|
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 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 |
$55.85 |
| 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 |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$134.10
|
| Rate for Payer: BCCCP Commercial |
$86.41
|
| Rate for Payer: BCN Commercial |
$134.10
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| 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 |
$104.19
|
| 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 |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.50
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$263.50
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$195.30
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.15
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$85.59
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$114.70
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.50
|
|
|
HC US ELASTOGRAPHY EA ADDL LESION
|
Facility
|
IP
|
$31.21
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
40200076
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$13.73 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna American Axle |
$20.29
|
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.29
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$21.85
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| 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: UMR Bronson Commercial |
$13.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
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 |
$15.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.29
|
| Rate for Payer: BCBS Complete |
$12.48
|
| Rate for Payer: BCBS Trust/PPO |
$75.95
|
| Rate for Payer: BCN Commercial |
$75.95
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$21.85
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| 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 All Payor (Choice/PPO) |
$62.69
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Exchange |
$56.99
|
| Rate for Payer: UMR Bronson Commercial |
$11.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC US ELASTOGRAPHY EA ADDL TARGET LESION
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
40200083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$56.99 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Aetna American Axle |
$136.50
|
| Rate for Payer: Aetna Commercial |
$178.50
|
| Rate for Payer: Aetna Medicare |
$105.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.50
|
| Rate for Payer: BCBS Complete |
$84.00
|
| Rate for Payer: BCBS Trust/PPO |
$75.95
|
| Rate for Payer: BCN Commercial |
$75.95
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$147.00
|
| Rate for Payer: Cofinity Commercial |
$180.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$147.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.00
|
| Rate for Payer: Healthscope Commercial |
$189.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$147.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.50
|
| Rate for Payer: PHP Commercial |
$178.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.50
|
| Rate for Payer: Priority Health SBD |
$132.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.69
|
| Rate for Payer: UHC Exchange |
$56.99
|
| Rate for Payer: UMR Bronson Commercial |
$77.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.50
|
|
|
HC US ELASTOGRAPHY EA ADDL TARGET LESION
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
40200083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$92.40 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Aetna American Axle |
$136.50
|
| Rate for Payer: Aetna Commercial |
$178.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.50
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$147.00
|
| Rate for Payer: Cofinity Commercial |
$180.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$147.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.00
|
| Rate for Payer: Healthscope Commercial |
$189.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$147.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.50
|
| Rate for Payer: PHP Commercial |
$178.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.50
|
| Rate for Payer: Priority Health SBD |
$132.30
|
| Rate for Payer: UMR Bronson Commercial |
$92.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.50
|
|
|
HC US ELASTOGRAPHY ORGAN
|
Facility
|
IP
|
$244.80
|
|
|
Service Code
|
CPT 76981
|
| Hospital Charge Code |
40200074
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$107.71 |
| Max. Negotiated Rate |
$220.32 |
| Rate for Payer: Aetna American Axle |
$159.12
|
| Rate for Payer: Aetna Commercial |
$208.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.12
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cofinity Commercial |
$171.36
|
| Rate for Payer: Cofinity Commercial |
$210.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$171.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.84
|
| Rate for Payer: Healthscope Commercial |
$220.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.08
|
| Rate for Payer: PHP Commercial |
$208.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.12
|
| Rate for Payer: Priority Health SBD |
$154.22
|
| Rate for Payer: UMR Bronson Commercial |
$107.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.60
|
|
|
HC US ELASTOGRAPHY ORGAN
|
Facility
|
OP
|
$244.80
|
|
|
Service Code
|
CPT 76981
|
| Hospital Charge Code |
40200074
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna American Axle |
$159.12
|
| Rate for Payer: Aetna Commercial |
$208.08
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$156.68
|
| Rate for Payer: BCN Commercial |
$156.68
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cofinity Commercial |
$210.53
|
| Rate for Payer: Cofinity Commercial |
$171.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$171.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$220.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.60
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.08
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$208.08
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$154.22
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.97
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$95.43
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$90.58
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.60
|
|
|
HC USE OF SPEECH DEVICE SERVICE
|
Facility
|
OP
|
$473.16
|
|
|
Service Code
|
CPT 92609
|
| Hospital Charge Code |
44000003
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$89.98 |
| Max. Negotiated Rate |
$436.95 |
| Rate for Payer: Aetna American Axle |
$307.55
|
| Rate for Payer: Aetna Commercial |
$402.19
|
| Rate for Payer: Aetna Medicare |
$236.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.55
|
| Rate for Payer: BCBS Complete |
$189.26
|
| Rate for Payer: BCBS Trust/PPO |
$436.95
|
| Rate for Payer: BCN Commercial |
$436.95
|
| Rate for Payer: Cash Price |
$378.53
|
| Rate for Payer: Cash Price |
$378.53
|
| Rate for Payer: Cash Price |
$378.53
|
| Rate for Payer: Cofinity Commercial |
$331.21
|
| Rate for Payer: Cofinity Commercial |
$406.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$331.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.53
|
| Rate for Payer: Healthscope Commercial |
$425.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$331.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.19
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$402.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.48
|
| Rate for Payer: Priority Health Narrow Network |
$89.98
|
| Rate for Payer: Priority Health SBD |
$298.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.91
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$97.19
|
| Rate for Payer: UMR Bronson Commercial |
$175.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.87
|
|
|
HC USE OF SPEECH DEVICE SERVICE
|
Facility
|
IP
|
$473.16
|
|
|
Service Code
|
CPT 92609
|
| Hospital Charge Code |
44000003
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$208.19 |
| Max. Negotiated Rate |
$425.84 |
| Rate for Payer: Aetna American Axle |
$307.55
|
| Rate for Payer: Aetna Commercial |
$402.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.55
|
| Rate for Payer: Cash Price |
$378.53
|
| Rate for Payer: Cofinity Commercial |
$331.21
|
| Rate for Payer: Cofinity Commercial |
$406.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$331.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.53
|
| Rate for Payer: Healthscope Commercial |
$425.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$331.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.19
|
| Rate for Payer: PHP Commercial |
$402.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.55
|
| Rate for Payer: Priority Health SBD |
$298.09
|
| Rate for Payer: UMR Bronson Commercial |
$208.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.87
|
|
|
HC US EXTREMITY NONVASC LTD
|
Facility
|
OP
|
$687.01
|
|
|
Service Code
|
CPT 76882
|
| Hospital Charge Code |
40200038
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$618.31 |
| Rate for Payer: Aetna American Axle |
$446.56
|
| Rate for Payer: Aetna Commercial |
$583.96
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$446.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$63.63
|
| Rate for Payer: BCCCP Commercial |
$60.92
|
| Rate for Payer: BCN Commercial |
$63.63
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$549.61
|
| Rate for Payer: Cash Price |
$549.61
|
| Rate for Payer: Cofinity Commercial |
$590.83
|
| Rate for Payer: Cofinity Commercial |
$480.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$480.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$618.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$480.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$515.26
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.96
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$583.96
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$432.82
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.03
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$59.12
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$254.19
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$515.26
|
|
|
HC US EXTREMITY NONVASC LTD
|
Facility
|
IP
|
$687.01
|
|
|
Service Code
|
CPT 76882
|
| Hospital Charge Code |
40200038
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$302.28 |
| Max. Negotiated Rate |
$618.31 |
| Rate for Payer: Aetna American Axle |
$446.56
|
| Rate for Payer: Aetna Commercial |
$583.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$446.56
|
| Rate for Payer: Cash Price |
$549.61
|
| Rate for Payer: Cofinity Commercial |
$480.91
|
| Rate for Payer: Cofinity Commercial |
$590.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$480.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.61
|
| Rate for Payer: Healthscope Commercial |
$618.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$480.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$515.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.96
|
| Rate for Payer: PHP Commercial |
$583.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.56
|
| Rate for Payer: Priority Health SBD |
$432.82
|
| Rate for Payer: UMR Bronson Commercial |
$302.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$515.26
|
|
|
HC US EXTREMITY NONVASCULAR COMP
|
Facility
|
IP
|
$687.01
|
|
|
Service Code
|
CPT 76881
|
| Hospital Charge Code |
40200037
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$302.28 |
| Max. Negotiated Rate |
$618.31 |
| Rate for Payer: Aetna American Axle |
$446.56
|
| Rate for Payer: Aetna Commercial |
$583.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$446.56
|
| Rate for Payer: Cash Price |
$549.61
|
| Rate for Payer: Cofinity Commercial |
$480.91
|
| Rate for Payer: Cofinity Commercial |
$590.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$480.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.61
|
| Rate for Payer: Healthscope Commercial |
$618.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$480.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$515.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.96
|
| Rate for Payer: PHP Commercial |
$583.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.56
|
| Rate for Payer: Priority Health SBD |
$432.82
|
| Rate for Payer: UMR Bronson Commercial |
$302.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$515.26
|
|
|
HC US EXTREMITY NONVASCULAR COMP
|
Facility
|
OP
|
$687.01
|
|
|
Service Code
|
CPT 76881
|
| Hospital Charge Code |
40200037
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$22.58 |
| Max. Negotiated Rate |
$618.31 |
| Rate for Payer: Aetna American Axle |
$446.56
|
| Rate for Payer: Aetna Commercial |
$583.96
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$446.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$22.58
|
| Rate for Payer: BCN Commercial |
$22.58
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$549.61
|
| Rate for Payer: Cash Price |
$549.61
|
| Rate for Payer: Cofinity Commercial |
$590.83
|
| Rate for Payer: Cofinity Commercial |
$480.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$480.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$618.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$480.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$515.26
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.96
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$583.96
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$432.82
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.19
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$51.08
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$254.19
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$515.26
|
|
|
HC US EYE B MODE
|
Facility
|
OP
|
$1,212.48
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
40200004
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$36.95 |
| Max. Negotiated Rate |
$1,091.23 |
| Rate for Payer: Aetna American Axle |
$788.11
|
| Rate for Payer: Aetna Commercial |
$1,030.61
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$788.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$36.95
|
| Rate for Payer: BCN Commercial |
$36.95
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$969.98
|
| Rate for Payer: Cash Price |
$969.98
|
| Rate for Payer: Cofinity Commercial |
$848.74
|
| Rate for Payer: Cofinity Commercial |
$1,042.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$848.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$969.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$1,091.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$848.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$909.36
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.61
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$1,030.61
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$763.86
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.24
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$44.76
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$448.62
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$909.36
|
|
|
HC US EYE B MODE
|
Facility
|
IP
|
$1,212.48
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
40200004
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$533.49 |
| Max. Negotiated Rate |
$1,091.23 |
| Rate for Payer: Aetna American Axle |
$788.11
|
| Rate for Payer: Aetna Commercial |
$1,030.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$788.11
|
| Rate for Payer: Cash Price |
$969.98
|
| Rate for Payer: Cofinity Commercial |
$1,042.73
|
| Rate for Payer: Cofinity Commercial |
$848.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$848.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$969.98
|
| Rate for Payer: Healthscope Commercial |
$1,091.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$848.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$909.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.61
|
| Rate for Payer: PHP Commercial |
$1,030.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.11
|
| Rate for Payer: Priority Health SBD |
$763.86
|
| Rate for Payer: UMR Bronson Commercial |
$533.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$909.36
|
|
|
HC US EYE B MODE BILAT
|
Facility
|
OP
|
$2,425.09
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
40200005
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$36.95 |
| Max. Negotiated Rate |
$2,182.58 |
| Rate for Payer: Aetna American Axle |
$1,576.31
|
| Rate for Payer: Aetna Commercial |
$2,061.33
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,576.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$36.95
|
| Rate for Payer: BCN Commercial |
$36.95
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$1,940.07
|
| Rate for Payer: Cash Price |
$1,940.07
|
| Rate for Payer: Cofinity Commercial |
$2,085.58
|
| Rate for Payer: Cofinity Commercial |
$1,697.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,697.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,940.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$2,182.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,697.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,818.82
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,061.33
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$2,061.33
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,576.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$1,527.81
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.24
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$44.76
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$897.28
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,818.82
|
|
|
HC US EYE B MODE BILAT
|
Facility
|
IP
|
$2,425.09
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
40200005
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$1,067.04 |
| Max. Negotiated Rate |
$2,182.58 |
| Rate for Payer: Aetna American Axle |
$1,576.31
|
| Rate for Payer: Aetna Commercial |
$2,061.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,576.31
|
| Rate for Payer: Cash Price |
$1,940.07
|
| Rate for Payer: Cofinity Commercial |
$1,697.56
|
| Rate for Payer: Cofinity Commercial |
$2,085.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,697.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,940.07
|
| Rate for Payer: Healthscope Commercial |
$2,182.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,697.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,818.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,061.33
|
| Rate for Payer: PHP Commercial |
$2,061.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,576.31
|
| Rate for Payer: Priority Health SBD |
$1,527.81
|
| Rate for Payer: UMR Bronson Commercial |
$1,067.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,818.82
|
|
|
HC US FETAL FLUID DRAIN INCL GUID
|
Facility
|
IP
|
$862.48
|
|
|
Service Code
|
CPT 59074
|
| Hospital Charge Code |
36100088
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$379.49 |
| Max. Negotiated Rate |
$776.23 |
| Rate for Payer: Aetna American Axle |
$560.61
|
| Rate for Payer: Aetna Commercial |
$733.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$560.61
|
| Rate for Payer: Cash Price |
$689.98
|
| Rate for Payer: Cofinity Commercial |
$603.74
|
| Rate for Payer: Cofinity Commercial |
$741.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$603.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$689.98
|
| Rate for Payer: Healthscope Commercial |
$776.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$603.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$646.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$733.11
|
| Rate for Payer: PHP Commercial |
$733.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.61
|
| Rate for Payer: Priority Health SBD |
$543.36
|
| Rate for Payer: UMR Bronson Commercial |
$379.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$646.86
|
|
|
HC US FETAL FLUID DRAIN INCL GUID
|
Facility
|
OP
|
$862.48
|
|
|
Service Code
|
CPT 59074
|
| Hospital Charge Code |
36100088
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$159.75 |
| Max. Negotiated Rate |
$936.74 |
| Rate for Payer: Aetna American Axle |
$560.61
|
| Rate for Payer: Aetna Commercial |
$733.11
|
| Rate for Payer: Aetna Medicare |
$309.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$560.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$372.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$372.55
|
| Rate for Payer: BCBS Complete |
$167.74
|
| Rate for Payer: BCBS MAPPO |
$298.04
|
| Rate for Payer: BCBS Trust/PPO |
$280.44
|
| Rate for Payer: BCN Commercial |
$280.44
|
| Rate for Payer: BCN Medicare Advantage |
$298.04
|
| Rate for Payer: Cash Price |
$689.98
|
| Rate for Payer: Cash Price |
$689.98
|
| Rate for Payer: Cash Price |
$689.98
|
| Rate for Payer: Cofinity Commercial |
$741.73
|
| Rate for Payer: Cofinity Commercial |
$603.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$603.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$689.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.04
|
| Rate for Payer: Healthscope Commercial |
$776.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$603.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$646.86
|
| Rate for Payer: Mclaren Medicaid |
$159.75
|
| Rate for Payer: Mclaren Medicare |
$298.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.94
|
| Rate for Payer: Meridian Medicaid |
$167.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$342.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$733.11
|
| Rate for Payer: Nomi Health Commercial |
$625.88
|
| Rate for Payer: PACE Medicare |
$283.14
|
| Rate for Payer: PACE SWMI |
$298.04
|
| Rate for Payer: PHP Commercial |
$733.11
|
| Rate for Payer: PHP Medicare Advantage |
$298.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$936.74
|
| Rate for Payer: Priority Health Medicare |
$298.04
|
| Rate for Payer: Priority Health Narrow Network |
$749.39
|
| Rate for Payer: Priority Health SBD |
$543.36
|
| Rate for Payer: Railroad Medicare Medicare |
$298.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.74
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.04
|
| Rate for Payer: UHC Exchange |
$305.22
|
| Rate for Payer: UHC Medicare Advantage |
$298.04
|
| Rate for Payer: UHCCP Medicaid |
$159.75
|
| Rate for Payer: UMR Bronson Commercial |
$319.12
|
| Rate for Payer: VA VA |
$298.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$646.86
|
|
|
HC US FETAL MCA DOPPLER VELOCIMETREY
|
Facility
|
OP
|
$291.84
|
|
|
Service Code
|
CPT 76821
|
| Hospital Charge Code |
40200029
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna American Axle |
$189.70
|
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$114.95
|
| Rate for Payer: BCN Commercial |
$114.95
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$250.98
|
| Rate for Payer: Cofinity Commercial |
$204.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$204.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$262.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$204.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.88
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$183.86
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.13
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$81.94
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$107.98
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.88
|
|
|
HC US FETAL MCA DOPPLER VELOCIMETREY
|
Facility
|
IP
|
$291.84
|
|
|
Service Code
|
CPT 76821
|
| Hospital Charge Code |
40200029
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$128.41 |
| Max. Negotiated Rate |
$262.66 |
| Rate for Payer: Aetna American Axle |
$189.70
|
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.70
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$204.29
|
| Rate for Payer: Cofinity Commercial |
$250.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$204.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Healthscope Commercial |
$262.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$204.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: Priority Health SBD |
$183.86
|
| Rate for Payer: UMR Bronson Commercial |
$128.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.88
|
|
|
HC US FETAL UMBILICAL ART DOPPLER
|
Facility
|
OP
|
$291.84
|
|
|
Service Code
|
CPT 76820
|
| Hospital Charge Code |
40200028
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$41.60 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna American Axle |
$189.70
|
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$43.79
|
| Rate for Payer: BCN Commercial |
$43.79
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$250.98
|
| Rate for Payer: Cofinity Commercial |
$204.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$204.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$262.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$204.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.88
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$183.86
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.76
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$41.60
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$107.98
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.88
|
|
|
HC US FETAL UMBILICAL ART DOPPLER
|
Facility
|
IP
|
$291.84
|
|
|
Service Code
|
CPT 76820
|
| Hospital Charge Code |
40200028
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$128.41 |
| Max. Negotiated Rate |
$262.66 |
| Rate for Payer: Aetna American Axle |
$189.70
|
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.70
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$204.29
|
| Rate for Payer: Cofinity Commercial |
$250.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$204.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Healthscope Commercial |
$262.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$204.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: Priority Health SBD |
$183.86
|
| Rate for Payer: UMR Bronson Commercial |
$128.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.88
|
|
