for Payer: Cofinity Commercial |
$484.34
|
| Rate for Payer: Cofinity Commercial |
$595.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$484.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$553.53
|
| Rate for Payer: Healthscope Commercial |
$622.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$484.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$588.12
|
| Rate for Payer: PHP Commercial |
$588.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.74
|
| Rate for Payer: Priority Health SBD |
$435.90
|
| Rate for Payer: UMR Bronson Commercial |
$304.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.93
|
|
|
HC US OB FETAL CARDIOVASCULAR FU
|
Facility
|
OP
|
$691.91
|
|
|
Service Code
|
CPT 76826
|
| Hospital Charge Code |
40200055
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$663.58 |
| Rate for Payer: Aetna American Axle |
$449.74
|
| Rate for Payer: Aetna Commercial |
$588.12
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.74
|
| 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 |
$553.53
|
| Rate for Payer: Cash Price |
$553.53
|
| Rate for Payer: Cofinity Commercial |
$595.04
|
| Rate for Payer: Cofinity Commercial |
$484.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$484.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$553.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$622.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$484.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.93
|
| 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 |
$588.12
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$588.12
|
| 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 |
$449.74
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$435.90
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$367.00
|
| 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 |
$256.01
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.93
|
|
|
HC US OB FU
|
Facility
|
IP
|
$486.00
|
|
|
Service Code
|
CPT 76816
|
| Hospital Charge Code |
40200024
|
|
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 OB FU
|
Facility
|
OP
|
$486.00
|
|
|
Service Code
|
CPT 76816
|
| Hospital Charge Code |
40200024
|
|
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 OB GREATER THAN 14 WEEKS
|
Facility
|
IP
|
$581.99
|
|
|
Service Code
|
CPT 76805
|
| Hospital Charge Code |
40200017
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$256.08 |
| Max. Negotiated Rate |
$523.79 |
| Rate for Payer: Aetna American Axle |
$378.29
|
| Rate for Payer: Aetna Commercial |
$494.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$378.29
|
| Rate for Payer: Cash Price |
$465.59
|
| Rate for Payer: Cofinity Commercial |
$407.39
|
| Rate for Payer: Cofinity Commercial |
$500.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$407.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$465.59
|
| Rate for Payer: Healthscope Commercial |
$523.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$407.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$436.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$494.69
|
| Rate for Payer: PHP Commercial |
$494.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$378.29
|
| Rate for Payer: Priority Health SBD |
$366.65
|
| Rate for Payer: UMR Bronson Commercial |
$256.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$436.49
|
|
|
HC US OB GREATER THAN 14 WEEKS
|
Facility
|
OP
|
$581.99
|
|
|
Service Code
|
CPT 76805
|
| Hospital Charge Code |
40200017
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$523.79 |
| Rate for Payer: Aetna American Axle |
$378.29
|
| Rate for Payer: Aetna Commercial |
$494.69
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$378.29
|
| 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 |
$465.59
|
| Rate for Payer: Cash Price |
$465.59
|
| Rate for Payer: Cofinity Commercial |
$500.51
|
| Rate for Payer: Cofinity Commercial |
$407.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$407.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$465.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$523.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$407.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$436.49
|
| 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 |
$494.69
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$494.69
|
| 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 |
$378.29
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$366.65
|
| 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 |
$215.34
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$436.49
|
|
|
HC US OB LESS THAN 14 WEEKS
|
Facility
|
OP
|
$581.86
|
|
|
Service Code
|
CPT 76801
|
| Hospital Charge Code |
40200015
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$523.67 |
| Rate for Payer: Aetna American Axle |
$378.21
|
| Rate for Payer: Aetna Commercial |
$494.58
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$378.21
|
| 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 |
$465.49
|
| Rate for Payer: Cash Price |
$465.49
|
| Rate for Payer: Cofinity Commercial |
$500.40
|
| Rate for Payer: Cofinity Commercial |
$407.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$407.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$465.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$523.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$407.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$436.39
|
| 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 |
$494.58
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$494.58
|
| 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 |
$378.21
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$366.57
|
| 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 |
$215.29
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$436.39
|
|
|
HC US OB LESS THAN 14 WEEKS
|
Facility
|
IP
|
$581.86
|
|
|
Service Code
|
CPT 76801
|
| Hospital Charge Code |
40200015
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$256.02 |
| Max. Negotiated Rate |
$523.67 |
| Rate for Payer: Aetna American Axle |
$378.21
|
| Rate for Payer: Aetna Commercial |
$494.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$378.21
|
| Rate for Payer: Cash Price |
$465.49
|
| Rate for Payer: Cofinity Commercial |
$407.30
|
| Rate for Payer: Cofinity Commercial |
$500.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$407.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$465.49
|
| Rate for Payer: Healthscope Commercial |
$523.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$407.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$436.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$494.58
|
| Rate for Payer: PHP Commercial |
$494.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$378.21
|
| Rate for Payer: Priority Health SBD |
$366.57
|
| Rate for Payer: UMR Bronson Commercial |
$256.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$436.39
|
|
|
HC US OB LTD
|
Facility
|
OP
|
$486.11
|
|
|
Service Code
|
CPT 76815
|
| Hospital Charge Code |
40200023
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$437.50 |
| Rate for Payer: Aetna American Axle |
$315.97
|
| Rate for Payer: Aetna Commercial |
$413.19
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.97
|
| 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 |
$388.89
|
| Rate for Payer: Cash Price |
$388.89
|
| Rate for Payer: Cofinity Commercial |
$418.05
|
| Rate for Payer: Cofinity Commercial |
$340.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$340.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$388.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$437.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$340.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$364.58
|
| 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 |
$413.19
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$413.19
|
| 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 |
$315.97
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$306.25
|
| 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 |
$179.86
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$364.58
|
|
