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Charge Type Setting Price  
Service Code HCPCS 28810
Min. Negotiated Rate $271.36
Max. Negotiated Rate $1,367.24
Rate for Payer: Aetna Commercial $565.84
Rate for Payer: BCBS Complete $284.93
Rate for Payer: BCBS Trust/PPO $1,367.24
Rate for Payer: Cash Price $1,126.40
Rate for Payer: Cash Price $1,126.40
Rate for Payer: Meridian Medicaid $284.93
Rate for Payer: Priority Health Choice Medicaid $271.36
Rate for Payer: Priority Health Cigna Priority Health $985.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network $642.91
Rate for Payer: Priority Health Narrow Network $642.91
Rate for Payer: Priority Health SBD $642.91
Rate for Payer: UMR Bronson Commercial $647.68
Service Code CPT 28810
Hospital Charge Code 28810
Min. Negotiated Rate $619.52
Max. Negotiated Rate $1,267.20
Rate for Payer: Aetna American Axle $915.20
Rate for Payer: Aetna Commercial $1,196.80
Rate for Payer: Aetna New Business (MI Preferred) $915.20
Rate for Payer: Cash Price $1,126.40
Rate for Payer: Cofinity Commercial $1,210.88
Rate for Payer: Cofinity Commercial $985.60
Rate for Payer: Encore Health Key Benefits Commercial $1,126.40
Rate for Payer: Healthscope Commercial $1,267.20
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $985.60
Rate for Payer: Lakeland Regional Health Systems Commercial $1,056.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $1,196.80
Rate for Payer: PHP Commercial $1,196.80
Rate for Payer: Priority Health Cigna Priority Health $985.60
Rate for Payer: Priority Health SBD $887.04
Rate for Payer: UMR Bronson Commercial $619.52
Rate for Payer: Van Buren County Sheriff Dept. Commercial $1,056.00
Service Code HCPCS 54125
Min. Negotiated Rate $523.55
Max. Negotiated Rate $2,350.94
Rate for Payer: Aetna Commercial $1,048.07
Rate for Payer: BCBS Complete $549.73
Rate for Payer: BCBS Trust/PPO $2,350.94
Rate for Payer: Cash Price $1,217.60
Rate for Payer: Cash Price $1,217.60
Rate for Payer: Meridian Medicaid $549.73
Rate for Payer: Priority Health Choice Medicaid $523.55
Rate for Payer: Priority Health Cigna Priority Health $1,065.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network $1,316.31
Rate for Payer: Priority Health Narrow Network $1,316.31
Rate for Payer: Priority Health SBD $1,316.31
Rate for Payer: UMR Bronson Commercial $700.12
Service Code HCPCS 54120
Min. Negotiated Rate $403.85
Max. Negotiated Rate $3,526.40
Rate for Payer: Aetna Commercial $809.58
Rate for Payer: BCBS Complete $424.04
Rate for Payer: BCBS Trust/PPO $3,526.40
Rate for Payer: Cash Price $942.40
Rate for Payer: Cash Price $942.40
Rate for Payer: Meridian Medicaid $424.04
Rate for Payer: Priority Health Choice Medicaid $403.85
Rate for Payer: Priority Health Cigna Priority Health $824.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network $1,009.38
Rate for Payer: Priority Health Narrow Network $1,009.38
Rate for Payer: Priority Health SBD $1,009.38
Rate for Payer: UMR Bronson Commercial $541.88
Service Code HCPCS 54130
Min. Negotiated Rate $756.58
Max. Negotiated Rate $3,502.63
Rate for Payer: Aetna Commercial $1,532.39
Rate for Payer: BCBS Complete $794.41
Rate for Payer: BCBS Trust/PPO $3,502.63
Rate for Payer: Cash Price $1,946.40
Rate for Payer: Cash Price $1,946.40
Rate for Payer: Meridian Medicaid $794.41
Rate for Payer: Priority Health Choice Medicaid $756.58
Rate for Payer: Priority Health Cigna Priority Health $1,703.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network $1,897.20
Rate for Payer: Priority Health Narrow Network $1,897.20
Rate for Payer: Priority Health SBD $1,897.20
Rate for Payer: UMR Bronson Commercial $1,119.18
Service Code HCPCS 27590
Min. Negotiated Rate $499.27
Max. Negotiated Rate $2,644.67
Rate for Payer: Aetna Commercial $1,060.77
Rate for Payer: BCBS Complete $524.23
Rate for Payer: BCBS Trust/PPO $2,644.67
Rate for Payer: Cash Price $2,024.80
Rate for Payer: Cash Price $2,024.80
Rate for Payer: Meridian Medicaid $524.23
Rate for Payer: Priority Health Choice Medicaid $499.27
Rate for Payer: Priority Health Cigna Priority Health $1,771.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network $1,190.84
Rate for Payer: Priority Health Narrow Network $1,190.84
Rate for Payer: Priority Health SBD $1,190.84
Rate for Payer: UMR Bronson Commercial $1,164.26
Service Code HCPCS 27596
Min. Negotiated Rate $454.33
Max. Negotiated Rate $1,666.00
Rate for Payer: Aetna Commercial $958.03
Rate for Payer: BCBS Complete $477.05
Rate for Payer: BCBS Trust/PPO $1,116.83
Rate for Payer: Cash Price $1,904.00
Rate for Payer: Cash Price $1,904.00
Rate for Payer: Meridian Medicaid $477.05
Rate for Payer: Priority Health Choice Medicaid $454.33
Rate for Payer: Priority Health Cigna Priority Health $1,666.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network $1,087.18
Rate for Payer: Priority Health Narrow Network $1,087.18
Rate for Payer: Priority Health SBD $1,087.18
Rate for Payer: UMR Bronson Commercial $1,094.80
Service Code HCPCS 27592
Min. Negotiated Rate $427.49
Max. Negotiated Rate $2,125.20
Rate for Payer: Aetna Commercial $901.24
Rate for Payer: BCBS Complete $448.86
Rate for Payer: BCBS Trust/PPO $1,803.62
Rate for Payer: Cash Price $2,428.80
Rate for Payer: Cash Price $2,428.80
Rate for Payer: Meridian Medicaid $448.86
Rate for Payer: Priority Health Choice Medicaid $427.49
Rate for Payer: Priority Health Cigna Priority Health $2,125.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network $1,019.77
Rate for Payer: Priority Health Narrow Network $1,019.77
Rate for Payer: Priority Health SBD $1,019.77
Rate for Payer: UMR Bronson Commercial $1,396.56
Service Code HCPCS 28825
Min. Negotiated Rate $110.12
Max. Negotiated Rate $995.32
Rate for Payer: Aetna Commercial $235.79
Rate for Payer: BCBS Complete $115.63
Rate for Payer: BCBS Trust/PPO $995.32
Rate for Payer: Cash Price $1,056.00
Rate for Payer: Cash Price $1,056.00
Rate for Payer: Meridian Medicaid $115.63
Rate for Payer: Priority Health Choice Medicaid $110.12
Rate for Payer: Priority Health Cigna Priority Health $924.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network $260.94
Rate for Payer: Priority Health Narrow Network $260.94
Rate for Payer: Priority Health SBD $260.94
Rate for Payer: UMR Bronson Commercial $607.20
Service Code HCPCS 28820
Min. Negotiated Rate $112.89
Max. Negotiated Rate $1,068.20
Rate for Payer: Aetna Commercial $243.14
Rate for Payer: BCBS Complete $118.53
Rate for Payer: BCBS Trust/PPO $852.68
Rate for Payer: Cash Price $1,220.80
Rate for Payer: Cash Price $1,220.80
Rate for Payer: Meridian Medicaid $118.53
Rate for Payer: Priority Health Choice Medicaid $112.89
Rate for Payer: Priority Health Cigna Priority Health $1,068.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network $269.62
Rate for Payer: Priority Health Narrow Network $269.62
Rate for Payer: Priority Health SBD $269.62
Rate for Payer: UMR Bronson Commercial $701.96
Service Code CPT 28820
Hospital Charge Code 28820
Hospital Revenue Code 960
Min. Negotiated Rate $173.54
Max. Negotiated Rate $9,057.42
Rate for Payer: Aetna American Axle $991.90
Rate for Payer: Aetna Commercial $1,297.10
Rate for Payer: Aetna Medicare $2,992.24
Rate for Payer: Aetna New Business (MI Preferred) $991.90
Rate for Payer: Allen County Amish Medical Aid Commercial $3,596.44
Rate for Payer: Amish Plain Church Group Commercial $3,596.44
Rate for Payer: BCBS Complete $1,652.63
Rate for Payer: BCBS MAPPO $2,877.15
Rate for Payer: BCBS Trust/PPO $2,429.32
Rate for Payer: BCN Medicare Advantage $2,877.15
Rate for Payer: Cash Price $1,220.80
Rate for Payer: Cash Price $1,220.80
Rate for Payer: Cofinity Commercial $1,068.20
Rate for Payer: Cofinity Commercial $1,312.36
Rate for Payer: Encore Health Key Benefits Commercial $1,220.80
Rate for Payer: Health Alliance Plan Medicare Advantage $2,877.15
Rate for Payer: Healthscope Commercial $1,373.40
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $1,068.20
Rate for Payer: Lakeland Regional Health Systems Commercial $1,144.50
Rate for Payer: Mclaren Medicaid $1,573.80
Rate for Payer: Mclaren Medicare $2,877.15
Rate for Payer: Meridian Medicaid $1,652.63
Rate for Payer: Meridian Wellcare - Medicare Advantage $3,021.01
Rate for Payer: MI Amish Medical Board Commercial $3,308.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $1,297.10
Rate for Payer: PACE Medicare $2,733.29
Rate for Payer: PACE SWMI $2,877.15
Rate for Payer: PHP Commercial $1,297.10
Rate for Payer: PHP Medicare Advantage $2,877.15
Rate for Payer: Priority Health Choice Medicaid $1,573.80
Rate for Payer: Priority Health Cigna Priority Health $1,068.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network $9,057.42
Rate for Payer: Priority Health Medicare $2,877.15
Rate for Payer: Priority Health Narrow Network $7,245.94
Rate for Payer: Priority Health SBD $961.38
Rate for Payer: Railroad Medicare Medicare $2,877.15
Rate for Payer: UHC All Payor (Choice/PPO) $190.89
Rate for Payer: UHC Dual Complete DSNP $2,877.15
Rate for Payer: UHC Exchange $173.54
Rate for Payer: UHC Medicare Advantage $2,963.46
Rate for Payer: UMR Bronson Commercial $564.62
Rate for Payer: VA VA $2,877.15
Rate for Payer: Van Buren County Sheriff Dept. Commercial $1,144.50
Service Code HCPCS 28820
Hospital Charge Code 28820
Min. Negotiated Rate $112.89
Max. Negotiated Rate $1,068.20
Rate for Payer: Aetna Commercial $243.14
Rate for Payer: BCBS Complete $118.53
Rate for Payer: BCBS Trust/PPO $852.68
Rate for Payer: Cash Price $1,220.80
Rate for Payer: Cash Price $1,220.80
Rate for Payer: Meridian Medicaid $118.53
Rate for Payer: Priority Health Choice Medicaid $112.89
Rate for Payer: Priority Health Cigna Priority Health $1,068.20
Rate for Payer: Priority Health HMO/PPO/Tiered Network $269.62
Rate for Payer: Priority Health Narrow Network $269.62
Rate for Payer: Priority Health SBD $269.62
Rate for Payer: UMR Bronson Commercial $701.96
Service Code CPT 28820
Hospital Charge Code 28820
Hospital Revenue Code 960
Min. Negotiated Rate $671.44
Max. Negotiated Rate $1,373.40
Rate for Payer: Aetna American Axle $991.90
Rate for Payer: Aetna Commercial $1,297.10
Rate for Payer: Aetna New Business (MI Preferred) $991.90
Rate for Payer: Cash Price $1,220.80
Rate for Payer: Cofinity Commercial $1,068.20
Rate for Payer: Cofinity Commercial $1,312.36
Rate for Payer: Encore Health Key Benefits Commercial $1,220.80
Rate for Payer: Healthscope Commercial $1,373.40
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $1,068.20
Rate for Payer: Lakeland Regional Health Systems Commercial $1,144.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $1,297.10
Rate for Payer: PHP Commercial $1,297.10
Rate for Payer: Priority Health Cigna Priority Health $1,068.20
Rate for Payer: Priority Health SBD $961.38
Rate for Payer: UMR Bronson Commercial $671.44
Rate for Payer: Van Buren County Sheriff Dept. Commercial $1,144.50
Service Code HCPCS 95978
Min. Negotiated Rate $198.80
Max. Negotiated Rate $347.90
Rate for Payer: BCBS Complete $198.80
Rate for Payer: Cash Price $397.60
Rate for Payer: Priority Health Cigna Priority Health $347.90
Rate for Payer: UMR Bronson Commercial $228.62
Service Code HCPCS 95979
Min. Negotiated Rate $85.60
Max. Negotiated Rate $149.80
Rate for Payer: BCBS Complete $85.60
Rate for Payer: Cash Price $171.20
Rate for Payer: Priority Health Cigna Priority Health $149.80
Rate for Payer: UMR Bronson Commercial $98.44
Service Code HCPCS 61711
Min. Negotiated Rate $134.19
Max. Negotiated Rate $5,398.40
Rate for Payer: Aetna Commercial $3,326.27
Rate for Payer: BCBS Complete $1,771.31
Rate for Payer: BCBS Trust/PPO $134.19
Rate for Payer: Cash Price $6,169.60
Rate for Payer: Cash Price $6,169.60
Rate for Payer: Meridian Medicaid $1,771.31
Rate for Payer: Priority Health Choice Medicaid $1,686.96
Rate for Payer: Priority Health Cigna Priority Health $5,398.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network $4,382.00
Rate for Payer: Priority Health Narrow Network $4,382.00
Rate for Payer: Priority Health SBD $4,382.00
Rate for Payer: UMR Bronson Commercial $3,547.52
Service Code HCPCS 64868
Min. Negotiated Rate $190.19
Max. Negotiated Rate $1,691.31
Rate for Payer: Aetna Commercial $1,278.09
Rate for Payer: BCBS Complete $668.71
Rate for Payer: BCBS Trust/PPO $190.19
Rate for Payer: Cash Price $1,457.60
Rate for Payer: Cash Price $1,457.60
Rate for Payer: Meridian Medicaid $668.71
Rate for Payer: Priority Health Choice Medicaid $636.87
Rate for Payer: Priority Health Cigna Priority Health $1,275.40
Rate for Payer: Priority Health HMO/PPO/Tiered Network $1,691.31
Rate for Payer: Priority Health Narrow Network $1,691.31
Rate for Payer: Priority Health SBD $1,691.31
Rate for Payer: UMR Bronson Commercial $838.12
Service Code HCPCS 47780
Min. Negotiated Rate $1,284.83
Max. Negotiated Rate $4,331.60
Rate for Payer: Aetna Commercial $3,347.72
Rate for Payer: BCBS Complete $1,656.57
Rate for Payer: BCBS Trust/PPO $1,284.83
Rate for Payer: Cash Price $3,694.40
Rate for Payer: Cash Price $3,694.40
Rate for Payer: Meridian Medicaid $1,656.57
Rate for Payer: Priority Health Choice Medicaid $1,577.69
Rate for Payer: Priority Health Cigna Priority Health $3,232.60
Rate for Payer: Priority Health HMO/PPO/Tiered Network $4,331.60
Rate for Payer: Priority Health Narrow Network $4,331.60
Rate for Payer: Priority Health SBD $4,331.60
Rate for Payer: UMR Bronson Commercial $2,124.28
Service Code HCPCS 47760
Min. Negotiated Rate $328.07
Max. Negotiated Rate $3,944.71
Rate for Payer: Aetna Commercial $3,045.85
Rate for Payer: BCBS Complete $1,507.62
Rate for Payer: BCBS Trust/PPO $328.07
Rate for Payer: Cash Price $3,347.20
Rate for Payer: Cash Price $3,347.20
Rate for Payer: Meridian Medicaid $1,507.62
Rate for Payer: Priority Health Choice Medicaid $1,435.83
Rate for Payer: Priority Health Cigna Priority Health $2,928.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network $3,944.71
Rate for Payer: Priority Health Narrow Network $3,944.71
Rate for Payer: Priority Health SBD $3,944.71
Rate for Payer: UMR Bronson Commercial $1,924.64
Service Code HCPCS 01953
Min. Negotiated Rate $0.40
Max. Negotiated Rate $44.50
Rate for Payer: BCBS Complete $0.40
Rate for Payer: Cash Price $0.80
Rate for Payer: Cash Price $0.80
Rate for Payer: Priority Health Cigna Priority Health $0.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network $44.50
Rate for Payer: Priority Health Narrow Network $44.50
Rate for Payer: Priority Health SBD $44.50
Rate for Payer: UMR Bronson Commercial $0.46
Service Code HCPCS 01952
Min. Negotiated Rate $2.00
Max. Negotiated Rate $3.50
Rate for Payer: BCBS Complete $2.00
Rate for Payer: Cash Price $4.00
Rate for Payer: Priority Health Cigna Priority Health $3.50
Rate for Payer: UMR Bronson Commercial $2.30
Service Code HCPCS 01951
Min. Negotiated Rate $1.20
Max. Negotiated Rate $2.10
Rate for Payer: BCBS Complete $1.20
Rate for Payer: Cash Price $2.40
Rate for Payer: Priority Health Cigna Priority Health $2.10
Rate for Payer: UMR Bronson Commercial $1.38
Service Code HCPCS 01842
Min. Negotiated Rate $2.40
Max. Negotiated Rate $4.20
Rate for Payer: BCBS Complete $2.40
Rate for Payer: Cash Price $4.80
Rate for Payer: Priority Health Cigna Priority Health $4.20
Rate for Payer: UMR Bronson Commercial $2.76
Service Code HCPCS 01440
Min. Negotiated Rate $3.20
Max. Negotiated Rate $5.60
Rate for Payer: BCBS Complete $3.20
Rate for Payer: Cash Price $6.40
Rate for Payer: Priority Health Cigna Priority Health $5.60
Rate for Payer: UMR Bronson Commercial $3.68
Service Code HCPCS 01654
Min. Negotiated Rate $3.20
Max. Negotiated Rate $5.60
Rate for Payer: BCBS Complete $3.20
Rate for Payer: Cash Price $6.40
Rate for Payer: Priority Health Cigna Priority Health $5.60
Rate for Payer: UMR Bronson Commercial $3.68