|
HC US GUIDED INTERSTITIAL THERAPY
|
Facility
|
IP
|
$413.36
|
|
|
Service Code
|
CPT 76965
|
| Hospital Charge Code |
40200063
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$181.88 |
| Max. Negotiated Rate |
$372.02 |
| Rate for Payer: Aetna American Axle |
$268.68
|
| Rate for Payer: Aetna Commercial |
$351.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.68
|
| Rate for Payer: Cash Price |
$330.69
|
| Rate for Payer: Cofinity Commercial |
$289.35
|
| Rate for Payer: Cofinity Commercial |
$355.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$289.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.69
|
| Rate for Payer: Healthscope Commercial |
$372.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$289.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$351.36
|
| Rate for Payer: PHP Commercial |
$351.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.68
|
| Rate for Payer: Priority Health SBD |
$260.42
|
| Rate for Payer: UMR Bronson Commercial |
$181.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.02
|
|
|
HC US GUIDED INTERSTITIAL THERAPY
|
Facility
|
OP
|
$413.36
|
|
|
Service Code
|
CPT 76965
|
| Hospital Charge Code |
40200063
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$56.79 |
| Max. Negotiated Rate |
$372.02 |
| Rate for Payer: Aetna American Axle |
$268.68
|
| Rate for Payer: Aetna Commercial |
$351.36
|
| Rate for Payer: Aetna Medicare |
$206.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.68
|
| Rate for Payer: BCBS Complete |
$165.34
|
| Rate for Payer: BCBS Trust/PPO |
$56.79
|
| Rate for Payer: BCN Commercial |
$56.79
|
| Rate for Payer: Cash Price |
$330.69
|
| Rate for Payer: Cash Price |
$330.69
|
| Rate for Payer: Cofinity Commercial |
$289.35
|
| Rate for Payer: Cofinity Commercial |
$355.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$289.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.69
|
| Rate for Payer: Healthscope Commercial |
$372.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$289.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$351.36
|
| Rate for Payer: PHP Commercial |
$351.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.68
|
| Rate for Payer: Priority Health SBD |
$260.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.72
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Exchange |
$88.84
|
| Rate for Payer: UMR Bronson Commercial |
$152.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.02
|
|
|
HC US GUIDE FOR NEEDLE PLACEMENT
|
Facility
|
OP
|
$643.95
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
40200045
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.20 |
| Max. Negotiated Rate |
$579.56 |
| Rate for Payer: Aetna American Axle |
$418.57
|
| Rate for Payer: Aetna Commercial |
$547.36
|
| Rate for Payer: Aetna Medicare |
$321.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$418.57
|
| Rate for Payer: BCBS Complete |
$257.58
|
| Rate for Payer: BCBS Trust/PPO |
$58.15
|
| Rate for Payer: BCCCP Commercial |
$55.83
|
| Rate for Payer: BCN Commercial |
$58.15
|
| Rate for Payer: Cash Price |
$515.16
|
| Rate for Payer: Cash Price |
$515.16
|
| Rate for Payer: Cofinity Commercial |
$553.80
|
| Rate for Payer: Cofinity Commercial |
$450.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$450.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$515.16
|
| Rate for Payer: Healthscope Commercial |
$579.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$450.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$482.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$547.36
|
| Rate for Payer: PHP Commercial |
$547.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$418.57
|
| Rate for Payer: Priority Health SBD |
$405.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.62
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Exchange |
$54.20
|
| Rate for Payer: UMR Bronson Commercial |
$238.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$482.96
|
|
|
HC US GUIDE FOR NEEDLE PLACEMENT
|
Facility
|
IP
|
$643.95
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
40200045
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$283.34 |
| Max. Negotiated Rate |
$579.56 |
| Rate for Payer: Aetna American Axle |
$418.57
|
| Rate for Payer: Aetna Commercial |
$547.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$418.57
|
| Rate for Payer: Cash Price |
$515.16
|
| Rate for Payer: Cofinity Commercial |
$450.76
|
| Rate for Payer: Cofinity Commercial |
$553.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$450.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$515.16
|
| Rate for Payer: Healthscope Commercial |
$579.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$450.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$482.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$547.36
|
| Rate for Payer: PHP Commercial |
$547.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$418.57
|
| Rate for Payer: Priority Health SBD |
$405.69
|
| Rate for Payer: UMR Bronson Commercial |
$283.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$482.96
|
|
|
HC US HYSTEROSONOGRAM
|
Facility
|
OP
|
$357.38
|
|
|
Service Code
|
CPT 76831
|
| Hospital Charge Code |
40200032
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$106.46 |
| Max. Negotiated Rate |
$744.36 |
| Rate for Payer: Aetna American Axle |
$232.30
|
| Rate for Payer: Aetna Commercial |
$303.77
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$168.99
|
| Rate for Payer: BCN Commercial |
$168.99
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| 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 |
$236.83
|
| 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 |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: Nomi Health Commercial |
$710.49
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$303.77
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$744.36
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$595.49
|
| Rate for Payer: Priority Health SBD |
$225.15
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.11
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$106.46
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: UMR Bronson Commercial |
$132.23
|
| Rate for Payer: VA VA |
$236.83
|
| 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
|
OP
|
$388.71
|
|
|
Service Code
|
CPT 76885
|
| Hospital Charge Code |
40200040
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$46.24 |
| 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 |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$207.31
|
| Rate for Payer: BCN Commercial |
$207.31
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| 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 |
$86.27
|
| 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 |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$244.89
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.49
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$124.08
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$143.82
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
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 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 INFANT HIPS WO MANIPULATION
|
Facility
|
OP
|
$324.21
|
|
|
Service Code
|
CPT 76886
|
| Hospital Charge Code |
40200041
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$46.24 |
| 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 |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$145.04
|
| Rate for Payer: BCN Commercial |
$145.04
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| 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 |
$86.27
|
| 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 |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$275.58
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$275.58
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$204.25
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.47
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$91.34
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$119.96
|
| Rate for Payer: VA VA |
$86.27
|
| 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 |
$31.11 |
| 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: BCBS Trust/PPO |
$31.47
|
| Rate for Payer: BCN Commercial |
$31.47
|
| Rate for Payer: Cash Price |
$473.73
|
| 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: UHC All Payor (Choice/PPO) |
$34.22
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Exchange |
$31.11
|
| 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 |
$109.47 |
| 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: BCBS Trust/PPO |
$109.47
|
| Rate for Payer: BCN Commercial |
$109.47
|
| 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
|
OP
|
$642.88
|
|
|
Service Code
|
CPT 76819
|
| Hospital Charge Code |
40200027
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.85 |
| 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 |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$417.87
|
| 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 |
$101.95
|
| Rate for Payer: BCN Commercial |
$101.95
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| 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 |
$104.19
|
| 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 |
$55.85
|
| 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 |
$546.45
|
| 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 |
$546.45
|
| 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 |
$417.87
|
| 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 |
$405.01
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.18
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$79.25
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$237.87
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$482.16
|
|
|
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 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
|
Facility
|
OP
|
$583.28
|
|
|
Service Code
|
CPT 76811
|
| Hospital Charge Code |
40200019
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$744.36 |
| Rate for Payer: Aetna American Axle |
$379.13
|
| Rate for Payer: Aetna Commercial |
$495.79
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$181.31
|
| Rate for Payer: BCN Commercial |
$181.31
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| 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 |
$236.83
|
| 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 |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: Nomi Health Commercial |
$710.49
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$495.79
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$744.36
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$595.49
|
| Rate for Payer: Priority Health SBD |
$367.47
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.31
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$164.83
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: UMR Bronson Commercial |
$215.81
|
| Rate for Payer: VA VA |
$236.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.46
|
|
|
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 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 |
$194.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.66
|
| Rate for Payer: BCBS Complete |
$155.48
|
| Rate for Payer: BCBS Trust/PPO |
$221.67
|
| Rate for Payer: BCN Commercial |
$221.67
|
| Rate for Payer: Cash Price |
$310.97
|
| 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: UHC All Payor (Choice/PPO) |
$194.94
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Exchange |
$177.22
|
| Rate for Payer: UMR Bronson Commercial |
$143.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
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 |
$126.94 |
| Max. Negotiated Rate |
$744.36 |
| Rate for Payer: Aetna American Axle |
$449.74
|
| Rate for Payer: Aetna Commercial |
$588.12
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$242.20
|
| Rate for Payer: BCN Commercial |
$242.20
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| 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 |
$236.83
|
| 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 |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$588.12
|
| Rate for Payer: Nomi Health Commercial |
$710.49
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$588.12
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$744.36
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$595.49
|
| Rate for Payer: Priority Health SBD |
$435.90
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.26
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$142.96
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: UMR Bronson Commercial |
$256.01
|
| Rate for Payer: VA VA |
$236.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.93
|
|
|
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 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 |
$55.85 |
| 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 |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.90
|
| 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 |
$143.68
|
| Rate for Payer: BCN Commercial |
$143.68
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| 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 |
$104.19
|
| 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 |
$55.85
|
| 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 |
$413.10
|
| 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 |
$413.10
|
| 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 |
$315.90
|
| 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 |
$306.18
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.29
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$101.17
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$179.82
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$364.50
|
|
|
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 |
$55.85 |
| 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 |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$378.29
|
| 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 |
$182.67
|
| Rate for Payer: BCN Commercial |
$182.67
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| 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 |
$104.19
|
| 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 |
$55.85
|
| 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 |
$494.69
|
| 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 |
$494.69
|
| 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 |
$378.29
|
| 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 |
$366.65
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.29
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$124.81
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$215.34
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$436.49
|
|
