|
HC XR CHEST 4 OR MORE VIEWS
|
Facility
|
IP
|
$369.24
|
|
|
Service Code
|
CPT 71048
|
| Hospital Charge Code |
32400012
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$162.47 |
| Max. Negotiated Rate |
$332.32 |
| Rate for Payer: Aetna American Axle |
$240.01
|
| Rate for Payer: Aetna Commercial |
$313.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.01
|
| Rate for Payer: Cash Price |
$295.39
|
| Rate for Payer: Cofinity Commercial |
$258.47
|
| Rate for Payer: Cofinity Commercial |
$317.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$258.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$295.39
|
| Rate for Payer: Healthscope Commercial |
$332.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$258.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.85
|
| Rate for Payer: PHP Commercial |
$313.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.01
|
| Rate for Payer: Priority Health SBD |
$232.62
|
| Rate for Payer: UMR Bronson Commercial |
$162.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.93
|
|
|
HC XR CHEST 4 OR MORE VIEWS
|
Facility
|
OP
|
$369.24
|
|
|
Service Code
|
CPT 71048
|
| Hospital Charge Code |
32400012
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$41.94 |
| Max. Negotiated Rate |
$332.32 |
| Rate for Payer: Aetna American Axle |
$240.01
|
| Rate for Payer: Aetna Commercial |
$313.85
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.01
|
| 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 |
$64.31
|
| Rate for Payer: BCN Commercial |
$64.31
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$295.39
|
| Rate for Payer: Cash Price |
$295.39
|
| Rate for Payer: Cofinity Commercial |
$317.55
|
| Rate for Payer: Cofinity Commercial |
$258.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$258.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$295.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$332.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$258.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.93
|
| 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 |
$313.85
|
| 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 |
$313.85
|
| 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 |
$240.01
|
| 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 |
$232.62
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.13
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$41.94
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$136.62
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.93
|
|
|
HC XR CHEST ABD FOREIG BOD CHILD
|
Facility
|
OP
|
$275.97
|
|
|
Service Code
|
CPT 76010
|
| Hospital Charge Code |
32000234
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$26.95 |
| Max. Negotiated Rate |
$271.13 |
| Rate for Payer: Aetna American Axle |
$179.38
|
| Rate for Payer: Aetna Commercial |
$234.57
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.38
|
| 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 |
$43.10
|
| Rate for Payer: BCN Commercial |
$43.10
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$220.78
|
| Rate for Payer: Cash Price |
$220.78
|
| Rate for Payer: Cofinity Commercial |
$237.33
|
| Rate for Payer: Cofinity Commercial |
$193.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$193.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$248.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$193.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.98
|
| 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 |
$234.57
|
| 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 |
$234.57
|
| 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 |
$179.38
|
| 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 |
$173.86
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.64
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$26.95
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$102.11
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.98
|
|
|
HC XR CHEST ABD FOREIG BOD CHILD
|
Facility
|
IP
|
$275.97
|
|
|
Service Code
|
CPT 76010
|
| Hospital Charge Code |
32000234
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$121.43 |
| Max. Negotiated Rate |
$248.37 |
| Rate for Payer: Aetna American Axle |
$179.38
|
| Rate for Payer: Aetna Commercial |
$234.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.38
|
| Rate for Payer: Cash Price |
$220.78
|
| Rate for Payer: Cofinity Commercial |
$193.18
|
| Rate for Payer: Cofinity Commercial |
$237.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$193.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.78
|
| Rate for Payer: Healthscope Commercial |
$248.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$193.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.57
|
| Rate for Payer: PHP Commercial |
$234.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.38
|
| Rate for Payer: Priority Health SBD |
$173.86
|
| Rate for Payer: UMR Bronson Commercial |
$121.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.98
|
|
|
HC XR CHEST SINGLE VIEW
|
Facility
|
OP
|
$270.92
|
|
|
Service Code
|
CPT 71045
|
| Hospital Charge Code |
32400009
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$23.67 |
| Max. Negotiated Rate |
$271.13 |
| Rate for Payer: Aetna American Axle |
$176.10
|
| Rate for Payer: Aetna Commercial |
$230.28
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.10
|
| 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 |
$35.58
|
| Rate for Payer: BCN Commercial |
$35.58
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$216.74
|
| Rate for Payer: Cash Price |
$216.74
|
| Rate for Payer: Cofinity Commercial |
$232.99
|
| Rate for Payer: Cofinity Commercial |
$189.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$189.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$243.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$189.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.19
|
| 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 |
$230.28
|
| 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 |
$230.28
|
| 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 |
$176.10
|
| 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 |
$170.68
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.04
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$23.67
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$100.24
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.19
|
|
|
HC XR CHEST SINGLE VIEW
|
Facility
|
IP
|
$270.92
|
|
|
Service Code
|
CPT 71045
|
| Hospital Charge Code |
32400009
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$119.20 |
| Max. Negotiated Rate |
$243.83 |
| Rate for Payer: Aetna American Axle |
$176.10
|
| Rate for Payer: Aetna Commercial |
$230.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.10
|
| Rate for Payer: Cash Price |
$216.74
|
| Rate for Payer: Cofinity Commercial |
$189.64
|
| Rate for Payer: Cofinity Commercial |
$232.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$189.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.74
|
| Rate for Payer: Healthscope Commercial |
$243.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$189.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.28
|
| Rate for Payer: PHP Commercial |
$230.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.10
|
| Rate for Payer: Priority Health SBD |
$170.68
|
| Rate for Payer: UMR Bronson Commercial |
$119.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.19
|
|
|
HC XR CHOLANGIOGRAM IN OR
|
Facility
|
OP
|
$510.39
|
|
|
Service Code
|
CPT 74300
|
| Hospital Charge Code |
32000149
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$84.15 |
| Max. Negotiated Rate |
$459.35 |
| Rate for Payer: Aetna American Axle |
$331.75
|
| Rate for Payer: Aetna Commercial |
$433.83
|
| Rate for Payer: Aetna Medicare |
$255.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.75
|
| Rate for Payer: BCBS Complete |
$204.16
|
| Rate for Payer: BCBS Trust/PPO |
$84.15
|
| Rate for Payer: BCN Commercial |
$84.15
|
| Rate for Payer: Cash Price |
$408.31
|
| Rate for Payer: Cash Price |
$408.31
|
| Rate for Payer: Cofinity Commercial |
$438.94
|
| Rate for Payer: Cofinity Commercial |
$357.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$357.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.31
|
| Rate for Payer: Healthscope Commercial |
$459.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$357.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.83
|
| Rate for Payer: PHP Commercial |
$433.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.75
|
| Rate for Payer: Priority Health SBD |
$321.55
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UMR Bronson Commercial |
$188.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.79
|
|
|
HC XR CHOLANGIOGRAM IN OR
|
Facility
|
IP
|
$510.39
|
|
|
Service Code
|
CPT 74300
|
| Hospital Charge Code |
32000149
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$224.57 |
| Max. Negotiated Rate |
$459.35 |
| Rate for Payer: Aetna American Axle |
$331.75
|
| Rate for Payer: Aetna Commercial |
$433.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.75
|
| Rate for Payer: Cash Price |
$408.31
|
| Rate for Payer: Cofinity Commercial |
$357.27
|
| Rate for Payer: Cofinity Commercial |
$438.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$357.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.31
|
| Rate for Payer: Healthscope Commercial |
$459.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$357.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.83
|
| Rate for Payer: PHP Commercial |
$433.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.75
|
| Rate for Payer: Priority Health SBD |
$321.55
|
| Rate for Payer: UMR Bronson Commercial |
$224.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.79
|
|
|
HC XR CLAVICLE
|
Facility
|
OP
|
$316.49
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000060
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$29.87 |
| Max. Negotiated Rate |
$284.84 |
| Rate for Payer: Aetna American Axle |
$205.72
|
| Rate for Payer: Aetna Commercial |
$269.02
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.72
|
| 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 |
$50.63
|
| Rate for Payer: BCN Commercial |
$50.63
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$253.19
|
| Rate for Payer: Cash Price |
$253.19
|
| Rate for Payer: Cofinity Commercial |
$272.18
|
| Rate for Payer: Cofinity Commercial |
$221.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$221.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$253.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$284.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$221.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$237.37
|
| 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 |
$269.02
|
| 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 |
$269.02
|
| 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 |
$205.72
|
| 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 |
$199.39
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.86
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$29.87
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$117.10
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$237.37
|
|
|
HC XR CLAVICLE
|
Facility
|
IP
|
$316.49
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000060
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$139.26 |
| Max. Negotiated Rate |
$284.84 |
| Rate for Payer: Aetna American Axle |
$205.72
|
| Rate for Payer: Aetna Commercial |
$269.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.72
|
| Rate for Payer: Cash Price |
$253.19
|
| Rate for Payer: Cofinity Commercial |
$221.54
|
| Rate for Payer: Cofinity Commercial |
$272.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$221.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$253.19
|
| Rate for Payer: Healthscope Commercial |
$284.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$221.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$237.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$269.02
|
| Rate for Payer: PHP Commercial |
$269.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.72
|
| Rate for Payer: Priority Health SBD |
$199.39
|
| Rate for Payer: UMR Bronson Commercial |
$139.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$237.37
|
|
|
HC XR CLAVICLE BIL
|
Facility
|
IP
|
$340.34
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000061
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$149.75 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Aetna American Axle |
$221.22
|
| Rate for Payer: Aetna Commercial |
$289.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.22
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$238.24
|
| Rate for Payer: Cofinity Commercial |
$292.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$238.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Healthscope Commercial |
$306.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$238.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.29
|
| Rate for Payer: PHP Commercial |
$289.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.22
|
| Rate for Payer: Priority Health SBD |
$214.41
|
| Rate for Payer: UMR Bronson Commercial |
$149.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.26
|
|
|
HC XR CLAVICLE BIL
|
Facility
|
OP
|
$340.34
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
32000061
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$29.87 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Aetna American Axle |
$221.22
|
| Rate for Payer: Aetna Commercial |
$289.29
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.22
|
| 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 |
$50.63
|
| Rate for Payer: BCN Commercial |
$50.63
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$292.69
|
| Rate for Payer: Cofinity Commercial |
$238.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$238.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$306.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$238.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.26
|
| 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 |
$289.29
|
| 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 |
$289.29
|
| 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 |
$221.22
|
| 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 |
$214.41
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.86
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$29.87
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$125.93
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.26
|
|
|
HC XR COLON
|
Facility
|
OP
|
$857.44
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
32000273
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$93.49 |
| Max. Negotiated Rate |
$771.70 |
| Rate for Payer: Aetna American Axle |
$557.34
|
| Rate for Payer: Aetna Commercial |
$728.82
|
| Rate for Payer: Aetna Medicare |
$181.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.02
|
| Rate for Payer: BCBS Complete |
$98.16
|
| Rate for Payer: BCBS MAPPO |
$174.42
|
| Rate for Payer: BCBS Trust/PPO |
$215.52
|
| Rate for Payer: BCN Commercial |
$215.52
|
| Rate for Payer: BCN Medicare Advantage |
$174.42
|
| Rate for Payer: Cash Price |
$685.95
|
| Rate for Payer: Cash Price |
$685.95
|
| Rate for Payer: Cofinity Commercial |
$737.40
|
| Rate for Payer: Cofinity Commercial |
$600.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$600.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$685.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.42
|
| Rate for Payer: Healthscope Commercial |
$771.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$600.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$643.08
|
| Rate for Payer: Mclaren Medicaid |
$93.49
|
| Rate for Payer: Mclaren Medicare |
$174.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.14
|
| Rate for Payer: Meridian Medicaid |
$98.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$728.82
|
| Rate for Payer: Nomi Health Commercial |
$523.26
|
| Rate for Payer: PACE Medicare |
$165.70
|
| Rate for Payer: PACE SWMI |
$174.42
|
| Rate for Payer: PHP Commercial |
$728.82
|
| Rate for Payer: PHP Medicare Advantage |
$174.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$557.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$548.19
|
| Rate for Payer: Priority Health Medicare |
$174.42
|
| Rate for Payer: Priority Health Narrow Network |
$438.55
|
| Rate for Payer: Priority Health SBD |
$540.19
|
| Rate for Payer: Railroad Medicare Medicare |
$174.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$154.84
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.42
|
| Rate for Payer: UHC Exchange |
$140.76
|
| Rate for Payer: UHC Medicare Advantage |
$174.42
|
| Rate for Payer: UHCCP Medicaid |
$93.49
|
| Rate for Payer: UMR Bronson Commercial |
$317.25
|
| Rate for Payer: VA VA |
$174.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$643.08
|
|
|
HC XR COLON
|
Facility
|
IP
|
$857.44
|
|
|
Service Code
|
CPT 74270
|
| Hospital Charge Code |
32000273
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$377.27 |
| Max. Negotiated Rate |
$771.70 |
| Rate for Payer: Aetna American Axle |
$557.34
|
| Rate for Payer: Aetna Commercial |
$728.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.34
|
| Rate for Payer: Cash Price |
$685.95
|
| Rate for Payer: Cofinity Commercial |
$600.21
|
| Rate for Payer: Cofinity Commercial |
$737.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$600.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$685.95
|
| Rate for Payer: Healthscope Commercial |
$771.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$600.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$643.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$728.82
|
| Rate for Payer: PHP Commercial |
$728.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$557.34
|
| Rate for Payer: Priority Health SBD |
$540.19
|
| Rate for Payer: UMR Bronson Commercial |
$377.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$643.08
|
|
|
HC XR COLON HIGH DENSITY
|
Facility
|
OP
|
$1,224.87
|
|
|
Service Code
|
CPT 74280
|
| Hospital Charge Code |
32000146
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$93.49 |
| Max. Negotiated Rate |
$1,102.38 |
| Rate for Payer: UHC Dual Complete DSNP |
$174.42
|
| Rate for Payer: Aetna American Axle |
$796.17
|
| Rate for Payer: Aetna Commercial |
$1,041.14
|
| Rate for Payer: Aetna Medicare |
$181.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$796.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.02
|
| Rate for Payer: BCBS Complete |
$98.16
|
| Rate for Payer: BCBS MAPPO |
$174.42
|
| Rate for Payer: BCBS Trust/PPO |
$329.77
|
| Rate for Payer: BCN Commercial |
$329.77
|
| Rate for Payer: BCN Medicare Advantage |
$174.42
|
| Rate for Payer: Cash Price |
$979.90
|
| Rate for Payer: Cash Price |
$979.90
|
| Rate for Payer: Cofinity Commercial |
$857.41
|
| Rate for Payer: Cofinity Commercial |
$1,053.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$857.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$979.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.42
|
| Rate for Payer: Healthscope Commercial |
$1,102.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$857.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$918.65
|
| Rate for Payer: Mclaren Medicaid |
$93.49
|
| Rate for Payer: Mclaren Medicare |
$174.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.14
|
| Rate for Payer: Meridian Medicaid |
$98.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,041.14
|
| Rate for Payer: Nomi Health Commercial |
$523.26
|
| Rate for Payer: PACE Medicare |
$165.70
|
| Rate for Payer: PACE SWMI |
$174.42
|
| Rate for Payer: PHP Commercial |
$1,041.14
|
| Rate for Payer: PHP Medicare Advantage |
$174.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$548.19
|
| Rate for Payer: Priority Health Medicare |
$174.42
|
| Rate for Payer: Priority Health Narrow Network |
$438.55
|
| Rate for Payer: Priority Health SBD |
$771.67
|
| Rate for Payer: Railroad Medicare Medicare |
$174.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$221.12
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Exchange |
$201.02
|
| Rate for Payer: UHC Medicare Advantage |
$174.42
|
| Rate for Payer: UHCCP Medicaid |
$93.49
|
| Rate for Payer: UMR Bronson Commercial |
$453.20
|
| Rate for Payer: VA VA |
$174.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$918.65
|
|
|
HC XR COLON HIGH DENSITY
|
Facility
|
IP
|
$1,224.87
|
|
|
Service Code
|
CPT 74280
|
| Hospital Charge Code |
32000146
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$538.94 |
| Max. Negotiated Rate |
$1,102.38 |
| Rate for Payer: Aetna American Axle |
$796.17
|
| Rate for Payer: Aetna Commercial |
$1,041.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$796.17
|
| Rate for Payer: Cash Price |
$979.90
|
| Rate for Payer: Cofinity Commercial |
$1,053.39
|
| Rate for Payer: Cofinity Commercial |
$857.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$857.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$979.90
|
| Rate for Payer: Healthscope Commercial |
$1,102.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$857.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$918.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,041.14
|
| Rate for Payer: PHP Commercial |
$1,041.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.17
|
| Rate for Payer: Priority Health SBD |
$771.67
|
| Rate for Payer: UMR Bronson Commercial |
$538.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$918.65
|
|
|
HC XR COLON THERAPEUTIC FOR INTUS
|
Facility
|
OP
|
$583.28
|
|
|
Service Code
|
CPT 74283
|
| Hospital Charge Code |
32000147
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$93.49 |
| Max. Negotiated Rate |
$548.19 |
| Rate for Payer: Aetna American Axle |
$379.13
|
| Rate for Payer: Aetna Commercial |
$495.79
|
| Rate for Payer: Aetna Medicare |
$181.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.02
|
| Rate for Payer: BCBS Complete |
$98.16
|
| Rate for Payer: BCBS MAPPO |
$174.42
|
| Rate for Payer: BCBS Trust/PPO |
$320.88
|
| Rate for Payer: BCN Commercial |
$320.88
|
| Rate for Payer: BCN Medicare Advantage |
$174.42
|
| 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 |
$174.42
|
| 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 |
$93.49
|
| Rate for Payer: Mclaren Medicare |
$174.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.14
|
| Rate for Payer: Meridian Medicaid |
$98.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: Nomi Health Commercial |
$523.26
|
| Rate for Payer: PACE Medicare |
$165.70
|
| Rate for Payer: PACE SWMI |
$174.42
|
| Rate for Payer: PHP Commercial |
$495.79
|
| Rate for Payer: PHP Medicare Advantage |
$174.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$548.19
|
| Rate for Payer: Priority Health Medicare |
$174.42
|
| Rate for Payer: Priority Health Narrow Network |
$438.55
|
| Rate for Payer: Priority Health SBD |
$367.47
|
| Rate for Payer: Railroad Medicare Medicare |
$174.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.20
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.42
|
| Rate for Payer: UHC Exchange |
$234.73
|
| Rate for Payer: UHC Medicare Advantage |
$174.42
|
| Rate for Payer: UHCCP Medicaid |
$93.49
|
| Rate for Payer: UMR Bronson Commercial |
$215.81
|
| Rate for Payer: VA VA |
$174.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.46
|
|
|
HC XR COLON THERAPEUTIC FOR INTUS
|
Facility
|
IP
|
$583.28
|
|
|
Service Code
|
CPT 74283
|
| Hospital Charge Code |
32000147
|
|
Hospital Revenue Code
|
320
|
| 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 XR CYSTOGRAM MIN 3 VW
|
Facility
|
IP
|
$439.05
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000163
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$193.18 |
| Max. Negotiated Rate |
$395.14 |
| Rate for Payer: Aetna American Axle |
$285.38
|
| Rate for Payer: Aetna Commercial |
$373.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.38
|
| Rate for Payer: Cash Price |
$351.24
|
| Rate for Payer: Cofinity Commercial |
$307.34
|
| Rate for Payer: Cofinity Commercial |
$377.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$307.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.24
|
| Rate for Payer: Healthscope Commercial |
$395.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$307.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.19
|
| Rate for Payer: PHP Commercial |
$373.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.38
|
| Rate for Payer: Priority Health SBD |
$276.60
|
| Rate for Payer: UMR Bronson Commercial |
$193.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.29
|
|
|
HC XR CYSTOGRAM MIN 3 VW
|
Facility
|
OP
|
$439.05
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000163
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$38.18 |
| Max. Negotiated Rate |
$1,099.76 |
| Rate for Payer: Aetna American Axle |
$285.38
|
| Rate for Payer: Aetna Commercial |
$373.19
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$54.06
|
| Rate for Payer: BCN Commercial |
$54.06
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$351.24
|
| Rate for Payer: Cash Price |
$351.24
|
| Rate for Payer: Cofinity Commercial |
$377.58
|
| Rate for Payer: Cofinity Commercial |
$307.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$307.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$395.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$307.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.29
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.19
|
| Rate for Payer: Nomi Health Commercial |
$1,049.73
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$373.19
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,099.76
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$879.81
|
| Rate for Payer: Priority Health SBD |
$276.60
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.00
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$38.18
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: UMR Bronson Commercial |
$162.45
|
| Rate for Payer: VA VA |
$349.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.29
|
|
|
HC XR CYSTOGRAM VOIDING
|
Facility
|
OP
|
$510.39
|
|
|
Service Code
|
CPT 74455
|
| Hospital Charge Code |
32000166
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$94.20 |
| Max. Negotiated Rate |
$744.36 |
| Rate for Payer: Aetna American Axle |
$331.75
|
| Rate for Payer: Aetna Commercial |
$433.83
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.75
|
| 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 |
$181.99
|
| Rate for Payer: BCN Commercial |
$181.99
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$408.31
|
| Rate for Payer: Cash Price |
$408.31
|
| Rate for Payer: Cofinity Commercial |
$438.94
|
| Rate for Payer: Cofinity Commercial |
$357.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$357.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$459.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$357.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.79
|
| 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 |
$433.83
|
| 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 |
$433.83
|
| 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 |
$331.75
|
| 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 |
$321.55
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.62
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$94.20
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: UMR Bronson Commercial |
$188.84
|
| Rate for Payer: VA VA |
$236.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.79
|
|
|
HC XR CYSTOGRAM VOIDING
|
Facility
|
IP
|
$510.39
|
|
|
Service Code
|
CPT 74455
|
| Hospital Charge Code |
32000166
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$224.57 |
| Max. Negotiated Rate |
$459.35 |
| Rate for Payer: Aetna American Axle |
$331.75
|
| Rate for Payer: Aetna Commercial |
$433.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.75
|
| Rate for Payer: Cash Price |
$408.31
|
| Rate for Payer: Cofinity Commercial |
$357.27
|
| Rate for Payer: Cofinity Commercial |
$438.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$357.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.31
|
| Rate for Payer: Healthscope Commercial |
$459.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$357.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.83
|
| Rate for Payer: PHP Commercial |
$433.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.75
|
| Rate for Payer: Priority Health SBD |
$321.55
|
| Rate for Payer: UMR Bronson Commercial |
$224.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.79
|
|
|
HC XR DEFECOGRAPHY 4 WAY
|
Facility
|
IP
|
$816.54
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000164
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$359.28 |
| Max. Negotiated Rate |
$734.89 |
| Rate for Payer: Aetna American Axle |
$530.75
|
| Rate for Payer: Aetna Commercial |
$694.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.75
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$571.58
|
| Rate for Payer: Cofinity Commercial |
$702.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$571.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Healthscope Commercial |
$734.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$571.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$612.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: PHP Commercial |
$694.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health SBD |
$514.42
|
| Rate for Payer: UMR Bronson Commercial |
$359.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$612.40
|
|
|
HC XR DEFECOGRAPHY 4 WAY
|
Facility
|
OP
|
$816.54
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
32000164
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$38.18 |
| Max. Negotiated Rate |
$1,099.76 |
| Rate for Payer: Aetna American Axle |
$530.75
|
| Rate for Payer: Aetna Commercial |
$694.06
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$54.06
|
| Rate for Payer: BCN Commercial |
$54.06
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$702.22
|
| Rate for Payer: Cofinity Commercial |
$571.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$571.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$734.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$571.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$612.40
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: Nomi Health Commercial |
$1,049.73
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$694.06
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,099.76
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$879.81
|
| Rate for Payer: Priority Health SBD |
$514.42
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.00
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$38.18
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: UMR Bronson Commercial |
$302.12
|
| Rate for Payer: VA VA |
$349.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$612.40
|
|
|
HC XR ELBOW 2 BIL VW
|
Facility
|
IP
|
$388.71
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000072
|
|
Hospital Revenue Code
|
320
|
| 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
|
|
